Sleep Flashcards
what is the sleep disorders questionnaire?
a tool to guide assessment of insomnia and direct ddx to a particular cause (insomnia, psychiatric, circadian rhythm, movement disorder, parasomnias)
what is the insomnia severity index
assess the nature, severity, and impact of insomnia on adult population - can be used to monitor response to treatment
what is the epworth sleepiness scale
subjective test to determine level of sleepiness with may point to underlying sleep disorder
what are the 6 Ps?
pain, pills, pee, partner, physical environment, paroxysmal noctural dyspnea (PND)
what are the 5 most common meds that disrupt sleep?
Levodopa
prednisone
venlafaxine
fluvoxamine
rotigotine
what is first line treatment for sleep disturbance?
CBTi - comprised of sleep hygiene, stimulus control therapy, sleep restriction therapy, relaxation exercises, and cognitive therapy
what are the hypnotic pharm options for sleep disturbance
Benzodiazepines: flurazepam, oxazepam, triazolam
Z-drugs: zopicoline & eszopiclone
sedating antidepressants: trazodone, remeron (mirtazapine), TCA
what is first line pharm?
melatonin
what other meds (not hypnotic or melatonin) are available for sleep diturbance?
magnesium, orexin-antagonists, cannabis
what is the diagnostic criteria for OSA? (STOPBANG)
Snore
Tired
Observed Apnea
bP high
BMI >35
age >50
neck circumference >40cm
gender male
what are management options for OSA
CPAP
Weight loss
bed positioning
NO sedatives
avoid alcohol & smoking
