Environmental Factors And Target Group Of Non-Rapid Eye Movement Sleep Arousal Disorders Research Paper Samples
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The research paper investigates Non-rapid eye movement sleep arousal disorders, its symptoms, causes, historical overview, treatment, preventive measures, cultural and Biblical worldview. The target group described in the introduction and environmental factors in causes are the main topics of the paper which serve as a basis. The following abbreviations are applied in the work: NREM – Non-rapid eye movement, REM stages – rapid eye movement stages.
Non-rapid eye movement sleep arousal disorder is included into parasomnias (category of sleep disorders) and is currently mostly observed in 10-30% of population, from which a great majority are children in the age of 6-16; the cases become less frequent with the growing age of a person (Pressman, 2011). The disorder happens during the NREM stage which consists of 1-3 sleep stages during which dreaming is rare and body muscles of the dreaming individual are not paralyzed unlike REM stages. Some people experience only NREM sleep during the night and because of the fact that his/her muscles are not paralyzed, an individual can physically walk about. NREM sleep arousal disorder describes incomplete awakening while sleeping which includes sleepwalking or sleep terrors in different individuals. One episode of such disorder normally lasts for several minutes up to half an hour after which the sleepwalk individual returns to bed in most cases; the individual can only partially recollects the episodes or in the majority of cases do not recollect them at all (Moorcroft, 2013). During sleepwalking, an individual rises from his bed and walks around the room, walks out of his/her room, sometimes apartment and even building; usually, there have been reported cases of regular casual actions people were doing while sleepwalking, for example, eating food, sometimes it may be something uneatable, or using water closet but there are also reports from the patients which give evidence of more complex motor behavior during the sleepwalking, like, unlocking the door or doing some exercises. People suffering from the disorders usually sit quietly not intending to do anything or walk about but there are cases in the history of illness when an individual want furious and could make harm to anything or anyone. During sleepwalk an individual has a blank and unmoving face with usually opened eyes; he/she also is unresponsive at another person’s trying to tell him something or stop. It is as well extremely difficult for another person to comfort or awake the individual walking about. Sleep terrors is a type of NREM sleep arousal disorders when an individual arouses from sleep with panicky scream, frightened and with symptoms of complex breathing disorders; the individual is hard to comfort during such episodes. Psychologists have been trying to investigate and determine the reasons of NREM sleep arousal disorders for centuries. Various assumptions are present for the present time but what is the main reason of the arising of such disorder and can it be prevented? May it be environmental factor that influences psychological disorder and why does it normally observed in children rather than in adults?
II. Historical Overview
History of the disorder may be traced back to Egyptian society in which people could experience insomnia and the cases of sleepwalk occurred. It is in that time when people became partially aware of the sleeping processes but due to the lack of technical equipment and other privileges accessible now, they couldn’t investigate symptoms of sleep disorders, reasons of their appearance and prevention measures, so Egyptians used opium as a hypnotic drug substance. Further investigations of NREM sleep arousal disorders were conducted by such scientists as Robert MacNish, Roger Broughton, Henri Pieron, etc. who have written works based on the conducted investigations which became essential for further development of investigation process of the disorder. Among them, Dr. Brought made the most valuable contribution into the science of Psychology in the area of sleep disorders: he has always been concerned by the stage between the wakefulness and sleep and great discoveries in the field answering the questions of the most scientists.
III. Causes of the Illness
Both in children and adults NREM sleep arousal disorders may be observed as a result of taking medical drugs. Genetic predisposition plays very important role in the disorder and may be cause of its appearance. Out of sleepwalking individuals 80% have genetic predisposition to the disorder (Poceta, 1998). The factor of immaturity of psychological system may be regarded in the list of causes of NREM sleep arousal disorders. The fact the disorders are normally observed in most cases in children who are physically as well as psychologically immature, and therefore, unlike adults, are more attributable to fear and different unknown emotions to them which they experience more intensely due to lack of such experiences. This can explain the occurrence of the disorder in children. Biological factor is another important element of the occurrence of sleep arousal disorders. Improper regime results in interruption of the biological rhythm. Sleep disorders can be explained by psychological disturbance during the day, for example, stress. The environmental factor can be definitely mentioned as the main one in the list of causes of NREM sleep arousal disorders as life situations of different people in which they live differ a lot; this can include, but not limited to family relationships, work status, social importance and quantity of friends who ensure communication to an individual, sexual relationships, presence of the life goal and its implementation (Russell, 2013). Psychological stability of a person depends mostly on all the abovementioned factors; lack of them or insufficient presence of those influences a person’s psychology which may result then in night manifestations. People can also start sleepwalking after injuring head, having constant headaches, sleeping in unfamiliar surroundings, travelling, having high fever and using tobacco and alcohol in a great amount.
IV. Treatment and Recommendations
NREM sleep arousal disorders observe various behaviors during sleepwalk and also episodes occur in different time after people fall asleep. These and several other factors have to be taken into account by sleepwalking individual (or by parents, in case with a child), who decided to address his/her problem and try to avoid the disorder. The episodes have to be reported distinctly and consequently mentioning all the details of them. Sleep disorders may be diagnosed with the help of several methods such as polysomnography, in-laboratory sleep study allowing the investigators to determine type of disorder observing symptoms in an individual; electroencephalogram which shows brain’s spontaneous electrical activity (Stolerman, 2010). There are some recommendations to people from the surrounding of the individuals suffering from NREM sleep arousal disorder which include: closing doors and windows so that an individual could not walks out of the building, setting alarm systems for people with deep sleep; when an individual sleepwalks, surrounding people should not try to waken him/her as the patient may be harmed psychologically, be frightened and not understand where he/she is; or the aggressive behavior may also be demonstrated in such case, a person should direct the individual to bed place holding him/her gently by the elbow and talking softly. If the individual does not remember episodes in the next morning, it is better not to tell him/her about the incidence with the purpose of avoiding causing additional anxiety in the patient. Also, it is recommended that a sleep arousal disorder sufferer (or parents) put a mattress on the floor; it is rather hard for a sleeping person to get out of bed when it the bed in the lowest level. The cases are quite different and, therefore, require different methods of treatment, though there are some common approaches to treatment of NREM sleep arousal disorders. More than 90% of all children tend to outgrow sleepwalk and sleep terrors, predominantly, by the age of 16 but in separate cases the treatment is needed (Berry, 2012). The first that has to be applied to avoid the disorder are non-pharmacological measures including active exercises before sleeping, drinking caffeine-containing beverages, try to schedule the time when the individual goes to bed; if the time when an individual rises is predicted, surrounding people have to waken the patient in order to prevent the incident and in such a manner lessen further cases; avoid situations where the level of anxiety may be increased (Ferber, 1985). Medications may only be applied in case of potential threat to the patients or other people. Among the medications which have been applied and reported to be effective are benzodiazepines and tricyclic antidepressants. Parents may also give to children low-dose clonazepam (start treatment from 0,25 mg an hour before sleeping and may be increased with attention to manifestation of the syndromes with treatment duration of 3-6 weeks) (Shatkin, 2009).
V. Prevention of NREM Sleep Arousal Disorders
Preventive measures of the sleep disorder include decreasing use of caffeine-containing beverages, limiting food and water consumption before sleeping, decreasing tobacco and alcohol, avoiding stresses and anxieties during the day. Second that can be done to avoid the disorder is scheduling bedtime and going to bed every day at the same time, also, sleeping conditions have to be comfort and usual. Individuals may also consult with psychiatrist and undergo the course of psychotherapy if they experienced a strong stress or are aware of the anxiety caused by some events or situations. Sufferers from sleepwalk also should not use medications, especially, before going to bed (Engdahl, 2011). There were also reports from patients that children sleepwalked at night when they shared bed with another child. Some doctors also advise that the individual kept bed for sleeping, that is didn’t use it during the day time, or, at least, bed cloths; this will teach the body that the bed is for sleeping not for walking, so here the psychological factor acts again.
VI. Cross Cultural Issues of the Illness
Cross-cultural issues of NREM sleep arousal disorders presuppose distinction between people of different origin in experiencing this type of sleep disorders. Statistics composed on the basis of investigations had to determine levels of occurring NREM sleep arousal disorders by race. Occurrence of NREM sleep arousal disorders is rather influenced by lack of comfort of sleeping area, environmental situation which results in psychological response including anxiety, depressive state, anger, etc.; also, consumption by an individual big amount of alcohol, tobacco, caffeine-containing beverages, absence of regular sleeping regime and rise of activity before sleeping time are quite causes of the illness. Sleeping conditions is one of the major preventing majors of sleep out of non-pharmacological treatments. Such conditions may vary depending on possibilities of the surrounding community and conditions in which people live. Level of richness of a country can be a predicating factor in mass manifestation of NREM sleep arousal disorders in children. Asian countries with poor economics are predominant by the quantity of children experiencing sleep disorders. Most children in Asian countries sleep together and, therefore, frequently sleepwalk because of irregular regime and unfavorable conditions. All the abovementioned factors matter much in the periodization of occurrence of symptoms of the disorder but the race and ethnicity can only be an important cause NREM sleep arousal disorders as it was reported in the Associated Professional Sleep Societies annual meetings in Boston. The scientists say that blacks and Asians tend to experience the disorder more frequent that the whites do; also, it was stated that foreign-born Americans had lower tendency of occurrence of the psychological illness than those born in the United States. The mentioned data gives evidence to presence of the meaning of ethnical factor in occurrence of NREM sleep arousal disorders.
VII. Biblical Worldview on the Illness
It should be mentioned that from the very beginning religion does not admit mental disorders, only several of them can be mentioned in the list of the disorders the Bible admits: these are chemical disorders and brain gene inheritance, damage and tumors. All the other disorders considered by the Psychology as illnesses are not regarded as illnesses by the Bible. From the Christian point of view sleep was God’s idea and, consequently, it could not be started in such a way that the sleeper could go somewhere at night, and even in some cases harm surrounding people. Thus, in the perspective that the Bible excludes the psychological factor and influence of any environmental situations in the occurrence of NREM sleep arousal disorders, it should be stated that the Bible does not admit the illness under analysis and investigation. The Christian worldview on the disorder is rather negative than positive as sleep goes not like God created it. Because of this NREM sleep arousal disorder is regarded as diabolizing of an individual sleepwalking and something unholy. It is recommended by the Christianity that the individual go to church and pray so that all those things could go out of him/her.
Having researched and analyzed symptoms, causes, treatment, prevention, cross-cultural issues and biblical point of view on NREM sleep arousal disorders it can be concluded that the target group of the illness are children aged 6-16 and this can be explained by their psychological immaturity and fluctuation which results in constant stresses and anxieties which then find their manifestation in night sleep arousals. In most cases, the illness disappears by itself, and in case of necessity, it is curable by non-pharmacological treatment measures as well as by applying drug antidepressants. The main cause of occurrence of NREM sleep arousal disorders is environmental factor which presupposes social community and conditions in which the individual lives. Occurrence of NREM sleep arousal disorders is attributed to psychological health of an individual, and the last one depends on socio-economic status of a person, relationships with the colleagues, family members and other people of his/her surroundings. In order to prevent the illness, an individual can set his/her own sleep regime; reduce consumption of alcohol, tobacco, caffeine-containing beverages and following some other common recommendations. In case of occurring of the illness in children, alarm can be placed on the room door, child may sleep on mattress, not drink and eat before the bedtime and not do active physical exercises. NREM sleep arousal disorder is a spread type of illnesses which is observed in a big amount of children and less adults. The researches made a great contribution into the investigation of this disorder but there still remain uninvestigated fields in this area. The environmental factors can be divided into categories and studied closer in order to determine certain situations in which an individual can experience anxiety resulting in sleep disturbance illnesses.
Berry, R. (2012). Fundamentals of sleep medicine. Philadelphia: Elsevier/Saunders.
Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association.
Engdahl, S. (2011). Sleep disorders. Detroit: Greenhaven Press.
Ferber, R. (1985). Solve your child's sleep problems. New York: Simon and Schuster.
Moorcroft, W. (2013). Understanding sleep and dreaming (2nd ed.). New York: Springer.
Poceta, J. (1998). Sleep disorders: Diagnosis and treatment. Totowa, N.J.: Humana Press.
Pressman, M. (2011). Parasomnias. Philadelphia, PA: Saunders.
Russell, J. (2013). Non-rapid eye movement sleep. S.l.: Book On Demand.
Shatkin, J. (2009). Pediatric sleep disorders. Philadelphia, Pa.: Saunders.
Stolerman, I. (2010). Encyclopedia of psychopharmacology. Berlin: Springer.
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