PATHOPHYS: Sleep Medicine Flashcards
What is the behavioral definition of normal sleep?*
a reversible state of perceptual disengagement from (and unresponsiveness to) the environment
What is normal sleep USUALLY accompanied by?*
Postural recumbency
Physical quiescence
How much of every day do we sleep?
around 8 hours
How many years of our life do we sleep?
25 years (so sleep takes up around 1/3 of our life–and this is important for many reasons)
What are some symptoms seen by sleep specialists?*
- Sleepiness
- Insomnia
- Snoring
- Abnormal behaviors
- Nightmares
- Abnormal movements
What is insomnia closely linked to?
depression
What things should you ask about during a patient’s history in the sleep clinic?
medications pain medical conditions depression environmental "problems" bed partner
What is mallampati?*
amount of airway obstruction
What is class 4 mallampati?
when you can see no glottis
Why is the mouth important to examine?
teeth grinding
airway
etc.
Who have more sleep problems, the young or the elderly?
elderly
What causes of morbidity and mortality can be caused by sleep deprivation?
- Car accidnets
- Cognitive harm
- CVD
- HTN
- CHF/PHTN
- A Fib
How is the heart linked to sleep?
sleep interruptions arouse the brain (giving increases in epinephrine) so that you do not get normal BP drop at night
How often do you have REM sleep?
every 90 minutes (and the periods of REM get longer as the night progresses)
What is REM sleep associated with?
muscle paralysis and brain activity is ON
What is the role of the thalamus in sleep? When you are awake?
produces disengagement during sleep
Awake: place where all sensory information stops before going to brain
What is the role of the suprachiasmatic nucleus in sleep?
controls the “switch” of going to sleep at night and waking up in the morning
What are of the brain controls the “need” for sleep?
hypothalamus
What hormones are released when we are sleeping?
melatonin
growth hormone
prolactin
etc.
What is OHS?
obesity hypoventilation syndrome (people have CO2 retention at night and during hte day)
What is RLS?
restless leg syndrome
What is parasomnia?
movement/behavior during sleep
What causes periods of no breathing in sleep apnea?
hypoid bone is just attached to ligaments, so during REM sleep, when the muscles relax, the airway can collapse (usually collapse is correlated with weight gain pusing down on airway in neck)
What is the prevalence of men and women aged 30-60 with diagnosed sleep apnea?*
4% men
2% women
What percentage of people with sleep apnea are not diagnosed?
50%
What are the common symptoms of sleep apnea?
snoring + day time sleepiness
What is the treatment used for sleep apnea?
CPAP- cutaneous positive airway pressure
What is a multiple sleep latency test?
EEG defined sleep latency during 4-5 daytime naps
What is the Epworth sleepiness scale?
self-reported tendency to fall asleep in 8 different situations in their soporific nature
What are the major symptoms of narcolepsy?
Excessive daytime sleepiness
Cataplexy
Hypnagogic hallucinations
sleep paralysis
