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MEDS 525 - Mental Health > 7. Sleep Disorders > Flashcards

7. Sleep Disorders Flashcards

1
Q

Why is sleep important?

A
  • sleep deprivation can be fatal
  • lack of sleep or too much sleep can lead to comorbidities
  • flushes out toxins
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2
Q

Causes of sleeplessness include:

A
  • caffeine (coffee/tea, soft drinks)
  • alcohol
  • medication
  • stress
  • noise/ distracting surroundings
  • phones, TVs, technology
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3
Q

T/F everybody needs the same amount of sleep

A

FALSE. The required amount of sleep varies with age. Typically, more sleep is needed when younger.

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4
Q

Stage 1 (sleep cycle)

A
  • drowsiness, light sleep
  • slow eye movement
  • sawtooth pattern
  • alpha waves
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5
Q

Stage 2 (sleep cycle)

A
  • asleep
  • slow eye movement
  • body temperature decreases and HR begins to slow
  • first stage of NREM
  • sleep spindles and K complexes
  • theta waves
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6
Q

Stage 3 and 4 (sleep cycle)

A
  • deepest sleep
  • difficult to wake
  • most restorative stage of sleep
  • mostly slow waves
  • delta waves
  • NREM
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7
Q

REM (sleep cycle)

A
  • paradoxical sleep
  • dreaming
  • body effectively paralyzed, muscle atonia
  • rapid eye movement
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8
Q

Common consequences of lack of sleep:

A
  • decreases productivity
  • comorbidities
  • might need stimulants like caffeine to stay awake
  • difficult to function (i.e. driving sleep deprived is just as dangerous as driving intoxicated)
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9
Q

Consequences of lack of sleep on the GI system & causes

A
  • peptic ulcers, constipation, diarrhea

- eating at unusual times, poor diet, increased consumption of caffeinated beverages and/or alcohol

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10
Q

Consequences of lack of sleep on the cardiovascular system & causes

A
  • myocardial infarction, heart failure, total and cardiovascular mortality
  • change in hormone secretions regulating metabolism, change in sympathetic and parasympathetic cardiac regulation, increased tobacco use, reduced physical activity
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11
Q

Consequences of lack of sleep on the endocrine system & causes

A
  • diabetes, metabolic syndrome, increased cholesterol and triglycerides
  • disruptions in hormone secretions involved in appetite regulation and glycemic control, poor diet, lack of exercise
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12
Q

Consequences of lack of sleep on the reproductive system & causes

A
  • decreased fertility, problems with pregnancy, menstrual irregularities
  • disruption of hormone secretions, elevated stress, lack of needed nutrients in diet
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13
Q

Consequences of lack of sleep on the neuro/psych system & causes

A
  • impaired memory and/or cognition, anxiety, depression

- lack of exposure to sunlight, lack of social interaction, increased potential for alcohol use

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14
Q

Consequences of lack of sleep in general:

A
  • breast cancer, colorectal cancer, prostate cancer
  • possible alterations in cancer-related pathways, changes in hormone production connected to specific cancers, immune system function impairment
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15
Q

T/F: The glymphatic system is activated during sleep.

A

True

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16
Q

What two tests did we discuss for studying sleep?

A

EEG-electroencephalogram

MSLT-multiple sleep latency test

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17
Q

EEG

A

tracks and records brain wave patterns to find problems related to electrical activity of the brain

18
Q

MSLT

A
  • sleep disorder diagnostic tool that usually takes a full day
  • commonly used for to test for narcolepsy
  • 5 schedules naps separated by breaks
  • measures how long it takes to fall asleep, also includes light in testing (light on=awake, light off=time)
  • based on the idea that you will fall asleep faster the more tired you are
19
Q

World view of sleep (map based on survey)

A

US: most likely to take a drug or use sleep aid
Brazil: least time between eating last meal and bedtime
UK: most impacted by SO sleep habits
France: larger bedroom
Germany: least distracted by TV/technology
S. Korea: most likely to sleep on floor, most stressed

20
Q

Sleep Quality World Comparison (Best and Worst)

A

Best: Switzerland
Worst: USA

21
Q

Nocturnal Sleep Problems by Gender in Africa and Asia (women)

A

highest: Bangladesh
lowest: Indonesia

22
Q

Nocturnal Sleep Problems by Gender in Africa and Asia (men)

A

highest: Vietnam
lowest: Kenya and Indonesia (tie)

23
Q

What are the sleep/wake disorders?

A 
Insomnia Disorder
Hypersomnolence Disorder
Narcolepsy
Breathing-related sleep Disorder
Circadian Rhythm Sleep-Wake Disorder
Non-REM Sleep Arousal Disorders
Nightmare Disorder
REM Sleep Behavior Disorder
Restless Leg Syndrome
Substance/Medication-Induced Sleep Disorder
24
Q

Insomnia Disorder is characterized by complaint of dissatisfaction w/ sleep quality plus one or more of:

A
  • difficulty initiating sleep
  • difficulty maintaining sleep
  • early morning awakening w/ inability to return to sleep
  • Remember 3x3 criteria
25
Q

_____ _____ causes clinically significant distress or impairment in social, educational, academic, behavioral, or other important areas of functioning.

A

Sleep disturbance

26
Q

T/F time is important for an insomnia diagnosis.

A

TRUE. Remember the 3x3 criteria.

27
Q

3x3 criteria

A

-must occur for at least 3 nights per week and be present for at least 3 months

28
Q

Sleep disturbance from insomnia:

A
  • occurs despite adequate opportunity for sleep
  • is not better explained by another sleep disorder
  • not attributable to the psychological effects of substance abuse
29
Q

Hypersomnolence Disorder

A

excessive sleepiness after 7+ hrs of sleep w/ 1 of :

  • 9+ hrs nonrestorative sleep
  • recurrent sleep periods or lapses into sleep on the same day
  • trouble being fully awake after abrupt awakening
30
Q

Restless Leg Syndrome (symptoms)

A
  • sharp pulling, tingling, drawing, bubbling pain beneath the skin in calf area
  • irresistible urge to move legs
  • periodic involuntary limb movement
  • severe insomnia, anxiety, depression
  • lack of social activity
31
Q

Narcolepsy

A
  • recurrent periods of an irrepressible need to sleep or napping occurring w/in the same day
  • 3x3 criteria
32
Q

Narcolepsy includes at least 1 of the 3 following:

A
  • cataplexy
  • hypocretin deficiency
  • REM sleep latency = 15 minutes by nocturnal sleep PSG or MSLT = 8 minutes and 2+ onset REM periods
33
Q

Circadian Rhythm

A
  • Approximately a 24-hour cycle, also known as the sleep/wake cycle that is modulated by sunlight and body temperature
  • works best with regular sleep
34
Q

SCN

A
  • suprachiasmatic nucleus

- aka biological clock

35
Q

What is the impact of light on the circadian rhythm?

A

Light stimulates the hypothalamus to send “tired” signals that stimulate the release of melatonin from the pineal gland

36
Q

How is the “tired” signal transmitted?

A
  1. Light/darkness is detected by the eye
  2. Signal travels along eye-pineal neuron to SCN (suprachiasmatic nucleus)
  3. Signal from SCN to PVN (paraventricular nucleus)
  4. PVN to spinal cord
  5. Spinal cord to SCG (superior cervical ganglion)
  6. SCG to pineal gland where melatonin production is stimulated
37
Q

Circadian Rhythm Cycle

A
  • not absolute, can fluctuate
  • biggest dips are usually early in the morning when most are sleeping (2-4 am) and lunchtime (1-3 pm)
  • ideally aligns with sunlight/nightfall
38
Q

Circadian Rhythm Disorders: Non-24 (blind)

A
  • sleep times out of alignment, doesn’t follow normal night sleep times
  • sleep shifts a little later each day
  • don’t have 24-hour reset due to lack of light, wake up later and later
  • often don’t sleep until morning (sun up)
39
Q

Circadian Rhythm Disorders: Shift work

A
  • difficult to adjust to work schedule
  • only characterized as a disorder if unable to adjust after several weeks of working
  • typically sleepy at work, and alert when they have time to sleep (producing melatonin when working)
40
Q

Circadian Rhythm Disorders: Time Zone Change/Jet Lag

A
  • difficulty adjusting after traveling across multiple time zones (@ least 2)
  • usually takes one day per time zone to adjust
  • Does it meet 3x3 criteria?

MEDS 525 - Mental Health (9 decks)

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