Sleep Flashcards
What acronym is used to recall the sleep stages and their associated findings?
at night BATS Drink Blood
at night BATS Drink Blood
Awake = Beta waves
Awake but eyes closed = Alpha waves
Stage 1 = Theta waves
Stage 2 = Sleep spindles and K complexes
Stage 3 = Delta waves
REM = Beta waves
at night BATS Drink Blood
Awake = Beta waves
Awake but eyes closed = Alpha waves
Stage 1 = Theta waves
Stage 2 = Sleep spindles and K complexes
Stage 3 = Delta waves
REM = Beta waves
What stage of sleep is the hardest to arouse from?
Stage 3 NREM
Besides Beta waves, what will be seen during REM sleep? (3)
Erections
Atonia
Rapid eye movements
During what stage of sleep do Nightmares occur?
REM
During what stage of sleep do Night Terrors occur?
Stage 3 NREM
Describe Night Terrors in order to differentiate from Nightmares
Patient is active/moving and seems awake but is NOT and will not usually remember the event
How do you know Night Terrors occur during Stage 3 NREM?
Patient is moving and seems awake
– During REM = ATONIA (nightmares)
Treatment for Night Terrors?
Will often be outgrown
What is the cause of Obstructive Sleep Apnea?
Excess tissue in the airway/obstruction, obesity
–> this will cause frequent awakenings during the night which means they are not making it to REM
What are the signs of Obstructive Sleep Apnea?
Snoring
Daytime somnolence
Depression/HTN/Cor Pulmonale
What is the treatment for Obstructive Sleep Apnea?
CPAP and lose weight
What are some causes of Central Sleep Apnea?
Opiates
COPD
Idiopathic
What occurs with Central Sleep Apnea?
Patient “forgets” to breathe while sleeping which results in low oxygen saturation
What may a patient with Central Sleep Apnea wake up with?
Headaches and mood changes
What is the treatment for Central Sleep Apnea?
BiPAP
How are the sleep disorders usually diagnosed?
Polysomnography (sleep study)
Insomnia is trouble falling or staying asleep. How often must it occur to be diagnosed?
More than 3x/week for > 1 month
What is the best initial treatment for Insomnia?
Sleep hygiene
If a patient still has Insomnia after changing their sleep hygiene, what are 4 drugs that can be used?
Diphenhydramine
Trazodone
Quetiapine
Zolpidem
If a patient still has Insomnia after changing their sleep hygiene, what are 4 drugs that can be used?
Diphenhydramine
Trazodone
Quetiapine
Zolpidem
What often causes an episode of Narcolepsy?
Something that startles them or an intense emotion
With Narcolepsy, the patient will fall right into what stage of sleep?
REM
List 4 signs of Narcolepsy?
Cataplexy
Sleep paralysis
HynaGOgic and Hypnopompic hallucinations
List 4 signs of Narcolepsy?
Cataplexy
Sleep paralysis
HynaGOgic and Hypnopompic hallucinations
What is Cataplexy?
Sudden loss of muscle tone that leads to collapse
- Seen with Narcolepsy
What is Sleep Paralysis?
Brief paralysis upon awakening
- Seen with Narcolepsy
When do Hypnagogic hallucinations occur?
As the patient is falling asleep
When do Hypnopompic hallucinations occur?
As the patient is awakening
How often must the Narcoleptic episodes occur in order to diagnose?
> 3x/week for > 3 months
What is the best initial treatment for Narcolepsy?
Scheduling naps
What drug class and specific drug are often used for Narcolepsy?
Stimulants
- Modafinil
What specific drug class can be used to treat the Cataplexy with Narcolepsy?
SSRIs
