We Sleep/Wake Disorders and Parasomnias

Order Instructions

Week 10: Sleep/Wake Disorders and Parasomnias

Tick, tock, and here we go again. I have been in bed trying to go to sleep for three hours now. I have not gotten more than a few hours of sleep a night in months. My work is being affected and so is my relationship with my wife. She’s over there sleeping like a baby and cannot understand why I can’t sleep. ‘Just close your eyes and relax’, she says. When I close my eyes, all I see is all the work I have to do.

Riley, age 34

Sleep is essential for a healthy mind and body, and lack of quality sleep can cause distress during the daytime. Sleep disorders can involve difficulties with quality, timing, and amount of sleep and frequently accompany other disorders, especially depression, anxiety, and PTSD. Obtaining a good sleep history is essential to diagnosing sleep disorders, prescribing a treatment plan, and monitoring the plan’s effectiveness. Understanding and managing sleep problems frequently leads to improvement in other mental health disorders that the patient is experiencing.

This week, you will analyze the diagnostic criteria and treatment options of insomnia, hypersomnolence, narcolepsy, sleep apnea, non-rapid eye movement, nightmare disorder, sleep behavior disorder, and other DSM-5 sleep and parasomnic disorders.

Learning Resources

Required Readings

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Sleep-Wake Disorders”

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.

Chapter 36, “Sleep-Wake Disorders”

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 13, “Psychosomatic Medicine” (pp. 465–503)

Chapter 16, “Normal Sleep and Sleep-Wake Disorders” (pp. 533–563)

Note: This is review from the Learning Resource in Week 3.

Stahl, S. M. (2017). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (6th ed.). New York, NY: Cambridge University Press.

To access information on specific medications, click on The Prescriber’s Guide, 6th Ed. tab on the Stahl Online website and select the appropriate medication.

Excessive sleepiness in narcolepsy, obstructive sleep apnea/hypopnea syndrome, shift work sleep disorder Insomnia Narcolepsy Restless leg syndrome

armodafinil

modafinil

sodium oxybate (in narcolepsy only)

agomelatine

alprazolam

amitriptyline

amoxapine

clomipramine

clonazepam

desipramine

diazepam

dothiepin

doxepin

estazolam

eszopiclone

flunitrazepam

flurazepam

hydroxyzine

imipramine

lofepramine

lorazepam

maprotiline

mianserin

nortriptyline

quazepam

ramelteon

temazepam

trazodone

triazolam

trimipramine

zaleplon

zolpidem

zopiclone amphetamine (d)

amphetamine (d,l)

lisdexamfetamine

methylphenidate (d)

methylphenidate (d,l)

modafinil

sodium oxybate gabapentin ER

Optional Resources

Bélanger, L., Harvey, A. G., Fortier-Brochu, É., Beaulieu-Bonneau, S., Eidelman, P., Talbot, L., . . . Morin, C. M. (2016). Impact of comorbid anxiety and depressive disorders on treatment response to cognitive behavior therapy for insomnia. Journal of Consulting and Clinical Psychology, 84(8), 659–667. doi:10.1037/ccp0000084

Olaithe, M., Nanthakumar, S., Eastwood, P. R., & Bucks, R. S. (2015). Cognitive and mood dysfunction in adult obstructive sleep apnoea (OSA): Implications for psychological research and practice. Translational Issues in Psychological Science, 1(1), 67–78. doi:10.1037/tps0000021

Discussion: Treatment of Sleep/Wake Disorders

The power of sleep to heal the body cannot be underestimated. Most research indicates that 7–8 hours of sleep are a minimum that people need to stay healthy. Clients who come to the PMHNP’s office frequently complain of sleep problems. It is estimated that 10–20% of patients report some type of sleeping problem.

In this Discussion, you will analyze the diagnostic criteria and evidence-based psychotherapy and psychopharmacologic treatment for sleep/wake disorders.

Learning Objectives

Students will:

Analyze diagnostic criteria for sleep/wake disorders

Analyze evidence-based psychotherapy and psychopharmacologic treatment for sleep/wake disorders

Analyze criteria for referring clients to primary care physicians for treatment of sleep/wake disorders

Compare differential diagnostic features of sleep/wake disorders

Topic is, Circadian Rhythm Sleep-Wake Disorders.

Explain the diagnostic criteria for your assigned sleep/wake disorder.

Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned sleep/wake disorder.

Describe at what point you would refer the client to their primary care physician for an additional referral to a neurologist, pulmonologist, or physician specializing in sleep disorders and explain why.

Support your rationale with references to the Learning Resources or other academic resource.