Sleep Flashcards
ICSD 3 Criteria for OSA
(A+B) or C:
A. >=1 of 4:
- Pt c/o sleepiness, non-restorative sleep, fatigue or insomnia
- Pt wakes w/ breath holding, gasping, or choking
- Pt bed partner or observer reports habitual snoring, breathing interruptions or BOTH during sleep
- Pt Dx’d w/: HTN, mood d/o, cog dysf, CAD, stroke, DM, CHF, Afib
B. PSG or out of centre sleep testing (OCST) demos: >=5 predom obstructive resp events (obstructive; mixed apneas, hypopneas, or resp effort related arousals (RERA)/hr of sleep OR
C. PSG or OCST demo’s: >=15 predom obstructive resp events (apneas, hypopneas, or RERAs)/hr
ICSD-3 Primary CSA
A-D must be met:
A. Presence >=1/5:
- Sleepiness
- Difficulty falling or staying asleep, freq awakenings, or non-resotrative sleep
- Waking SOB
- Snoring
- Witnessed apneas
B. PSG shows ALL:
- >=5 central apneas or central hypopneas/hr sleep
- >50% of total number apneas; hypopneas are central apneas or central hypopneas
- Absence of cheyne stokes breathing
C. No evid of daytime or noctural hypoventilation
D. D/o not explained by another current sleep disorder, medical or neuro d/o, med use or SUD
7 classifications of sleep disorders as per ICSD
- Insomnia disorder
- Parasomnias
- Sleep-related breathing disorders
- Sleep related movement disorders
- Central disorders of hypersomnolence
- Circadian rhythm sleep-wake disorders
- Other
Insomnia Disorder
A. One or more of:
- Difficulty maintaining sleep
- Difficulty initiating sleep
- Early morning awakening
- Resistance to going to bed on time
- sleep distrubance causes - ANYTHING
B. at least 3 nights per week
C. at least 3 months
D. sleep difficulty despite adequate opportunity
E. Not better expalined by other sleep D/O
RLS essential Dx criteria?
URGE
- Urge to move
- Rest induced
- Gets better with activity
- Evening and night accentuation
What are the components of a polysomnography test?
- EOM
- EEG
- EMG
- pulse oximetry
- vitals
- EtCO2 monitoring
- video and sound monitoring
What EEG pattern is seen in patients with FM (and other chronic pain syndromes)?
alpha wave intrusions on delta sleep
What brain region is thought to be involved in the overlap between sleep-wake disturbance and headaches?
posterior hypothalamus
What abnormalities are seen in FM patients on polysomnography?
- increased
- sleep onset latency
- stage 1
- decreased
- total sleep time
- sleep efficiency
- REM
- Slow wave sleep
- More frequent arousals and awakenings
- Awakenings prolonged
Circadian ryhythm sleep-wake distrubance Dx criteria?
A persistent or recurrent pattern of sleep disruption that is primarily due to an alteration of the endogenous circadian system or to a misalignment between the endogenous circadian rhythm and the sleep–wake schedule required by an individual’s physical environment or social or professional schedule.
- The sleep disruption leads to excessive sleepiness or insomnia, or both
- The sleep disturbance causes clinically significant distress or impairment in social, occupational, and other important areas of functioning
Specify:
- Delayed sleep phase
- Advanced sleep phase
- Irregular sleep-wake cycle
Conditions that are associated with RLS?
- uremia
- iron deficiency
- pregnancy
- anemia
- FM
- PD
Medications that can cause/contribute to RLS?
- antidepressants
- dopamine antagonists
- antihistamines
What assessment procedures are done in Breathing related sleep disorders?
PSG
What assessment procedures are done in Hypersolmnolence Disorders?
PSG
MSLT
Sleep diary
actigraphy
What assessment procedures are done in Insomnia Disorders?
sleep diary
actigraphy
Not PSG rountinely
