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05 Psych > 14de Sleep and PTSD > Flashcards

14de Sleep and PTSD Flashcards

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0
Q

Stage 1 sleep

A

Theta waves

  • 5% sleep
  • 10 mins
  • slow regular breathing, =HR, dec. BP temp and cranial blood flow,
  • easily awoken
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1
Q

Rem sleep

A

Random pattern with sawtooth waves

  • 25% of sleep
  • 90 minute cycles 10-40 minutes each
  • ^ Bp, pulse, resp
  • erection
  • Skeletal muscle paralysis
  • dreams
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2
Q

Stage 2 sleep

A

K complexes and sleep spindles

  • 45% sleep (MOST TIME)
  • 20 mins
  • slowing bodily functions
  • blindness
  • awoken by sounds
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3
Q

Stage 3 and 4

A

Delta waves

  • 25% sleep- most during first 1/2 of night
  • 30-45 mins after start of sleep
  • wakens only to loud noises and active wakening attempts
  • Stage 4 is disoriented upon awakening
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4
Q

Awake

A

Alpha and beta waves

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5
Q

Aging sleep changes

A
  • Increased latency and awakenings

* decreased REM and DELTA

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6
Q

Depression sleep changes

A
  • Frequent awakenings, early waking
  • Decreased rem latency- INCREASED REM
  • Decreased DELTA
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7
Q

Dyssomnias

A

Abnormal timing

  • Narcolepsy
  • Cicadian rhythm sleep disorder

Abnormal quality

  • RLS
  • Apnea

Abnormal amount

  • insomnia
  • hypersomnia
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8
Q

Parasomnia

A

Bruxism -stage 2
Night terror and sleepwalking - DELTA
REM sleep behavior disorder

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9
Q

Narcolepsy

A
  • Sleep attacks
  • hallucinations hypnagogic(going to sleep)and(hypnopompic)post sleep
  • cataplexy
  • sleep paralysis

-decreased sleep latency, decreased rem latency, less rem

  • Orexin D
  • adolescent
  • significant genetic component

Tx: Schedduled naps, stimulants: ritalin/methylphenidate and modafinil/provigil

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10
Q

Circadian Rhythm sleep disorder

A
  • inability to sleep at appropriate times (delayed or advanced)
  • blindness, head trauma, shift work etc.

Tx: Melatonin for delayed, Light for Advanced
Modafinil/caffeine for shift work, Melatonin/hypnotic at bed

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11
Q

RLS

A
  • uncomfortable sensation in legs leading to jerking
  • frequent awakenings
  • older adults

TX:
Anti-parkinsonian agents
Levodopa, carbidopa, ropinarole

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12
Q

Apnea

A

Cessation of breathing
Frequent reawakenings
increased risk sudden death

Tx: weightloss, CPAP, Medroxyprogesterone acetate, uvuloplasty/tracheostomy

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13
Q

Insomnia

A 
Increased sleep latency and awakenings
>3x/wk, one month or more
Daytime sleepiness
*30% population
*cognative impairment common

Tx:
No caffeine, AM exercise, Sleep routine and relaxation technicques, Hypnotics

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14
Q

Bruxism

A

STAGE 2

Tx: dental appliance

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15
Q

REM Sleep behavior disorder

A

Motor activity while dreaming
Awakens with dream memory
Associated with parkinson diseasee and LBD

Tx:
melatonin, low dose benzos, and environment protection

16
Q

PTSD

A
  • repeated re-experiencing threat of death, serious injury, or sexual violence directly or in close proximity
  • symptoms last > 1 month
  • significant distress
  • Repeated intrusions/relivings
  • avoidance of stimuli associated with trauma
  • Hyperarousal
  • Emotional Numbing
17
Q

PTSD epidemiology

A

40-45% of natural disaster survivors, Disaster workers
6.8% US adults - 3.6% men, 9.7% women

30.9% male vietnam vets, 26.9% female vietnam vets
10-30%firefighters
19.3% EMS
13.8% Iraqi and enduring freedom
12% gulf war vets
10-15% law enforcement
18
Q

PTSD Neurophys

A

Increased Amygdala response:

  • Safe or not safe barometer- ANXIETY
  • Lateral amygdala input
  • central amygdala output

Decreased Hippocampus
*contextualizes fear - is lion in cage or free

Less prefrontal cortex activation
*Shutoff of communication and higher level processing by amygdala

19
Q

PTSD Psychotherapy

A
  • Traumatic memories stored with High arousal- Must be accessed wit high arousal
  • Anxiety helps us avoid fear evoking stimuli
  • Avoidance blocks exposure that promotes extinction - re-expose to fix
20
Q

PTSD CBT

A
  • Most effective
  • Stress inoculation- desensitization
  • imagery rescripting and reprocessing
  • Congnative restructuring within reliving
  • Imaginal/In Vivo exposure
  • Cognative processing therapy
21
Q

PTSD Screening Type I trauma

A

Have you experienced any vivd thoughts about event?
What do you believe caused event?
Are you able to return to the place of event?
What do you think could have been done to prevent event?

22
Q

PTSD screening tool

A
  • Concentration problems?
  • sleep disturbances?
  • Hyper-vigilance/ increased startle
  • Increased irritability
  • Changes in mood
  • appetite changes
23
Q

PTSD Type II trauma screening

A
  • somatic complaints with neg diagnostic testing
  • chronic depression/anxiety
  • difficulty sleeping
  • difficulty concentrating
  • memory problems
  • flashbacks/nightmares
  • increased startle response
  • difficult with certain foods
  • difficulty with anger
  • Trust issues

05 Psych (8 decks)

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