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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
Q

how does REM change throughout the night?

A

REM cycles get longer and have more eye movements per cycle

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26
Q

assessment of sleep is comprised of (3 things)

A

physio assessment
self-report measures
semi-strctured interview

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27
Q

different kinds of physio assessments?

A

Electroencephalography (EEG)
Measures of blood pressure and body temperature
Actigraphy monitor measures rest/activity cycles

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28
Q

name three self-report measures you can use

A

Pittsburgh Sleep Quality Index (PSQI)
Iowa Sleep Disturbance Inventory (ISDI)
Sleep Hygiene Index (Mastin, Bryson & Corwyn, 2006)

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29
Q

semi-strcut interview for sleep all consist of (there’s a long list)

A

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)

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30
Q

of the things you assess in the interview, what are things that are good starting points for intervention?

A

pre sleep bx’s

precipitants of night wakening (e.g. bad dreams)

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31
Q

Sleep apnea is the…

A

most common sleep do

32
Q

how long does a person have to stop breathing to qualify for SA?

A

more than 10 secs

33
Q

What else characrertizes sleep apnea?

A

very very loud snoring

GASPING (key)

34
Q

risk factors for SA?

A 
Obesity
Facial/skeletal abnormalities
Short thick neck
Septal deviation causing an obstruction
Enlarged tonsils
Mucosal edema
Large tongue/soft palate
Small pharynx
35
Q

what should you notice about these risk factors?

A

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
Q

3 types of SA?

A

Central
Obstructive
Complex

37
Q

which is the most common type? least common?

A 
obstructive most (85%)
central least (.4%)
38
Q

which is the most dangerous?

A

obstruct

39
Q

Dx requires…

A

Overnight polysomnography, which includes assessment of:

Respiratory effort
Air flow
Stages of sleep
Oxygen saturation
Electrocardiogram
Body position
40
Q

bx and affective consequences

A 
Daytime sleepiness
Mood changes (irritability)
Memory impairment
Difficulty concentrating
Fatigue
Work productivity
Reaction times
Greater accidents
Relationships
41
Q

health/medical conseqeunces

A 
Hypertension– more prominent issue 
even when control for age, sex, and obesity
Cardiac arrhythmias
Coronary artery disease
Stroke 
mortality
42
Q

What combo might present o you as the psychologist that would make you think sleep apnea?

A

mood sx’s + other ax’s + daytime sleepiness + reporting “enough” sleep

43
Q

tx for SA?

A

behavioral (weight loss, position tx, reduce drinking and smoking)
medications (tricyclics, but not very effective)
CPAP
surgical (fix strcut/anatom abnorms)

44
Q

What’s a CPAP

A

a machine that forces air through mouth and nasal passage while you sleep

45
Q

How effective is it?

A

95%

46
Q

What are th adherence rates?

A

45-70%

47
Q

are adherence rates so low?

A

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
Q

ppl with CPAP, do they really wake up more?

A

no, they just feel that way, research shows they acutely wake up less than they would without the machine

49
Q

narcolepsy, prev rate?

A

1 in 2000

50
Q

narcolepsy, gender differences?

A

no

51
Q

narco, characterized by?

A

excessive daytime sleepiness
dysregulation of REM sleep (awake more)
urge for sudden brief sleep during day (seconds, minutes)

52
Q

narco, recommended to drive?

A

no

53
Q

narco, ancillary features?

A 
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
Q

narco, how to dx

A

Polysomnography
Sleep latency tests
Sleep diary (amount prior to test)

55
Q

narco, eval/dx?

A

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
Q

what does quicker than usual mean in terms of falling asleep

A

less than 10 minutes

57
Q

Narco, tx

A

Stimulant medications most effective

58
Q

if you’re gonna rx stimulants, what do you need

A

a cardio workup

59
Q

What is a parasomia

A

an acture, episodi, physical phenom that occurs only during sleep

60
Q

Parasomnias usually occur

A

in the first third of the night

aout 2-3 hours after falling asleep

61
Q

how long do they usually last?

A

10 mins to an hour

62
Q

parasomnias, associated with psychopathology? if so , what kind?

A

yes, depression psychosis and anxiety

63
Q

more common in adults or children?

A

children, dissipates by adolescence

64
Q

name some different types of parasomnias

A 
sleep walking
sleep talking
bruxism
sleep terrors
extreme confusion while seeming awake
RBD
65
Q

what % of kids sleep walk?

A

5-30

66
Q

what % of adult sleep walk?

A

2-5

67
Q

What % of kids have sleep terrors? Adults?

A

1-6.5; unknown

68
Q

bruxism and sleep talking, rates?

A

we don’t know

69
Q

What does “extreme confusion while seeming awake look like?”

A

dissorientation (i.e. to person, place, and time)
inappropriate bx
reduced cogntive responsiveness

70
Q

What’s RBD

A

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
Q

One way RBD is different that other sleep disorders?

A

actually more common in older adult than in children

72
Q

parasomnias, tx?

A

Combination of behavioral and medical
Most are outgrown by adolescence/young adulthood
If persist into adulthood, medications be necessary

73
Q

parasomnias, what classes of meds are rx’ed

A

Benzodiazepines (Klonopin)
Tricyclics
anticonvulsants

74
Q

define insomnia

A

Chronic inability to obtain sufficient sleep for optimal functioning and well-being

75
Q

insom, what % dx? % that repot occasional? % that report chronic?

A

6-30% diagnosed
up to 50% report occasional insomnia
19% report chronic insomnia

76
Q

Clinical manifestations of insomnia?

A

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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