We report the case of a 22-year-old female victim of childhood sexual abuse with dissociative identity disorder and hypersomnia who remitted from both clinical conditions with the use of modafinil 400 mg/day.We review the literature supporting the sleep-dissociation theory, where trauma-related memories induce a labile sleep-wake cycle allowing dreamlike mentation to intrude into waking consciousness and precipitate dissociative symptoms.The studies examined here found high correlations between dissociation and unusual sleep experiences.This may explain why in our case report modafinil, a medication with wake-promoting properties, improved both excessive daytime sleepiness and dissociation.Future studies are needed to determine which alterations in the sleep-wake cycle are most associated with dissociative disorders.We suggest a new perspective on the use of medications for comorbid hypersomnia, such as modafinil, in the treatment of dissociation.
This article reviews the role of evocative communication in psychotherapy and hypnosis.In hypnosis, the goal is to elicit a change in the client's state.Hypnosis is defined in a relational context and does not require conscious awareness to have an impact.Therapists can extend their understanding of hypnotic processes to psychotherapy to elicit conceptual realizations that empower changes in states and identities.Metaphor and signification, two examples of evocative communication, are widely used in the arts to create emotional impact.The therapist's "palette of colors" includes words, gestures, tone, tempo and locus of voice, and posture.The authors contend that: a) effective hypnotherapy and psychotherapy are anchored in evocative communication; b) communication techniques can be taught and studied; c) evocative communication spurs the activation of the subconscious; and d) the subconscious can effect changes in state that can result in solutions to psychological problems.
Background: Sleep is a state of reduced consciousness and responsiveness from which an individual can be aroused by external stimulus. In humans, is also associated with reduced movement. It enables to restore energy in the body and initiate neural plasticity for learning and memory. Several studies in the world identified poor sleep quality among nurses and tried to explore associated factors. But there is no any study in Ethiopia on sleep quality and associated factors among nurses. Objectives: the main aim of this study was to determine the prevalence of sleep quality and associated factors among nurses in Jimma zone public hospitals. Methods: An institution based cross-sectional study was conducted on 550 nurses from June 1 to July 1, 2018. Data was collected using self-administered questionnaire; sleep quality was measured using PSQI which is standard validated tool. Collected data was checked for completeness, entered Epi data version 3.1 and exported to SPSS Version 20.0. Frequencies, means and percentages were used for the descriptive analysis of data. Bivariate analysis was done to select candidate variables. Variables having p< 0.05 was considered statistically significant. Results: A total of 528 nurses were included in the study with a response rate of 96%. The mean age was 31.73 7.36 years and 54.7% of nurses were females. Prevalence of poor sleep quality among nurses was 70.6%. According to the multiple logistic regression analysis current khat chewing, BMI in overweight individual, BMI in Obese individual, medium job related stress, high job related stress , and Shift working were significantly associated with poor sleep quality. Conclusion: The magnitude of poor quality of sleep among nurses working in hospitals, Jimma Zone was very high. Independent predictors of poor sleep quality as identified by this study were current khat chewing, overweight, obesity, job related stress, and shift work.
Working time is the period of time that a person spends at paid labour.For every shift our body needs to adopt to the external changes.This may cause dreadful disruption of circadian rhythm which maintains all the biological responses including sleep-wake cycle, hormone inductioninhibition, hunger, growth and other cellular processes.Hence preventing the disruption of the circadian rhythm can prevent the disturbances in biological responses.The specific objectives include numerating the working pattern of general and shifting workers.To compare food habits, incidence of various health effects such as Cardiovascular risks, Sleep wake disorders, Endocrinological disorders (Diabetes, Cholesterol), Obesity, BMI, Blood Pressure among general and shift workers.An observational prospective study was carried out by approaching the workers, by a standard questionnaire which was designed to collect the data of the employees from the company and data was analyzed using statistical software.The observed values have shown that out of 302 workers general workers were 112 and shift workers were 190 and P-value <0.001 which is found to be significant.This study shows that the diabetic status, sleep disorders, appetite and GERD disturbances of the workers are dependent on the shift pattern being followed by them.There was a significant difference between shift and general workers in terms of Glucose levels, Blood Pressure, Total Cholesterol levels and GIT disturbances.Conclusion of our study revealed that prople working in shifts tend to have higher risk of prevalence of disorders such as Hypertension (Blood Pressure compared), Diabetes (Random Blood Sugar compared), Sleep and GIT disturbances.Body Mass Index, Total cholesterol levels of both general and shift workers did not show any high significance when compared.The risk of metabolic disorders was higher among those working in shift work rather than in the general workers.
Patients with anorexia nervosa (AN) frequently complain of insomnia and poor sleep quality. Some studies report changes in sleep self-reports and in several polysomnography parameters. These studies suggest that patients with AN and concomitant sleep disturbances have a poorer quality of life, are more predisposed to the appearance of comorbidities and have a poor prognosis of AN. The presence of sleep problems appears to influence the course and prognosis of AN. This article intends to briefly discuss the possible impact of sleep disturbances in AN and describe potential pathophysiological mechanisms involved.
