Chapter 8: Sleep-Wake Disorders Flashcards
Dyssomnia
all disordered sleeping that has to do with trouble getting to sleep, trouble maintaining sleep, or complaints about quality of sleep
Parasomnia
all disordered sleeping that has to do with abnormal behaviour/physiological during sleep, like sleepwalking or sleep terrrors
Chronotype
when you like to go to bed/whether you’re a night or morning person, which is heavily influenced by your environment and circadian rhythm
Polysomnographic Evaluation
PSG; the clearest and most comprehensive test for sleep issues
sleep in the lab! :)
Insomnia
characterised by complaint of sleep quality for 1/3 reasons
- difficulty initiating sleep
- difficulty maintaining sleep
- early morning awakenings
persisting for 3+mo, 3x a week
Etiology for Insomnia
lack of temperature drop when drowsy
differences in usual environment
anxiety because of bedtime preventing sleep
sleep stress: negative pre-sleep routines
Treatment for Insomnia
short acting drugs like triazolam and zaleplon
melatonin
benzodiazepines
CBT-I
progressive relaxation
graduated extinction
guided imagery relaxation
Rebound Insomnia
when taking a sleeping aid and suddenly withdrawing, symptoms of insomnia return
Hypersomnolence Disorders
characterised by a self proclamation of excessive sleepiness despite 7+ hr of sleep
1 of the following:
- recurring periods of sleep/lapses into sleep within the same day
- 9+hr of sleep that is nonrestorative
- Difficulty being fully awake after abruptly awakening
must persist 3x week for 3mo
Treatent for Hypersomnolence Disorders
usually involves a stimulant drug
catalepsy can be treated with antidepressants
Narcolepsy
characterised by a lapsing or uncontrollable need to sleep
1 of the following catalepsy categories:
- if long standing disease: loss of bilateral muscle tone following laughing or joking, but maintaining consciousness
- In children/people w/i 6mo of onset, spontaneous grimacing or jaw opening episodes with thrusting tongue, no triggers
hypocretin deficiency
REM latency lasts less than 15 minutes
Catalepsy + REM
bypasses the sleep cycles and goes straight to REM sleep while fully awake
sleep paralysis also usually comes w/ catalepsy/narcolepsy
Breathing Related Sleep Disorders (3)
obstructive sleep apnea hypopnea
central sleep apnea
sleep related hypoventilation
Obstructive Sleep Apnea Hypopnea
characterised by 5 interruptions per hour of sleep
nocturnal breathing disturbances
Treatment for Obstructive Sleep Apnea Hypopnea
CPAP (continuous positive air pressure machine)
weight loss
Central Sleep Apnea
characterised by 5 interruptions per hour of sleep, with a paused respiratory rate that results in waking up
not characterised by daytime sleepiness like others
Sleep Related Hypoventilation
characterised by a decreased breathing rate while sleeping, along with elevated CO2 levels, though breathing doesn’t stop
Circadian Rhythm Sleep Disorder
characterised by disturbances in sleep due to inability to synchronise sleep patterns to match environmental cues of night and day
can lead to excessive sleepiness or insomnia (or both)
Treatment for Circadian Rhythm Sleep Disorder
phase delays: moving bedtime later and later until it is the set time
phototherapy
Parasomnia Disorders (3)
nightmare disorder
nonrapid eye movement sleep arousal disorder
rapid eye movement sleep behaviour disorder
Nightmare Disorder
characterised by dreams that are usually about a threat to one’s safety, security, or survival, and occur in the second half of a major sleep episode
waking out of sleep alert and oriented
Nonrapid Eye Movement Sleep Arousal Disorder
characterised by incomplete awakening followed by either night terrors or sleepwalking
not easily comforted after sleep terrors
sleep walkers are relatively unresponsive
no dream imagery
amnesia of the event
Somnambulism
sleep walking
Rapid Eye Movement Sleep Behaviour Disorder
characterised by repeated episodes of arousal during sleep with complex vocalisations/motor behaviour, occurring during REM sleep
alert when woken up
1 of the following
- REM sleep w/muscle tone (no atonia)
- history suggestive of REM sleep behaviour disorder
