Sleep Disorders

Insomnia, Sleepwalking and Narcolepsy

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  • Sleep Disorders
    • Insomnia
      • AO1
        • Risk Factors
          • Sleep apnoea occurs 5-30 times an hour.
          • Personality - Insomniacs convinced themselves they have insomnia - makes them anxious and unable to sleep.
          • Age and Gender - Increasing physical problems such as artharitus
      • AO2
        • Watson - 50% risk may be genetic, so also environmental.
        • Main obstacle - controversy over diagnosis. Especially when symptom info. is given by the patients, so self report shouldn't be overly relied upon.
          • Test re-test shows reliability in most other areas of diagnosis.
        • Important to distinguish between primary and secondary for treatment implications.
          • 15,000 Europeans - insomnia often comes before cases of mood disorder. Maybe helpful to treat insomnia regardless of whether it's primary or secondary as it may get rid of the underlying problem if insomnia was causing it.
      • IDA
        • Supports Biological Approach
          • Scientific - can be falsified as it provides clear predictions of physiology on insomnia
        • Support for biological differences
          • 5 Female insomniacs, and 4 controls - EEG readings over 3 nights - insomniacs showed consistent and significant blood flow compared to controls.
            • Shows brains function differently
        • Genocentric
        • Primary caused by belief they can't sleep - insomniacs given placebo, and told it will either stimulate or sedate them. Those expecting arousal fell asleep faster.
    • Sleep Walking
      • AO1
        • Diathesis-stress: Not soely caused by genetics
        • Brain development: delayed in childrens brains = more common
        • EEG shows mixture of slow delta waves (typical of NREM) and beta waves (typical when awake) during sleepwalking. -sugggests partially awake
        • Genetic - runs in families
      • AO2
        • Twin Studies - concordance rate of 55% in MZ twins, 35% in DZ twines
          • Apply Diathesis stress modle as vulnerability may be triggered by the enviroment
        • Zadra - 40 sleepwalkers in lab conditions for 3 nights - tiredness can trigger SW, however 1st night was a control - may have made them use to the enviroment so findings are unreliable
        • More common among kids (20% compared to 2% iin adults)
      • IDA
        • Reductionist - focuses on genetics rather than role of childhood and cognition.
          • However explanations for biology are limited -  little research conducted.
        • Free will vs. Determinism - legal system
    • Narcolepsy
      • AO1
        • Randomly fall asleep - symptoms triggered by stress, angry, and fear.
        • Symptoms: Sleepiness, catalepsy, and sleep paraltsis
        • 1960's - suggested caused by malfunctioning REM system due to abnormal REM
        • 1980's - mutation of the immune system, higher frequency of the HLA gene found in narcoleptic's (90% have this gene)
        • Hypocretin - regulates sleep and wakefulness. Preserved brains of 4 narcoleptics found 93% fewer hypocretin neurones than the norm.
      • AO2
        • Identification of associated genes - doesn't provide a causal relationship.
        • First hypocretin evidence came from dogs that had a mutated gene disrupting the process of hypocretin.
        • Mice who couldn't produce hypocretin showed narcoleptic symptoms
      • IDA
        • Low hypocretin unlikely to be due to inherited factors as human narcolepsy only having 30% concordence rate in MZ - so doesn't run in families - enviromental
        • Hypocretin is relatively reactive - can't be taken as a tablet or injection - more research needs to be done to find a suitable replacement to cure symptoms

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