Flashcards in Insomnia Deck (41)
What is the most prevalent sleep disorder?
Is insomnia difficult to diagnose?
Yes because it is subjective
What is initial insomnia?
Trouble falling asleep
What is middle insomnia?
Trouble remaining asleep
What is terminal insomnia?
Waking up too early
What is insomnia?
It is about not having the right amount of sleep but not the right quality of sleep
When is insomnia diagnosed? (2)
1) Experiencing sleep difficulties for more than a month
2) Resulting in daytime fatigue causes severe distress or impairs work, social or personal functioning
Name 4 symptoms of insomnia
1) Waking up in the night
2) Not feeling refreshed after sleep, not being able to function normally during the day, irritable and tired, difficult to concentrate
3) Waking when disturbed by pain or noise
4) Waking up early in the morning
What is transient insomnia?
What is intermittent insomnia?
What is chronic insomnia?
Long term - more than 4 weeks
What is short-term insomnia?
What is occasional insomnia?
What is long-term insomnia?
What is primary insomnia?
More common in women and increasing in age - not directly associated with any other health condition or physical cause which occurs alone with no cause for than one month
What is secondary insomnia?
Underlying medical, psychiatric or environmental problem
Name and explain 2 risk factors of insomnia
1) Age and gender - increased physical problems with age (arthritis and diabetes), females affected by hormonal fluctuations
2) Personality - Kales (1976) found insomniacs more likely to internalise psychological disturbance, internalisation leads to increased levels of emotional arousal and increased likelihood of anxiety
What might actually cause primary insomnia?
Poor sleep hygiene like staying up late, sleep where too light, playing computer games that cause sleep difficulties
Name 5 causes of secondary insomnia
1) Hormonal changes
2) Decreased melatonin - older
3) Medical conditions - allergies, arthritis, asthma, heart disease, high blood pressure
4) Psychiatric - symptom of depression, associated anxiety, PTSD and dementia
5) Other sleep disorders like sleep apnoea - obstructions in breathing
Name the main study supporting insomnia
Outline Smith (2002)
Neuro-transmitting of NREM sleep - found clear evidence of abnormalities in insomniacs - 9 females (5 insomniacs and 4 controls) for 3 nights - insomniacs showed consistent and significant reduced blood flow in frontal medial, occipital and parietal cortices - provide evidence may be associated with abnormal nervous activity during NREM sleep
Explain a positive evaluative point about insomnia
External validity - studies examined whether the findings from sleep labs related to reported sleep disorders from patients, so Garcia-Borregeuro (2004) found positive correlation between rating scales and lab measures of sleep of the sleep disorder restless leg syndrome - so some evidence that lab measures are good indicators of certain disorders & Schramm (1993) examined test-retest reliability of structured-sleep interview compared to lab recordings and found excellent reliabilities
Outline Garcia-Borregeuro (2004)
Found positive correlation between rating scales and lab measures of sleep of the sleep disorder restless leg syndrome - so some evidence that lab measures are good indicators of certain disorders
Outline Schramm (1993)
Examined test-retest reliability of structured-sleep interview compared to lab recordings and found excellent reliabilities
Name and explain 4 negative evaluative points about insomnia
1) Difficulty in generalisations as there are so many types - Zisapel (2000) melatonin effective in a small group of elderly patients but ineffective in general treatment
2) May not be a sleep disorder at all but a symptom of something else so doctors should search for the cause of it (Dement 1999)
3) Vgontzas (1993) argue that using a number of sleep lab criteria is unsatisfactory in diagnosing - study 375 insomniacs & 150 controls and found 'sleep lab recording provide little relevant info for confirming or excluding the presence of insomnia'
4) Research complications - highly complex with large number of factors contributing to insomnia and research only finds small effects and is unlikely to uncover clear solutions to the problem
Outline Zisapel (2000)
Melatonin effective in a small group of elderly patients but ineffective in general treatment
Outline Vgontzas (1993)
Argue that using a number of sleep lab criteria is unsatisfactory in diagnosing - study 375 insomniacs & 150 controls and found 'sleep lab recording provide little relevant info for confirming or excluding the presence of insomnia'
Why is it important to distinguish between primary and secondary insomnia?
If insomnia is a symptom it is important to treat the underlying disorder
Why is it not important to distinguish between primary and secondary insomnia?
Does depression cause insomnia or is insomnia causing depression? Ohayon & Roth (2003) - 15,000 Europeans and found insomnia more often precedes cases of mood disorders so suggests it is helpful to treat insomnia regardless of primary and secondary