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Rachel Bega Psychologist.  Insomnia  Hypersomnia  Narcolepsy  Parasomnia – nightmares etc  Sleep disorders due to...

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Presentation on theme: "Rachel Bega Psychologist.  Insomnia  Hypersomnia  Narcolepsy  Parasomnia – nightmares etc  Sleep disorders due to..."— Presentation transcript:

1 Rachel Bega Psychologist

2  Insomnia  Hypersomnia  Narcolepsy  Parasomnia – nightmares etc  Sleep disorders due to...

3  How is it defined?  Difficulties falling asleep – Initial Insomnia  Difficulties staying asleep – middle insomnia  Difficulties ??  Consequences of not sleeping: ◦ irritability, difficulty concentrating, accidents, mood disturbance, interpersonal difficulties

4  Mental illness: depression, anxiety, stress  Substance use: alcohol, drugs  Medication: Antidepressants  Medical conditions: asthma, allergies, chronic pain  Other conditions: shift work, pregnancy

5  Cognitive Behavioural Therapy is an established and very effective modality in the management of chronic insomnia ◦ Stimulus control ◦ Cognitive therapy ◦ Sleep restriction ◦ Relaxation training ◦ Sleep hygiene

6  Conditioned arousal – situations associated with sleep become alerting rather than relaxing – further impairing sleep.

7  Principle: to re-associate bed, bedtime and the bedroom with sleepiness and sleep  Go to bed only when sleepy  Use the bed only for sleep or sex  If unable to sleep after 20 minutes, move to another room  Return to bed only when sleepy  Repeat the above as often as necessary  Get up at the same time every morning  Do not nap  Maybe contraindicated in patients with mania, epilepsy or at high risk of falls.

8  Insomnia occurs acutely in relation to both predisposing and precipitating factors.  e.g?  Insomnia is then maintained by maladaptive coping behaviours  Cognitive Behavioural therapy focuses on eliminating the perpetuating factors that lead to the development of chronic insomnia

9  Help you understand, challenge and change unhelpful thoughts  Can be as simple as “I must have 8hours of sleep each night”

10  Challenging self-defeating thoughts that fuel insomnia  Unrealistic expectations: ◦ I should be able to sleep well every night like a normal person. I shouldn’t have a problem! ◦ Lots of people struggle with sleep from time to time. I will be able to sleep with practice. ◦ Exaggeration: It’s the same every single night, another night of sleepless misery. ◦ Not every night is the same. Some nights I do sleep better than others. ◦ Catastrophizing: If I don’t get some sleep, I’ll tank my presentation and jeopardize my job. ◦ I can get through the presentation even if I’m tired. I can still rest and relax tonight, even if I can’t sleep. ◦ Hopelessness: I’m never going to be able to sleep well. It’s out of my control. ◦ Insomnia can be cured. If I stop worrying so much and focus on positive solutions, I can beat it.

11  Have an allocated worry time  Keep a note book next to your bed to write down thoughts or any issues. They will still be there in the morning.

12  Requires the patient to: ◦ Limit his /her time in bed to amount that equals their total sleep time ◦ Time restrictions determined by clinician and patient using sleep diaries and balancing the patient’s lifestyle – 5 day sleep diary ◦ Establish a fixed wake up time ◦ Delay bed time ◦ As sleep efficiency increases patients are gradually allowed to spend more time in bed – increased in 15 minute increments ◦ Over course of therapy, patients begin to find it difficult to stay up until prescribed hour.

13  Deep breathing  Progressive muscle relaxation  More effective than no treatment but not as effective as sleep restriction  More effective with younger rather than older adults

14  Avoid alcohol, nicotine, caffeine, chocolate  Cut down on non-sleeping time in bed  Avoid bedside clock  Exercise regularly  Have a hot shower and/or hot drink before bedtime  Establish a regular sleep schedule

15  Adjust bedroom environment ◦ Dark, cool ◦ Minimum lighting if you have to use bathroom at night ◦ White noise machine or fan to drown out other sounds ◦ Comfortable bed

16  Treating the underlying reason for the sleep disorder may be what is required and may resolve the sleep issues.


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