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TMD > 12. Sleep > Flashcards

12. Sleep Flashcards

1
Q

What are the different stages of sleep

A
  • Autogensis
  • Stage I
  • Stage II
  • Stage III
  • REM
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2
Q

Describe autogenesis stage of sleep

A
  • Short 30-35 seconds
  • Before stage I
  • Increased peripheral and core temp
  • Relaxation of muscles
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3
Q

Stage I sleep is characterized how

A

replacement of alpha with theta waves

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4
Q

Describe Stage I sleep

A
  • First stage of sleep
  • Drowsiness/presleep
  • Hypnic jerks
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5
Q

what is the predominant sleep stage

A

stage II (45% of sleep)

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6
Q

Stage II sleep is characterized by

A

K complexes which are associated with sleep spindles

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7
Q

Describe Stage II sleep

A
  • no eye movement
  • Easily wake
  • Dreaming rare
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8
Q

Stage III sleep is also called

A

slow-wave sleep (SWS)

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9
Q

Stage III sleep is characterized by

A

delta waves

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10
Q

Describe Stage III sleep

A
  • Dreaming is more common in this stage than other NREM stages
  • Parasomnia is most common here
  • Amount of time spent in SWS decreases with increases in age
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11
Q

Describe REM sleep

A
  • Defined by
    • Rapid eye movement
    • Muscle atonia
    • EEG desynchronization
  • Brain activity similar to that during waking hours (paradoxical sleep)
  • Lightest stage of sleep
  • Normally occurs close to morning
  • REM periods in the beginning of the night are shorter than at the end
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12
Q

Describe the effect each drug has on sleep

  • Presleep alcohol
  • Marijuana
  • Benzons
  • TCAs
A
  • Presleep alcohol= REM supression early in ngiht
  • Marijuana= SWS depression with chronic use
  • Benzons= supress SWS
  • TCAs and MAOIs= Supress REM
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13
Q

Snoring is (inspiratory/expiratory) noise

A

inspiratory

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14
Q

Describe the differences between benign and pathological snoring

A

Bengin

  • Soft palate vibration
  • No mechanical impingement to breathing

Pathological

  • Pharyngeal narrowing
  • Higher pitched noise
  • Higher frequency
  • Turbulent airflow
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15
Q

Increased snoring leads to increased risk of carotid_

A

atherosclerosis

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16
Q

Upper airway resistance syndrome is defined as

A
  • Crescendo snoring
  • Arousal with snoring –> sleep fragmentation
  • No O2 desaturation
  • Frequent RERAs (Respiratory effort related arousal
  • Common in thin women menopausal
  • Inspiration and expiration take the same amount of time
17
Q

In normal breathing which takes longer inspiration or expiration

A

inspiration (3x)

18
Q

what are the three different kinds of sleep apnea and describe them

A
  • Obstructive= absence of airflow despite breathing effort
  • Central apnea= absence of airflow due to lack of breathing effort
  • Mixed- both
19
Q

Sleep apnea signs and symptoms

A
  • Snoring
  • Excessive daytime sleepiness
  • Awakening with gasps or choking
  • Fragmented light sleep
  • Poor memory
  • Irritable
  • Decreased sex drive
  • Morning headaches
  • GERD
20
Q

Prevalence of sleep apnea is higher in (men/women)

A

men

21
Q

Risk factors for OSA

A
  • Obesity
  • Snoring
  • Witnessed apneas
  • Neck circumference (male= >17 inches and women >15 inches)
  • Large tongue (scalloping)
  • HTN
  • etc.
22
Q

Presence of OSA is a predictor for what major CV event

A

MI

23
Q

Define apnea and hypopnea

A

Apnea= cessation of breathing for at least 10 seconds

Hypopnea= At least a 30% reduction in airflow for 10 seconds at least 4% reduction in blood oxygen

24
Q

What is the AHI

A

Apnea/hypopnea index (total number of apnea and hypopnea events her hr of sleep)

25
Q

What is RERA

A

Respiratory effort related arousal

26
Q

What is RDI

A

Respiratory Disturbance index (total number of apnea, hypopnea, and RERA) events per hr of sleep Always higher than AHI

27
Q

About _% is good O2 saturation

A

90

28
Q

Describe the different classifications for AHI scoring

A

none/minimal <5 per hr
mild more than 5 less than 15 /hr
moderate is more than 15 less than 30 /hr
severe is more than or equal to 30 /hr

29
Q

What does stop-bang stand for

A 
Snoring
tiredness
observed apnea 
high blood pressure 
body mass index
age
neck circumference 
gender
30
Q

Gold standard treatment for OSA is

A

CPAP

31
Q

Oral appliances are first line therapy in what pateints

A

mild to moderate OSA or with snoring

32
Q

Oral appliances are contraindicated when

A
  • Insufficent dentition
  • Perio disease
  • Dental decay
  • TMJ pain
  • Restricted mandibular opening or protrusion
33
Q

Side effects of occlusal appliances

A
  • Muscle or TMJ pain
  • Excess saliva
  • Early morning occlusal discomfort
  • Tongue, tooth, gum discomfort
  • Occlusal changes (~14% of patients)

TMD (13 decks)

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