CU-MA-PSY-SEM-I-Clinical Psychology Psycho Diagnostics - Second Draft-converted

• Unusual development or different encounters while sleeping • Unintentional changes to your rest/wake plan • Irritability or tension • Impaired execution at work or school • Lack of fixation • Depression • Weight acquire 13.8 SUMMARY • Advancing age just as senescent changes straightforwardly impact the design and nature of rest. Issues identified with upset rest are multifactorial and require wide and adaptable clinical methodology. Helpful methodologies have been all around organized and uncommon accentuation given to rest appraisals, wellbeing schooling and rest cleanliness and fitting pharmacologic and psychologic procedures in treating complex rest issues in the old. • The impacts of rest problems can be troublesome to such an extent that you will probably need quick alleviation. Shockingly, long haul cases can set aside a smidgen more effort to determine. • However, on the off chance that you stay with your treatment design and routinely speak with your PCP, you can discover your approach to rest more readily. • Most individuals sporadically experience resting issues because of stress, chaotic timetables, and other external impacts. Be that as it may, when these issues start to happen consistently and meddle with day-by-day life, they may show a dozing problem. • Depending on the sort of rest issue, individuals may struggle nodding off and may feel very drained for the duration of the day. The absence of rest can adversely affect energy, mind-set, focus, and generally speaking wellbeing. • In a few cases, rest problems can be a side effect of another clinical or emotional wellness condition. These resting issues may in the long run disappear whenever treatment is acquired for the fundamental reason. • When rest problems aren't brought about by another condition, therapy typically includes a blend of clinical medicines and way of life changes. • It's critical to get an analysis and treatment immediately in the event that you speculate you may have a rest issue. At the point when left untreated, the adverse consequences of rest issues can prompt further wellbeing results. • They can likewise influence your exhibition at work, cause strain seeing someone, and hinder your capacity to perform day by day exercises. 251 CU IDOL SELF LEARNING MATERIAL (SLM)

13.9 KEYWORDS • Narcolepsy is described by \"rest assaults\" that happen while alert. This implies that you will unexpectedly feel amazingly drained and nod off abruptly. • Frequent Urination Nocturia, or regular pee, may disturb your rest by making you awaken during the evening. Hormonal lopsided characteristics and illnesses of the urinary plot may add to the advancement of this condition. • Chronic Pain Constant torment can make it hard to nod off. It may even awaken many as you nod off. • Sleep Apnea Sleep apnea is described by stops in breathing during rest. This is a genuine ailment that makes the body take in less oxygen. It can likewise make you awaken during the evening. • Insomnia alludes to the powerlessness to nod off or to stay snoozing. It very well may be brought about by fly slack, stress and uneasiness, chemicals, or stomach related issues. It might likewise be an indication of another condition. 13.10 LEARNING ACTIVITY 1. Conduct a survey in your locality and measure how many person have sleep disorder. ............................................................................................................................................. .............................................................................................................................................. 2. Enumerate lab investigations for insomnia. ............................................................................................................................................. ...... ...................................................................................................................................... 13.11 UNIT END QUESTIONS A. Descriptive Questions 252 Short Questions 1. Explain sleep disorders? 2. Explain the different types of sleep disorders? 3. Explain the symptoms of sleep disorders? 4. Explain causes of sleep disorders? 5. How are sleep disorders diagnosed? Long Questions 1. How are sleep disorders treated? CU IDOL SELF LEARNING MATERIAL (SLM)

2. What is the outlook for someone with a sleep disorder? 253 3. Explain DSM criteria. 4. Explain ICD-10 in detail? 5. Discuss assessment of sleep disorders? B. Multiple Choice Questions 1. Prolonged lack of sleep can result in: a. Impaired driving b. Increased anxiety c. Memory problems d. All of these 2. From birth to adulthood, the measure of rest we need each night: a. Increases b. Decreases c. Stays the same d. Decreases then increases 3. ________ waves are to alertness as ________ waves are too profound rest. a. Alpha, beta b. Beta, delta c. Alpha, delta d. Beta, theta 4. What is another name for N3 stage rest? a. Rapid eye movement sleep b. Beta wave sleep c. Dream sleep d. Slow wave sleep 5. What did Freud view as the essential capacity of dreams? a. Enhanced cognition b. Wish fulfilment c. Memory suppression d. Enhanced self-esteem Answers CU IDOL SELF LEARNING MATERIAL (SLM)

1(d) 2(b) 3(c) 4(d) 5(b) 13.12 REFERENCES Textbooks • Hickey, Eric, W. (2005). Personality disorders Sage Publication, NY. • Holmes, R.M. (2007). Personality disorders Prentice Hall, London. Reference Books • Carson, R.C, Butcher, J. N. &Mineka Susan (2000). Abnormal Psychology and Modern Life.Allyn and Bacon. • Carson, Robert C., Butcher, James N., Mineka Susan & Hooley Jill M. (2007). Abnormal Psychology (13th Ed.), Pearson Education Inc. & Dorling Kindersley Publishing Inc. India. • Davison, Gerald C. & Neale, J.M. (2004).Abnormal Psychology (8th Ed.), John Wiley & Sons Inc, USA. • Sadock BJ, Sadock VA (2007): Kaplan & Sadock’s Synopsis of Psychiatry: Behavioural Sciences/Clinical Psychiatry, 10th Edition. Lippincott Williams & Wilkins. • Sarason Irwin G. &Sarason Barbara R. (2002). Abnormal Psychology: The Problem of Maladaptive Behaviour, Prentice Hall. Websites • https://manhattanmentalhealthcounseling.com/ • https://www.webmd.com/mental-health/sleep-disorders • https://www.health.harvard.edu/sleep 254 CU IDOL SELF LEARNING MATERIAL (SLM)

UNIT 14: SLEEP DISORDERS: PART II Structure 14.0 Learning Objectives 14.1 Introduction 14.2 Incidence 14.3 Prevalence 14.4 Assessment 14.5 Prognosis and Treatment 14.6 Summary 14.7 Keywords 14.8 Learning Activity 14.9 Unit End Questions 14.10 References 14.0 LEARNING OBJECTIVES After studying this unit, student will be able to: • State the prognosis and treatment in sleep disorders. • Explain prevalence of sleep disorders. • Describe the diagnose sleep disorders. • Illustrate the treatment of sleep disorders. • Describe mode of sleep disorders. 14.1 INTRODUCTION Sleep is characterized based on social and physiological rules isolating it into two states: non rapid eye movement (NREM) sleep which is partitioned into three phases (N1, N2, N3); and rapid eye movement (REM) sleep portrayed by rapid eye movements, muscle atonia and desynchronized EEG. Circadian cadence of sleep alertness is constrained by the expert check situated in the suprachiasmatic cores of the nerve centre. The neuroanatomical substrates of the NREM sleep are found primarily in the ventrolateral preoptic core of the nerve centre and those of REM sleep are situated in pons. An assortment of critical physiological changes 255 CU IDOL SELF LEARNING MATERIAL (SLM)

happen in all body frameworks and organs during sleep because of practical adjustments in the autonomic and substantial sensory systems. The worldwide characterization of sleep issues records eight classifications of sleep problems alongside reference section An and index B. The four significant sleep grievances incorporate inordinate daytime sluggishness, sleep deprivation, strange developments or conduct during sleep and powerlessness to sleep at the ideal time. The main advance in surveying a patient with a sleep protest is getting a definite history including family and past accounts, clinical, mental, neurological, medication, liquor and substance misuse problems. Some significant research facility tests for exploring sleep problems comprise of an overnight polysomnography, different sleep inertness and upkeep of alertness tests just as actigraphy. General doctors ought to have a fundamental information on the notable clinical highlights of regular sleep problems, like sleep deprivation, obstructive sleep apnoea condition, narcolepsy-cataplexy condition, circadian beat sleep issues (e.g., jet leg, shift work disorder, etc.) and parasomnias (e.g., partial arousal disorders, REM behaviour disorder, etc.) and these are briefly described in this chapter. The principle of treatment of sleep disorders is first to find cause of the sleep disturbance and vigorously treat the co-morbid conditions causing the sleep disturbance. If a satisfactory treatment is not available for the primary condition or does not resolve the problem, the treatment should be directed at the specific sleep disturbance. Most sleep disorders, once diagnosed, can be managed with limited consultations. The treatment of primary sleep disorders, however, is best handled by a sleep specialist. An overview of sleep and sleep disorders viz., Basic science; international classification and approach; and phenomenology of common sleep disorders are presented. Sleep is the process that allows functioning throughout the day without feeling drowsy and impairment in concentration, memory and the performance. A person normally sleep approximately 1/3rd of the day (8 hr). Changes in structure and quality have long been associated as a feature of the aging process. Development in research methodology, especially polysomnography have demonstrated changes in sleep pattern with advancing age and there is increased incidence of insomnia in general population. The understanding in sleep and its disorders is important in knowing the risks involved in deterioration in quality of life, the development of emotional problems such as depression, the worsening of the cognitive impairment and the risk for motor vehicle accident and for mortality which may be adversely affected by too much sleep (more than nine hours) as mediated by sleep apnea or too little sleep (less than 5 hours out of 24) and hence quality of sleep affect the quality of life and death. Before discussing the sleep disorders, we would like to apprise you about the changes that occur in the elderly. Sleep becomes ‘shallow’ i.e., the auditory threshold for awakening diminishes which is manifested by reduction in slow wave sleep the deepest level of non- rapid eye movement sleep (non-REM). There is increase in intermittent wakefulness during 256 CU IDOL SELF LEARNING MATERIAL (SLM)

the night as the age advances. Both long and short arousal, are observed mostly in second half of the night and results in fragmented nocturnal sleep. There is evidence of frequent napping in day-time and older persons spend more time in bed often not asleep. The 24-hour sleep- wake patterns become polyphasic. Gradually as age increases, the prevalence of both sleep disorder breathing, and periodic limb movements are seen in about 25% cases. This accounts for decreasing physiological ability to deep sleep and involved in day-time sleepiness. The sleep disorder is 1.5 times more common in persons aged > 65 years compared to younger counterparts and incidence in women is 1.3 times greater than in men. Sleep is required based on social and physiological models isolating it into two states: non rapid eye movement (NREM) sleep which is partitioned into three phases (N1, N2, N3); and rapid eye movement (REM) sleep described by rapid eye movements, muscle atonia and desynchronized EEG. Circadian musicality of sleep alertness is constrained by the expert check situated in the suprachiasmatic cores of the nerve centre. The neuroanatomical substrates of the NREM sleep are found chiefly in the ventrolateral preoptic core of the nerve centre and those of REM sleep are situated in pons. An assortment of huge physiological changes happen in all body frameworks and organs during sleep because of practical modifications in the autonomic and substantial sensory systems. The worldwide grouping of sleep issues records eight classifications of sleep problems alongside supplement An and index B. The four significant sleep objections incorporate over the top daytime drowsiness, sleep deprivation, unusual developments or conduct during sleep and failure to sleep at the ideal time. The main advance in evaluating a patient with a sleep objection is getting a definite history including family and past accounts, clinical, mental, neurological, medication, liquor and substance misuse issues. Some significant lab tests for researching sleep problems comprise of an overnight polysomnography, numerous sleep inertness and support of attentiveness tests just as actigraphy. General doctors ought to have a fundamental information on the remarkable clinical highlights of normal sleep issues, like a sleeping disorder, obstructive sleep apnoea condition, narcolepsy-cataplexy disorder, circadian musicality sleep problems (e.g., fly leg, shift work issue, and so on) and parasomnias (e.g., incomplete excitement issues, REM conduct issue, and so forth) and these are momentarily depicted in this section. The rule of treatment of sleep issues is most noticeably terrible to and reason for the sleep aggravation and energetically treat the co-sullen conditions causing the sleep unsettling influence. On the off chance that a good treatment isn't accessible for the essential condition or doesn't resolve the issue, the treatment ought to be aimed at the particular sleep unsettling influence. Most sleep issues, once analysed, can be dealt with sleepricted counsels. The treatment of essential sleep problems, in any case, is best dealt with by a sleep trained professional. An outline of sleep and sleep issues viz., Basic science; worldwide characterization and approach; and phenomenology of basic sleep issues are introduced Sleep is characterized based on conduct and physiological rules isolating it into two states: non rapid eye movement (NREM) sleep which is partitioned into three phases 257 CU IDOL SELF LEARNING MATERIAL (SLM)

(N1, N2, N3); and rapid eye movement (REM) sleep described by rapid eye movements, muscle atonia and desynchronized EEG. Circadian musicality of sleep alertness is constrained by the expert check situated in the suprachiasmatic cores of the nerve centre. The neuroanatomical substrates of the NREM sleep are found essentially in the ventrolateral preoptic core of the nerve centre and those of REM sleep are situated in pons. An assortment of critical physiological changes happen in all body frameworks and organs during sleep because of useful modifications in the autonomic and physical sensory systems. The worldwide characterization of sleep issues records eight classes of sleep problems alongside reference section An and index B. The four significant sleep grievances incorporate unnecessary daytime sluggishness, sleep deprivation, unusual developments or conduct during sleep and failure to sleep at the ideal time. The main advance in evaluating a patient with a sleep grievance is acquiring a point-by-point history including family and past narratives, clinical, mental, neurological, medication, liquor and substance misuse issues. Some significant lab tests for exploring sleep problems comprise of an overnight polysomnography, different sleep dormancy and support of attentiveness tests just as actigraphy. General doctors ought to have an essential information on the striking clinical highlights of normal sleep problems, like a sleeping disorder, obstructive sleep apnoea condition, narcolepsy-cataplexy condition, circadian mood sleep issues (e.g., fly leg, shift work issue, and so on) and parasomnias (e.g., fractional excitement issues, REM conduct issue, and so on) and these are momentarily depicted in this section. The guideline of treatment of sleep issues is most exceedingly awful to end reason for the sleep unsettling influence and overwhelmingly treat the co-grim conditions causing the sleep aggravation. On the off chance that an agreeable treatment isn't accessible for the essential condition or doesn't resolve the issue, the treatment ought to be aimed at the particular sleep aggravation. Most sleep problems, once analysed, can be dealt with sleepricted discussions. The treatment of essential sleep problems, notwithstanding, is best taken care of by a sleep trained professional. An outline of sleep and sleep issues viz., Basic science; global arrangement and approach; and phenomenology of normal sleep problems are introduced. Sleep is a dynamic and directed arrangement of social and physiological states during which numerous cycles essential to wellbeing and prosperity occur. The sleep cycle happens in 5 phases (which we will take a gander at later in this booklet) and incorporates two sorts of sleep: • NREM • REM In the event that you at any point find the opportunity to watch somebody sleeping (albeit that sounds somewhat unpleasant) you will finish up three primary actual signs – shut eyes, sleeping and hushing up. Sleep is regularly seen as when the body is dormant. Indeed, the inverse is valid. Sleep is a functioning, fundamental and compulsory interaction, without 258 CU IDOL SELF LEARNING MATERIAL (SLM)

which we can't work viably. Primarily, sleep is for the brain, allowing it to recover and regenerate. Sleep is not a lifestyle choice, but a necessity. 14.2 INCIDENCE Table 14.1 shows the percentage of patients reporting night-time disturbances in each group. A significantly higher percentage of patients with MSA complained of sleep disorders compared with patients with PD (70% v 51%, p=0.03). A significantly higher percentage of patients with MSA reported night-time vocalisation and RBD than patients with PD (60% v 13%, p =0.0004). Table 14.1: Night-time Problems in Patients 14.3 PREVALENCE The University of Bordeaux 2 ethical committee approved the study. Fifty-seven consecutive patients with MSA underwent a standardised face to face interview and examination protocol to fulfil MSA clinical diagnostic criteria for “possible” and “probable” MSA.11 Comparison was made with 62 outpatients with PD, who were recruited in parallel and matched as a group for sex, age, and disease duration Semiquantitative scales rating parkinsonism severity (Hoehn and Yahr stage, unified Parkinson’s disease rating scale (UPDRS-III) motor score, Schwab and England activity of daily living scale), self-reported depressive symptoms (Centre for Epidemiological Studies depression scale, CES-D), and mini mental state examination (MMSE) were administered. A structured interview collected data on disease history and medication. The standardised interview also assessed sleep problems (“yes” or “no” type of answer). On the off chance that \"yes\", they needed to determine whether they had: 1, steady starting a sleeping disorder (trouble nodding off inside 30 minutes or more); 2, sleep discontinuity (more than two >30- minute night-time enlightenments autonomously of the need to utilize the washroom); 3, early arousing (unfortunate early daytime arousing with powerlessness to nod off once more); 4, daytime sleepiness (unwanted and unseemly snoozing during waking hours). Information were gathered with the help of the patient's bed accomplice or a prompt family part for every one of the patients. Data was likewise looked for on whether patients wheezed or had night- time engine manifestations (torment, cramps, night-time compulsory winding developments, 259 CU IDOL SELF LEARNING MATERIAL (SLM)

uncontrolled abrupt jerks, and other unusual night-time appendage developments). Night- time stridor, depicted as a brutal or stressed shrill sound, and talking were researched from the reports of the patients' bed accomplices' or guardians'. Sleepless legs condition and rapid eye movement (REM) sleep conduct issue (RBD) were analysed by the International grouping of sleep issues (ICSD) insignificant indicative criteria.12 A Fisher's precise test or a χ2 test was utilized when fitting to think about the rate of sleep problems, types, determinants, and sex circulation in patients with MSA or PD. The mean age, sickness term and seriousness, span of levodopa therapy, day by day portion of levodopa, utilization of dopamine agonists and amantadine (\"yes\" or \"no\" sort of answer), burdensome manifestations, incapacity, and psychological weakness scores were contrasted in patients and MSA or PD with and without sleep protests utilizing Student's t test. The mean age (67.3 (SD 8.5) a long time), sex dissemination, and mean sickness term (5.75 (SD 3.36) long stretches) of the 57 patients with MSA didn't vary fundamentally from those of the 62 patients with PD (65.2 (SD 8.7) a long time and 7 (SD 4.37) a long time separately). About a third of patients with MSA were delegated MSA-C and 70% as MSA-P. Parkinsonism was essentially more extreme in patients with MSA than in those with PD (mean Hoehn and Yahr score=3.23 (SD 1.36) v 2.18 (SD 0.76), p <0.001; mean and 57% of patients with PD (p=0.02) 23% of patients with MSA utilized amantadine v 15% of patients with PD. 14.4 ASSESSMENT Symptoms differ depending on the severity and type of sleeping disorder. They may also vary when sleep disorders are a result of another condition. However, general symptoms of sleep disorders include: • Difficulty falling or staying asleep. • Daytime fatigue. • Strong urge to take naps during the day. • Unusual breathing patterns. • Unusual or unpleasant urges to move while falling asleep. • Unusual movement or other experiences while asleep. • Unintentional changes to your sleep/wake schedule. • Irritability or anxiety. • Impaired performance at work or school. • Lack of concentration. • Depression. • Weight gain. Statistical Analysis 260 CU IDOL SELF LEARNING MATERIAL (SLM)

All data were analysed using SPSS 19.0 statistical software; with an a priori alpha level set to 0.05. It was used the Cronbach's alpha coefficient in order to verify the PSQI internal consistency. Internal consistency refers to the degree of uniformity and consistency between the survey participants’ responses to each items of the test, i.e., it assesses the degree to which the overall variation in results is associated with the sum of the variance item by item. It was also calculated the 95% confidence interval for the PSQI classification. 14.5 PROGNOSIS AND TREATMENT While the risk and prognostic factors discussed in this section increase vulnerability to insomnia, sleep disturbances are more likely to occur when predisposed individuals are exposed to precipitating events, such as major life events (e.g., illness, separation) or less severe but more chronic daily stress. Most individuals resume normal sleep patterns after the initial triggering event has disappeared, but others—perhaps those more vulnerable to insomnia—continue experiencing persistent sleep difficulties. Perpetuating factors such as poor sleep habits, irregular sleep scheduling, and the fear of not sleeping feed into the insomnia problem and may contribute to a vicious cycle that may induce persistent insomnia. Temperamental Anxiety or worry-prone personality or cognitive styles, increased arousal predisposition, and tendency to repress emotions can increase vulnerability to insomnia. Environmental Noise, light, uncomfortably high or low temperature, and high altitude may also increase vulnerability to insomnia. Genetic and Physiological Female gender and advancing age are associated with increased vulnerability to insomnia. Disrupted sleep and insomnia display a familial disposition. The prevalence of insomnia is higher among monozygotic twins relative to dizygotic twins; it is also higher in first-degree family members compared with the general population. The extent to which this link is inherited through a genetic predisposition, learned by observations of parental models, or established as a by-product of another psychopathology remains undetermined. Course Modifiers deleterious course modifiers include poor sleep hygiene practices (e.g., excessive caffeine use, irregular sleep schedules). Sleep issues incorporate a wide range of sicknesses with critical individual wellbeing outcomes and high monetary expenses to society. To work with the finding and treatment of sleep problems, this survey gives a structure utilizing the International Classification of Sleep Disorders, Primary and optional sleep deprivation are separated, and pharmacological and nonpharmacological medicines are talked about. Basic circadian beat issues are portrayed related to intercessions, including chronotherapy and light treatment. The finding and treatment of sleepless legs condition/intermittent appendage development problem is tended to. Consideration is centred around obstructive sleep apnea and upper aviation route 261 CU IDOL SELF LEARNING MATERIAL (SLM)

opposition disorder, and their treatment. The group of stars of manifestations and discoveries in narcolepsy are looked into along with demonstrative testing and treatment, Parasomnias, including sleep dread, sleepwalking, and rapid eye movement (REM) conduct sleep problems are depicted, along with related research centre testing results and treatment. The International Classification of Sleep Disorders indicative and coding manual 2000 records four significant classifications of sleep problems: dyssomnias; parasomnias; sleep issues related with mental, neurologic, or other clinical issues; and proposed sleep issues. Dyssomnias are messes described by either extreme languor or trouble starting or looking after sleep. Based on pathophysiological components, they can be partitioned into inborn, outward, and circadian mood sleep problems. Inherent sleep issues are messes that start or create inside the body or that emerge from causes inside the body. Basic natural sleep problems incorporate idiopathic and psychophysiological sleep deprivation, narcolepsy, obstructive sleep apnea condition (OSAS), periodic limb movement disorder (PLMD), and sleepless legs syndrome (RLS). Sleep issues brought about by outer variables are named extraneous sleep problems and incorporate lacking sleep cleanliness, natural sleep issue, change sleep issue, deficient sleep condition, limit-setting sleep issue, sleep beginning affiliation. 14.6 SUMMARY • Sleep is a fundamental biological function in memory consolidation, in binocular vision, thermoregulation, energy conservation and sleep oration, and sleep oration of brain energy metabolism. Recent studies show that about one third of the general population. • Circadian rhythms refer to the daily rhythms in physiology and behavior. These rhythms are thought to regulate sleep-wake cycle, modulate physical activity and nutritional intake and control different bodily functions e.g., temperature, heart rate or hormone secretion. Circadian rhythms are generated by neural structures in the hypothalamus. • Circadian timing, working in tandem with the neurotransmitter adenosine and melatonin hormone, determines the ideal timing of and a correctly structure of the sleep episode.13 Sleeping is an important part of human function and proper sleep is needed to work in an efficient and safe manner, not to mention the health aspect of sleep. • Impaired or disrupted sleep quality can result in harmful effects causing a reduction in mental, cognitive and physical abilities and is an important cause of labour abstention, consequently reflecting on inefficient work.14 Global disasters such as 262 CU IDOL SELF LEARNING MATERIAL (SLM)

the tanker Exxon Valdez accident, Chernobyl nuclear accident, and the disaster of the space shuttle Challenger, were related to sleep deprivation. • When looking at the transformations in work organization, it is clear the even acting as a stressor on the individual. One of such changes is the shift work that can be seen as a way to fairly common organization currently. Companies give increasing emphasis to continuous 24-hour shifts for purely economic reasons. The justification for the organization shifts in modernity are the needs of a technological nature, that cause, in certain areas of production, to stop the production process (with respect to the working hours) adversely affects the quality of products; economic constraints, requiring expensive machinery have to be used continuously to allow the return of timely investment. • Advancing age as well as senescent changes directly influence the structure and quality of sleep. Problems related to disturbed sleep are multifactorial and require broad and flexible clinical approach. Therapeutic approaches have been well systematized and special emphasis given to sleep assessments, health education and sleep hygiene and appropriate pharmacologic and psychologic strategies in treating complex sleep problems in the elderly. • The impacts of sleep problems can be troublesome to the point that you will probably need prompt alleviation. Tragically, long haul cases can set aside somewhat more effort to determine. • However, in the event that you stay with your treatment design and consistently speak with your PCP, you can discover your approach to sleep more readily. • Most individuals incidentally experience sleeping issues because of stress, feverish timetables, and other external impacts. Be that as it may, when these issues start to happen consistently and meddle with day-by-day life, they may demonstrate a dozing problem. • Depending on the sort of sleep issue, individuals may struggle nodding off and may feel amazingly drained for the duration of the day. The absence of sleep can adversely affect energy, state of mind, fixation, and in general wellbeing. • In a few cases, sleep problems can be an indication of another clinical or psychological well-being condition. These sleeping issues may ultimately disappear whenever treatment is acquired for the basic reason. • When sleep problems aren't brought about by another condition, therapy typically includes a blend of clinical medicines and way of life changes. • It's essential to get a determination and treatment immediately on the off chance that you presume you may have a sleep problem. At the point when left untreated, the adverse consequences of sleep problems can prompt further wellbeing results. • They can likewise influence your presentation at work, cause strain seeing someone, and hinder your capacity to perform day by day exercises. 263 CU IDOL SELF LEARNING MATERIAL (SLM)

14.7 KEYWORDS • NREM – for separative functions • REM – for processing memories and dreaming. • Temperamental Anxiety or worry-prone personality or cognitive styles, increased arousal predisposition, and tendency to repress emotions can increase vulnerability to insomnia. • Environmental Noise, light, uncomfortably high or low temperature, and high altitude may also increase vulnerability to insomnia. • Genetic and Physiological Female gender and advancing age are associated with increased vulnerability to insomnia. 14.8 LEARNING ACTIVITY 1. Demonstrate the causes of sleep disorders? ..................................................................................................................................................... .................................................................................................................................................... 2. Enumerate lab investigations for sleep disorders. .................................................................................................................................................... ................................................................................................................................................... 14.9 UNIT END QUESTIONS A. Descriptive Questions 264 Short Questions 1. Give complete introduction of sleep disorders? 2. Explain the treatments for sleep disorders? 3. Explain the symptoms of sleep disorders? 4. Explain causes of sleep disorders? 5. How are sleep disorders diagnosed? Long Questions 1. How are sleep disorders treated? 2. Explain the assessment of sleep disorder? 3. Explain summary of sleep disorders. 4. Explain incidence in detail? 5. Discuss assessment of sleep disorders? CU IDOL SELF LEARNING MATERIAL (SLM)

B. Multiple Choice Questions 1. The term “hypnosis” is based on the Greek word for: a. Trance b. Drug c. Sleep d. Dream 2. What did Freud call the hidden psychological content of a dream? a. Its manifest content b. Its literal content c. Its latent content d. Its soporific content 3. Which hormone helps us fall asleep? a. Nor-adrenalin b. Estrogen c. Oxytocin d. Melatonin 4. The appearance of sleep spindles on a sleeper’s EEG recording would indicate they are in: a. REM sleep b. N1 stage sleep 265 CU IDOL SELF LEARNING MATERIAL (SLM)

c. N2 stage sleep d. N3 stage sleep 5. Which of the following is NOT a sleep disorder? a. Narcolepsy b. Somnambulism c. Sleep apnea d. Epilepsy Answers 1(c) 2(c) 3(d) 4(c) 5(d) 14.10 REFERENCES Textbooks • Hickey, Eric, W. (2005). Personality disorders Sage Publication, NY. • Holmes, R.M. (2007). Personality disorders Prentice Hall, London. Reference Books • Carson, R.C., Butcher, J. N. &Mineka Susan (2000). Abnormal Psychology and Modern Life.Allyn and Bacon. • Carson, Robert C., Butcher, James N., Mineka Susan & Hooley Jill M. (2007). Abnormal Psychology (13th Ed.), Pearson Education Inc. & Dorling Kindersley Publishing Inc. India. • Davison, Gerald C. & Neale, J.M. (2004). Abnormal Psychology (8th Ed.), John Wiley & Sons Inc, USA. • Sadock BJ, Sadock VA (2007): Kaplan & Sadock’s Synopsis of Psychiatry: Behavioural Sciences/Clinical Psychiatry, 10th Edition. Lippincott Williams & Wilkins. • Sarason Irwin G. &Sarason Barbara R. (2002). Abnormal Psychology: The Problem of Maladaptive Behaviour, Prentice Hall. Websites 266 CU IDOL SELF LEARNING MATERIAL (SLM)

• https://manhattanmentalhealthcounseling.com/ • https://www.webmd.com/mental-health/sleep-disorders • https://www.health.harvard.edu/sleep 267 CU IDOL SELF LEARNING MATERIAL (SLM)