Sleep Disorders
4.5 Do you have
- Sleepwalking?
Somnambulism: occurs normally in children and adolescents: in stage III or IV of NREM sleeps Psychopathology may be found if the episodes begin or persist into adulthood
- frightening or "bad" dreams?
- With detailed dream recall?
Nightmares: occur during REM sleep: in adolescence and adulthood: recur- rent nightmares are suggestive of psychopathologic causes
- without recall of the episode?
Night terrors: psychopathology suspected if onset is in adulthood
5 Iatrogenic Factors See Etiology
5.1 Do you use hypnotics? Sedatives? Tranquilizers?
- Regularly and chronically?
As tolerance develops with continuous use, the sleep promoting properties of such drugs arc lost
5.2 Have you recently stopped using hypnotics?
Withdrawal from hypnotic agents may cause both insomnia and nightmares
6. Personal and Social Profile
6.1 What is your consumption or alcohol?
Heavy and sustained ingestion of alcohol severely disrupts sleep-stage organization: REM sleep periods are short-ened and nightly awakenings occur. In the abstaining alcoholic, abnormal sleep Patterns may persist for many weeks
6.2 Have your sleep difficulty affected your work or social life?
Insomniacs may avoid family and social interactions by insisting they are too tired
7 Personal Antecedents Pertaining to the Insomnia
7.1 Do you have?
- Personal, familial, professional problems?
- A psychiatric condition?
Psychoneuroses and psychoses commonly produce sleeplessness
- Paroxysmal nocturnal dyspnea? Nocturnal asthma? A rheumatic illness? a gastrointestinal illness?