MAIN DQ

1. Choose an interesting DSM-5 parasomnia (Sleepwalking; Sleep Terrors; Nightmare Disorder; etc.) and briefly summarize a recent empirical research study that examines the disorder. What treatments are available for the disorder?

OR

2. There is emerging research that has found that adolescents are not getting enough sleep (e.g., averaging 4-5 hours per night). What are three research-supported reasons why adolescents need to make sure they are meeting the minimum sleep requirements? Support your answer with at least one research citation.

The following articles may be helpful as you address these questions:

Fleetham, J.A., & Fleming, J.A.E. (2014). Parasomnias. Canadian Medical Association Journal, 186(8), E273-E280.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4016090/

Roberts, R.E., Roberts, C.R., & Duong, H.T. (2009). Sleepless in adolescence: Prospective data on sleep deprivation, health and functioning. Journal of Adolescence, 32(5), 1045-1057. doi: 10.1016/j.adolescence.2009.03.007

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2735816/

RONS RESPOND TO THE MAIN POST

        An article on sleep disorder by Fleetham and Fleming (2014) advances sleepwalking, night terrors, talking in ones sleep, and sleep paralysis are some of the behavioral expressions indicative of parasomnias. Parasomnias are a category of sleep disorders that are undesirable physical events or experiences that manifest at sleep onset, throughout sleep, or at waking up from sleep. In describing parasomnias during sleep, there is a cyclical rotation between wakefulness, nonrapid eye movement sleep, and rapid eye movement sleep (Carlson and Birkett, 2017). Non-rapid eye movement sleep is divided into stages, the first is the transition from wakefulness to sleep, the second is most of the sleep period, the third and fourth is when a more potent stimulus is needed to wake the sleeper. Parasomnias occur when transitional stages are blurred, most ubiquitously between the third and fourth stages where there is a lack of awareness in wakefulness and orientation.

      Fleetham and Fleming (2014) address parasomnias in adults. Non-rapid eye movement parasomnias are rare and therefore, there are limited randomized control trials to serve as a guide n research. Rapid eye movement parasomnias are more prevalent with much corroborating research.

      According to Fleetham and Fleming (2014), all parasomnias occur from sleep issues, while non-rapid eye movement parasomnias occur among individuals between ages 5-25 with a family history of the disorder. Generally, the one experiencing the disorder returns to sleep without a memory of what occurred, with others reporting the behaviors or from an injury that occurred. External factors, such as noise or temperature or internal factors such as apnea may cause arousal or partial awakening, generally from the third/fourth stage of sleep. These stages usually occur within the first 90 minutes of sleep.

      Rapid eye movement sleep, by contrast, usually entails verbalization or actions in confluence with a dream sequence, such as fight or flight behaviors. This is different than non-rapid eye movement parasomnias in that the sleeper can usually recall the events.

      Non-rapid eye movement parasomnias are ubiquitous in young people are usually outgrown, while rapid eye movement sleep parasomnias occur in later life and have an association with brain disease (Fleetham & Fleming, 2014).

      Fleetham and Fleming (2014) advance that parasomnias are diagnosed by taking a detailed history of various time stamps and behaviors in the home environment. Additionally, a sleep diary can be a useful tool to monitor events and special attention is paid to those that may harm themselves in the process. Moreover, ruling out other issues such as apnea or limb movement is necessary to ensure a proper diagnosis (Fleetham & Fleming, 2014).

          Fleetham and Fleming (2014) advance three types of parasomnias, namely confusional arousals, sleepwalking, and sleep terrors. Confusional arousals can occur anytime sleep is interrupted and can be ancillary to other sleep conditions such as narcolepsy, apnea, limb movement disorder, and sleep-deprived individuals. The events may of confusional arousal may include sleep talking or motor behaviors without responsiveness to the environment. Two types of confused arousal are morning sleep inertia or sleep drunkenness and sleep-related sexual behaviors or sexsomnia. Working on improving sleep hygiene and at time benzodiazepines or SSRIs are useful treatment options.

      Sleepwalking is the result of a series of complex behaviors while the person is an altered state of consciousness. It is interesting that the persons eyes remain open. In older individuals, it may present as fight or flight and may result in injury to bystanders. There is a genetic predisposition suspected, however, the cause remains unknown. Psychotherapy and clonazepam have been used successfully in treatment. 

      Sleep terrors usually last between 30 seconds and 5 minutes and initiate with the sleeper exhibiting behaviors of intense fear such as a loud scream. Dream imagery may be an accompaniment. There is an association between sleep disorders and psychiatric disorders. Therapy and tricyclic antidepressant have been utilized in treatment for sleep terrors (Fleetham & Fleming, 2014).

References

Carlson, N. R., & Birkett, M. A. (2017). Physiology of Behavior, 12th Edition. Boston, Massachusetts: Pearson.

Fleetham, J. A., & Fleming, J. A. (2014). Parasomnias. CMAJ, 186(8), E273-E280.