SLEEP DISORDERS

Mety Tri Nurnuzulawati., S.Psi., M.Psi, Psikolog

The transition phase from consciousness to sleep is called the predormitium and the transition phase from sleep back to consciousness is called the postdormitium. The medical science that studies sleep disorders is called somnology.

Sleep is relatively sensitive to all kinds of emotional disturbances that an individual may experience and disturbances in sleep patterns, especially in children, are the earliest indication that emotional tension will increase. Although sleep habits vary greatly according to each individual, certain sleep symptoms can be clearly identified as disorders. The most important symptoms include somnambulism, nightmares and sleep terrors, narcolepsy and insomnia.

SOMNAMBULISM

Somnambulism or what is also called sleep-walking is a reaction where an individual is in a dream-like state of wandering or walking around and carrying out certain activities, but cannot remember them again when conscious. Individuals with somnabulism get out of bed with their eyes half-open or open, but are unconscious and appear to be trying to achieve a particular goal. He avoids any obstacles that could harm him, and will even answer all questions and orders given to him while he remains asleep. If he hears a sound that is too loud or touches hot or cold objects, he can wake up, become confused, shy and go back to sleep in his original place.

Somnabulism patients are classified into two types, namely monodeic and polydeic. Monodeic somnabulism patients always carry out somnabulistic behavior related to only one idea so that their behavior is always the same. Meanwhile, polydeic somnabulism patients are always disturbed by different ideas so that their behavior also varies at different times.

Causes of Somnabulism

In general, somnabulism is caused by the following things:

1) There is an experience in the form of emotional shock that has not been resolved and which results in dissociation. Dramatically, this experience is repeated while the person concerned is sleeping.

2) Attempts to symbolically resolve conflict situations which are often related to sexual fantasies and masturbation

3) Efforts in sleep to act out the contents of dreams

4) When sleeping, somnabulism sufferers are usually dominated by one idea, which they are no longer aware of when they wake up. Almost all somnabulism sufferers show symptoms of anxiety, worry, fatigue and emotional instability.

NIGHTMARES AND SLEEP TERRORS (Nightmares and Night Terrors)

Even though they are similar, the two sleep disorders are not identical. Distinguishing nightmares from sleep terrors, namely by paying attention to the clinical picture that is typical for each of these disorders.

The following clinical features are essential for the definitive diagnosis of nightmares, namely:

1) Waking up from a night's sleep or nap related to a frightening dream that can be recalled in detail and clearly, usually about a threat to survival, security or self-esteem

2) After awakening from a frightening dream, the individual immediately wakes up and is able to recognize his environment

3) The dream experience and the resulting disturbed sleep, causes considerable suffering for the individual.

Sleep terrors are frightening states that appear during sleep, accompanied by screaming, sweating, thrashing, crying, or even hallucinations. Sleep terrors and somnabulism are closely related, both having the same clinical and pathophysiological characteristics. The individual rarely regains consciousness spontaneously and even when semi-conscious he is unaware of his surroundings and cannot be calmed while the attack is ongoing. The clinical picture is as follows:

1) The main symptoms are one or more episodes of waking up from sleep, starting with screaming in panic, accompanied by intense anxiety, whole body shaking and autonomic hyperactivity such as heart palpitations, rapid breathing, dilated pupils and sweating.

2) This episode can recur and the duration of each episode ranges from 1-10 minutes and usually occurs in the first third of the night's sleep

3) Relatively unresponsive to various other people's attempts to influence his sleep terror state and then within a few minutes after waking up there is usually disorientation and repetitive movements

4) Memory for events is very minimal (usually limited to one or two discrete images.

5) There is no evidence of organic mental disorder

NARCOLEPSY

Daytime sleepiness (during waking hours) which often leads to sleeping for several minutes or even hours, which cannot be explained as a result of lack of sleep at night is called narcolepsy (narco = numbness, lepsy = attack). The attacks of drowsiness come suddenly and are unbearable so that people fall asleep. Sufferers tend to smile and talk while sleeping.

INSOMNIA AND SLEEP APNEA

A common sleep disorder is insomnia. Insomnia is a sleep disorder in which a person consistently has difficulty falling asleep or wakes up too quickly. It may appear only sporadically as a reaction to emotional outbursts or emotional disturbances, or it may occur as a characteristic of an individual's relatively fixed sleep pattern. Insomnia is sometimes also related to physical conditions, such as extreme fatigue, changes in sleeping equipment, changes in the main daily diet, and also excessive use of stimulants. Insomnia is often seen as a symptom of adults, but is also found in children, and if it persists it should be seen as a serious emotional disorder.

A serious sleep disorder that is more difficult to treat is sleep apnea, where breathing stops temporarily. This is what causes people to snore when they sleep and is one of the causes of sudden infant death syndrome (SIDS) or "crib death". Sleep apnea occurs because the respiratory tract is blocked or the brain stops sending signals to the diaphragm which causes breathing to stop. This respiratory tract disorder is sometimes related to obesity, so sleep apnea can be cured by dieting.