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Sleep and Sleep-Wake Disorders: Assessment, Differential Diagnosis and Psychoeducation


Presented by:

Author: Charles D. Safford, LCSW

Charles D. Safford, LCSW is President of, Inc., with guidance and input from other senior, Inc. course developers and from NASW GA. Mr. Safford has over 30 years of post-master’s experience as a clinician, and has over twenty-five years of experience as a training developer and trainer in business and clinical settings.


Course Length and Cost

This course is designed for clinicians at all stages of their career.

This course is approved for 4 core contact or clock hours

This course is the copyrighted property of and may not be copied in part or in entirety without the express written permission of For information on how to secure permission to use this course or any part of this course, contact us at:





Course Objectives:

  1. Understand the complex processes of sleep.
  2. Learn how to engage in a preliminary sleep assessment.
  3. Grasp the major types of sleep disorders and appropriate diagnosis under DSM-5.
  4. Separate common myths about sleep from established facts about sleep.
  5. Learn the best practices approaches to addressing problems with uncomplicated insomnia.
  6. Comprehend the main factors underlying good sleep hygiene.


Section 1: Introduction
Section 2: Sleep and Health
Section 3: A Brief Overview of Performing a Preliminary Sleep Assessment
Section 4: Information that Indicates Insomnia Disorder
Section 5: Information that Indicates Sleep Apnea
Section 6: Information that Indicates Sleep Related Hypoventilation
Section 7: Information that Indicates Restless Leg Syndrome
Section 8: Information that Indicates REM Sleep Behavior Disorder
Section 9: Information that Indicates Narcolepsy
Section 10: Information that Indicates Nightmare Disorder
Section 11: Information that Indicates Non-Rapid Eye Movement Sleep Arousal Disorders
Section 12: Information that Indicates Circadian Rhythm Sleep Wake Disorders
Section 13: Information that Indicates Hypersomnolence Disorder
Section 14: Information that Indicates Substance/Medication-Induced Sleep Disorder
Section 15: A Handout to Support Coaching and Education about Good Sleep Habits
Section 16: Sleep - Separating the Facts from the Fictions
Section 17: Summary and Recommendations
References and Test




Section 1: Introduction

Why have we written this course and what are we hoping to provide to mental health clinicians that will improve the quality of their work?

Clinicians, due to the nature of their work, tend to know more about wellness issues than the general public, and they tend to know that sleep is a problem in this country. However, even clinicians frequently underestimate the degree to which insufficient sleep and sleep disorders contribute to all kinds of health problems, including mental health problems. Moreover, many clinicians do not know enough about this arena to provide good consultation to their clients around how to get more and better sleep – and why this is important. This course is designed to help fill that gap. 

The evidence is pretty conclusive that too many Americans are not getting enough sleep, and there are direct correlations between the amount of sleep that people get and their intellectual, psychological, and emotional functioning. In many instances, clients who present with symptoms of anxiety and depression may in fact be suffering from sleep insufficiency. This sleep insufficiency may be one of the signs and symptoms of depression or anxiety – or it may actually be the cause of the depression and anxiety. Among the other tasks of good differential diagnosis, a thorough bio-psycho-social assessment must be successful in discerning when the primary problem leading to mental health concerns is simply not enough sleep.

There is another reason for the focus of this course. Over and above the mental health aspects, insufficient sleep is also involved in all kinds of health problems and even increases in overall mortality. In fact, the widespread problem of sleep deprivation appears to be a significant contributor to the declining health of our nation.

The growing problem of sleep insufficiency has not gone unreported. Americans are told about the importance of sleep on TV, in magazines, in blogs, on web sites. Yet something about this information transfer is not being effective. In spite of what people know, they are still often unable – or unwilling - to establish sleep as a top priority and commit to good sleep hygiene. They are exposed to the information but do not absorb it in ways that lead to real change.

Among the many roles of the mental health clinician is that of an educator and/or coach, and among our many skill sets are tools for mobilizing motivation for change and applying this motivation to improvement processes. One of the keys behind this ability to build motivation for change is our capacity to establish professional authority in ways that generate both trust and influence.  

Likewise, a key part of our professional authority and building motivation for change arises from our expert knowledge base. In our counseling sessions, we provide a trusted conduit for expert information to reach our clients, information that helps them shape their lifestyle choices. For us to maintain that professional authority, the information we pass forward needs to be accurate and up to date. If we do not know the right things – or teach false information – it harms our professional authority and erodes our ability to mobilize change processes.

Like many areas of our practice, the core knowledge base about sleep and sleep disturbances has, of late, been updated, revised, and reshaped by the latest research in sleep and neuroscience. Even those of us who work conscientiously to keep up with wellness issues can find ourselves operating with outdated information in this key area.  This course is designed to serve as an update to the knowledge base concerning sleep, what is now better understood - and what is still unknown.

We will not be covering everything, because there are parts of this knowledge that require too large a background in organic chemistry and neurochemistry. The knowledge we will focus on will be the facts that are practical and useable for the clinician. We have kept our focus on those items that will help the clinician’s capacity to successfully diagnosis sleep-wake disturbances and then engage in effective discussions with their clients around the importance of sleep, the risks of sleep deprivation, and practical steps that can be taken to improve sleep. We will stay focused on what will help build motivation for change while enhancing the professional authority of the clinician.

This course is not designed to allow any mental health clinician to position him/herself as an expert in sleep or sleep disturbances. Where health-threatening sleep disturbances are noted by clinicians, it will still be important for each clinician to operate within one’s area of competence and make appropriate referrals to experts in this field. This means knowing how to look for and assess the presence of sleep disturbances, and how to facilitate a successful referral to a sleep expert.

However, there are still areas in which clinicians who are not sleep experts can competently utilize a good and accurate body of knowledge about sleep and have positive effects on the well-being of their clients. This can include:

- Accurately assessing for sleep-wake disorders and making appropriate referrals for further diagnosis and treatment

- Encouraging and supporting good sleep habits while building motivation for change

- Helping clients establish conditions to maximize their sleep patterns

- Normalizing variations in sleep schedules so clients don’t become anxious if their sleep patterns don’t match the “norm”

- Educating clients about factors that can affect sleep patterns, such as medications, food and beverages, and nutritional supplements