Eating and Sleep-wake

Disorders

Zhaydee Tropia
Major Types of Eating Disorders
Bulimia Nervosa
• eating a larger amount of food—typically, more junk food than fruits and
vegetables—than most people would eat under similar circumstances.
• Just as important as the amount of food eaten is that the eating is
experienced as out of control.
• Another important criterion is that the individual attempts to compensate
for the binge eating and potential weight gain, almost always by purging
techniques.
• purging type (e.g., vomiting, laxatives, or diuretics) or nonpurging type
(e.g., exercise and/or fasting).

Medical Consequences
• One is salivary gland enlargement caused by repeated vomiting, which
gives the face a chubby appearance.
• Repeated vomiting also may erode the dental enamel on the inner surface of Associated Psychological Disorders
the front teeth as well as tear the esophagus. More important, continued • An individual with bulimia usually presents with
vomiting may upset the chemical balance of bodily fluids, including sodium additional psychological disorders, particularly
and potassium levels. anxiety and mood disorders.
Anorexia Nervosa
• Although decreased body weight is the most notable feature of
anorexia nervosa, it is not the core of the disorder. Many people
lose weight because of a medical condition, but people with
anorexia have an intense fear of obesity and relentlessly pursue
thinness.
• two subtypes of anorexia nervosa: In the restricting type,
individuals diet to limit calorie intake; in the binge eating–
purging type, they rely on purging. Unlike individuals with
bulimia, binge-eating–purging anorexics binge on relatively small
amounts of food and purge more consistently, in some cases each
time they eat.
• Individuals with anorexia are never satisfied with their weight
loss. Staying the same weight from one day to the next or gaining
any weight is likely to cause intense panic, anxiety, and
Medical Consequences
depression. • One common medical complication of anorexia nervosa is
cessation of menstruation (amenorrhea), which also occurs
relatively often in bulimia.
 • Other medical signs and symptoms of anorexia include dry
skin, brittle hair or nails, and sensitivity to or intolerance of
cold temperatures. Also, it is relatively common to see
lanugo, downy hair on the limbs and cheeks.

Associated Psychological Disorders

• As with bulimia nervosa, anxiety disorders and mood
disorders are often present in individuals with anorexia.

Binge-Eating Disorder
• Binge eating disorder (BED) is a severe, life-threatening,
and treatable eating disorder characterized by recurrent
episodes of eating large quantities of food (often very
quickly and to the point of discomfort); a feeling of a loss
of control during the binge; experiencing shame, distress Causes of Eating Disorders
• Biological, psychological, and social factors contribute to the
or guilt afterwards.
development of these serious eating disorders. The evidence is
increasingly clear, however, that the most dramatic factors are
social and cultural.
Social Dimensions • This may manifest as strikingly low self esteem They
• For many young women, looking good is more important than also display more perfectionistic attitudes, perhaps
being healthy. For young females in competitive environments, learned or inherited from their families, which may
self-worth, happiness, and success are largely determined by reflect attempts to exert control over important events
body measurements and percentage of body fat, factors that in their lives.
have little or no correlation with personal happiness and
success in the long run. The cultural imperative for thinness Treatment of Eating Disorders
directly results in dieting, the first dangerous step down the Drug Treatments
slippery slope to anorexia and bulimia. • At present, drug treatments have not been found to
Biological Dimensions be effective in the treatment of anorexia nervosa.
• Like most psychological disorders, eating disorders run in • On the other hand, there is some evidence that drugs
families and thus seem to have a genetic component. may be useful for some people with bulimia,
Psychological Dimensions particularly during the bingeing and purging cycle.
• Clinical observations over the years have indicated that many The drugs generally considered the most effective for
young women with eating disorders have a diminished sense of bulimia are the same antidepressant medications
personal control and confidence in their own abilities and proven effective for mood disorders and anxiety
talents. disorder.
Psychological Treatments • The first is binge eating, and the second is night eating
• psychological treatments for people with eating disorders were syndrome
directed at the patient’s low self-esteem and difficulties in • Individuals with night eating syndrome consume a
developing an individual identity. Disordered patterns of family third or more of their daily intake after their evening
interaction and communication were also targeted for treatment. meal and get out of bed at least once during the night to
• Short-term cognitive-behavioral treatments target problem have a high-calorie snack. In the morning, however,
eating behavior and associated attitudes about the overriding they are not hungry and do not usually eat breakfast.
importance and significance of body weight and shape, and These individuals do not binge during their night eating
these strategies became the treatment of choice for bulimia. and seldom purge.

Obesity Causes
• abnormal or excessive fat accumulation that presents a risk to Henderson and Brownell (2004) make a point that this
health. obesity epidemic is clearly related to the spread of
Disordered Eating Patterns in Cases of Obesity modernization. In other words, as we advance
• There are two forms of maladaptive eating patterns in people technologically, we are getting fatter. That is, the promotion
who are obese. of an inactive, sedentary lifestyle and the consumption of a
high-fat, energy-dense diet is the largest single contributor
to the obesity epidemic.
 Sleep–Wake Disorders: The Major Dyssomnias
Treatments Dyssomnias involve difficulties in getting enough sleep,
• Treatment is usually organized in a series of steps from least problems with sleeping when you want to (not being able to
intrusive to most intrusive depending on the extent of fall asleep until 2 a.m. when you have a 9 a.m. class), and
obesity. The first step is usually a self directed weight-loss complaints about the quality of sleep, such as not feeling
program in individuals who buy a popular diet book. refreshed even though you have slept the whole night.
Furthermore, these books do little to change lifelong eating Parasomnias are characterized by abnormal behavioral or
and exercise habits and few individuals successfully achieve physiological events that occur during sleep, such as
long-term results on these diets.
nightmares and sleepwalking.
• The next step is commercial self-help programs such as
• The clearest and most comprehensive picture of your
Weight Watchers and Jenny Craig. Weight Watchers reports
sleep habits can be determined only by a
that, in 2014, more than 800,000 people attended more than
polysomnographic (PSG) evaluation
36,000 meetings weekly around the world (Weight Watchers
• Actigraph- This instrument records the number of arm
International, 2014). These programs stand a better chance of
movements, and the data can be downloaded into a
achieving some success, at least compared with self-directed
computer to determine the length and quality of sleep.
programs.
 • People are considered to have insomnia if they have
Insomnia Disorder trouble falling asleep at night (difficulty initiating
Insomnia is one of the most common sleep–wake disorders. You sleep), if they wake up frequently or too early and can’t
may picture someone with insomnia as being awake all the time. go back to sleep (difficulty maintaining sleep), or even
if they sleep a reasonable number of hours but are still
not rested the next day (nonrestorative sleep).
 Another sleep problem that can cause a similar excessive
Hypersomnolence Disorders sleepiness is a breathing-related sleep disorder called sleep
• Insomnia disorder involves not getting enough sleep (the apnea. People with this problem have difficulty breathing
prefix in means “lacking” or “without”), and at night. They often snore loudly, pause between breaths,
hypersomnolence disorders involve sleeping too much and wake in the morning with a dry mouth and headache.
(hyper means “in great amount” or “abnormal excess”).
Narcolepsy
In addition to daytime sleepiness, some people with
narcolepsy experience cataplexy, a sudden loss of muscle
tone. Cataplexy occurs while the person is awake and can
range from slight weakness in the facial muscles to
complete physical collapse. Cataplexy lasts from several
seconds to several minutes; it is usually preceded by strong
emotion such as anger or happiness.
Breathing-Related Sleep Disorders
• People whose breathing is interrupted during their sleep often
experience numerous brief arousals throughout the night and do not
feel rested even after 8 or 9 hours asleep. For some, unfortunately,
breathing is constricted a great deal and may be labored The second type of apnea, central sleep apnea,
(hypoventilation) or, in the extreme, there may be short periods (10 involves the complete cessation of respiratory activity
to 30 seconds) when they stop breathing altogether, called sleep for brief periods and is often associated with certain
apnea. central nervous system disorders, such as cerebral
There are three types of apnea: vascular disease, head trauma, and degenerative
Obstructive sleep apnea hypopnea syndrome
disorders.
occurs when airflow stops despite continued activity by the respiratory
system.
 Circadian Rhythm Sleep Disorder
• This disorder is characterized by disturbed sleep
(either insomnia or excessive sleepiness during
the day) brought on by the brain’s inability to
synchronize its sleep patterns with the current
patterns of day and night.

The third breathing disorder, sleep-related hypoventilation, is a

decrease in airflow without a complete pause in breathing.
 • Preventing Sleep Disorders Sleep professionals
Treatment of Sleep Disorders
generally agree that a significant portion of the
• medical treatments
sleep problems people experience daily can be
• environmental treatments
prevented by following a few steps during the
• psychological treatments
day. Referred to as sleep hygiene, these changes
in lifestyle can be relatively simple to follow and
can help avoid problems such as insomnia for
some people.
Parasomnias and Their Treatment
Nightmares (or nightmare disorder) occur during REM or
dream sleep. To qualify as a nightmare disorder, according to
DSM-5 criteria, these experiences must be so distressful that
they impair a person’s ability to carry on normal activities
(such as making a person too anxious to try to sleep at night).
• Nightmares are defined as disturbing dreams that awaken
the sleeper; bad dreams are those that do not awaken the
person experiencing them.
Disorder of arousal includes a number of motor movements
and behaviors during NREM sleep such as sleepwalking, sleep
terrors, and incomplete awakening.
Sleep terrors, which most commonly afflict children, usually
begin with a piercing scream.
Sleepwalking (also called somnambulism) occurs during
NREM sleep. It occurs during the deepest stages of sleep.
Thank you!