15

Sleeping Disorder
Tutor: dr. Nesyana N, M.Gizi

1. What is the Classification of

Somatoform Disorders
Dyssomnias
Intrinsic Sleep
Disorders
Extrinsic Sleep
Disorders
Circadian Rhythm
Sleep Disorders

The International Classification of

Sleep Disorders, Revised.
Diagnostic and Coding Manual.
USA : American Academy of Sleep
Medicine. Page 216

Sleep
Disorders

Parasomnias

Arousal Disorders
Sleep-Wake Transition Disorders
Parasomnias Usually Associated with
REM Sleep
Other Parasomnias

Sleep Disorders Associated

with Mental, Neurologic, or
Other Medical Disorders
Associated with Mental
Disorders
a. Psychoses
b. Mood Disorders
c. Anxiety Disorders
d. Panic Disorder
e. Alcoholism
.Associated with Neurologic
Disorders
.Associated with Other Medical
Disorders

Sleep
Disorders

Proposed
Sleep
Disorders

The International Classification of Sleep Disorders, Revised. Diagnostic and Coding

Manual. USA : American Academy of Sleep Medicine. Page 216

Cont...
Mood Disorders
Mood disorders are mental disorders
characterized by either one or more episodes of
depression or partial or full manic or hypomanic
episodes Typically insomnia and, occasionally,
excessive sleepiness, are features of mood
disorders.
The International Classification of Sleep Disorders, Revised. Diagnostic and
Coding Manual. USA : American Academy of Sleep Medicine. Page 219-224

Associated Features

The severity of the

mood disturbance
Culminating with the
most severe insomnia in
association with
psychotic depression
In general, sleep-onset
difficulty is more
prominent for younger
patients, where as sleep
continuity is more
prominent for older
patients.

Prevalence

90% of patients with mood

disorders have sleep
disturbances at some
time.
6% for major depression
With a lifetime risk for
major depression of 15%
to 20%
The lifetime risk for bipolar
disorder is approximately
1%.
The International Classification of Sleep Disorders,
Revised. Diagnostic and Coding Manual. USA :
American Academy of Sleep Medicine. Page
219-224

Age of Onset
Major
depression
and
bipolar depression with
concurrent
sleep
complaints usually start
between ages 20 and 40
years and are rarely seen
in pre-pubertal years.

The International Classification of Sleep

Disorders, Revised. Diagnostic and
Coading Manual. USA : American
Academy of Sleep Medicine. Page
219-224

Sex Ratio
Female > Male

Complications
Depressed or manic patients
may engage in self-medication
of their sleep disturbance by
using alcohol or sedativehypnotic
medication.
This
treatment may lead to the
development of drug tolerance
or dependence.

Diagnostic Criteria
The patient has a complaint of insomnia or excessive sleepiness.
2. The complaint is temporally associated with a diagnosis of mood
disorder.
3. The complaint is expected to remit if the mood disorder resolves.
4. Polysomnographic monitoring demonstrates at least one of the following:
a. A shortened REM sleep latency
b. An increased REM density
c. Reduced delta sleep
d. An increased sleep latency, reduced sleep efficiency, and increased
number and duration of awakenings
e. Multiple sleep latency test demonstrates a normal or reduced mean
sleep latency.
5. The patient does not have any medical or other mental disorder that can
account for the symptom.
6. The symptoms do not meet the diagnostic criteria for other sleep
disorders that produce insomnia or excessive sleepiness
1.

The International Classification of Sleep Disorders, Revised. Diagnostic and Coding

Manual. USA : American Academy of Sleep Medicine. Page 219-224

 Minimal Criteria: A plus B.

Severity Criteria
Mild: Mild insomnia or mild excessive sleepiness, as
defined on page 23.
Moderate: Moderate insomnia or moderate excessive
sleepiness, as defined on page 23.
Severe: Severe insomnia or severe excessive sleepiness,
as defined onpage 23.
Duration Criteria: The minimum length of the mood
disturbance itself is two
Acute: 4 weeks or less.
Subacute: More than 4 weeks but less than 2 years.
Chronic: 2 years or longer
The International Classification of Sleep Disorders, Revised. Diagnostic and Coding
Manual. USA : American Academy of Sleep Medicine. Page 219-224

2. Whats the Definition of

Somatoform Disorder?
In psychology somatoform.
taken from the Greek word soma, which means "body".
Somatoform disorders are a group of disorders
characterized by complaints about problems or
physical symptoms (;pain, dizziness, nausea) which
can not be explained medically.

Jeffrey S. Nevit A. Rhathus, Beverly Greene, Psikologi Abnormal, Ed.5, Jilid1, Erlangga, Jakarta, 2003
V. Mark D dan David HB, Intisari Psokologi Abnormal, ed. 4 Cet.1 Pustaka pelajar: Jogjakarta, 2006.
Fitri Fauziyah dan Julianti W., Psikologi Abnormal Klinis Dewasa, UII Press, Jakarta, 2007

3. Whats The Etiology of

Somatoform Disorder?
Broadly speaking, the factors that cause
grouped as follows:
a. Biological Factors
b. Social Environmental Factors
c. factors Behavior
d. Emotional and Cognitive Factors
Jeffrey S. Nevit A. Rhathus, Beverly Greene, Psikologi Abnormal, Ed.5, Jilid1, Erlangga, Jakarta, 2003
V. Mark D dan David HB, Intisari Psokologi Abnormal, ed. 4 Cet.1 Pustaka pelajar: Jogjakarta, 2006.
Fitri Fauziyah dan Julianti W., Psikologi Abnormal Klinis Dewasa, UII Press, Jakarta, 2007

4. Whats the Classification and Clinical

Manifestation of Somatoform Disorder?

Somatization Disorder
Undifferentiated Somatoform Disorder
Conversion Disorder
Pain Disorder
Hypochondriasis
Body Dysmorphic Disorder
Somatoform Disorder Not Otherwise Specified

www.aafp.org/afp/Somatoform-Disorder
Winter, A. O. (2014). Psychiatric and Behavioral Disorders | Somatoform Disorders. In Medicine and
Surgery (pp. 14811486). http://doi.org/10.1016/B978-1-4557-0605-1.00113-5

5. What can cause Somatoform

Disorder?

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th
ed. rev. Washington, D.C.: American Psychiatric Association, 2000

6. How to diagnose this

Scenario?
ANAMNESIS
Identifying Data
Chief Complaint
History of Present Illness
Past Illnesses
Family History
Social Relationships
School History
Cognitive and Motor Development
Emotional and Physical Problems
Occupational History

EXAMINATION
Physical examination
Neurological examination
Additional psychiatric
diagnostic
Interviews with family
members, friends, or
neighbors by a social worker
Psychological, neurological,
or laboratory
Mental Status

Dr. Rusdi Maslim, Diagnosis of Soul Disorders. Jakarta: Medical Faculty, Unika Atmajaya. 9-16.

Cont...
DIAGNOSIS
Axis I: Clinical
Axis II: Personality disorders,
mental retardation
Axis III: Any general medical
conditions
Axis IV: Psychosocial and
environmental problems
Axis V: Global assessment of
functioning exhibited by the
patient during the interview

THERAPY
Farmacotherapy
Psychotherapy
Social Therapy
Ocupasional Therapy
Ect.
FURTHER ACTION
Therapy evaluation
Diagnosis evaluation
Ect.

Dr. Rusdi Maslim, Diagnosis of Soul Disorders. Jakarta: Medical Faculty, Unika Atmajaya. 9-16.

7. What is the Differential

Diagnosis?

Benjamin J. Sadock, et.al. 2009. Kaplan & Saddock Comprehensive Textbook Of Psychiatry. Vol 1. 9th
Edition. Philadelphia, USA: Lippincott Williams & Wilkins. Pg. 1936-46.

8. What is the Treatment based

on Scenario?
Pharmacologic treatment

(http://www.jabramowitz.com/uploads/1/0/4/8/10489300/hypo_for_psychiatric_clinics.pdf)

Cont...
Psychological treatment: cognitivebehavioral therapy (CBT)
Psychoeducation
Modifying erroneous beliefs

(http://www.jabramowitz.com/uploads/1/0/4/8/10489300/hypo_for_psychiatric_clinics.pdf)

9. How is the Prognosis?

Stress and anxiety may make the symptoms of
hypochondriasis worse. Many people may also
struggle with costly medical tests and develop a
dependency
on
certain
medications.
Hypochondriasis is a chronic illness (it persists for
a long time), but getting early psychiatric
treatment and having a strong motivation to
change may increase the chances of getting
better.
(http://www.jabramowitz.com/uploads/1/0/4/8/10489300/hypo_for_psychiatric_clinics.pdf)

10. What is Islams Perspective

based on Scenario?
1. Does Not Matter
2. Took The
Opposite Stance

ISLAMIC
PRESPECTIVE

3. Keep Practicing
Patiently

"Leave something doubted you to something that is not doubted."

(HR. Tirmidhi and Nasa'i, Tirmidhi said: This is a Hadith Hasan Saheeh)

4. Many Took Refuge From

The Temptations Of Satan

5. Learn How To Do
Properly Worship/Prayer

Written by Ustadz Nur Ammi Baits (Board of Trustees www.KonsultasiSyariah.com)

Thank you! (: