sleep 2 Flashcards
what melatonin agonist is used to improve sleep onset that effects primarily melatonin 1 receptors
ramelteon (Rozerem)
what melatonin agonist has a balanced effect on all melatonin receptors; helps both sleep onset and sleep duration
tasimelteon
what melatonin agonist is recommended for blind patients
tasimelteon
what drug is a selective antagonist of orexin
suvorexant
what are the adverse effects of suvorexant
- hang over
2. cataplexy - ‘weak knees when laughing’
75% of narcoleptics don’t have what neurotransmitter
hypocretin-orexin
what is the most effective treatment for sleep disorders
cognitive behavioral therapy
what are the most common forms of circadian rhythm disorders
jet lag
shift work
what are 3 effects of working night shifts
- decreased alertness
- decreased performance
- decreased quality of daytime sleep
what two stimulants can be used to increase alertness for night shifts
armadofanil and modafinil
why is modafinil not allowed in Europe for shift work (narcolepsy only)
increased risk for depression and other disorders
what is obstructive sleep apnea
effort to breath, but obstruction of upper airway prevents
what is the non-pharm treatment for obstructive sleep apnea
positice airway pressure (CPAP mask)
what are adjunctive therapies for patients with sleep apnea on PAP
- modafinil/ armodafinil
- methylphenidates
- amphetamines
what is cataplexy
sudden bilateral loss of muscle tone without loss of consciousness
what antidepressants are used to treat REM related disorders in narcolepsy
- TCA’s
- venlafaxine
- fluoxetine
what drug improves excessive daytime sleepiness and decreases cataplexia/ REM abnormalities
sodium oxybate (hydroybutyrate)
what is used in narcolepsy to treat excessive day time sleepiness
modafinil/ armodafinil
what is second line for REM related abnormalities in narcolepsy other than antidepressents
selegiline
what is known as ‘liquid exstacy;
hydroxybutyrate
what is restless leg syndrome
parestheisas felt deep in the calf muscle with the urge to move limb
what are two common physiological causes of RLS
- low dopamine levels in hypothalamic cells
2. iron deficiency within the CNS
what are the treatments for RLS
- stop alcohol caffeine, stress and fatigue
- d/c dopamine blocking drugs
- screen for iron deficiency
- engaging mental activities reduce symptoms of boredom
what is the agent of choice for RLS
dopamine agonists (pramipexole, ropinirole, rotigotine)
what is term for repetitive movements of legs that occur during sleep
periodic limb movements of sleep (PLMS)
