032615 sleep Flashcards

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1
Q

normal sleep-primary neurotransmitters?

A

REM: Ach, NE
NREM: serotonin

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2
Q

sleep efficiency

A

time sleeping/time spent trying to sleep

in normal individuals, is 100%

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3
Q

what stage of sleep makes of 45% of the sleep?

A

stage 2

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4
Q

most deep sleep occurs

A

first half of night

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5
Q

what waves are slow and large

A

delta (stage 3, 4)

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6
Q

aging’s effects on sleep

A

decreased REM
decreased stage 3, 4

increased night time awakenings-decreased sleep efficiency

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7
Q

depression’s effects on sleep

A
frequent awakenings
early morning awakening
decreased REM latency (first REM in 45 minutes)
INCREASED total REM
decreased stage 3, 4 sleep
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8
Q

dyssomnias

A

abnormal timing, quality, and amount of sleep

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9
Q

parasomnias

A

abnormal behaviors assoc w sleep (bruxism in stage 2, night terror, sleepwalking, REM sleep behavior disorder)

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10
Q

dyssomnias-list them

A

timing: narcolepsy, circadian rhythm sleep disorder
quality: restless legs, sleep apnea
amount: insomnia, hypersomnia

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11
Q

narcolepsy

A

sleep attacks (a lot of REM sleep)

hypnogogic/hypnopompic hallucinations

cataplexy (sudden loss of muscle tone)

sleep paralysis (when falling asleep or waking up)

decreased REM latency (less than 10 min), less REM overall

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12
Q

neurobiologic factors in narcolepsy

A

hypocretin (orexin) deficiency association

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13
Q

tx for narcolepsy

A

scheduled daytime naps

psychostimulants (methylphenidate, modafinil)

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14
Q

circadian rhythm sleep disorder

A

inability to sleep at appropriate or desired times

two types: delayed or advanced

causes: intrinsic and extrinsic. extrinsic would be things like shift work, jet lag

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15
Q

tx for circadian rhytm sleep disorder

A

for delayed: melatonin, light at desired waking time

for advanced: light in the evening

for shift work: modafinil or caffeine for alertness, melatonin or hypnotic at bedtime

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16
Q

restless legs syndrome

A

uncomfortable sensation in legs causing jerking and frequent night time awakenings

17
Q

epidemiologic factors for restless legs syndrome

A

usually older adults. Parkinson’s, CKD, pregnant

18
Q

tx for restless legs syndrome

A

antiparkinsonian agents (levodopa, carbidopa/levodopa, ropinirole)

19
Q

insomnia

A

3x/wk or more
duration of at least 1 month
daytime sleepiness

20
Q

tx for insomnia

A
avoid caffeine
AM exericse
develop sleep routine
relaxation techniques
hypnotic medication (benzodiazepines-may however decrease REM and delta sleep)
21
Q

REM sleep behavior-eyes open or closed?

A

closed

22
Q

REM sleep behavior disorder is assoc w

A

Parkinson dis and Lewy body dementia

23
Q

tx for REM sleep behavior disorder

A

making environment safe

melatonin or low dose benzodiazepines