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3032 > sleep > Flashcards

sleep Flashcards

1
Q

sleep is

a) a rapid reversible state of altered consciousness.
b) rapid irreversible state of altered consciousness.
c) state unconsciousness
d) none of the above

A

A

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2
Q

@wakefulness, brain stem’s arousal centres project to the _________

A

thalamus+ CX

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3
Q

@night, ___________ signals for the arousal systems to stop

A

ventralateral preoptical area

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4
Q

The homeostatic sleep load _________ throughout the day and peaks at________

A

increases; 9pm ish to signal sleepiness

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5
Q

the circadian process promotes__________ . After peaking it produces________

A

wakefulness; melatonin

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6
Q

Stage 3+ 4 sleep were combined to being labelled_________

A

SWS

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7
Q

Sleep disorders can be diagnosed with___________

A

DSM or ICD

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8
Q

The broad categories of sleep disorders are__________

A

Insomnia disorder
nightmare disorder
REM sleep behaviour disorder

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9
Q

Diagnostic features of insomnia disorder

A 
o early morning awakening
o Sleep Initiation problems
o Poor sleep quality 
o Daytime impairment
Clinically significant distress/impairment 
Occur DESPITE opportunities for sleep
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10
Q

Insomnia disorder symptoms must be present for ___________

A

3+ times a week for 3+ months

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11
Q

The INCORRECT statement is;

a) Insomnia may be caused by offset body clock which causes hyperarousal
b) may be caused by Extrinsic factors i.e. noise
c) Insomnia is underdiagnosed
d) none of the above

A

D - all true

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12
Q

Insomnia is more common in females, why might this be

A

Different lifestyle factors i.e. waking children for school BUT may just be bc seek help more

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13
Q

Sleep is most likely to occur when core body temperature is_________

A

at its lowest

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14
Q

NORMAL sleep efficiency is__________

A

85-95%

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15
Q

Sleep efficiency refers to_______

A

the amount of time SPENT IN BED that is actually used for sleep i.e. in bed @9 but sleeping @11:30

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16
Q

The MOST common type of insomnia is________ and is caused by

A

Psychophysiological insomnia; hyperarousal-person gets preoccupied with sleep, anx means even less sleep

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17
Q

Paradoxical insomnia refers to________

A

self reported insomnia in the absence of objective markers of insomnia, inv day time disturbances

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18
Q

The ICD-10 outlines ______ types of insomnias

A

6

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19
Q

Idiopathic insomnia refers to

A

Insomnia with no real cause, most common in childhood. Long lasting

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20
Q

Sleep hygeine refers to

A

irregularities in sleep/wake cycles because they don’t have routines i.e. on phone/ caffeine,

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21
Q

Behavioural insomnia is associated with _______ stage of development and caused by_________

A

Childhood;

wrongly learns incorrect indicators of sleep. i.e. only falls asleep when being rocked, gets used to such sleep cues

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22
Q

Spielman (1987) model of insomnia dictates that we have 3 pillars influencing insomnia expression

A

Predisposing- female, anxiety, hyperarousal,
Precipitating - medical psychological enviro events that triggers insomnia
Perpetuating -caffeine, naps etc., other factors that exacerbateing insomnia

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23
Q

What was the 2015 change in insomnia classification

A

BEFORE
•Primary insomnia – insomnia that is not associated with a known physical Or psychological disorder
•Secondary insomnia – where insomnia is considered second to another disorder i.e. MDD, where primary one is treated first
AFTER
insomnia considered as standalone illness

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24
Q

Some CBTi treatments for insomnia are____________

A
  • Sleep restriction
  • Stimulus control
  • Relaxation techniques
  • Cognitive therapy
  • Improve sleep hygiene
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25
Q

Sleep restriction refers to____________

A

strengthen relationship between being in bed and ‘sleeping’ i.e. only use bed for SLEEPING not studying etc.,

26
Q

the difference between relaxation and cognitive therapy is

A

a) shift attention away from conscious sleep

b) ease anxiety associated with sleep, reduce stress

27
Q

Are meds recommended for insomnia? why?

A

Only for SHORT term, because get dependent, tolerant.

28
Q

Insomnia is most often comorbid with___________

A

MDD

29
Q

Narcolepsy requires recurrent periods of irrepressible need to sleep ______a week, for ______period

A

3+; 3+ months

30
Q

Cataplexy refers to____________

A

losing all muscle tone

31
Q

Narcolepsy is associated with deficiency of;

a) orexin
b) serotonin
c) hypocretin
d) both A and C

A

D

32
Q

Narcolepsy requires patients have sleep latency _________ minutes or 2 REM periods in under__________ minutes

A

15; 8

33
Q

Multiple sleep latency test (MSLT) measures day time sleepiness by_______________

A

electrodes on scalp, measure ‘fall asleep as fast as you can’ The longer it takes to fall asleep=more awake you are. Narcoleptics need LESS than 15mins

34
Q

Orexin is a neuropeptide that is important for______________

A

feeding + capacity to stay awake = low in narcolepsy

35
Q

Narcoleptic episode may be induced by_________ and

A

strong emotions

36
Q

due to orexin loss there is _________stimulation to areas that_______sleep

A

LESS; INHIBIT

37
Q

Possible biological causes for narcolepsy are

A

Swine flu injection, HLA gene presence.

Both NOT causal but strong links

38
Q

The 2 types of narcolepsy are

A

Orexin depletion WITH cataplexy

Orexin depletion WITHOUT cataplexy

39
Q

hypnagogic hallucinations are

A

vivid DREAMS

40
Q

Which class of drugs can be used for narcolepsy

A

STIMULANTS -for day time sleepiness. Ritalin, modafinil/nuvigil ,
or sleeping meds to increase sleep regularity. Xyrem - highly controlled drug.

41
Q

Parasomnia refers to______________

A

abnormal behavioural, experiential or physiological events associated with sleep specific sleep stages, or sleep-wake transitions

42
Q

Parasomnia is more common in __________whereas insomnia is more common in____________

A

MALES; FEMALES

43
Q

Parasomnia is likely to occur in____________ part of the night and includes __________ symptoms of which the client __________ aware of

A

first THIRD of the night
sleep walking/ terrors
is NOT aware of

44
Q

Sleep terrors are associated with _________ age and linked with __________of the CNS

A

3-8; IMMATURITY

45
Q

Which is INCORRECT of sleep terrors;

a) you should wake someone out of one
b) they occur in SWS and so can be recalled
c) has an onset of 4-12 yo
d) associated with increased autonomic arousal

A

B - DOES occur in SWS but child does NOT recall the dream

46
Q

Sleep terror is different to nightmare because____________

A

Sleep Terror- typically in kids, ND – chronic + wider age gap;
Sleep Terror-NREM, ND-REM,
Sleep Terror-no arousal, ND- wake up and recall dream.

47
Q

Which is INCORRECT regarding sleep terror tmt;

a) involves counselling parents as they are mostly traumatised
b) proposes scheduled awakenings
c) recommends excessive play / excess heat to wear child down
d) recommends harm reduction in the room

A

C - excessive tiredness NOT recommended

48
Q

Sleep walking is triggered by _____________. TMT’s include

A

Excessive sleep deprivation;

harm reduction, scheduled awakenings

49
Q

REM disorders ____________

A 
Nightmare disorder 
REM sleep behaviour disorder 
Sleep paralysis
Child head banging 
Restless leg syndrome 
Confusional arousal 
Bruxism – teeth grinding 
Enuresis – bedwetting
50
Q

Nightmare disorder typically occurs _____________ of the night and is ____________ remembered

A

second half of night or after 90 mins of sleep; WELL

51
Q

Nightmares are often caused by____________ and occur in ________ of the population annually

A

stress, anxiety, PTSD, meds ; 85%

52
Q

Nightmares may begin in childhood and are likely to go away by _______ age or otherwise persist. Treatment invovles__________

A

10; therapy changing the end of the dream

53
Q

REM sleep behaviour disorder is diagnosed with_________ and associated with_____________muscle tone

A

PSG; abnormally preserved muscle tone in REM sleep

54
Q

REM sleep behaviour disorder is present in _____________ population

A

middle aged / elderly / those with a neurological disorder. Onset age 52-62

55
Q

REM sleep behaviour disorder may be a prodromal stage of ___________ as it has an onset 5-10 years before disease onset

A

AD/PD

56
Q

Treatment of REM sleep BD is __________ which controls symptoms but does NOT control______

A

diazepines; likelyhood of later developing neurodegenerative diseases

57
Q

Sleep paralysis is when___________ is inhibited but ___________are intact

A

voluntary muscle tone; ocular +respiratory

58
Q

Sleep paralysis is associated with________sleeping position and is likely to occur ___________time

A

Lying flat on back; sleep onset or offset

59
Q

Hypnagogic ___________ whereas hypnopompic___________

A

sleep ONSET; sleep OFFSET

60
Q

We used to think sleep disturbances were secondary to psychiatric illnesses, NOW we think_____________

A

that because they often co-occur with other shit, they may share similar aetiology

3032 (12 decks)

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