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Health Psych post midterm > Sleep > Flashcards

Sleep Flashcards

1
Q

what percent of ppl will exp some kinds of sleep DO in their life?

A

40%

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2
Q

What is the most common sleep DO, but most underdx’ed?

A

sleep apnea

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3
Q

insomnia vs. hypersom; which do you have to be sure to ask about?

A

hypersomnia, most ppl won’t complain about it unless you ask

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4
Q

why are sleep do’s underdx’ed

A

rarely reported, most ppl just think they’re normal

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5
Q

What natural rhythm regulates sleep patterns?

A

light dark cycle

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6
Q

How dies light-dark cycle impact sleep?

A

via retnia to hypothalamus which triggers release of certain hormones

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7
Q

What hormone is released, why does this make sense?

A

cortisol, increases arousal

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8
Q

What else decreases as we ready for sleep and increases as we wake and throughout the day?

A

body temp

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9
Q

what environ factors impact light dark cycle?

A

location of bed(room)
seasonal change
northern lights (russia alaska)
travel across time zones

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10
Q

what can ppl take to help regulate sleep when traveling?

A

melatonin

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11
Q

how many hours of sleep to most ppl need?

A

8

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12
Q

If ppl say they need more, what might you suspect?

A

poor quality throughout the night

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13
Q

developmental consideration to amount of sleep needed?

A

teenagers tend to sleep more, this may be normative

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14
Q

what are the stages of sleep?

A

falling asleep
NREM
REM

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15
Q

How long do most ppl need to fall asleep?

A

10 mins

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16
Q

How can we differentiate between the sleep stages?

A 
each characterized by its own:
neural structure
neurochemical properties
neurophysio characteristics
electrographic patterns
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17
Q

Do most ppl remember falling asleep?

A

no

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18
Q

once we fall asleep, what phases do we cycle between?

A

NREM REM

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19
Q

on average how many cycles per night? (between NREM and REM

A

4-5

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20
Q

How long after falling asleep does it typically take to get to first REM cycle?

A

about 90 mins, then we cycle quicker

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21
Q

How many stages does NREM have in of itself?

A

4

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22
Q

Dreams, NREM vs REM?

A

NREM - tend to be fragmented

REM - tend be longer, more involved, elaborate

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23
Q

NREM vs REM, which one varies with age, which remain constant?

A

NREM varies

REM stable

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24
Q

how does NREM vary with age?

A

with age spend less time in stage 3 and 4

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25
how does REM change throughout the night?
REM cycles get longer and have more eye movements per cycle
26
assessment of sleep is comprised of (3 things)
physio assessment self-report measures semi-strctured interview
27
different kinds of physio assessments?
Electroencephalography (EEG) Measures of blood pressure and body temperature Actigraphy monitor measures rest/activity cycles
28
name three self-report measures you can use
Pittsburgh Sleep Quality Index (PSQI) Iowa Sleep Disturbance Inventory (ISDI) Sleep Hygiene Index (Mastin, Bryson & Corwyn, 2006)
29
semi-strcut interview for sleep all consist of (there's a long list)
History of sleep problems (when began, frequency, any changes) Sleep environment (comfort, noise, kids in bed, pets) Pre-sleep behaviors (exercise, eating, smoking, caffeine, sleeping pills, TV, reading, relaxation) Patterns of sleep (time go to bed, when wake up, frequency of waking up at night, worry at night, naps, what do when wake up, stay in bed when awake) Consequences (feel restored/tired when wake up, sleepy during day, fall asleep when inappropriate, difficulty concentrating, impact on daily functioning, naps during day Questions to RULE OUT RARE conditions (periodic limb movements, sleep walking/talking, snoring)
30
of the things you assess in the interview, what are things that are good starting points for intervention?
pre sleep bx's | precipitants of night wakening (e.g. bad dreams)
31
Sleep apnea is the...
most common sleep do
32
how long does a person have to stop breathing to qualify for SA?
more than 10 secs
33
What else characrertizes sleep apnea?
very very loud snoring | GASPING (key)
34
risk factors for SA?
``` Obesity Facial/skeletal abnormalities Short thick neck Septal deviation causing an obstruction Enlarged tonsils Mucosal edema Large tongue/soft palate Small pharynx ```
35
what should you notice about these risk factors?
obesity is the only one amenable to psychological intervention the rest require medical/surgical intervention - therefore, it's professionally responsible to refer out for sleep study/sleep doc
36
3 types of SA?
Central Obstructive Complex
37
which is the most common type? least common?
``` obstructive most (85%) central least (.4%) ```
38
which is the most dangerous?
obstruct
39
Dx requires...
Overnight polysomnography, which includes assessment of: ``` Respiratory effort Air flow Stages of sleep Oxygen saturation Electrocardiogram Body position ```
40
bx and affective consequences
``` Daytime sleepiness Mood changes (irritability) Memory impairment Difficulty concentrating Fatigue Work productivity Reaction times Greater accidents Relationships ```
41
health/medical conseqeunces
``` Hypertension– more prominent issue even when control for age, sex, and obesity Cardiac arrhythmias Coronary artery disease Stroke mortality ```
42
What combo might present o you as the psychologist that would make you think sleep apnea?
mood sx's + other ax's + daytime sleepiness + reporting "enough" sleep
43
tx for SA?
behavioral (weight loss, position tx, reduce drinking and smoking) medications (tricyclics, but not very effective) CPAP surgical (fix strcut/anatom abnorms)
44
What's a CPAP
a machine that forces air through mouth and nasal passage while you sleep
45
How effective is it?
95%
46
What are th adherence rates?
45-70%
47
are adherence rates so low?
they have to use it of the ret of their ives its heavy, it has a tube, its loud, etc ppl say they wake up more with the machine
48
ppl with CPAP, do they really wake up more?
no, they just feel that way, research shows they acutely wake up less than they would without the machine
49
narcolepsy, prev rate?
1 in 2000
50
narcolepsy, gender differences?
no
51
narco, characterized by?
excessive daytime sleepiness dysregulation of REM sleep (awake more) urge for sudden brief sleep during day (seconds, minutes)
52
narco, recommended to drive?
no
53
narco, ancillary features?
``` Cataplexy (Sudden motor paralysis during wakefulness; loss of tone) Hynogogic hallucinations (Dream like images during as fall asleep/waking up) Sleep paralysis (Mind waking up while body still asleep) ```
54
narco, how to dx
Polysomnography Sleep latency tests Sleep diary (amount prior to test)
55
narco, eval/dx?
Sleep onset quicker than usual Spend more time in REM during brief naps (this is a good Ddx) Disrupted sleep pattern without other symptoms
56
what does quicker than usual mean in terms of falling asleep
less than 10 minutes
57
Narco, tx
Stimulant medications most effective
58
if you're gonna rx stimulants, what do you need
a cardio workup
59
What is a parasomia
an acture, episodi, physical phenom that occurs only during sleep
60
Parasomnias usually occur
in the first third of the night | aout 2-3 hours after falling asleep
61
how long do they usually last?
10 mins to an hour
62
parasomnias, associated with psychopathology? if so , what kind?
yes, depression psychosis and anxiety
63
more common in adults or children?
children, dissipates by adolescence
64
name some different types of parasomnias
``` sleep walking sleep talking bruxism sleep terrors extreme confusion while seeming awake RBD ```
65
what % of kids sleep walk?
5-30
66
what % of adult sleep walk?
2-5
67
What % of kids have sleep terrors? Adults?
1-6.5; unknown
68
bruxism and sleep talking, rates?
we don't know
69
What does "extreme confusion while seeming awake look like?"
dissorientation (i.e. to person, place, and time) inappropriate bx reduced cogntive responsiveness
70
What's RBD
REM sleep behavioral disorder Decreased skeletal muscle tone during REM sleep Movement of limbs in purposeful ways (e.g. looks like trying to act something out, getting into a physical altercation with someone)
71
One way RBD is different that other sleep disorders?
actually more common in older adult than in children
72
parasomnias, tx?
Combination of behavioral and medical Most are outgrown by adolescence/young adulthood If persist into adulthood, medications be necessary
73
parasomnias, what classes of meds are rx'ed
Benzodiazepines (Klonopin) Tricyclics anticonvulsants
74
define insomnia
Chronic inability to obtain sufficient sleep for optimal functioning and well-being
75
insom, what % dx? % that repot occasional? % that report chronic?
6-30% diagnosed up to 50% report occasional insomnia 19% report chronic insomnia
76
Clinical manifestations of insomnia?
Can look different Wake up frequently at night Waking up too early Feeling “not rested” when wake up

Health Psych post midterm (4 decks)

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