Term
| Should patients having difficulty sleeping watch TV, read, study, work on their computers in their beds? |
|
Definition
No
They should remove stimuli/stimulating behaviors
(TV, reading, computer, chores, pay bills, study) |
|
|
Term
| What is the appropriate temperature for sleep? |
|
Definition
|
|
Term
| TV emits blue light which suppresses __________ release |
|
Definition
|
|
Term
What behavior prior to bedtime does NOT help?
Exercise during the day
Eating right before bed
Same bedtimes and arising times
Avoiding naps >20 mines |
|
Definition
Eating before bed (can contribute to weight gain and is stimulating factor)
should eat at dinner |
|
|
Term
Humans function optimally with hrs continuous sleep
Limit caffeine use (if problems with caffeine, stop after ___pm) |
|
Definition
|
|
Term
| What class would be considered crowded posterior oropharynx? |
|
Definition
| Cl 3 or 4 (can barely see opening/can't see opening at all when patient's mouth is open) = obstructive sleep apnea |
|
|
Term
What is a part of the focused sleep physical?
Neck: increased size
CV: arrhythmias
Pulm: dyspnea, abnormal findings
Neurological: abnormal movements, peripheral neuropathy
Psychiatric: depressed, manic
All of the above |
|
Definition
|
|
Term
| In a focused sleep physical, what do we look for in general? |
|
Definition
|
|
Term
In a focused sleep physical, what do we look for in the neck?
cardiovascular?
Pulmonary?
Muscholoskeletal? |
|
Definition
Neck: increased size
CV: arrhythmias
Pulm: dyspnea, abnormal findings
Musculoskeletal: peripheral edema |
|
|
Term
True or false:
You should try to interview the bed partner in a diagnostic investigation and have the patient keep a sleep diary. |
|
Definition
|
|
Term
| What is the scale that measures psychometric testing? |
|
Definition
|
|
Term
| What is the test that is like a watch that the patient wears and it monitors movement throughout the day/night. |
|
Definition
|
|
Term
| What is the test that makes a person try to stay awake in a dim lit room (may be used for truck drivers before companies hire them)? |
|
Definition
| maintenance of wakefulness test |
|
|
Term
| What the test that monitors multiple parameters of sleep such as EEG, EOG, EMG, EKG, snoring, airflow, respiratory effort, O2 saturation, body position? |
|
Definition
|
|
Term
| Rapid eye movement sleep is non-REM or REM sleep? |
|
Definition
|
|
Term
True or false:
The majority of our sleep throughout the night is REM sleep |
|
Definition
|
|
Term
| What sleep stage is drowsiness? |
|
Definition
|
|
Term
| What sleep stage is light sleep, sleep spindles (reticular n. of thalamus), K complexes? |
|
Definition
|
|
Term
| What sleep stage is slow wave sleep (SWS), delta sleep, deep sleep, 1st third of the night? |
|
Definition
|
|
Term
| What sleep stage is Rapid eye movements, Dreams, latter half of the night, penile erections, muscle atonia |
|
Definition
|
|
Term
True or false:
You are paralyzed during REM sleep. |
|
Definition
True
muscle atonia (protective mechanism so you don't hurt yourself during your dreams) |
|
|
Term
| What is sleep disordered breathing (Brief disruptions in breathing during sleep due to obstruction of airway despite continued respiratory effort)? |
|
Definition
| Obstructive Sleep Apnea (OSA) |
|
|
Term
True or false:
Obstructive sleep apnea is more prevalent in the older populations |
|
Definition
|
|
Term
What is NOT an OSA symptom?
Loud snoring
Nocturia
Increased movement
Morning headache
Decreased memory
Abnormal daytime sleepiness |
|
Definition
|
|
Term
What is NOT risk factor for OSA?
Obesity
Increased neck size
Male
> 50 years old
Pre-menopausal women
Crowded posterior oropharynx
Family History of obstructive sleep apnea |
|
Definition
Pre-menopausal women
POST-menopausal will catch up with men for OSA |
|
|
Term
| What (3) things can worse OSA? |
|
Definition
| Alcohol, sedatives, smoking |
|
|
Term
What is a clinical consequence of OSA?
Neurocognitive dysfunction
Hypertension
Arrhythmias
Coronary artery disease
Stroke
Erectile dysfunction
All of the above |
|
Definition
|
|
Term
True or false:
Reducing weight of obese people can decrease OSA severity in half. |
|
Definition
|
|
Term
| What position of sleep can obstruct the airway the most? |
|
Definition
supine (lungs press down do airway)
try to sleep on your side (positional therapy) |
|
|
Term
What is NOT an OSA treatment?
Weight loss
positional therapy
Pharyngeal surgery
benzodiazepines
Continuous Positive Airway Pressure (CPAP)
Oral Appliance |
|
Definition
| Avoid benzodiazepines before bed, may worsen OSA |
|
|
Term
| If a patient with mild OSA does not respond to/not appropriate candidate for weight loss or sleep position change, what should you recommend? |
|
Definition
|
|
Term
| A patient with moderate to severe OSA need an initial trial of ________. |
|
Definition
|
|
Term
| If a patient with mild to severe OSA is intolerant or refuse CPAP or surgery, what should you recommend? |
|
Definition
|
|
Term
True or False:
Oral appliances are best in obese patients with mild to moderate OSA that is worse supine position |
|
Definition
False
Best in THIN patients with mild to moderate OSA that is worse supine position |
|
|
Term
| What type of OSA treatment is used at night to reposition the lower jaw, tongue, soft palate and uvula, stabilizing the lower jaw and tongue, and increase the muscle tone of the tongue ? |
|
Definition
|
|
Term
| What is a chronic disabling disorder affecting control of wakefulness and sleep with intrusion of REM sleep into waking state |
|
Definition
|
|
Term
| What disorder is pathologic sleepiness with sleep onset REM? |
|
Definition
|
|
Term
What is the sudden, temporary loss of bilateral muscle tone with preserved consciousness and memory triggered by strong emotions such as laughter, anger, or surprise?
What disorder is this associated with? |
|
Definition
|
|
Term
| If a patient present with pathologic sleepiness, cataplexy, Vivid dreams (increased REM sleep), Hypnagogic/hypnopompic hallucinations (may feel, see, hear things that aren't there), and Disrupted sleep, what disorder may they have? |
|
Definition
|
|
Term
True or false:
Eye muscles and diaphragm are impaired during cataplexy. |
|
Definition
False
Eye muscles and diaphragm not impaired |
|
|
Term
True or false:
There is decreased muscle tone and loss deep tendon reflexes in cataplexy that lasts for seconds to minutes (rare > 2 minutes) |
|
Definition
|
|
Term
| What is the test that measures how sleepy a patient is and preceded by polysomnogram without evidence of sleep disorder and patient must have at 6 hours of good sleep beforehand? |
|
Definition
| Multiple Sleep Latency Test |
|
|
Term
The Multiple Sleep Latency Test consists of how many naps separated by how hours of wakefulness?
How much time is given to fall asleep?
If they do fall asleep, you give them an additional 15 minutes to evaluate what? |
|
Definition
5 naps, separated by 2 hours of wakefulness
20 minutes to fall sleep
If sleep, 15 additional minutes to evaluate for REM (sleep onset REM) |
|
|
Term
True or false:
During the multiple sleep latency test, it is normal to see a REM during the 15 minute nap. |
|
Definition
False
It would be abnormal to see REM sleep in a 15 minute nap (REM suppose to take 90 minutes) |
|
|
Term
| How early must a patient be off off sedating and stimulant medications before performing a Multiple Sleep Latency Test? |
|
Definition
|
|
Term
In the Multiple Sleep Latency Test, if the mean sleep latency is 10-15 minutes what is that considered?
Normal
Mild Sleepiness
Pathological Sleepiness |
|
Definition
|
|
Term
In the Multiple Sleep Latency Test, if the mean sleep latency is 5-10 minutes what is that considered?
Normal
Mild Sleepiness
Pathological Sleepiness |
|
Definition
|
|
Term
In the Multiple Sleep Latency Test, if the mean sleep latency is less then 5 minutes what is that considered?
Normal
Mild Sleepiness
Pathological Sleepiness |
|
Definition
|
|
Term
| If patient has a mean sleep latency < 5 minutes and 2 sleep onset REMs, what is their diagnosis? |
|
Definition
|
|
Term
| How many hours of continuous sleep should a narcoleptic person get? |
|
Definition
| 8-10 hrs continuous sleep, strict sleep times |
|
|
Term
True or False
Narcoleptic people should schedule 1 to 3 daytime naps (20 minutes)? |
|
Definition
|
|
Term
True or False:
Narcoleptic people should not nap after a sleep attack. |
|
Definition
False
Should nap after sleep attack (bodys way of telling you it needs a nap) |
|
|
Term
True or false:
150 to 300mg of caffeine is as effective as a 3-4hr prophylactic nap prior to 24 hr lost sleep |
|
Definition
|
|
Term
True or false:
Bright light may improve night shift performance, delay sleep onset, and increase alertness |
|
Definition
|
|
Term
| List some pharmacologic treatment for sleep disorders |
|
Definition
Non stimulants
Stimulants (indirect sympathomimetics)
MAO-B inhibitors
Nighttime benzodiazepines
Sodium oxybate may improve sleepiness by consolidating nocturnal sleep |
|
|
Term
| Narcolepsy can be associated with cataplexy which is characterized by? |
|
Definition
| Loss of muscle tone with laughter |
|
|
Term
| What disorder includes abnormal sleep related movements, behaviors, emotions, perceptions, dreaming, and autonomic nervous system functioning that can happen as you're falling asleep, NREM, REM, and after arousals |
|
Definition
|
|
Term
What is NOT a common feature of non-REM parasomnia?
Arise from slow wave sleep (N3)
Latter half of the night
Common in childhood
Family history
Amnesia of event |
|
Definition
Latter half of the night
happens in the first half of the night |
|
|
Term
What does NOT precipitate NREM parasomnias?
Rotating shift work
Forced awakenings
neurodegenerative disorder
Alcohol use/abuse
Sleep deprivation |
|
Definition
| neurodegenerative disorder (more associated with REM behavior disorder) |
|
|
Term
| If a child has autonomic, behavioral manifestations of unresponsive, piercing scream, incoherent vocalization and if awakened may be confused, disoriented, violent and has no recollection of it (amnesia). What disorder do you expect? |
|
Definition
| NREM Parasomnia: Sleep Terrors |
|
|
Term
| If a patient is sleepwalking with an altered consciousness, wide-eyed stare, may leave room, limited patchy memory (if any), and may cook, eat, dress, agitation, violence, urinate, drive. What disorder do you expect? |
|
Definition
| NREM Parasomnia: Somnambulism |
|
|
Term
| What can induce NREM Parasomnia: Somnambulism? |
|
Definition
| Induced by alcohol, medication (lithium, zolpidem, anticholinergics) |
|
|
Term
True or false:
In normal REM sleep, there is paralysis/atonia (except for eyes and diaphragm) |
|
Definition
| True (Protection from injury during consolidated dream periods) |
|
|
Term
True or false:
Normal REM sleep is associated with worsened obstructive sleep apnea due to lack of accessory muscle use |
|
Definition
|
|
Term
| In REM behavior disorder, what is disrupted and impaired that causes Dream enactment behaviors during REM sleep? |
|
Definition
| Disrupted paralysis and impaired modulation motor system |
|
|
Term
What is NOT characteristic of REM behavior disorder
If awoken during event, usually cannot recall dream
More common last 1/3 of the night
Can be associated w/neurodegenerative d/o (Parkinson’s) |
|
Definition
If awoken during event, usually cannot recall dream
If awoken during event, usually RECALLS dream |
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