Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Lifestyle Medicine > Sleep > Flashcards

Sleep Flashcards

1
Q

What is first line treatment for insomnia?

A

CBT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What type of disorders is bright light therapy good for?

A

circadian and phase shift disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the components of CBT for insomnia?

A

sleep hygiene, stimulus control, sleep restriction, cognitive therapy and relaxation therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is stimulus control in regards to sleep?

A

stimulus control seeks to reassociate lying in bed with sleep.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is sleep hygiene?

A

focuses on healthy sleep practices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is considered the body’s master clock?

A

the suprachiasmatic nucleus (SCN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are physiologic changes induced by healthy sleep?

A

Lower cortisol and glucose
greater insulin sensitivity
higher daytime leptin and reduced food seeking behaviors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how does healthy sleep impact cardiovascular disorders?

A

lower sympathetic tone and bp
greater nighttime peripheral perfusion and core body temp cooling
increased stamina and faster cardiovascular recovery time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are short duration and disrupted sleep correlated with metabolic disorders?

A

elevated BMI
Obesity (2 fold increased risk)
metabolic syndrome
type 2 diabetes
cardiovascular risk and mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does impaired sleep and/or short sleep duration effect cardiovascular disorders?

A

elevated sympathetic tone
endothelial injury
dyslipidemia
elevated BP
reduced nighttime peripheral perfusion
increased nighttime core body temp
refractory hypertension
increased heart attacks
increased risk of cardiovascular disease deaths

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does impaired sleep quality and short sleep effect mood and cognition?

A

Less REM sleep
reduced BNF
impaired learning and memory
emotional distress, imparied moral judgement, and misinterpretation of social cues
decreased alertness and cognitive processing speed
diminished extinguishing of fear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What behavioral health disorders are short sleep correlated with?

A

major depression
bipolar disorder
seasonal affective disorder
premenstrual syndrome
worsened PTSD, if the sleep deprivation occurs 2 weeks prior to the traumatic event
Worsened TBI if the sleep deprivation occurs before and/or following the injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which cancers are sleep disruption and short sleep duration correlated with?

A

breast, endometrial, prostate, colorectal and acute myeloid leukemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When should you order a sleep study?

A

order a sleep study if you suspect breathing related sleep disorder, narcolepsy, nocturnal seizures, periodic limb movement disorder, REM sleep behavior disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What phase of sleep is characterized by sleep spindles and k-complexes?

A

NREM stage 2, spend about 50% of the night in this phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What phase of sleep is characterized by slow brain waves

A

NREM stage 1, usually only experience this at the very beginning of the night

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what stage of sleep is called slow wave or deep sleep?

A

NREM stage 3. 20-25% of the night.
see slow delta waves on EEG
most occurs during the first 1/2 of the night.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What 2 things is deep sleep important for?

A
  1. short and long term memories
  2. restoration of the body, boosting immune system and resorting bones, muscles and tissues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describes what happens during REM sleep.

A

20-25% of the night is in REM sleep
first REM occurs about 90-120 minutes after sleep onset
majority of REM occurs during the 2nd half of the night.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is REM sleep important for?

A

memory consolidation and promotes brain development.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the 4 measures that can be recorded with at home sleep study?

A

respiratory movement and airflow, heart rate or echocardiogram
arterial oxygen saturation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is actigraph?

A

it is a type of accelerometer intended to approximate sleep via algorithms that log physical activity and then estimate sleep.
Gold standard measure of sleep
can over-estimate sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is a sleep diary?

A

Self-report of typical daily sleep patterns captured over at least 1 week.
provides data on time in bed, bedtime, time awake during sleep period, wake time and time out of bed

23
Q

What are signs for general sleep disturbance in sleep diaries and mini retrospective sleep assessments?

A

<7 or >9 hours sleep duration
>1 hour weekday-weekend difference
irregular sleep timing or duration
frequency of daytime fatigue, sleepiness and/or difficulty waking up

24
Q

What is the STOP-BANG?

A

brief assessment for OSA

25
Q

What does the acronym STOP-BANG stand for?

A

Snoring
Tired
Observed patient apnea
Pressure, elevated BP
BMI >35
Age >50
Neck size, >17 in for men, >16 in for women
Gender- male

26
Q

What are lifestyle medicine treatment strategies for delayed sleep onset or difficulty with sleep initiation?

A

Environment: Use bed only for sleep and sex, minimize noise and lights, allow natural cooling of temp throughout the night and warm extremities at bedtime
Light exposure: increase early morning sunlight, increase afternoon physical activity, and decrease light at night
Diet: reduce/eliminate nighttime caffeine, alcohol, and high-sodium foods; eat a carbohydrate rich breakfast and a low carb dinner.
Exercise: seek to exercise in the morning or late afternoon if possible
Stress: start winding down at least 1 hour before bed and include active relaxation.

27
Q

What are lifestyle medicine treatment strategies for sleep fragmentation and difficulty maintaining sleep?

A

Environment: darken bedroom, allow bedroom to cool gradually through the night, and keep a cool glass of water at bedside
Light: increase morning and midafternoon sunlight exposure, increase physical activity, use red toned nightlights if necessary
Diet: increase late afternoon hydration and avoid evening diuretic beverages
Exercise: seek an exercise program without creating a burden of pain.
Stress: mitigate nighttime worrying, planning and ruminating

28
Q

What are lifestyle medicine treatment strategies for sleep deficiency from waking too early?

A

Environment: ensure sufficient bedcovers to warm early in the morning
Light: avoid bright light until ideal wake time, increase late afternoon and evening sunlight to increase melatonin production, increase evening physical activity, use blue spectrum 6500K lights until 1 hr before bed.
Diet: Avoid eating or drinking caffeine until 30-60 minutes after ideal wake-up time, and shift carbs from breakfast to dinner.

29
Q

What are lifestyle medicine treatment strategies for jet-lag?

A

Environment: Get late afternoon and early evening bright light, preferably outdoors. Avoid dim light exposure until 1 hr before new ideal sleep time
Diet: eat a heart healthy breakfast within 30-45 minutes after new ideal wake up time. eat a complex carb-rich dinner 2-3 hours before new ideal sleep time
To assit melatonin can be used

30
Q

What are the most common sleep disorders in children and teens? (4)

A

insomnia
circadian rhythm sleep wake disorders
OSA
Partial arousal parasomnia

31
Q

What are the most common sleep disorders in adults and pregnant women?

A

insomnia
osa
restless leg syndrome

32
Q

Which populations are at high risk of OSA?

A

pregnant women
black individuals of all ages

33
Q

What are the OSA serverities?

A

Peds: mild AHI 2-<5, moderate 5-<10, severe +10
Adults: mild 5-<15, 15-30, severe +30

34
Q

What can you see on physical exam for someone who might have OSA?

A

Elevated BMI
neck circumference of +15 inches in females, +17 inches in males
Abnormal craniofacial anatomy
Crowded upper airway
Other signs/symptoms that might be difficult to control- HTN,GERD, asthma,COPD.

35
Q

what is the most common sleep disorder?

A

insomnia.

36
Q

Who is at high risk for insomnia?

A

pregnant women
females and older latino adults
two fold increase risk of insomnia with onset of puberty

37
Q

What are symptoms of insomnia?

A

Difficulty initiating and/or maintaining sleep despite adequate opportunity to sleep.
fatigue, malaise, and sleepiness, concentration/ memory impairment, decreased motivation, mood disturbances/irritability, errors at work/driving, physical symptoms like HA, GI distress, persistent worry about sleep.
most occur at least 3x/wk and last for at least 3 months.

38
Q

What are the 3 types of circadian phase disorders?

A

delayed phase
advanced phase
shift work sleep disorder

39
Q

What is delayed phase?

A

delay in sleep onset and wake time

40
Q

What is advanced phase?

A

advance in sleep onset and wake time

41
Q

How can you treat delayed circadian phase disorder?

A

goal is to shift sleep onset and offset times earlier. adding bright light in the morning helps. if needed you can use melatonin 3-4 hours prior to targeted bedtime

42
Q

How can you treat advance phase circadian disorder?

A

the goal is to shift sleep onset and offset times to later. Exposure to bright light in the afternoon can help. A low dose melatonin in the morning can help promote a late waketime.

43
Q

What are symptoms of NREM sleep arousal disorders?

A

episodes of complex, physical behaviors during NREM. abnormal sleep related movements, behaviors, emotions, perceptions, dreaming and autonomic nervous system functioning.

44
Q

How can you distinguish btwn partial arousal parasomnia vs nightmares?

A

nightmares usually occur during REM so usually later 3rd of the night. Partial parasomnia events occur during the first 3rd of the night when NREM stage 3 sleep is more prevalent.

45
Q

What is narcolepsy disorder?

A

classified under central disorders of hypersommolence.
Excessive daytime sleepiness
frequent transitions between sleep and wake.
unintended daytime sleep.
fragmented nocturnal sleep.
REM-like phenomena while awake.
sleep paralysis
cataplexy
results from the loss of the neuropeptide orexin.

46
Q

What is behaviorally induced insufficient sleep syndrome?

A

7.3-20% of general population
disparity btwn sleep needed and sleep obtained.
inadequate sleep for function
voluntary restriction of sleep time
longer sleep duration on weekends

47
Q

what is associated with BIIS?

A

younger age
alcohol abuse
longer work hours
stress
depression

48
Q

Symptoms of RLS

A

urge to move legs, usually accompanied or caused by uncomfortable and unpleasant sensations in the legs.
urge to move or unpleasant sensations start or worsen during periods of rest or inactivity
urge to move or unpleasant sensations worsen or only occur in thee evening or at night.

49
Q

What is RLS associated with?

A

periodic movements of sleep
delay of sleep onset
disruptions of sleep
fatigue
periodic involuntary and jerky movements of limbs while awake or at rest
either low iron <75ng/ml or elevated ferritin

50
Q

Symptoms of periodic limb movement disorder

A

limb movements occur at roughly 30 second intervals during sleep
patients are typically unaware of these movements and the brief arousals so they do not report the abnormal movements. They will report restless sleep or middle of the night awakening. often associated with RLS.

51
Q

When should you refer to a sleep medicine specialist?

A

if your inital triage suggests a disorder that requires a PSG study to confirm or maybe RLS consider referring unless you are trained to treat OSA.

52
Q

When should you refer a patient with OSA to a sleep medicine specialist?

A

if OSA is confirmed and they are non-adherent to PAP. Adherence is >4 hours of use a night.

53
Q

What sleeps disorders are best treated by a sleep specialist?

A

narcolepsy, periodic limb movement, and RLS.

54
Q

How does impaired sleep quality and short duration effect cancer at the molecular level?

A

melatonin and immune system suppression
increased cancer stimulation cytokines
dysfunction in gene transcription and cell cycle
aberrant DNA methylation, meaning DNA expression is not being coded correctly.

Lifestyle Medicine (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions