Individual Programmatic Assessment
TREATMENTS OPTIONS FOR IRREGULAR SLEEP-WAKE SYNDROME
Irregular Sleep-Wake Syndrome is a form of a psychological disorder also called Irregular Sleep-Wake Rhythm. People with Irregular Sleep-Wake Syndrome have non-aligned sleep times. These people have sleeping patterns that do not adhere to the "normal" times of sleeping at night. The sleeping patterns are disorganized to a magnitude that one cannot tell the presence of a clear sleep or wake pattern. Such people have a tendency to sleep off on some naps over a 24-hour period. The sleep patterns have been split into pieces. They behave like infants who sleep for a few hours, wake up for some other few hours, and also sleep off for some few hours, with the cycle repeating with no clear sequence. During the day, the number of sleep times may be high since they like napping a lot. During the night, they seem to suffer from insomnia since they are awake for long times. Their sleep patterns are subdivided into small pieces day and night. They do not have one main sleep time that happens once, and it is over in 24 hours (Lee-Chiong, 2006).
Symptoms
Irregular Sleep-Wake Syndrome is characterized by some symptoms as follows:
Sleeping off and on in a series of naps that occur during the day and the night
Failure to have no regular pattern of when they are to sleep and when they are to wake up
Having hard times sleeping well, or they may be sleepy when they are awake
Having a total sleeping time that is not normal according to their age
Irregular Sleep-Wake Syndrome has some risk factors that are likely to build up in the case that the patient is not treated. In some conditions like mental retardation, brain damage, and dementia, people might suffer from Irregular Sleep-Wake Syndrome because of having what is called mental clock. Irregular Sleep-Wake Syndrome can also occur in people who do not have a neurological problem. Certain conditions may make this condition be heightened. For instance, daily light triggers sleep patterns, besides the daily activities (Reiter et, al., 2009).
There are different approaches through which Irregular Sleep-Wake Syndrome can be treated. These methods are classified as cognitive, pharmacological, and alternative treatment. Either of these approaches has the tendency to alleviate the challenges that characterize the disorder.
Treatment
I. Cognitive treatment of Irregular Sleep-Wake Syndrome
Some of the cognitive approaches that can be involved in the treatment of Irregular Sleep-Wake Syndrome are sleep hygiene for sleep disorders, cognitive therapy, sleep restriction therapy, stimulus control, and relaxation training for sleep disorders. These are lifestyle modification and cognitive behavioral treatments approaches that can be used to control the occurrence of sleep problems among individuals (Flamez & Sheperis, 2015).
Relaxation Training
Through this method, patients are made to exercise progressive muscle relaxation, breathing techniques, self-hypnosis, and imagery, among others, that are intended to help people overcome sleep disorder. Through progressive muscle relaxation, individuals are helped to tense sequentially and relax the body's muscle groups as they concentrate on making sure the muscles contract sensibly as they relax.
Cognitive therapy
With cognitive therapy, individuals are assisted in developing appropriate sleep thoughts and beliefs that will assist them to nurture a sleep pattern or get sleep when they want. Such therapy involves a psychological involvement of thoughts and mental processes in attracting sleep. Such attraction features involve those that patients enjoy and hence enable them to attract sleep. The individuals are assisted to have a tradition of thinking before sleep to usher in sleep. Through cognitive therapy, people can get proper information as concerns sleep norms, reasonable sleep goals, the influence of naps and exercise, and sleep changes that are related to age. Through cognitive therapy, patients are assisted to have a genuine and balanced state of mind as they try to attract sleep.
Stimulus Control
Stimulus control is a mechanism through which the stimulus is set appropriately to attract sleep. Sleeping environments are associated with how fast or slow one gets to sleep. With stimulus variation and control, the bedroom is designed to contribute towards the improvement of sleep patterns. For instance, the bedroom is supposed to be made for sleep and other related features like dressing and sex. Making the environment deserve what it serves to make it appropriate is what is meant by stimulus control. For instance, the bedroom should not be involved with sleep-taking situations like the presence of a television or as a reading area.
Sleep Restriction Therapy
Sleep Restriction Therapy bases its functionalism on the fact that having excess times in bed increase sleep problems. As such, sleeping time is limited to only sleeping time, and at no other time should one be in bed when it is not the time for sleep. Sleep Restriction Therapy helps to control boredom associated with lack of sleep, something that helps to increase the chances of falling asleep immediately one gets to bed.
Sleep Hygiene
According to McKay & Storch, (2009), Sleep Hygiene incorporates the habits, practices, together with the environmental factors that are necessary and assist in contributing to the presence of sleep. There are four main areas that are important to sleep hygiene. They are the circadian rhythm, aging, use of stimulants, and psychological stressors that trigger mini-awakenings. The circadian rhythm influences on how, when, for how long, how much people can sleep. Circadian rhythms can be altered by the timing of the different factors like naps, exercise, bedtime, and being exposed to light. Aging has a great impact on the sleeping patterns of an individual. It is stated that sleep patterns appear to change when one gets to the age of forty years. As people increase in age, they tend to develop more nocturnal awakenings. Awakenings interfere with the normal sleep quality, and may contribute to other factors that deter normal sleep patterns. The more a person becomes awake at night, the more he/she is likely not to have enough rest and hence will tend to have an interference of the sleeping patterns.
Psychological stressors like deadlines and exams, or even stresses from a job, interfere with the normal sleep patterns. It is often recommended that people develop a pre-sleep ritual that will enable them to develop a pattern of sleep and hence help them to disconnect between sleeping time and these stresses. It is important to have a time of relaxation, like taking a period to meditate or take a warm bath, before sleeping. Such therapeutic approaches will assist a person to get rid of psychological stressors and hence assume a good pattern of sleep. Stimulants play a critical role in influencing the sleep patterns in people. Stimulants have a tendency to stay within the psychological system of the body and hence influence the patterns of sleep in an individual. They influence the number of times a person awakens at night. Therefore, it is important to consider getting rid of these stimulants before sleep, like caffeine, nicotine together with alcohol. In some other cases, specialists will say that alcohol consumption before sleep will assist in developing a quick sleep (Flamez & Sheperis, 2015). Nonetheless, when the alcohol content is exhausted in the body, one may get awakened and hence interfere with the regular pattern of sleep.
Validity, Efficacy, Symptom and Behavior Management, and Recidivism
Most of the psychological approaches to dealing with Irregular Sleep-Wake Syndrome are practical in nature. They are involving and have very fewer side effects resulting in sedation. They are not a sure way of treating Irregular Sleep-Wake Syndrome but the greatly contribute towards increasing the capability to eradicate the occurrence of Irregular Sleep-Wake Syndrome among people. When adapted well, they can be of great assistance in the management of Irregular Sleep-Wake Syndrome and other sleep disorders. They involve modifying behavior and adapting to the new ways of living. They are effective and practical as studies indicate that many people have used them. Nonetheless, it takes time before one gets adapted to these cognitive approaches.
II. Pharmacological Treatment of Irregular Sleep-Wake Syndrome
Pharmacological approaches are the mainstay of the short-term treatment of Irregular Sleep-Wake Syndrome and other sleep-disturbing disorders like dementia (Pandi-Perumal, 2006). With pharmacological approaches, they use antidepressants, antihistamines, non-benzodiazepines, and benzodiazepines.
Sedative-hypnotic agents like non-benzodiazepines and benzodiazepines are commonly used when it comes to treatment of short-term sleep disorders. Benzodiazepines works in a way that assists the person to decrease latency and hence raise the total amount of sleep time while decreasing the total amount time one that is used in stage two sleep. Nonetheless, they have very little effect on the maintenance of sleep problems that often occur among adults. Benzodiazepines increase the occurrences of sedation, amnesia, confusion, rebound amnesia, and sleeping in the daytime. Non-benzodiazepines were developed after benzodiazepines and had shorter half-lives. They have fewer side effects but do not have appropriate data not owned by older people (Pandi-Perumal, 2006).
Antidepressants are often prescribed to individuals who have had sleep disturbance because of dementia. The reason behind this is that the disturbance cannot be initially differentiated whether it is secondary to depression in the individuals or not. The most commonly used antidepressants are selective serotonin, among others. They are very effective in decreasing sleep latency. Nonetheless, they have undesirable side effects like sedation, weight gain among the older population, and somnolence. Antihistamines are commonly the over-the-counter drugs that are prescribed to older people. They have very high rates when it comes to side effects like sedation, anticholinergic responses, cognitive impairment, and somnolence. As a result of these side effects, they are advised against when it comes to adults. The functionalism of many of these drugs is to suppress the occurrence of sleep disturbance, mainly in adults.
Validity, efficacy, symptom and behavior management, and recidivism
Pharmacological treatment involves the use of drugs or medicine. These are drugs that help to alter, suppress, or trigger sleep or other substances that cause sleep. Drugs when rightfully taken are effective and efficient. They do not involve any modification of behavior and hence can be adapted with ease. Nonetheless, one challenge with the use of drugs is their side effects. All the drugs, unlike cognitive approaches, have serious side effects. Pharmacological approaches have been known to lead to sedation, weight gain, among other dangerous side effects.
III. Alternative treatment for Irregular Sleep-Wake Syndrome
Some of the alternative treatments for Irregular Sleep-Wake Syndrome include supplements use, acupuncture, meditation and relaxation, and exercise. Alternative medicine, often called complementary medicine involves treatments or medicine that is taken with other conventional treatments. They include some disciplines and varieties that include things like diet, exercise, mental conditioning, and observation of appropriate lifestyle. Some of the examples of these disciplines include massage, herbal remedies, biofeedback, guided imagery, hypnosis, aromatherapy, yoga, among others (Tusaie & Fitzpatrick, 2013).
Use of supplements
Herbal Treatments
This involves the use of things like the root of valerian that helps in staging sleep onset and maintenance of sleep. Nonetheless, there has not been any further research to bring out the safety measures and effectiveness of the use of valerian. Chamomiles, together with passionflower, among others, are some of the other materials that are natural and are used to treat insomnia. There is no so much clinical investigation to support and validate the use of these substances. Some of the other commonly used drugs are a lemon balm, hops, skullcap, among others. One challenge with these materials is that there is very little clinical evidence that serve to strengthen their safety and effectiveness in controlling Irregular Sleep-Wake Syndrome and other sleep-related disorders.
Acupuncture
Acupuncture is used in Chinese traditional medicine to cure sleep disorders. The procedure involves inserting very tiny needles into the skin at some parts of the body to influence the functioning of them. Sometimes, the thin needles are accompanied by small electrical stimulus (Lee-Chiong, 2006). It has been one of the effective approaches although there is a need for further research.
Relaxation and Meditation
Relaxation and meditation are meant to help calm down muscle contraction and expansion before sleep or when in bed. Increased muscle tension and entry of thoughts are some of the factors that contribute to Irregular Sleep-Wake Syndrome. Relaxation eases the tension of the muscles and hence enables one to calm down and have a smooth transition into sleep. Meditation helps to sooth the body and mind and hence appears to be something like a lullaby. In most cases, meditation has been derived as one of the main contributors to helping overcome Irregular Sleep-Wake Syndrome and other related sleeping challenges. It will take some weeks before a person adapts to meditation as a form of reducing Irregular Sleep-Wake Syndrome and Insomnia (American, 2015). Nonetheless, when it has ticked, it becomes a good mechanism for reducing the occurrence of Irregular Sleep-Wake Syndrome.
Exercise
Regular exercise can be used to deepen sleep in young people and young adults with or without sleeping troubles. According to several other studies, exercise has a greater chance to improve sleep among older people. For instance, recent studies indicate that Tibetan yoga exercises have a chance of aiding cancer patients when it comes to managing sleep problems. Consistent exercise is a factor that helps to improve sleep. Nonetheless, one of the precautions that are taken to improve sleep is to have an exercise early enough.
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