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GAM > Sleep 1: Insomnia & OSA > Flashcards

Sleep 1: Insomnia & OSA Flashcards

1
Q

What Rx for insomnia?

A

Behavior + Rx

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2
Q

What are some strategies of behavior change in sleep?

A
  • Stimulus control
  • Bedtime habits
  • Regular sleep time
  • Sleep ritual
  • If unable to sleep 15-20 minutes, get up do something soothing
  • Avoid screen and bright light
  • Relaxation techniques
  • CBT
  • Sleep restriction
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3
Q

How to sleep restrict?

A
  • increase meaningful sleep time
  • Ratio of time asleep to time in bed > 90%
  • increase by 15 minutes increments
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4
Q

What risk is involved in sleeping aids?

A

Fall

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5
Q

T of F: please, try best to avoid antihistamine in the elderly

A

T

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6
Q

What is the rule of Rx?

A
  • Lowest effective dose
  • Use intermittent dosing
  • D/C gradually
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7
Q

Which Rx is better for sleep onset insomnia?

A

Zolpidem (Ambien)

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8
Q

Whichn Rx is better for sleep maintenance?

A

Eszopicolone (Lunesta), Zolpidem ER

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9
Q

Is Zolpidem short-acting or long-acting?

A

Short

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10
Q

Is Eszopicolone short-acting or long-aciting?

A

Long

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11
Q

2nd line of meds

A
  • Trazodone
  • Benzos
  • Short-aciting non-benzo (zaleplon, zolpidem)
  • Melatonin
  • Antihistamine (doxepin)
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12
Q

What is the definition of OSA?

A

repeated episodes of apnea or hypopnea during sleep with excessive daytime sleepiness or altered cardiopulmonary function

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13
Q

What is apnea?

A

cessation of airflow for mroe than 10 sec

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14
Q

What is hypopnea?

A

Transient reduction fo airflow for mroe than 10 secs with more than 4% oxygen desat

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15
Q

What are the RF for OSA?

A
  • increase neck circ (17 cm)
  • Male
  • obesity
  • smoking
  • HTN, HF
  • hx of hypothyroidism
  • Asian
  • Upper airway structual abnormalities
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16
Q

What is the eval tool for OSA called?

A

Epworth sleepiness scale

17
Q

What is the sleep study tool?

A

Polysomnography

18
Q

What is the result of sleep study include?

A

AHI - apnea-hypopnea index

19
Q

Medicare CPAP depends on

A
  • polysomnography results, # of AHI and Sx
20
Q

Mgt of mild OSA

A
  • Wgt loss, Lifestyle change, oral appliance
21
Q

Mgt of moderate to severe4 OSA

A

CPAP

  • avoid EtOH and sedatives
  • lateral sleep position
  • weight loss
22
Q

What Rx to give for excessive daytime sleepiness?

A

Modafinil

23
Q

How successful is Uvulopalatopharyngoplasty?

A

Less than 50% successful

GAM (27 decks)

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