There are a number of theories regarding the purpose of sleep. “Sleep may provide a period of restoration in which deficits in somatic and central nervous system tissues are repaired.” (Netherton, Holmes, & Walker, 1999, p. 415) What I question is… wouldn’t we be able to detect that process (cellular creation/division)?
It has been suggested that sleep facilitates information processing and memory consolidation. This, too, seems plausible given the effects of sleep deprivation. “Fatigue, excessive sleepiness, decreased attention, decline in perceptual, cognitive, and psychomotor capabilities and performance, regressive behavior, and disoriented though may result from prolonged sleep deprivation. (Netherton et al., 1999, p. 415)
The “cycle of sleep” is a concept I found helpful to be able to conceptualize the process that takes place during sleep.
“While psychopathology is often comorbid with sleep disorders in adults, it is rarely so in children.” (Netherton et al., 1999, p. 420) NHW throws this out as a fact, but they don’t really give a reason why that is the case?
With regard to assessment, I very much approve of the use of sleep diaries as an effective way to document the course of events in a sleep-wake cycle. We currently employ this tool with a couple clients of mine with a great deal of success. One individual, in particular, had to take “the long way around” (which was particularly hard for the night staff I might add) but eventually we got them on a schedule that was amiable for all.
“Treatment of sleep disorders is designed to address both the symptoms and the causal factors of the disturbance; therefore, it is essential to cast a broad net in assessment to identify the likely etiology of a sleep disruption.” (Netherton et al., 1999, p. 420) I’m not sure it can be said better than that, great piece of writing in my opinion.
With insomnia, you sleep too little… with hypersomnia, you sleep too much. Just FYI.
With regard to treatment, it would appear that the first and most important step is to regulate sleep hygiene. This means we set and enforce a bedtime routine, and we foster the development of an environment that is conducive to sleep. Eating and drinking (especially liquids that contain caffeine) should be limited close to bedtime. (Netherton et al., 1999, p. 428) We should assess all medications and determine if any possess stimulant qualities. A “bedtime ritual” should be established and adhered to, including grooming and personal hygiene, flossing and brushing teeth, and using the bathroom. Although this may be the case for some people, I personally disagree with the concept that bathing is a stimulant. Personally, I have difficulty sleeping if I don’t bathe at night… it’s relaxing. Matter of fact, sitting in the hot tub on a cold winter night is the sure fire way to make sure I get a great night of sleep.
I was also particularly interested in the relaxation training suggestion. One method in particular that I was taught as a child, and that I endorse, is conceptualizing first that your lower extremities (starting with your feet) are “falling asleep.” I progressively work my way “up” until I reach my head. Usually, but the time I get to my arms, I am out like a light. Mileage may vary, but it is one relaxation technique that worked for me as a kid.
Netherton, S. D., Holmes, D., & Walker, C. E. (1999). Child and adolescent psychological disorders: A comprehensive textbook. Oxford, NY: Oxford University Press.