4.4-4.6

• Insomnia


  A consistent difficulty in falling or staying asleep
• Insomnia is the most common of the sleep disorders
• Insomnia


  • Individuals experience long delays between the times that they go to bed and actually fall asleep
  • Individuals may wake up several times during the night only to find that they have difficulty getting back to sleep
  • Symptoms occur for at least three nights a week for at least one month's time
• Increased anxiety about inability to fall asleep

  Leads to increased arousal, and higher levels of arousal make the prospect of falling asleep even more unlikely
• Chronic insomnia


  Almost always associated with feeling overtired and may be associated with symptoms of depression
• Factors that may contribute to insomnia

  • Age
  • Drug use
  • Exercise
  • Mental status
  • Bedtime routines
• Cognitive-behavioral therapy


  A type of psychotherapy that focuses on cognitive processes and problem behaviors, including stress management techniques and changes in problematic behaviors that could contribute to insomnia
• Cognitive-behavioral therapy has been demonstrated to be quite effective in treating insomnia
• Parasomnia


  One of a group of sleep disorders in which unwanted, disruptive motor activity and/or experiences during sleep play a role
• Parasomnias


  • Sleepwalking
  • Restless leg syndrome
  • Night terrors
• Sleepwalking


  The sleeper engages in relatively complex behaviors ranging from wandering about to driving an automobile, often with eyes open but unresponsive to communication
• Sleepwalking most often occurs during slow-wave sleep, but it can occur at any time during a sleep period in some affected individuals
• Sleepwalking is not alleviated with the use of benzodiazepines, but can be decreased when sleep-related breathing problems are effectively treated
• REM sleep behavior disorder (RBD)


  Occurs when the muscle paralysis associated with the REM sleep phase does not occur, leading to high levels of physical activity during REM sleep, especially during disturbing dreams
• People who suffer from RBD can injure themselves or their sleeping partners when engaging in the behaviors
• Substance use disorders


  Addictive disorders where a person uses more of a substance than they originally intended and continues to use despite adverse consequences. Involves both physical and psychological dependence.
• Physical dependence


  Changes in normal bodily functions, user will experience withdrawal from the drug upon cessation of use
• Psychological dependence


  Emotional, rather than physical, need for the drug, may use the drug to relieve psychological distress
• Tolerance


  Person requires more and more drug to achieve effects previously experienced at lower doses
• Drug withdrawal


  Negative symptoms experienced when drug use is discontinued, usually opposite of the effects of the drug
• Drug categories


  • Stimulants
  • Sedative-Hypnotics ("Depressants")
  • Opiates
  • Hallucinogens
• Stimulants


  • Increase overall levels of neural activity, often act as agonists of the dopamine neurotransmitter system
• Stimulants


  • Cocaine
  • Amphetamines (including some ADHD medications such as Adderall)
  • Methamphetamines
  • MDMA ("Ecstasy" or "Molly")
• Sedative-Hypnotics ("Depressants")


  • Suppress central nervous system activity, act as agonists of the GABA neurotransmitter system
• Sedative-Hypnotics ("Depressants")


  • Alcohol
  • Barbiturates
  • Benzodiazepines
• Opiates


  • Decrease pain, pupil constriction, decreased gut motility, decreased respiratory function
• Hallucinogens


  • Increase heart rate and blood pressure, cause mild to intense perceptual changes
• Alcohol and other depressants act as agonists of the GABA neurotransmitter system, which has a quieting effect on the brain
• Acute alcohol administration results in feelings of euphoria at low doses, sedation at higher doses, and can lead to complete loss of consciousness and/or memory loss
• Repeated use of central nervous system depressants like alcohol can lead to physical and psychological dependence, and withdrawal can be life-threatening
• Stimulants act as agonists of the dopamine neurotransmitter system, which is associated with reward and craving
• Cocaine and amphetamines block the reuptake of dopamine, leading to increased dopamine activity in the synapse
• Methamphetamine is a highly addictive form of amphetamine that can be easily manufactured from common ingredients
• Stimulant users seek a euphoric high, but repeated use can lead to depletion of neurotransmitters and compulsive use
• MDMA (also known as "Molly")


  A mild stimulant with perception-altering effects, typically consumed in pill form. Users experience increased energy, feelings of pleasure, and emotional warmth.
• Repeated use of these stimulants can have significant adverse consequences
• Adverse effects of stimulant use

  • Physical symptoms that include nausea, elevated blood pressure, and increased heart rate
  • Feelings of anxiety, hallucinations, and paranoia
• Normal brain functioning is altered after repeated use of these drugs
• Depletion of neurotransmitters


  Can lead to mood dysphoria, cognitive problems, and compulsive use of stimulants to reestablish the person's physical and psychological pre-use baseline
• Caffeine


  A stimulant drug that is probably the most commonly used drug in the world, but less potent than other stimulant drugs