Sleep Flashcards
Central sleep apnea is a disorder in which your breathing repeatedly stops and starts during sleep. Central sleep apnea occurs because your brain doesn’t send proper signals to the muscles that control your breathing
Not obstructive
Sleep-related hypoventilation is a breathing-related disorder that interrupts normal sleep. This condition may be diagnosed when all other sleep disorders have been ruled out, though it may appear simultaneously with other sleep disorders.
Defined
Non-rapid eye movement (NREM) sleep arousal disorders refer to the repeated episodes of incomplete awakening from sleep that include behaviors such as sleepwalking and sleep terrors.
Defined
Rapid eye movement sleep behavior disorder or REM behavior disorder (RBD) is a sleep disorder (more specifically a parasomnia) in which people act out their dreams. It involves abnormal behavior during the sleep phase with rapid eye movement (REM) sleep.
Defined
Unhappy with sleep quantity or quality and at least one of the following
Can’t get to sleep
Can’t stay asleep
insomnia
At least 3 nights a week
Present for at least 3 months
Patient has the opportunity for sleep
insomnia
Specify if….
Non-sleep disorder mental comorbidity (including substance abuse disorders)
Other medical comorbidity
Other sleep disorders
Also…
episodic = sxs for 1 month, but less than 3
Persistent = longer than 3 months
recurrent = Two+ episodes in 1 year
Essential feature is unsatisfactory sleep quantity/quality associated with getting to or staying asleep
Frequently presents with non-restorative sleep (poor sleep quality that does not leave the individual rested upon awakening despite adequate duration)
Typically involves daytime impairments as well as nighttime sleep difficulties
insomnia
Tx for insomnia?
Cognitive behavioral therapy such as sleep hygiene improvement
Research suggests that cognitive behavioral therapy for insomnia is as effective as zolpidem with benefits sustained 1 year after treatment
Pharmacological approach for insomnia?
Diphenhydramine/hydroxyzine Trazodone (Antidepressants) Lorazepam (intermediate acting BZD) zolpidem (ambien) zaleplon Eszopiclone (Lunesta)
Excessive sleepiness despite at least 7 hours of sleep and one of the following
Recurrent periods of sleep in a day
Prolonged non-restorative sleep of at least 9 hours
Difficulty being fully awake after abrupt awakening
Hypersomnolence Disorder
for at least 3 months for 3 months
broad term for excessive sleep with deteriorated wakefulness
Many experience automatic behavior
Such as driving for miles without remembering any of it
Take relatively long daytime naps
Sleepiness that develops over time Vs sudden “attacks”
Hypersomnolence
Encourage good sleep hygiene
Evaluate for and treat comorbidities
Refer to sleep medicine specialist PRN
Hypersomnolence Disorder Treatment
Recurrent irrepressible need to sleep; lapsing into sleep; napping within same day
One of the following
Cataplexy at least a few times per month
Hypocretin deficiency
Polysomnography showing decreased sleep latency (specific parameters needed)
Narcolepsy
3 times a week for 3 months
Narcolepsy is recurrent irrepressible need to sleep; lapsing into sleep; napping within same day with one of three other sxs, which are?
Cataplexy at least a few times per month
Hypocretin deficiency
Polysomnography showing decreased sleep latency (specific parameters needed)
3 times a week for 3 months
