DOCSLIB.ORG

Childhood Insomnia (Confusional Arousals).Pdf

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Childhood Insomnia (Confusional Arousals).Pdf Confusional Arousals Confusional Arousal: confusion during and Diagnosis following partial arousals from sleep, most Diagnosis begins with a careful medical history typically from the deep (NREM) stages of sleep. to determine whether the arousals are secondary to It is a parasomnia in which a person behaves in another health condition, or a side effect of certain a confused way because they are not fully awake medications. Providing a two week sleep log of your or asleep. It is very common in children, although sleep habits (or your child’s) and possibly video tapes some adults experience them. will demonstrate the episodes to your doctor or sleep specialist. An overnight sleep study will be key to conclusively identifying this sleep disorder, which can look similar to sleepwalking and sleep terrors. The sleep study involves an overnight polysomnogram, which records brainwaves, muscular activity and breathing during sleep. The sleep study Features may also record your sleep on videotape. This parasomnia occurs during periods of transition from sleep, either while waking up, or just Treatment after waking. For this reason, Confusional Arousals Behavioral Modification is an important part has been labeled as one of three “classical” arousal of treating Confusional Arousals in both adults and disorders, along with Sleepwalking and Sleep Terrors. children. Incorporating Healthy Sleep Habits will Episodes evolve gradually after a cycle of eliminate unnecessary interruptions during sleep. deep sleep, usually in the first third of the night. Limiting or avoiding the use of alcohol, especially Sometimes they arise later in the night, or after a nap. during the evening hours may also help. Parents can Confusion results from a brain that is divided between take specific measures to ensure their child’s safety wakefulness and sleep. You are still in the process of during an episode. Keep in mind that your child will not waking up! Behavior may include: confused thinking, remember the episode. slowed speech, poor memory, or incomplete responses > Respond in a calm, reassuring manner to avoid to questions. frightening her. Parents may find episodes in their children to > Try not to awaken your child. be bizarre or frightening, if they do not know what to > Watch over your child until she returns to sleep. expect. The child may be agitated or appear dazed. Medication may be helpful for severe or Episodes last an average of 5 to 15 minutes, but can persistent episodes. Antidepressants or last for one half hour or more. sleeping pills may be prescribed. A variation of confusional arousals called Severe Morning Sleep Inertia affects teens and adults. Behavior is similar to confusional arousals except that episodes occur in the morning. Also known as sleep drunkenness, this variation tends to affect people consistently every morning, for years. Because the episodes last for longer than just a few minutes, consequences such as traffic accidents and poor job or school performance are common. I have been told that I behave in a Do I Have My behavior upon awakening has way that is confused or strange when been described as inappropriate or Confusional Arousals? abruptly awakened by others. not making sense. I have been told that I behave in a My behavior upon awakening has way that is confused or strange when This pattern of behavior occurs on been described as aggressive or I awaken on my own. a regular basis. hostile. c. 2011 Mary Ouimette-Kinney, Editor www.sleepmedicinecenters.com (716)92-DREAM www.sleepmedicineeducation.com (877)53-SNORE AskTheDoc Confusional Arousal Mechanics Sleep specialists define sleep according to stages, or degrees of sleep. The brain Risks for Confusional Arousals behaves differently during each sleep stage. P Age (children and adults under 35 Confusional arousals occur during stages 3-4 of years of age) NREM sleep, the deepest sleep. NREM sleep P Rotating shift work is not associated with much dreaming, so the arousals are not nightmares or vivid dreams. P Sleep deprivation P Stress Part of the brain remains asleep while areas P Bi-polar and depressive disorders involved with movement, thinking, and emotion P Other sleep disorders become “awakened” or activated. They are not activated enough to render the person P The use of psychotropic medications fully conscious of their words and actions, P Renal (kidney) failure nor is the episode likely to be remembered. P Drug abuse P Being forced into wakefulness Effects of Confusional Arousals P Injury to oneself P Injury to bed partner or others P Destruction of nearby property P Increasingly worse episodes Need more information? Visit the SleepMedicine Education web site at: sleepmedicineeducation.com for additional publications. See also: SleepIssues: “Things That Go Bump” “Children and Sleep” SleepGuides: “Treating Sleep Disorders” To schedule an appointment at any Sleep Medicine Centers location, visit www.sleepmedicinecenters.com or call: (716)92-DREAM (877)53-SNORE There is a family history of partial arousals in up to 60% of cases, according to studies cited in the Principles and Practices of Sleep Medicine. Did You Know? Agitated arousals of all types are common in children, affecting In 2004, the European Journal of The American Academy of Sleep 17.3% of children between 3 and Pediatrics reported a prevalence of Medicine reports that as many 13 years of age, according to a sleep apnea in 13% of individuals as 17% of children experience large Canadian study published in with confusional arousals vs. 2% Confusional Arousals. Pediatrics 2000. without confusional arousals. c. 2011 Mary Ouimette-Kinney, Editor www.sleepmedicinecenters.com (716)92-DREAM www.sleepmedicineeducation.com (877)53-SNORE .
Load more

Recommended publications
  • S46. Parasomnias.Pdf
    PARASOMNIAS S46 (1) Parasomnias Last updated: May 8, 2019 Clinical Features ............................................................................................................................... 2 SLEEP TERRORS (S. PAVOR NOCTURNUS) ............................................................................................... 2 SLEEPWALKING (S. SOMNAMBULISM) .................................................................................................... 3 CONFUSIONAL AROUSALS (S. SLEEP DRUNKENNESS, SEVERE SLEEP INERTIA) ........................................ 3 Diagnosis .......................................................................................................................................... 3 Management ..................................................................................................................................... 3 HYPNIC JERKS (S. SLEEP STARTS) .......................................................................................................... 4 RHYTHMIC MOVEMENT DISORDER ........................................................................................................ 4 SLEEP TALKING (S. SOMNILOQUY) ......................................................................................................... 4 NOCTURNAL LEG CRAMPS ..................................................................................................................... 4 REM SLEEP BEHAVIORAL DISORDER (RBD) ........................................................................................ 4
    [Show full text]
  • Medical MARIJUANA’S Effect on Sleep
    QUARTER THREE 2019 / VOLUME 28 / NUMBER 03 Medical MARIJUANA’S Effect on Sleep WHAT’S INSIDE ADHD and Delayed Sleep Phase Syndrome May Be Linked Circadian Rhythm Sleep Disorders: An Overview Caffeine and Sleep The Pros and Cons of Group Setups Alice 6 PSG systems FULL PAGE AD Table of Contents QUARTER THREE 2019 VOLUME 28 / NUMBER 03 Medical Marijuana’s Effect on Sleep By Joseph Anderson, RPSGT, CCSH, RST, RPFT, CRT-NPS Many states are adopting the use of marijuana for medical purposes even though federal law does not yet support marijuana to be used in this context. This article discusses its medical use, as well as its use in society historically and today. 10 Attention Deficit Hyperactivity Disorder and Delayed Sleep Phase Syndrome May Be Linked 15 By Regina Patrick, RPSGT, RST Circadian Rhythm Sleep Disorders: An Overview 18 By Peter Mansbach, Ph.D. Caffeine and Sleep 21 By Brendan Duffy, RPSGT, RST, CCSH The Pros and Cons of Group Setups 24 By Sarah Brennecka DEPARTMENTS President & Editor’s Message – 07 Trends – 25 In the Moonlight – 29 Compliance Corner – 30 FULL PAGE AD QUARTER THREE 2019 VOLUME 28 / NUMBER 03 THE OFFICIAL PUBLICATION OF AAST ABOUT A2Zzz CONTRIBUTORS A2Zzz is published quarterly by AAST. DISCLAIMER EDITOR The statements and opinions contained SUBMISSIONS Rita Brooks. MEd, RPSGT, REEG/ in articles and editorials in this magazine EPT, FAAST Original articles submitted by AAST are solely those of the authors thereof members and by invited authors will be and not of AAST. The appearance of MANAGING EDITOR considered for publication. Published products and services, and statements Alexa Schlosser articles become the permanent property contained in advertisements, are the sole of AAST.
    [Show full text]
  • 260202 Sleep Inertia, Naps, and Memory
    260202 Sleep Inertia, Naps, and Memory 3 Contact Hours Sleep Inertia, Naps, and Memory Notes Care has been taken to confirm the accuracy of information presented in this course. The authors, editors, and the publisher, however, cannot accept any responsibility for errors or omissions or for the consequences from application of the information in this course and make no warranty, expressed or implied, with respect to its contents. The authors and the publisher have exerted every effort to ensure that drug selections and dosages set forth in this course are in accord with current recommendations and practice at time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package inserts of all drugs for any change in indications of dosage and for added warnings and precautions. This is particularly when the recommended agent is a new and/or infrequently employed drug. COPYRIGHT STATEMENT ©2006 Institute for Continuing Education Revised 2007 All rights reserved. The Institute of Continuing Education retains intellectual property rights to these courses that may not be reproduced and transmitted in any form, by any means, electronic or mechanical, including photocopying and recording, or by any information storage or retrieval system without the Institute’s written permission. Any commercial use of these materials in whole or in part by any means is strictly prohibited. 2 Sleep Inertia, Naps, and Memory Instructions for This Continuing Education Module Welcome to the Institute for Continuing Education. The course, test and evaluation form are all conveniently located within Notes this module to keep things easy-to-manage.
    [Show full text]
  • Ac 120-100 06/07/10
    U.S. Department Advisory of Transportation Federal Aviation Administration Circular Date: 06/07/10 AC No: 120-100 Subject: Basics of Aviation Fatigue Initiated by: AFS-200 Change: 1. PURPOSE. This advisory circular (AC): • Summarizes the content of the FAA international symposium on fatigue, “Aviation Fatigue Management Symposium: Partnerships for Solutions”, June 17-19, 2008; • Describes fundamental concepts of human cognitive fatigue and how it relates to safe performance of duties by employees in the aviation industry; • Provides information on conditions that contribute to cognitive fatigue; and • Provides information on how individuals and aviation service providers can reduce fatigue and/or mitigate the effects of fatigue. 2. APPLICABILITY. This AC is not mandatory and does not constitute a regulation. 3. DEFINITIONS. a. Circadian Challenge. Circadian challenge refers to the difficulty of operating in opposition to an individual’s normal circadian rhythms or internal biological clock. This occurs when the internal biological clock and the sleep/wake cycle do not match the local time. For example, the sleep period is occurring at an adverse circadian phase when the body wants to be awake. Engaging in activities that are opposite of this natural biological system represents the circadian challenge (e.g., night work, shift work, jet lag). b. Cognitive Performance. Cognitive performance refers to the ability to process thought and engage in conscious intellectual activity, e.g., reaction times, problem solving, vigilant attention, memory, cognitive throughput. Various studies have demonstrated the negative effects of sleep loss on cognitive performance. c. Circadian Rhythm. A circadian rhythm is a daily alteration in a person’s behavior and physiology controlled by an internal biological clock located in the brain.
    [Show full text]
  • Fatigue and Sleep Management
    EUROCONTROL EUROCONTROL Fatigue and Sleep Management Personal strategies for decreasing the effects of fatigue in Air Traffic Control 1 Fatigue and Sleep Management 2 For shift workers, fatigue and sleep debt can become a challenge and difficult to cope with. We have designed this booklet to give you knowledge and strategies that you can apply in your daily lives in order to help you better manage your sleep. When reading this booklet , bear in mind that whilst some of the ideas/suggestions may seem a little eccentric, people are different, and something that may work for one person may not work for another. Find what works for you, then you will be one step closer to getting a good night’s sleep and feeling less tired. Sweet dreams! 3 4 CONTENTS General Introduction to Fatigue, Sleep and Shift work.............................................................................................. 6 Circadian Rhythms and Sleep Patterns ........................................................................................................................................ 9 Shift work – A Better Understanding .........................................................................................................................................27 Tips and Tools for Fatigue and Sleep Management .....................................................................................................37 Bedtime Rituals ...................................................................................................................................................................................................37
    [Show full text]
  • Time Course of Sleep Inertia Dissipation in Memory Tasks
    applied sciences Article Time Course of Sleep Inertia Dissipation in Memory Tasks Miranda Occhionero 1,*, Marco Fabbri 2 , Lorenzo Tonetti 1 , Monica Martoni 3 and Vincenzo Natale 1 1 Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; [email protected] (L.T.); [email protected] (V.N.) 2 Department of Psychology, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy; [email protected] 3 Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40126 Bologna, Italy; [email protected] * Correspondence: [email protected]; Tel.: +39-05-1209-1871 Abstract: Sleep inertia (SI) refers to a complex psychophysiological phenomenon, observed after awakening, that can be described as the gradual recovery of waking-like status. The time course of cognitive performance dissipation in an everyday life condition is still unclear, especially in terms of the sleep stage at awakening (REM or NREM-stage 2) and the relative effects on perfor- mance. The present study aimed to investigate the SI dissipation in different memory performances upon spontaneous morning awakening after uninterrupted nighttime sleep. Eighteen young adults (7 females; mean age 24.9 ± 3.14 years) spent seven non-consecutive nights (one baseline, three REM awakenings and three St2 awakenings) in the laboratory under standard polysomnographic (PSG) control. Participants were tested after three REM awakenings and three St2 awakenings, and three times at 11:00 a.m. as a control condition. In each testing session, participants filled in the Global Vigor and Affect Scale and carried out one memory task (episodic, semantic, or procedural task). For each condition, participants were tested every 10 min within a time window of 80 min.
    [Show full text]
  • Effects of Sleep Deprivation on Fire Fighters and EMS Responders
    Effects of Sleep Deprivation on Fire Fighters and EMS Responders Effects of Sleep Deprivation on Fire Fighters and EMS Responders Effects of Sleep Deprivation on Fire Fighters and EMS Responders Effects of Sleep Deprivation on Fire Fighters and EMS Responders Final Report, June 2007 Diane L. Elliot, MD, FACP, FACSM Kerry S. Kuehl, MD, DrPH Division of Health Promotion & Sports Medicine Oregon Health & Science University Portland, Oregon Acknowledgments This report was supported by a cooperative agreement between the International Association of Fire Chiefs (IAFC) and the United States Fire Administration (USFA), with assistance from the faculty of Or- egon Health & Science University, to examine the issue of sleep dep- rivation and fire fighters and EMS responders. Throughout this work’s preparation, we have collaborated with Victoria Lee, Program Man- ager for the IAFC, whose assistance has been instrumental in success- fully completing the project. The information contained in this report has been reviewed by the members of the International Association of Fire Chiefs’ Safety, Health and Survival Section; Emergency Medi- cal Services Section and Volunteer and Combination Officers Sec- tion; and the National Volunteer Fire Council (NVFC). We also grate- fully acknowledge the assistance of our colleagues Esther Moe, PhD, MPH, and Carol DeFrancesco, MA, RD. i Effects of Sleep Deprivation on Fire Fighters and EMS Responders Preface The U.S. fire service is full of some of the most passionate individuals any industry could ever have. Our passion, drive and determination are in many cases the drivers that cause us to take many of the courageous actions that have become legendary in our business.
    [Show full text]
  • Sleep Inertia in Children
    SLEEP INERTIA IN CHILDREN THESIS Presented in Partial Fulfillment of the Requirements for the Degree Master of Mathematical Science in the Graduate School of the Ohio State University By Kelsy Kinderknecht, BS, BA Graduate Program in Mathematics The Ohio State University 2013 Thesis Committee: Dr. Janet Best, PhD, Advisor Dr. Mark Splaingard, MD Dr. Adriana Dawes, PhD c Copyright by Kelsy Kinderknecht 2013 ABSTRACT Sleep inertia is known to cause delayed reaction times and general performance deficits immediately after awakening, but specifics manifested in children are not well defined. This research aims to elucidate the effects of sleep inertia in children aged 5 to 12. Results were that younger children sustained slower reaction times than older children at baseline and upon awakening. All age groups had greater impairment after a second awakening, possibly due to a circadian effect and/or cumulative fatigue. All groups had improved reactions in the final 2 minutes of testing compared to the first 2 minutes after awakening (though reaction times were still slower than at baseline), suggesting partial recovery in sleep inertia with increased time. Recovery from sleep inertia may be due to wake-promoting neuromodulators; the increase in concentration may be responsible for improved performance with extended time awake. The current study constructs a model based on volume transmission of these neuromodulators. The model is capable of producing results similar to those observed in individuals with little variance in reaction time, but the model struggles to produce adequate replications of more variable data. Furthermore, the model cannot produce many of the dynamics found in the observed data, suggesting that the current model, if appropriate at all, requires many alterations.
    [Show full text]
  • Sleep Inertia and Alcohol Impairment in Young Adults: Neurocognitive Effects and Interactions Implications for Fire Escape Behaviours
    Sleep inertia and alcohol impairment in young adults: Neurocognitive effects and interactions Implications for fire escape behaviours Melanie Joy Tokley, BPsyc(Hons) Submitted in partial fulfilment of the requirements of the degree of Doctor of Psychology (Clinical Neuropsychology) School of Social Sciences & Psychology Victoria University, Melbourne AUSTRALIA June 2009 ABSTRACT Alcohol intoxication is known to considerably increase the probability of death from fire across the lifespan, to the extent that it has been isolated as the single most significant risk factor. The study investigated the combined effects of sleep inertia and alcohol impairment on fire emergency-relevant cognitive performance indicators in a young adult population. Mental tracking, visual scanning, psychomotor speed, working memory and sustained, selective, and divided attention functions were assessed for performance decrements and reference to speed-accuracy trade-off effects. Participants were 24 young adults (18-26 years) who participated in a repeated-measures study over 2 non- consecutive nights; 1 night with alcohol administration and 1 ‘sober’ night. During the alcohol administration night, 10-minute testing blocks occurred under (1) baseline sober and (2) baseline 0.05 blood alcohol concentration (BAC) conditions. Subsequently, subjects were awoken from stage 4 sleep and assessed in two consecutive 10-minute blocks (3) and (4). Self-reports of sleepiness and clearheadedness were also taken. The same procedure was used during the sober night (with condition (2) excluded). All cognitive functions assessed showed an alcohol effect (i.e., decrements between sober baseline (1) and conditions of alcohol (2)), and an even larger sleep inertia effect (i.e., greater decrements between sober baseline (1) and conditions of sleep inertia alone (3) and (4)).
    [Show full text]
  • The Spectrum of Disorders Causing Violence During Sleep Carlos H
    Schenck Sleep Science and Practice (2019) 3:2 Sleep Science and Practice https://doi.org/10.1186/s41606-019-0034-6 REVIEW Open Access The spectrum of disorders causing violence during sleep Carlos H. Schenck Abstract Violent behavior during sleep is a common problem, affecting > 2% of the population > 15 years old as found in two large epidemiologic studies. The differential diagnosis of sleep related injury and violence includes: REM sleep behavior disorder (RBD); NREM sleep parasomnias (sleepwalking, sleep terrors); parasomnia overlap disorder (RBD + NREM sleep parasomnias); obstructive sleep apnea; sexsomnia (sleep related abnormal sexual behaviors); sleep related dissociative disorder; trauma-associated sleep disorder/post-traumatic stress disorder; periodic limb movement disorder; rhythmic movement disorder; nocturnal scratching disorder; nocturnal seizures; and miscellaneous/mixed conditions. Careful clinical interviews, preferably with bed partners participating, and extensive, hospital-based, technologist-attended, overnight video-polysomnography (for one or more nights), is crucial for determining the accurate diagnosis that will guide proper therapy. Most of the disorders mentioned above are classified as parasomnias in the International Classification of Sleep Disorders, 3rd Edition, with parasomnias defined as abnormal behavioral, experiential and/or autonomic nervous system activity during entry into sleep, during any stage of sleep, and during emergence from any stage of sleep. Parasomnias are often manifestations of “state dissociation” in which components of one state of being (wake, REM sleep, NREM sleep) intrude into, and become admixed, with other states of being, with clinical consequences. There are forensic implications related to the parasomnias, with inadvertent and unintentional assaults, murder, and “pseudo-suicide” resulting from aggressive and violent behaviors arising from sleep with suspended awareness and judgement.
    [Show full text]
  • Tips for Better Sleep
    Tips for Better Sleep Environment • Use low wattage, incandescent lights in the bedroom. These should be less than 2500 Kelvin on the color temperature scale (warm white as opposed to cool light or daylight), Avoid blue, LED, fluorescent, or halogen lighting o Try not to turn the light on if you must get up in the night, or use low wattage, motion-activated night lights o Take note of any device LEDs, such as ones on fans, chargers, etc. Cover these as needed. o Avoid alarm clocks that always have the display on • Take the TV out of the bedroom, or avoid using it • Make the sleep environment dark, quiet, and cool o White noise, fans, and calming music can help o Use items like blackout curtains and sleeping masks as needed • Bedding o Invest in quality bedding made with natural fibers: cotton, silk, real linen, etc. o Change mattresses and pillows at recommended times Routine/ Pre-Sleep • Maintain a consistent sleep/wake schedule o Naps included* • Start pre-sleep routine 1-2 hours before bed • Stop working or doing stimulating activities • Avoid technology: No TV, phone on silent and placed face down, lights covered on fans/humidifiers/air filters/etc. o No screens 1-2 hours prior to bed o If you must work using technology, turn down the brightness, and use an app to reduce blue wavelength exposure (e.g. flux, Night Shift on iPhones, etc.) • Try not to exercise before bed • Try practicing meditation, deep breathing, mindfulness, and other calming techniques • Listen to calming music Nutrition and Food Services (06/2020) www.nutrition.va.gov • Take a shower or bath • Use socks or a heating pad for cold feet • Practice Cognitive Behavioral Therapy techniques for insomnia (CBTI) o Discuss with behavioral health provider • Can’t stop thinking about your to do list for tomorrow? Make a list so you won’t forget and get it off your mind.
    [Show full text]
  • Idiopathic-Hypersomnia-.Pdf
    Research & Reviews: Neuroscience Idiopathic Hypersomnia Diksha Gupta1* and Trisha Chatterjee2 1Amity Institute of Pharmacy, Amity University, India 2Department of Biotechnology, Amity University, India Review Article Received date: 08/11/2016 ABSTRACT Accepted date: 27/01/2017 Sleep is an unconsciousness form by which the person Published date: 06/02/2017 could be aroused by sensory or other stimuli. These days due to psychological and social dysfunction our daily routine affects the *For Correspondence quality of our life, according to survey much health related issues are being reported due to lack of sleep. An ancient literature Gupta D, Amity University, Noida, UP, India, Tel: review was given and explained the theory about the leading 8588829759. symptom of idiopathic hypersomnia was sleep drunkenness and the first patient was thus diagnosed with prolonged nocturnal E-mail: [email protected] sleep accompanied by excessive daytime sleepiness with long naps and difficult awakening. A severe issue with this disease is Keywords: Idiopathic hypersomnia, Lengthy that most people tend to suffer from "Depression". Due to ischemic sleep, Narcolepsy, Obstructive sleep changes along the border of mesencephalon and diencephalon and post-traumatic etiology in other, people thus suffer from "sleep apnea, Narcolepsy, Bruxism, Non-rapid eye drunkenness". The term idiopathic hypersomnia was given a variety movement, Hypersomnia of clinical labels including idiopathic central nervous hypersomnia or hypersomnolence, functional hypersomnia, mixed or harmonious hypersomnia, hypersomnia with automatic behavior, and non-rapid eye movement (NREM) narcolepsy. Two different clinical forms were recommended —idiopathic hypersomnia with long sleep time and IH without long sleep time which then reappeared in the latest International Classification of Sleep Disorders.
    [Show full text]