Discussion: Treatment of Sleep/Wake Disorders

Week 10: Sleep/Wake Disorders and Parasomnias

Tick, tock, and here we go again. I have been in bed trying to go to sleep for three hours now. I have not gotten more than a few hours of sleep a night in months. My work is being affected and so is my relationship with my wife. She’s over there sleeping like a baby and cannot understand why I can’t sleep. ‘Just close your eyes and relax’, she says. When I close my eyes, all I see is all the work I have to do.

Riley, age 34

Sleep is essential for a healthy mind and body, and lack of quality sleep can cause distress during the daytime. Sleep disorders can involve difficulties with quality, timing, and amount of sleep and frequently accompany other disorders, especially depression, anxiety, and PTSD. Obtaining a good sleep history is essential to diagnosing sleep disorders, prescribing a treatment plan, and monitoring the plan’s effectiveness. Understanding and managing sleep problems frequently leads to improvement in other mental health disorders that the patient is experiencing.

This week, you will analyze the diagnostic criteria and treatment options of insomnia, hypersomnolence, narcolepsy, sleep apnea, non-rapid eye movement, nightmare disorder, sleep behavior disorder, and other DSM-5 sleep and parasomnic disorders.


Learning Resources

Required Readings

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

  • Chapter 13, “Psychosomatic Medicine” (pp. 465–503)
  • Chapter 16, “Normal Sleep and Sleep-Wake Disorders” (pp. 533–563)

Note: This is review from the Learning Resource in Week 3.

  • Chapter 36, “Sleep-Wake Disorders”
  • “Sleep-Wake Disorders”
Excessive sleepiness in narcolepsy, obstructive sleep apnea/hypopnea syndrome, shift work sleep disorder Insomnia Narcolepsy Restless leg syndrome
armodafinil
modafinil
sodium oxybate (in narcolepsy only)
agomelatine
alprazolam
amitriptyline
amoxapine
clomipramine
clonazepam
desipramine
diazepam
dothiepin
doxepin
estazolam
eszopiclone
flunitrazepam
flurazepam
hydroxyzine
imipramine
lofepramine
lorazepam
maprotiline
mianserin
nortriptyline
quazepam
ramelteon
temazepam
trazodone
triazolam
trimipramine
zaleplon
zolpidem
zopiclone
amphetamine (d)
amphetamine (d,l)
lisdexamfetamine
methylphenidate (d)
methylphenidate (d,l)
modafinil
sodium oxybate
gabapentin ER

Optional Resources

Bélanger, L., Harvey, A. G., Fortier-Brochu, É., Beaulieu-Bonneau, S., Eidelman, P., Talbot, L., . . . Morin, C. M. (2016). Impact of comorbid anxiety and depressive disorders on treatment response to cognitive behavior therapy for insomnia. Journal of Consulting and Clinical Psychology, 84(8), 659–667. doi:10.1037/ccp0000084

Olaithe, M., Nanthakumar, S., Eastwood, P. R., & Bucks, R. S. (2015). Cognitive and mood dysfunction in adult obstructive sleep apnoea (OSA): Implications for psychological research and practice. Translational Issues in Psychological Science, 1(1), 67–78. doi:10.1037/tps0000021


Discussion: Treatment of Sleep/Wake Disorders

The power of sleep to heal the body cannot be underestimated. Most research indicates that 7–8 hours of sleep are a minimum that people need to stay healthy. Clients who come to the PMHNP’s office frequently complain of sleep problems. It is estimated that 10–20% of patients report some type of sleeping problem.

In this Discussion, you will analyze the diagnostic criteria and evidence-based psychotherapy and psychopharmacologic treatment for sleep/wake disorders.

Learning Objectives

Students will:

  • Analyze diagnostic criteria for sleep/wake disorders
  • Analyze evidence-based psychotherapy and psychopharmacologic treatment for sleep/wake disorders
  • Analyze criteria for referring clients to primary care physicians for treatment of sleep/wake disorders
  • Compare differential diagnostic features of sleep/wake disorders

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!

To prepare for this Discussion:

  • By Day 5 of Week 9, your Instructor will have assigned you a sleep/wake disorder, which will be the focus of your original post for this Discussion.
  • Review the Learning Resources.

By Day 3

Post:

  • Explain the diagnostic criteria for your assigned sleep/wake disorder.
  • Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned sleep/wake disorder.
  • Describe at what point you would refer the client to their primary care physician for an additional referral to a neurologist, pulmonologist, or physician specializing in sleep disorders and explain why.
  • Support your rationale with references to the Learning Resources or other academic resource.

By Day 6

Respond to at least two of your colleagues by comparing the differential diagnostic features of the disorder you were assigned to the diagnostic features of the disorder your colleagues were assigned.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 10 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 10 Discussion


Assignment 1: Week 10 Practicum Journal: Checkpoint for Certification Plan

Learning Objectives

Students will:

  • Evaluate progress on certification plans

Report your progress on the Certification Plan completed in Week 1 and submitted in Week 4.

  • What have you done to prepare for your certification?
  • Have you completed the scheduled tasks assigned on your timeline? If not, what are your plans to stay on schedule?

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK10Assgn1+last name+first initial.(extension)” as the name.
  • Click the Week 10 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 10 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Assgn1+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Week 10 Assignment 1 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 10 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 10 Assignment 1


Assignment 2: Week 8 Practicum: Decision Tree

By Day 7

Submit your Assignment. Refer to Week 8 for additional guidance.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK10Assgn2+last name+first initial.(extension)” as the name.
  • Click the Week 10 Assignment 2 Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 10 Assignment 2 link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Assgn2+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Week 10 Assignment 2 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 10 Assignment 2 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 10 Assignment 2


Assignment 3: Week 9 Practicum Journal: State Practice Agreements

By Day 7

Submit your Assignment. Refer to Week 9 for additional guidance.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK10Assgn3+last name+first initial.(extension)” as the name.
  • Click the Week 10 Assignment 3 Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 10 Assignment 3 link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Assgn3+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Week 10 Assignment 3 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 10 Assignment 3 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 10 Assignment 3


Practicum Reminder

Time Logs: You are required to keep a log of the time you spend related to your practicum experience and enter every patient you see each day. You can access your time log from the Welcome Page in your Meditrek account. You will track time individually for each patient you work with. Please make sure to continuously input your hours throughout the term.


Making Connections

This week, you analyzed the diagnostic criteria and treatment options of insomnia, hypersomnolence, narcolepsy, sleep apnea, non-rapid eye movement, nightmare disorder, sleep behavior disorder, and other DSM-5 sleep and parasomnic disorders.

Next week, you will analyze how to assess and care for individuals with sexual disorders. You also will analyze the concept of gender dysphoria and how to guide individuals through the process of establishing their sexual identity and preferred sexual orientation.