Eating And Sleep- Wake Disorders

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Anorexia Nervosa

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an eating disorder characterized by loss of body weight and refusal to eat

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Anorexia Nervosa

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2. psychopathology (arelentless drive forthinness or a morbid fearof fatness)

3.physiologicalsymptomatology(presence of medical signsand symptoms resultingfrom starvation)

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food-restricting category

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Subtype of Anorexia nervosa.

food intake is highly restricted –(usually with attemptsto consume fewer than 300 to 500 calories per dayand no fat grams)

–the patient may be relentlessly and compulsivelyoveractive, with overuse athletic injuries

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purging category

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Subtype of Anorexia nervosa

–patients alternate attempts at rigorous dieting withintermittent binge or purge episodes

–purging represents a secondary compensation for theunwanted calories, most often accomplished by self-induced vomiting, frequently by laxative abuse, lessfrequently by diuretics, and occasionally with emetics

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Bulimia Nervosa

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an eating disordercharacterized by recurrentand frequent binge eating with or without vomiting

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Bulimia Nervosa

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–derives from the terms for"ox hunger" in Greek and"nervous involvement" inLatin

–characterized by episodes ofbinge eating combined withinappropriate ways ofstopping weight gain

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purging category

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Subtype of Bulimia nervosa

–those who regularly engage in self-induced vomitingor the use of laxatives or diuretics

–may be at risk for certain medical com plications suchas hypokalemia from vomiting or laxative abuse andhypochloremic alkalosisthose who regularly engage in self-induced vomitingor the use of laxatives or diuretics

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non-purging category

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Subtype of Bulimia nervosa –who use strict dieting, fasting, or vigorous exercisebut do not regularly engage in purging

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Binge Eating Disorder

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a variant of bulimia nervosawith occasional, once aweek, binge eating.

–engage in recurrent bingeeating during which they eatan abnormally large amountof food over a short time.

–do not compensate in any wayafter a binge episode (e.g.,laxative use)

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Night Eating Syndrome

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characterized by theconsumption of largeamounts of food after theevening meal;individuals generally havelittle appetite during the dayand suffer from insomnia

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Purging Disorder

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characterized by recurrentpurging behavior afterconsuming a small amountof food in persons of normalweight who have a distortedview of their weight or bodyimage

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Pica

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the eating of non-nutritional substances (e.g., starch)

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Rumination Disorder

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the repeated regurgitation of food, usually beginning ininfancy or childhood

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Avoidant/RestrictiveFood Intake Disorder

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previously called feeding disorder of infancy or childhood in DSM IV;lack of interest in food oreating, resulting in failure tothrive

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Encopresis

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inability to maintain bowel control

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Enuresis

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inability to maintain bladder control

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Sleep deprivation

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longed periods of sleep deprivation sometimes lead to ego disorganization, hallucinations, and delusions

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Sleep Requirements

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–short sleepers require fewer than 6 hours of sleep each night to function adequately –long sleepers are those who sleep more than 9 hours each night to function adequately

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Sleep-Wake Rhythm

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–Within a 24-hour period, adultssleep once, sometimes twice.–Some women exhibit sleep patternchanges during the phases of themenstrual cycle.

–Naps taken at different times ofthe day differ greatly in theirproportions of REM and NREMsleep.

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Insomnia Disorder

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difficulty falling asleep or staying asleep; can be an independent condition, or it can be comorbid with another mental disorder, another sleep disorder, or another medical condition

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Persistent insomnia

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–composed of a fairly common group of conditions in which the problem is difficulty falling asleep or remaining asleep

–involves two problems: somatized tension and anxiety and a conditioned associative responsecomposed of a fairly common group of conditions in which the problem is difficulty falling asleep or remaining asleep

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Sleep state misperception

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–also known as subjective insomnia –characterized by a dissociation between the patient's experience of sleeping and the objective polygraphic measures of sleep

– diagnosed when a patient complains of difficulty initiating or maintaining sleep and no objective evidence of sleep disruption is found –can occur in individuals who are apparently free from psychopathology or it can represent a somatic delu sion or hypochondriasis

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Psychophysiological insomnia

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–typically presents as a primary complaint of difficulty in going to sleep

–A patient may describe this as having gone on for years and usually denies that it is associated withstressful periods in his or her life–sometimes called conditioned insomnia

–often occurs in com bination with other causes of insomnia, including episodes of stress and anxiety disorders, delayed sleep phasesyndrome, and hypnotic drug use and withdrawal

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Idiopathic insomnia

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its cause is unknown typically starts early in life, sometimes at birth, and continues throughout life

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Primary insomnia

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–diagnosed when the chief complaint is non- restorative sleep or difficulty in initiating or maintaining sleep, and the complaint continues for at least a month (accord ing to ICD-10, the disturbance must occur at least three times a week for a month) –The term primary indicates that the insomnia is independent of any known physical or mental condition

–often characterized both by difficulty falling asleep and by repeated awakening –Patients with primary insomnia are generally preoccupied with getting enough sleep. The more they try to sleep, the greater the sense of frustration and distress and the more elusive sleep becomes.

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Hypersomnolence Disorder or hypersomnia

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–occurs when a person sleeps too much and feels excessively tired despite normal or because of prolonged quantity of sleep

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Kleine-Levin Syndrome

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a relatively rare condition consisting of recurrent periods of prolonged sleep (from which patients may be aroused) with intervening periods of normal sleep and alert waking

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Menstrual-Related Hypersomnia

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The symptoms typically last for 1 week and resolve with menstruation

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Idiopathic Hypersomnia

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may be associated with very long sleep periods, after which the individual remains sleepy; can also occur without long sleep

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Behaviorally Induced Insufficient Sleep Syndrome

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Insufficient sleep syndrome stems from an individual's disregard for the sleep-wake schedule; diagnosed when an individual does not schedule an adequate amount of time for sleep and as a result suffers from daytime sleepiness, fatigue, loss of concentration, memory impairment, irritability, and moodiness

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Hypersomnia due to Medical Condition

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include head trauma, stroke, encephalitis, Parkinson's disease, inflammatory conditions, tumors, genetic diseases, and neurodegenerative diseases

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Hypersomnia due to Drug or Substance Use

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can be caused by use or abuse of sedative hypnotics, sedating antihistamines, sedating antidepressants, antiepileptics, neuroleptics, and opioid analgesics. Hypersomnia may also be provoked by withdrawal from traditional stimulants (cocaine, amphetamines), caffeine, or nicotine.

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Narcolepsy

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marked by sleep attacks, usually with loss of muscle tone (cataplexy); characterized by excessive sleepiness, as well as auxiliary symptoms that represent the intrusion of aspects of REM sleep into the waking state

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Parasomnias

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marked by unusual behavior, experiences, or physiological events during sleep

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non-REM movement sleep arousal disorders

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involve incomplete awakening from sleep accompanied by either sleepwalking or sleep terror disorder

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nightmare disorder

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in which nightmares induce awakening repeatedly and cause distress and impairment; sometimes called dream anxiety attacks; produce sympathetic activation and ultimately awaken the dreamer

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REM sleep behavior disorder

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characterized by vocal or motor behavior during sleep

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obstructive sleep apnea

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hypopnea the most common subtype; in which apneas (absence of airflow) and hypopneas (reduction in airflow) occur repeatedly during sleep, causing snoring and daytime sleepiness

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central sleep apnea

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the presence of Cheyne-Stokes breathing in addition to apneas and hypopneas

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sleep-related hypoventilation

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causes elevated C02 levels from decreased respiration

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Restless Legs Syndrome

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the compulsive movement of legs during sleep

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Circadian Rhythm Sleep-Wake Disorders

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a pattern of sleep disruption that alters or misaligns a person's circadian system, resulting in insomnia or excessive sleepiness