Sleeping Disorders

Common disorders associated with sleep.

Bruxism: The sufferer involentarily grinds his or her teeth while sleeping
Delayed sleep phase syndrome (DSPS): a sleep disorder of circadian rhythm
Insomnia: Inability to fall asleep at will or at normal times
Jet lag or desynchronosis: Temporary condition resulting in out of sync sleep patterns as a result of rapidly
travelling across multiple time zones
Narcolepsy: The condition of falling asleep spontaneously and unwillfully
Night terror or Pavor nocturnus or sleep terror disorder: abrupt awakening from sleep with behavior consistent
with terror
Parasomnias: Include a variety of disruptive sleep-related events
Periodic limb movement disorder (PLMD): Involuntary movement of arms and/or legs during sleep
Rapid eye movement behavior disorder (RBD): Acting out violent or dramatic dreams while in REM sleep
Restless leg syndrome (RLS): An irresistible urge to move legs while sleeping. Often accompanies PLMD.
Sleep apnea: The obstruction of the airway during sleep
Sleep paralysis: Conscious paralysis upon waking or falling asleep
Sleepwalking or somnambulism: Engaging in activities that are normally associated with wakefulness (such as
eating or dressing), which may include walking, without the conscious knowledge of the subject
Snoring: Loud breathing patterns while sleeping, sometimes accompanying sleep apnea

Sleep and Circadian Rhythm Disorders

Circadian rhythm disorders are disruptions in a person's circadian rhythm -- a name given to the "internal body clock" that
regulates the (approximately) 24-hour cycle of biological processes. The term circadian comes from Latin words that literally
mean around the day. There are patterns of brain wave activity, hormone production, cell regeneration, and other biological
activities linked to this 24-hour cycle.
The circadian rhythm is important in determining sleeping patterns such as when we sleep and when we wake, every 24
hours.The normal circadian clock is set by the light-dark cycle over 24 hours.

Causes of Circadian Rhythm Disorders

Circadian rhythm disorders can be caused by many factors, including:
Shift work
Pregnancy
Time zone changes
Medications
Changes in routine such as staying up late or sleeping in
Medical problems including Alzheimer's or Parkinson disease
Mental health problems

Common Circadian Rhythm Disorders

Jet Lag or Rapid Time Zone Change Syndrome: This syndrome consists of symptoms that include excessive
sleepiness and a lack of daytime alertness in people who travel across time zones.
Shift Work Sleep Disorder: This sleep disorder affects people who frequently rotate shifts or work at night.
Delayed Sleep Phase Syndrome (DSPS): This is a disorder of sleep timing. People with DSPS tend to fall asleep
very late at night and have difficulty waking up in time for work, school, or social engagements.
 Advanced Sleep Phase Syndrome (ASPD): This is a disorder in which a person goes to sleep earlier and wakes
earlier than desired. ASPD results in symptoms of evening sleepiness, going to bed earlier (for example, between 6
p.m. and 9 p.m.), and waking up earlier than desired (for example, between 1 a.m. and 5 a.m.)
Non 24-Hour Sleep Wake Disorder: This disorder frequently affects those that are totally blind since the circadian
clock is set by light-dark cycle over a 24 hour period. In non-24 hour sleep wake disorder the cycle is disturbed. The
disorder result in drastically reduced sleep time and sleep quality at night and problems with sleepiness during
daylight hours.

Hunger & Weight Regulation: The Physiology of Hunger

Hunger and satiety are sensations. Hunger represents the physiological need to eat food. Satiety is the absence of
hunger; it is the sensation of feeling full. Appetite is another sensation experienced with eating; it is the desire to eat food.
Metabolism bodys rate of energy utilization
Two-thirds of energy used goes to support basal metabolism, the resting, continuous metabolic work of
body cells
Immediate energy supply information interacts with other signals to regulate food intake (hunger not necessarily
linked to immediate energy needs)
Homeostatic mechanisms are designed to prevent people from running low on energy in the first place (organisms
will not wait until last second to eat)
Many researchers believe in a set point, an internal physiological standard, around which body weight is regulated
(if weight is altered, homeostatic mechanisms will return body close to original weight)
Body has long term signals that adjust appetite and metabolism:
Signals that start and terminate a meal
Hunger not triggered by empty stomach
People with nerves cut to stomach or stomach surgically removed still reported feelings of hunger
Sensors in hypothalamus and liver monitor blood glucose concentrations
If glucose levels drop, liver converts stored nutrients back into glucose, producing a drop-rise
glucose pattern
Humans display a temporary drop-rise glucose pattern prior to experiencing hunger
Walls of stomach and intestine stretch while eating, send nerve signals to brain to indicate fullness
Nutritionally rich food can produce full feeling quicker than equal volume of less nutritious food
Patients with removed stomachs can still experience satiety due to chemical signals
CCK (cholecystokinin) released into blood after eating, stimulates receptors that decrease eating
Signals that regulate general appetite and weight
Fat cells secrete leptin (hormone that decreases appetite) to regulate food intake and weight
Doesnt directly cause fullness, but affects amount of satiety signals required
Obese people have ample leptin in blood due to fat mass, but brain appears insensitive to signals
Brain mechanisms
Many parts of brain play a role in regulating hunger and eating
Lateral hypothalamus triggers hunger
Ventromedial hypothalamus ends hunger
Both found to not directly affect only hunger, but other factors that would also affect it
Paraventricular nucleus (PVN) cluster of neurons packed with receptor sites for various transmitters that
stimulate or reduce appetite
When losing weight, less leptin secreted, transmitters for hunger become more active (explains
why dieting causes hunger)

Psychological Aspects of Hunger

Eating is positively reinforced by the good taste of food and negatively reinforced by hunger reduction
Beliefs about caloric content of food, and memory of when and how much we last ate also affect consumption
Amnesia patients accepted multiple lunches half four after each other, while non-amnesia did not
Attitudes, habits, and psychological needs also regulate intake
Women overestimate how thin they must be to meet mens standards, while men overestimated how bulky
they must be
Environmental and Cultural Factors
Food availability is most obvious environmental regulator of eating
Food taste and variety powerfully regulate eating
 Classical conditioning associates smell and sight of food with taste, triggering hunger
Obesity
Genes and environment
Heredity influences basal metabolic rate and tendency to store energy as fat or lean tissue
Genetic facots account for 40-70% of variation in body mass
Experts believe obesity is due to abundance of inexpensive, tasty, high fat foods, a cultural emphasis on
getting the best value (causing supersizing of menu items), and technological advances that decrease need
for daily physical activity
Dieting and weight loss
Being fat alters body chemistry and energy expenditure, priming people to stay fat
Obese people have higher insulin levels, which convert glucose to fat
Eating Disorders

There is a commonly held view that eating disorders are a lifestyle choice. Eating disorders are actually serious and often
fatal illnesses that cause severe disturbances to a persons eating behaviors. Obsessions with food, body weight, and
shape may also signal an eating disorder. Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-
eating disorder.

Anorexia nervosa
People with anorexia nervosa may see themselves as overweight, even when they are dangerously underweight. People
with anorexia nervosa typically weigh themselves repeatedly, severely restrict the amount of food they eat, and eat very
small quantities of only certain foods. Anorexia nervosa has the highest mortality rate of any mental disorder. While many
young women and men with this disorder die from complications associated with starvation, others die of suicide. In women,
suicide is much more common in those with anorexia than with most other mental disorders.
Symptoms include:
Extremely restricted eating
Extreme thinness (emaciation)
A relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight
Intense fear of gaining weight
Distorted body image, a self-esteem that is heavily influenced by perceptions of body weight and shape, or a denial
of the seriousness of low body weight
Other symptoms may develop over time, including:
Thinning of the bones (osteopenia or osteoporosis)
Mild anemia and muscle wasting and weakness
Brittle hair and nails
Dry and yellowish skin
Growth of fine hair all over the body (lanugo)
Severe constipation
Low blood pressure, slowed breathing and pulse
Damage to the structure and function of the heart
Brain damage
Multiorgan failure
Drop in internal body temperature, causing a person to feel cold all the time
Lethargy, sluggishness, or feeling tired all the time
Infertility
Bulimia nervosa
People with bulimia nervosa have recurrent and frequent episodes of eating unusually large amounts of food and feeling a
lack of control over these episodes. This binge-eating is followed by behavior that compensates for the overeating such as
forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors.
Unlike anorexia nervosa, people with bulimia nervosa usually maintain what is considered a healthy or relatively normal
weight.
Symptoms include:
Chronically inflamed and sore throat
Swollen salivary glands in the neck and jaw area
Worn tooth enamel and increasingly sensitive and decaying teeth as a result of exposure to stomach acid
Acid reflux disorder and other gastrointestinal problems
Intestinal distress and irritation from laxative abuse
Severe dehydration from purging of fluids
Electrolyte imbalance (too low or too high levels of sodium, calcium, potassium and other minerals) which can lead
to stroke or heart attack
Binge-eating disorder
People with binge-eating disorder lose control over his or her eating. Unlike bulimia nervosa, periods of binge-eating are not
followed by purging, excessive exercise, or fasting. As a result, people with binge-eating disorder often are overweight or
obese. Binge-eating disorder is the most common eating disorder in the U.S.
Symptoms include:
Eating unusually large amounts of food in a specific amount of time
Eating even when you're full or not hungry
Eating fast during binge episodes
Eating until you're uncomfortably full
Eating alone or in secret to avoid embarrassment
Feeling distressed, ashamed, or guilty about your eating
Frequently dieting, possibly without weight loss