Morandin, Michelle (2005) Automatic Behaviour in Individuals With Narcolepsy: A Qualitative Approach. Other Degree thesis, Victoria University.

Abstract

Narcolepsy is a debilitating sleep disorder, characterized by excessive daytime sleepiness, cataplexy, hypnogogic hallucinations, sleep paralysis and automatic behaviour. Automatic behaviour can be defined as 'stereotyped and repetitive sequences of actions that are performed without awareness', which usually occur during monotonous tasks (Zorick, Salis, Roth, & Kramer, 1979, p. 194). A classic example is reaching a destination without realizing how one got there. At present little is known about this complex phenomenon, and research in the area is minimal. The aim of the current study was to document the phenomenon of automatic behaviour in ten individuals with narcolepsy (selected on the basis of self-report of moderate to severe automatic behaviour), via phenomenological analysis and a series of case studies. Data was obtained through two structured interviews with each participant, an interview with a spouse or family member, a weekly journal and a daily journal (completed on minimal medication). Using qualitative methodology, a number of important features of automatic behaviour were identified. The current study provided an in depth analysis of the loss of recall associated with episodes of automatic behaviour and was able to define the types of errors associated with this state (sequencing errors, item/ environment intrusions, perseverative action leading to nonsense, context inappropriate behaviours). Different types of automatic behaviour were identified. Type 1 (sleepiness with low cognitive load) and Type 2 (sleepiness with high cognitive load) have been previously reported in the literature (but not so labeled). Type 3 (high cognitive load without sleepiness) however has not previously been identified. The vigilance levels associated with these types (from microsleeps to fluctuating vigilance levels) were discussed, making comparisons with previous research in the area (Guilleminault et al, 1975; Valley, & Broughton, 1981; 1983). Subsequently, a hypothesised formula for automatic behaviour was developed, including the various factors in its manifestation (that is, excessive daytime sleepiness, cognitive load, and individually determined threshold for automatic behaviour). A descriptive model of automatic behaviour was also developed and compared to previous research. An explanation from a cognitive perspective was considered, linking the automatic behaviour experienced in narcolepsy to automatic behaviour in normals. Finally, a questionnaire to measure automatic behaviour was developed, for further research to pilot.

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