Sleep Disorders

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More than half of all patients with psychiatric disorders report disturbances of sleep and wakefulness. "Sleep disorders are associated with impaired daytime function and predict a heightened future vulnerability to psychiatric disease. They also diminish life span.” Details from an expert here.

This brief review addresses what is currently known about sleep problems in women. The main focus is on sleep issues that are particularly relevant to reproductive stages in a woman’s life cycle and therefore potentially linked to reproductive and/or hormonal factors.

Can you name an important part of good sleep hygiene? The use of which short-acting sedative-hypnotics to treat sleep disturbances in patients is associated with Alzheimer disease? These questions and more.

Substance Abuse Quiz

Are a history of complicated pneumonia and possible obstructive sleep apnea part of the DSM-IV exclusionary criteria for potential participants in anesthesia-assisted opioid withdrawal? How many alcoholic drinks a week does it take for a woman to be considered an at-risk drinker? These and more in this week's quiz.

During my medical training in the early 1980s, I attended a Grand Rounds on health care reform. Sleep-deprived physicians-in-training are easily conditioned to snooze upright in their auditorium seats, and economics is not an interest of choice for me, but when the speaker told us that there would be no solution to rising health care costs except to fracture the bond between patient and doctor, I found myself engaging in nightmarish fantasies that in subsequent decades have come true.

Pediatric bipolar disorder (PBD) is a serious psychiatric illness that impairs children’s emotional, cognitive, and social development. PBD causes severe mood instability that manifests in chronic irritability, episodes of rage, tearfulness, distractibility, grandiosity or inflated self-esteem, hypersexual behavior, a decreased need for sleep, and behavioral activation coupled with poor judgment. While research in this area has accelerated during the past 15 years, there are still significant gaps in knowledge concerning the prevalence, etiology, phenomenology, assessment, and treatment for PBD.

Depression is an insidious, ugly beast, creeping into the mind over time until one is engulfed and powerless, feeling only a sense of futility and heaviness. In my case it came some months after I had had to retire from a fruitful and enjoyable academic neurodevelopmental pediatrics practice, because of onset of a degenerative neuromuscular disease. My depression was manifested mainly by weight loss, poor affect, anger and irritability, fitful sleep, and thoughts of suicide. Luckily, my primary physician recognized the signs immediately and recommended both pharmacotherapy and psychotherapy. For both therapies and for this physician, I am extremely grateful. However, in this essay, I will speak of the ways I experienced psychodynamic psychotherapy and its ramifications into many parts of my life.