Chapter 19: Sleep Flashcards
Polysomnography
All-night test using electrodes to diagnose sleep-
related disorders and nocturnal seizure disorders
Insomnia Disorder
Difficulty with sleep initiation
Sleep maintenance
Early awakening
Nonrefreshing, nonrestorative sleep
Symptoms 3 times a week for at least 3 months
Narcolepsy
Uncontrollable need to sleep
Symptoms
Irresistible attacks of refreshing sleep, cataplexy,
sleep paralysis, and hypnagogic hallucinations
Do not feel rested regardless of amount of sleep
Diagnosis: measuring hypocretin levels
Treatment—lifestyle modifications and long-
acting stimulant medication
Can see levels of proteins to determine severity of narcolepsy symptoms
Obstructive Sleep Apnea
Hypopnea Syndrome
Repeated episodes of upper airway collapse
and obstruction
Results in sleep fragmentation
Cannot breathe and sleep at the same time
Diagnosis
Clinical evaluation and polysomnography
Treatment
Continuous positive airway pressure (CPAP) therapy
Restless Legs Syndrome
uncontrollable urge to move legs, especially at night. Some explain as tingling, burning, itching, discomfort. Alcohol, nicotine, caffeine. Look up in textbook (nonpharmalogical)
How do you know when they’re getting better
pt says so
Sleep latency:
the time it takes to fall asleep (associated with N1 stage)
Sleep architecture:
structural organization of NREM and REM sleep
Hypnogram:
Graphic display of sleep architecture
Sleep continuity:
Distribution of sleep and wakefulness across the sleep period
Sleep fragmentation:
Disruption of sleep stages
Sleep efficiency:
Ratio of sleep duration to time spent in bed
Sleep drive:
Homeostatic process; promotes sleep
Circadian drive:
Process that promotes wakefulness
Zeitgebers:
Exogenous factors that help set our eternal clock to a 24-hour cycle (“time-givers”)
Master biological clock:
SC nucleus in the hypothalamus that regulates a host of functions
Basal sleep requirement:
Amount of sleep necessary to feel fully awake and sustain normal levels of performance
3P Model of Insomnia
Predisposing factors: light sleeper/night owl
Precipitating factors: events that trigger insomnia (job stress, grief)
Perpetuating factors: sleep practices that maintain the sleep complaint (caffeine, too much time hanging out in bed)
obstructive vs central vs sleep-related sleep apnea
obstruction from airway collapse
central related to aging, advanced cardiac/pulmonary disease
sleep-related associated w/ morbid obesity O2 desat in sleep
