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BD > Sleep and Disorders > Flashcards

Sleep and Disorders Flashcards

1
Q

Undesirable physical events or experiences that arise from sleep or sleep-wake transition; not primarily disorders of sleep and wake state.

A

parasomnias

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2
Q

What are some examples of parasomnias?

A
  • Sleepwalking
  • Night terrors
  • Sleep-related eating disorder
  • RBD (REM sleep Behavior Disorder)
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3
Q

What are the symptoms of Restless Leg Syndrome (URGE)?

A

U- Unpleasant limb sensations with urge to move
R- Rest (symptoms caused by rest)
G- Getting up makes RLS better
E- Evening/night is when symptoms are thew orst

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4
Q

What are some of the complications of sleep apnea?

A
  • CVA risk increased 2x
  • Pulmonary HTN increased by 60%
  • Impotence
  • Increase in intraocular pressure
  • GERD
  • HTN
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5
Q

What are some of the physiologic functions in sleep?

A
  • Autonomic nervous system (parasympathetic branch)
  • Body temperature regulation (lower set-point)
  • Control of respiration and cardiovascular function (decreased ventilation)
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6
Q

What is restored in NREM sleep? REM sleep?

A
  • NREM: physical restoration

- REM: mental restoration

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7
Q

Does the amount of REM sleep increase or decrease with age?

A

Decreases!

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8
Q

What is one of the most important determinants of sleep?

A

Age!

  • Developmental course of sleep-wake cycle
  • Developmental course of REM/NREM
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9
Q

About how much of the night do adults spend in REM vs. NREM?

A

20-25% REM, 75-80% NREM

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10
Q

Slow wave sleep shows the largest decline during_____?

A

second decade of life

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11
Q

Do adults enter NREM or REM at the start of sleeping?

A

They enter sleep through NREM with REM cycles every 90-120 minutes.

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12
Q

Do children enter NREM or REM at the start of sleeping?

A

Infants enter into Sleep Onset REM Periods (SOREMs) until 3 months old, then their sleep cycle becomes more adult-like with entry into NREM first.

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13
Q

NREM is linked to______, while REM is linked to______.

A

prior level of wakefulness; circadian rhythms

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14
Q

What is a hypnogram?

A

A form of polysomnography that graphs a person’s sleep cycle and represents stages of sleep as a function of time.

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15
Q

Which is the sleep model stating that sleep responses are proportional to the duration of prior wakefulness?

A

Homeostatic sleep drive

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16
Q

Which is the sleep model describing the way in which most creatures show intrinsic rhythms of nearly 24 hours, even when isolated from time cues (such as sunlight)?

A

Circadian rhythms

17
Q

Where is the circadian pacemaker located that generates the circadian rhythm?

A

suprachiasmatic nuclei (SCN) of the hypothalamus (right near the optic chiasm)

18
Q

What is the densest input into the SCN?

A

The RHT (retinohypothalamic tract) - delivers light!

19
Q

How are circadian rhythms synced to the external environment?

A

Zeitgebers (stimuli that signal the time of day; can be photic or non-photic)

20
Q

What are some examples of bodily functions that are influenced by circadian rhythms?

A

hormones, temperature, immune system, drug metabolism, renal function, airway function, CV activity, hematology, neoplastic cells

21
Q

Why is it easier to travel West than East in terms of circadian rhythms?

A

It’s easier to stay up later than go to bed earlier because our circadian rhythms are actually a bit longer than 24 hours.

22
Q

What is the opponent process model of sleep?

A

According to this model, the circadian rhythm and the homeostatic rhythm oppose each other to produce sleep.

23
Q

What are the primary determinants of alertness/sleepiness?

A
  • Circadian
  • Hemostatic
  • Age
  • Others (drugs, sleep disorders)
24
Q

How much less sleep do we get than our ancestors 100 years ago?

A

20% less

25
Q

True or false: the payback requirement for sleep debt is less than the debt itself.

A

True!

26
Q

What is the Epworth Sleepiness Scale (ESS)?

A

A subjective scale that assesses a patient’s chance of dozing off in certain situations. (score of 10+ is indicative of sleepiess)

27
Q

What is the most common test used in sleep medicine?

A

Polysomnography!

28
Q

What are the two parameters measured in an MSLT?

A
  • Average latency to sleep onset

- Appearance of REM sleep

29
Q

What is normal sleep latency?

A

10-20 minutes

30
Q

Is a polysomnography necessary for diagnosing RLS?

A

No- just need to ask patients if they’ve been feeling any of the URGE symptoms frequently.

31
Q

What is the main example of a hypersomnia of central origin?

A

Narcolepsy!

32
Q

What are the main symptoms of narcolepsy?

A
  • Excessive daytime sleepiness
  • Cataplexy
  • Hypnagogic hallucinations
  • Sleep paralysis
33
Q

What causes narcolepsy?

A

Abnormal regulation of REM sleep (problem with SCN control).

34
Q

What is the most common age of onset for narcolepsy?

A

Adolescence

BD (8 decks)

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