NURS 6670:Week 10: Sleep/Wake Disorders and Parasomnias

NURS 6670:Week 10: Sleep/Wake Disorders and Parasomnias

NURS 6670: Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults | Week 10

NURS 6670: Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults | Week 10

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

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings – NURS 6670:Week 10: Sleep/Wake Disorders and Parasomnias

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.

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

• Chapter 36, “Sleep-Wake Disorders”

Note: You will access this book from the Walden Library databases.

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

• “Sleep-Wake Disorders”

Note: You will access this book from the Walden Library databases.

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

Note: All Stahl resources can be accessed through the Walden Library using the link below. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear.

To access information on specific medications, click on The Prescriber’s Guide, 5^th Ed. tab on the Stahl Online website and select the appropriate medication.

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 NURS 6670:Week 10: Sleep/Wake Disorders and Parasomnias

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

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!

To prepare for this Discussion:

• By Day 5 of Week 9, your Instructor will have assigned you a sleep/wake disorder, which will be the focus of your original post for this Discussion.
• Review the Learning Resources.

By Day 3

Post:

• 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.

By Day 6

Respond to at least two of your colleagues by comparing the differential diagnostic features of the disorder you were assigned to the diagnostic features of the disorder your colleagues were assigned. NURS 6670:Week 10: Sleep/Wake Disorders and Parasomnias

ADDITIONAL INFORMATION 

Treatment of Sleep/Wake Disorders

Introduction

Sleep and wakefulness are essential for our health, well-being and productivity. Sleep disorders can affect both adults and children. Sleep disorders can be caused by stress, diet or another underlying disorder. In some cases, the cause of sleep problems is not clear and treatment may include medication or lifestyle changes.

Stimulation or deprivation of light or darkness

• Light therapy

• Dark therapy

These are two ways to treat sleep disorders. They can be used individually or in combination with each other, depending on the severity of your symptoms.

Sleep hygiene

• Sleep hygiene is the practice of following a regular schedule, including minimizing exposure to bright light in the evening and keeping your bedroom dark.

• Avoid caffeine and alcohol in the evening before bedtime.

• If you’re having trouble falling asleep at night, avoid naps during the day as well.* If you’re suffering from insomnia or awakenings during your sleep period (such as nightmares), try physical activity before going to bed so that it helps induce drowsiness.

Treatment with medications

One of the most popular treatments for sleep disorders is medication. The majority of these medications are available as non-prescription drugs, but there are also some over-the-counter (OTC) options that you can use if you don’t want to go through your doctor.

The following is a list of medications used in the treatment of sleep and wake disorders:

• Nonprescription (OTC) Therapies:* Melatonin – This hormone regulates our circadian rhythms, which regulate many things including sleep/wake cycles.* Zolpidem – This drug affects serotonin levels in your brain; it’s also used as an antianxiety medication.* Doxepin – This drug helps control anxiety by blocking histamine H1 receptors on neuronal cells.* Bromide Salts – Bromide salts help control blood pressure by disarming sodium channels located in heart muscles during contraction periods

Melatonin supplementation

Melatonin is a hormone secreted by the pineal gland in the brain. It plays an important role in regulating sleep, and its levels are low during daylight hours, when we’re awake but not sleeping (or if you prefer, getting ready for bed). The melatonin cycle starts at about 7 p.m., peaks at 1 a.m., and then decreases until it reaches its lowest point at 2 or 3 a.m.. This pattern helps ensure that we don’t feel sleepy during daylight hours; however, if you’re traveling across multiple time zones on short notice (like flying across several time zones within 24 hours), your body will end up experiencing jet lag because it hasn’t adjusted properly yet—and this can lead to insomnia or other sleep disorders!

If you suffer from these symptoms regularly due to jet lag or other travel-related issues:

Treatment with herbal supplements

Herbal supplements can be used to treat sleep disorders. Some herbal supplements are safe and effective, while others may cause harm or even death if taken incorrectly. For example, some medications should not be taken with certain herbs because they may interact with each other in a harmful way and cause serious side effects.

Herbal solutions that contain valerian root (such as Valerian Root Extract) have been associated with serious side effects including drowsiness and confusion; therefore these products should never be used by people who have impaired motor skills or epilepsy (seizures). Those who take antidepressants such as selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants should also avoid taking valerian root because taking both together could lead to an increased risk of developing serotonin syndrome–a potentially life-threatening condition caused by an excess amount of neurotransmitter serotonin in the brain tissue due to overuse during treatment with these drugs

Mechanical and lifestyle approaches to improving sleep and wakefulness

• Use of a sleep diary. In order to understand what kind of sleep patterns you have, it’s helpful to keep track of the quality and quantity of your nightly rest. A good way to do this is by keeping a diary in which you record all aspects of your nighttime routine, including how much time you spend asleep or awake per hour or day.

• Avoidance of caffeine and alcohol before bedtime (or even close proximity). Caffeine causes an increase in alertness while alcohol reduces it; both substances can prevent us from falling asleep easily if consumed too close to bedtime. If these two substances are necessary for waking up early on weekends or vacations, then they should be combined with other strategies outlined below instead — such as regular exercise routine during daytime hours – but not later than 7pm since people who work shift work tend not have much control over when they fall asleep at night!

• Avoidance heavy meals before bedtime (especially if eating pasta). Some people find that eating large meals prior their bedtime makes falling asleep more difficult than usual because there is more energy stored up within our bodies after consuming them! So avoid eating anything substantial until at least 2 hours after retiring into our respective rooms.”

Takeaway:

Sleep disorders are common, and there are many different types of sleep disorders. The good news is that you have options when it comes to treating your sleep problems. You can talk with your doctor about your symptoms and find out what treatment options might be best for you.

It’s important to see a doctor if you have any kind of sleep problem or if you think that something else might be causing the problem.

Conclusion

We’re all so busy these days that it can be difficult to find time for ourselves. But if you do, it’s important to make sure your lifestyle is healthy and balanced. We hope this article has given you some ideas on how to make that happen. The next time someone asks what the best treatment for sleep disorders is, tell them about our list of options!