Procrastination, I Pay for it Often. IT\'s

Procrastination, I pay for it often. It's bad enough that I have trouble sleeping most nights, but when I put off studying for exams until the last moment and was up all hours of the night studying, it certainly did not help my day. By the time I was satisfied with my familiarity of the material I had to learn there were only a couple of hours left for sleep. Coffee helped a little, but I went through the day with the feeling of fatigue hanging over my head. I was able to complete my exams and go through the day feeling a little tired, but not worn out. I was not any crankier than I normally am; I felt a little slower, a little out of sync, but not useless. Perhaps a way to describe it is that there was less reserve energy in my tank than there is normally if I needed to suddenly expend a burst of energy; however, I was able to go about the day at my slightly below normal pace. As the day wore on I began to run down and was ready for bed earlier than usual. I slept unusually soundly that night and woke up the next morning with no after-effects. I did not feel any sleep deprivation effects.

Sleep Disorders

While there is still much to be learned about the functions of sleep, most investigators conclude that sleep serves as a restorative function. Ohayon & Reynolds (2009) reported that 40 million people a year suffer from sleep disorders and another 20 million suffer occasional sleep problems. There are over 70 recognized sleep disorders (American Psychiatric Association, 2000). The DSM-IV-TR divides primary sleep disorders (sleep disorders not caused by another medical condition, mental disorder, or a substance) into dyssomnias and parasominas. Dyssomnias are disorders of the timing or quality of sleep and can be further divided into insomnia, a disturbance in the quantity or quality of a person's sleep and hypersomnia, conditions of excessive sleepiness.

Primary Insomnia

Primary insomnia occurs when there is difficultly falling or staying asleep and this difficulty lasts for at least a month. Insomniacs are often preoccupied with getting enough sleep and the harder they try the less successful they are. Primary insomnia is often treated with benzodiazepines (Valium, Xanax) and hypnotic drugs like Ambien, Sonata, and Lunesta. Drugs that have long acting effects are better for middle or late insomnia (difficulty with waking in the night and not being able to go back to sleep) and shorter acting drugs are better for people with initial insomnia, people who have difficulty falling asleep. Many of the medications used to treat insomnia have the potential for addiction (Sadock & Sadock, 2007).

Hypersomnias

Primary hypersomnia occurs when there is no reason that can explain excessive sleepiness occurring in a person for over a month of longer. The treatment for these people is often stimulant drugs.

Narcolepsy is described by excessive daytime sleepiness, sleep attacks (the person falls asleep suddenly during the day), and REM sleep intrusion (such as REM sleep occurring to early in the sleep cycle). The sleep attacks can include cataplexy, a sudden loss of muscle tone where the person suddenly drops from an activity into sleep. Modafinil is a wake- promoting medication that has effects similar to traditional stimulants in promoting alertness, but without many of the side effects. It is considered the first line treatment for narcolepsy (Sadock & Sadock, 2007). Stimulants like Ritalin are also sometimes used for treatment.

Obstructive Sleep Apnea is a disorder where the quality of sleep, especially REM sleep, is disturbed by breathing difficulties associated with snoring. This disorder is most often treated with breathing aides such as nCPAP.

Parasomnias

Parasomnias are abnormal behaviors that occur during sleep or during the transition from sleep to waking. The most common are:

Nightmare disorder occurs when a person had repeated vivid dreams the produce anxiety and disturb sleep. These nightmares almost always occur during REM sleep, especially after long periods of REM sleep. Tricyclic antidepressant drugs and benzodiazepines are sometimes used.

Sleep terror disorder occurs when patients wake up (usually in the first third of the night) during non-REM sleep. These people almost always wake up in a panic with high levels of anxiety and often wake up screaming. They often fall back asleep and forget the incident; however, night terrors can frequently develop into sleep walking episodes. Investigation of stress may relieve the problem and small doses of benzodiazepines given at bedtime can treat the problem.

Sleep walking disorder (somnambulism) consists of complex behaviors occurring during stage III and IV sleep, and often but not always there is no memory of the episode. The acts can be anything from walking, talking, dressing, or even driving. The patient often returns to sleep, but sometimes wakes up in a confused state. The disorder usually begins between 4 and 8 years old and often terminates by age 12. Usually can be treated with therapy but benzodiazepines are sometimes used to treat it.

Sleep Reduction