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Clinical Neurosciences > Sleep > Flashcards

Sleep Flashcards

1
Q

a physiologic state of relative unconciousness and inaction of the voluntary muscles, the need for which recurs periodically

A

sleep

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2
Q

stage 1 sleep

A

light sleep

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3
Q

stage 2 sleep

A

K complexes and sleep spindles

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4
Q

stage 3-4 sleep

A

slow wave sleep; restorative sleep

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5
Q

REM sleep

A

rapid eye movement sleep; dream sleep

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6
Q

elderly sleep patterns

A

more stage II and less REM

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7
Q

the biological clock is located in what part of the brain

A

suprachiasmatic nucleus

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8
Q

what two other things are regulated by circadian rhythm besides sleep

A

body temperature and cortisol secretion

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9
Q

what structures within the brain are important for sleep

A

basal forebrain
anterior hypothalamus
dorsolateral medullary reticular formation

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10
Q

chemicals that are important for sleep

A

serotonin
melanocyte stimulating hormone
prostaglandin D2
uridine

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11
Q

what is the most common sleep disorder

A

insomnia

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12
Q

is the inability to fall asleep or to maintain sleep

A

insomnia

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13
Q

insomnia prevalence increases with

A

age, medical psychatric and substance abuse problems

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14
Q

insomnia is more prevalent in men or women

A

women

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15
Q

examples of predisposing factors for insomnia

A

sleep wake cycle
circadian rhythm
coping mechanism
age

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16
Q

examples of precipitating factors of insomnia

A

situational environmental, medical, psychiatric and medication

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17
Q

examples of perpetuating factors of insomnia

A

conditioning
substance abuse
performance anxiety
poor sleep hygiene

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18
Q

what is transient insonia

A

last for SEVERAL days and results from acute stress or environmental changes

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19
Q

what is short term insonia

A

can last up to 3 weeks duration and results from more severe causes such as bereavement, emotional trauma, hospitalization and pain

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20
Q

what is chronic insomnia

A

last greater than 3 weeks in duration and is associated with physical and emotional illnesses as well as medications, alcohol or illicit drugs (only 10% however are substance abusers)

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21
Q

what are the goals in treatment of insomnia

A

resolve underlying problems
improve quality of life
prevent progression of transient insomnia to chronic insomnia

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22
Q

examples of sleep hygiene

A 
do something enjoyable and relaxing
avoid taking trouble to bed
make bedroom comfortable
use bedroom for sleep or sex
avoid alcohol/caffeine
avoid napping
avoid exercising too late
maintain regular schedule
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23
Q

examples of stimulus control

A

go to bed only when your sleepy and get out of bed when you are unable to sleep, darken the room and reduce noise

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24
Q

examples of thought therapy

A

yells “stop”—>thought stopping

25
Q

combined therapy

A 
non-pharmacologic therapy
lowest dose of sleeper
short term use of sleeper
psychiatric care
drug withdrawal or rehabilitation
assess for other causes
26
Q

sedating antidepressants are contraindicated with

A

BPH or cardiovascular disease

27
Q

example of a sedating antidepressant

A

amytriptaline

28
Q

caution in what popuatlion should be used in patients with sedating antidepressants

A

elderly (at risk for falling)

29
Q

examples of antihistamines

A

hydroxyzine and diphenhydramine

30
Q

antihistamines may do what to insonia

A

worsen or cause insomnia

31
Q

side effects of antihistamines include

A

anticholinergic side effects

32
Q

causes of restless leg syndrome

A

idiopathic, pregnancy, uremia, RA, iron deficiency, peripheral neuropathy, drug withdrawal and myelopathy

33
Q

treatment of restless leg syndrome

A

anti-parkinson meds
benzodiazepine (chlonafin, lorazapam, chlorazapam)
opiates
tricyclic antidepressants such as amytriptaline, neurotin, and GABA pentin

34
Q

most common disorder of excessive daytime somnolence

A

sleep apnea

35
Q

patients are sleepy and have headaches, insomnia, memory trouble, irritable, slow reaction time, hypertension, and nocturia

A

sleep apnea

36
Q

what is the etiology of sleep apnea

A

obesity and possibly altered nasopharyngeal structures

37
Q

how do you diagnose sleep apnea

A

sleep apnea

38
Q

what is the treatment for sleep apnea

A 
lose weight
CPAP
tennis balls
surgery-UPPP
avoid taking sleepers and alcohol
39
Q

what chromosome is associated with narcolepsy

A

chromosome 6 (HLA-DR2/DQ1*0602)

40
Q

first symptoms of nacrolepsy begin when

A

second decade

41
Q

deficiency of hypocretin 2 (orexin B) is associated with

A

nacrolepsy

42
Q

what is the tetrad associated with narcolepsy

A

excessive daytime sleepiness
cataplexy
sleep paralysis
hypnagogic hallucinations

43
Q

the differential diagnosis for narcolepsy include

A

disorders of excessive insomence and epilepsy

44
Q

how do you diagnose narcolepsy

A

history and physical and sleep study

45
Q

treatment of narcolepsy

A

education
scheduled naps
exercise
medications

46
Q

what are some common medications for treatment of nacrolepsy

A 
caffeine
pemoline
methyphenidate
tricycclin antidepressants (decream REM)
modafil, armodafinil
sodium oxybate (good drug for cataplexy part)
47
Q

REM suppression and rebound

A

alcohol, drugs such as MAOI, tricyclic antidepresants and sleep deprivation

48
Q

when does somnabulism occur

A

stage III and IV

49
Q

somnabiulism

A

sleep walking

50
Q

pavor noturnus

A

night terros

51
Q

age group affected by pavor notrunus

A

2-12 years of age

52
Q

what are pavor notrunus characterized by

A

screaming, crying, or intense fear; stage III and IV sleep which lasts 3-5 minutes

53
Q

stages of sleep affected by night terrors

A

III and IV

54
Q

what is treatment for night terros

A

psychological
guard against injury
benzodiazepines
avoid precipitating causes like loud noises, medications, full bladder and sleep deprivation

55
Q

age group affected by nocturnal enuresis

A

age 4-14

56
Q

are boys or girls more susceptible for bedwetting

A

boys>girls

57
Q

what things should you rule out with nocturnal enuresis

A

diabetes mellitus
urinary tract infection
diabetes insipidus
seizure and myelopathy

58
Q

medications for nocturnal enuresis

A

imipramine for 5 months

DDAVP (desmopressin) usually short term

Clinical Neurosciences (16 decks)

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