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4.16 Sleep Disorders
By Dr. Conrad
54
Psychology
Professional
04/20/2012

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Cards

Term
What percent of the night is spent in nonrem sleep?
Definition
75%
Term
How much time is spent in the different stages of non rem sleep?
Definition
1= 5%, 2= 45%, 3= 12%, 4= 13%
Term
What are the vital sign changes that occur in non rem sleep?
Definition
heart rate slowed to 5 to 10 beats/min; BP and resp slowed with fewer variations
Term
What are the EEG patterns of awake people?
Definition
low voltage; random, fast
Term
What are the EEG findings of drowsy people?
Definition
alpha waves
Term
What are the EEG findings of stage 1 sleep?
Definition
theta waves
Term
What are the EEG findings of stage 2 sleep?
Definition
sleep spindles, K-complexes
Term
What are the EEG findings of stages 3 and 4 sleep?
Definition
delta waves
Term
T/F Dementia can casue insomnia.
Definition
true
Term
Name two types of sleep apnea?
Definition
obstructive versus central sleep apnea
Term
What is the prevalence of narcolepsy?
Definition
.06%
Term
What is the underlying problem of narcolepsy?
Definition
isolated fragments of REM sleep intrude into wakefulness
Term
What are the secondary symptoms of narcolepsy?
Definition
cataplexy, sleep paralysis, sleep hallucinations
Term
What percent of patients with narcolepsy get cataplexy?
Definition
70%
Term
How long does cataplexy last?
Definition
30 seconds or less
Term
What are the symptoms of cataplexy?
Definition
sudden weakness precipitated by hieghtened emotional states
Term
When during the course of narcolepsy does cataplexy occur?
Definition
usually begins approximately 4 years after narcolepsy
Term
What do you call sleep hallucinations that occur on awakening?
Definition
hypnopompic
Term
What do you called the sleep hallucinations that occur while your going to sleep?
Definition
hypnagogic
Term
T/F Narcolepsy is a familial disesae.
Definition
T/F only a small number of affected families have been identified so no longer considered to be familial
Term
What is the pathophysiologic mechanism of narcolepsy?
Definition
absence of hypocretin from CSF (99% specific for narcolepsy)
Term
What is hypocretin?
Definition
neuropeptide synthesized by a small number of neurons in the hypothalamus
Term
How do you rule out pseudo-cataplexy on patients?
Definition
absence of DTRs
Term
How do you diagnose narcolepsy?
Definition
multiple sleep latency test
Term
What is the treatment for narcolepsy?
Definition
methylphenidate, amphetamines, modafinil, GHB
Term
What is idiopathic hypersomnia?
Definition
unknown etiology; no sleep-onset REM as in narcolepsy but treated similarly to narcolepsy
Term
What are the symptoms of Kleine-levin syndrome?
Definition
lengthy but otherwise normal sleep (several days to two weeks); awaken during these periods to consume large quantities of food and display hypersexuality and irritability
Term
Who is the typical patient with Kleine-Levin Syndrome?
Definition
adolescent male
Term
What are parasomnias?
Definition
inappropriate intermittent motor behaviors during sleep
Term
What is REM sleep behavior disorder?
Definition
when patients act out their dreams in their sleep
Term
Who is the typical patient with REM sleep behavior disorder?
Definition
usually male and over 50 years old
Term
What diseases are associated with REM sleep behavior disorder?
Definition
parkinson's and lewy body dementia
Term
Which drugs are suggested as triggers for REM sleep behavior disorder?
Definition
SSRIs and venlafaxine
Term
How do you treat REM sleep behavior disorder?
Definition
rule out epilepsy; treat with modifying environment and hypnotics
Term
What is the medical term for sleepwalking disorder?
Definition
somnambulism
Term
When during sleep does sleepwalking occur?
Definition
first 1/3rd of the night in stages 3 and 4 NREM sleep
Term
Who is the typical patient with somnambulism?
Definition
usually begins between ages 4 and 8; peaks at age 12; more common in boys, tends to run in families
Term
What are the essential signs and symptoms of obstructive sleep apnea?
Definition
excessive daytime sleepiness; obstructed breathing during sleep
Term
What are the essential polysomnographic findings of obstructive sleep apnea?
Definition
more than 5 episodes of apnea (>10 seconds) per hour of sleep with evidence of respiratory effort and one of the following: 1) frequent arousals 2) oxygen desaturaiton >4% 3) bradytachycardia
Term
What is the prevalence of obstructive sleep apnea?
Definition
2% of women, 4% of men
Term
What ages are affected by obstructive sleep apnea?
Definition
30-60
Term
Obstructive sleep apnea is strongly associated with...
Definition
snoring and obesity
Term
What are the complications of obstructive sleep apnea?
Definition
HTN, right sided heart failure, CVA, MVA, depression
Term
How do you treat obstructive sleep apnea?
Definition
CPAP, weight loss, surgery
Term
What are the symptoms of restless leg syndrome?
Definition
desire to move limbs due to subjective discomfort; worse or exclusively associated with sedentary behavior; worse in evening or night
Term
What is the prevalence of restless leg syndrome?
Definition
10%
Term
T/F Restless leg syndrome can run in families.
Definition
true
Term
What other diseases are associated with restless leg syndrome?
Definition
anemia, iron deficiency, diabetes, peripheral neuropathy, and uremia
Term
What are the psychological effects of restless leg syndrome?
Definition
increased irritability and depression
Term
How do you diagnose restless leg syndrome?
Definition
based on history; CBC and sleep study to evaluate other disorders can sometimes be useful
Term
What is the pathophysiology of restless leg syndrome?
Definition
associated with decreased dopamine levels (dopamine antagonists= worsen; dopamine agonists= marked improvements)
Term
What is the proposed physiological link between restless leg syndrome and iron deficiency?
Definition
iron hypothesized to be cofactor for tyrosine hydroxylase (rate-limiting step in dopamine synthesis)
Term
What is the treatment for restless leg syndrome?
Definition
pramipexole, clonazepam, etc.
Term
Does excercise help you sleep?
Definition
yes; daily exercise can help you sleep but you should really finish at least 4 hours before bedtime
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