First Aid: Sleep disorder Flashcards
Dyssomnias
insufficient, excessive, or alliterated timing of sleep
- difficult to fall or remain asleep
- occurs 3 days for a week for at least 3 months
Parasomnias
Unusual sleep-related behaviors
acute insomnia
less than 3 months
chronic insomnia
lasts greater than or equal to 3 months
first line therapy for chronic insomnia
CBT
medication treatment for insomnia
Benzodiazepines: reduce sleep latency and nocturnal awakening
- Zolpidem, eszopiclone, zaleplon
- Trazadone
Hypersomnia
excessive quality of sleep despite 7 hours of sleep
- 3 times a week for 3 months
Etiology of hypersomnia
Viral infections
genetic
head trauma
treatment for hypersomnia
life-long modafinil or stimulant
scheduled napping
apneic episode
cessation of breathing or hypopneic episodes of reduced airflow
treatment for obstructive sleep apnea
- CPAP
- surgery
Cheyne stroke breathing
pattern of periodic crescendo-decrescendo variation in tidal volume due to medical condition
besdies cheyne stroke breathing, what else can cause central sleep apnea
opioid use
treatment for central sleep apnea
CPAP
- treat underlying cause
narcoleptic cataplexy
loss of muscle tone
catatonic catalepsy
unprovoked muscular rigidity
hyponopmic halllucination
occurs when waking up
Hypnagogic hallucination
going to sleep
what does polysomnography show for narcolepsy
reduced REM sleep latency
tetrad for narcolepsy
- excessive daytime sleepiness
- REM-related sleep phenomena: inability to move
- hypnagogic or hypnopompic hallucinatoins
- cataplexy
treatment for cataplexy
- sodium oxybate
- TCA
- SSRI
What coordinates 24-hour or circadian rhythmicity
suprachiasmic nucleus in hypothalamus
Delayed sleep phase disorder
chronic or recurrent delay in sleep onset and awakening times with preserved quality and duration of sleep
Advanced sleep phase disorder
normal duration and quality of sleep with sleep onset and awakening times earlier than desired
shift work disorder
sleep deprivation and misalignment of the circadian rhythm secondary to nontraditional work hours
jet lag disorder
sleep disturbances associated with travel across multiple times zones
treatment for Delayed sleep phase disorder
phototherapy
melatonin
treatment for Advanced sleep phase disorder
phototherapy before bedtime
name the nonREM sleep disorders
sleepwalking
sleep terrors
nightmare disorder
name REM sleep disorder
restless legs syndrome
treatment for sleep walking
no needed
- refectory cases may use benzos
sleep terror
dreams are not remembered
sleep terror comorbid with
sleep walking
when does sleep terror occur
slow-wave sleep
when does nightmare disorder occur
second half of sleep episode
treatment for nightmare disorder
- desensitization/imagery rehersal therapy
- Prazosin for PTSD
is there confusion after REM sleep distrubance
no
deficiency in what can cause restless leg syndrome
iron
first line treatment for restless leg syndrome
dopamine agonists and benzodiazepine
treatment for refractory restless leg syndrome
opioid
