Sleep-wake disorders are defined by disturbances to a person’s sleep patterns. Sleep disruptions impact physical, mental, and emotional health. There are 10 groups of sleep-wake disorders described in the DSM-5 (American Psychiatric Association, 2013): insomnia, hypersomnolence disorder, narcolepsy, breathing-related sleep disorders, circadian rhythm sleep-wake disorders, non-rapid eye movement sleep arousal disorders, nightmare disorder, rapid eye movement sleep behavior disorder, restless legs syndrome, and substance/medication-induced sleep disorder. 

The two key symptoms of a sleep disorder are fatigue and trouble focusing. People with mental health disorders like depression often have co-occurring sleep-wake disorders. It is critical that the clinician conduct an in-depth assessment when a client presents with a sleep-wake disorder, to include among other questions the following: nutrition, energy drink and other supplement/stimulant use, exercise, trauma history, technology use patterns, social and familial relationship health, and medical history with medication history

Consider the following scenario:

Alex, a male African American adolescent aged 14, has come to therapy because he is experiencing the symptoms of a sleep-wake disorder. His sleep-wake disorder is disrupting his school work, causing absenteeism from school, and negatively impacting his social engagements due to an increase in irritability and irrational thinking.

Write out a mini script showing what you, the counselor, might say to Alex 

Respond to the following prompts using your mini script.

• Provide four potential questions you might ask about Alex’s current sleep hygiene.
• Explain the role of counseling alongside sedative hypnotics.
• Explain the long-term consequences of a sleep-wake disorder.
• Include an empathetic reflection to Alex

Reference: American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5). Washington, DC: Author.