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N420 Flashcards > Sleep and Related Disorders > Flashcards

Sleep and Related Disorders Flashcards

1
Q

Define sleep

A

A state at which an individual lacks conscious awareness of environmental surroundings and from which one can be easily aroused

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2
Q

Sleep disorder and sleep disturbance are terns used to indicate those conditions that result in ______ ______ ______.

A

Poor sleep quality

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3
Q

Wake behavior is associated with an activated cortical brain-wave pattern. The ______ ______ system in the middle of the brainstem is associated with generalized EEG activation and behavioral arousal.

A

Reticular activating

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4
Q

Sleep behavior is regulated by a variety of neurologic structures. ______ ______ are important in meditating sleepiness and lethargy associated with infectious illness.

A

Proinflammatory cytokines

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5
Q

Peptides, such as ______ released by GI tract after food ingestion following meals creates ______ sleepiness.

A

Cholecystokinin

Postprandial

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6
Q

______ is na endogenous hormone produced by the pineal gland in the brain from the amino acid tryptophan.

A

Melatonin

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7
Q

Melatonin decreases sleep _____ and increases sleep ______. More melatonin is increased in the ______.

A

Latency

Efficiency

Evening

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8
Q

______ ______ persist when people are placed in isolated environments free of external time cues.

A

Circadian rhythms

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9
Q

Circadian rhythms are controlled by ______ clock mechanisms. The suprachiasmatic nucleus in the ______ is the master clock of the body.

A

Internal

Hypothalamus

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10
Q

______ is the strongest time cue for the sleep-wake rhythm.

A

Light

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11
Q

What are the two major states of sleep?

A

NREM sleep

REM sleep

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12
Q

NREM sleep stage 1

A

Beginning of sleep.
1-7 minutes.
Can be easily awakened.

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13
Q

NREM sleep stage 2

A

Period of sound sleep.
HR slows and body temp drops.
10-25 minutes.

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14
Q

NREM sleep stage 3

A

Deep sleep or slow-wave sleep.
Deepest stage of sleep.
20-40 minutes.
Dreaming more common (than other NREM).

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15
Q

REM sleep

A 
20-30% of sleep..
4-5 times during 7-8 hour sleep period.
Paradoxic because the brain waves resemble wakefulness.
Memory consolidation.
Vivid dreaming occurs.
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16
Q

Insomnia is devined as difficulty ______ asleep, difficulty ______ asleep, waking up too ______, or poor ______ of sleep.

A

falling
staying
early
quality

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17
Q

Acute insomnia refers to difficulties falling asleep or remaining asleep for at least ______ nights per week over a ______ week period.

A

3

2

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18
Q

Chronic insomnia is defined by the same symptoms of acute insomnia and a daytime ______ that persists for ______ month or longer

A

Complaint (e.g. fatigue, poor concentration)

1

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19
Q

Inadequate ______ ______ refers to those practices or behaviors that are inconsistent with quality sleep.

A

Sleep Hygiene

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20
Q

Consumption of ______, ______ ______ of many medicaitons, drinking alcohol to help ______ sleep, ______ close to bedtime, taking long ______ in the afternoon, sleeping ______ in the morning, nightmares, ______ near bedtime, and jet lag can exacerbate insomnia.

A 
Stimulants
Side Effects
Induce
Naps
Late
Exercise
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21
Q

Chronic insomnia can be classified as primary or secondary. Primary is a lifelong difficulty in ______ and ______ sleep resulting in poor daytime function after med, neuro, psych causes have been excluded.

A

Initiating

Maintaining

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22
Q

Secondary incomnia is due to ______ illness, ______ conditions, medications or ______ ______.

A

Psychiatric
Medical
Substance Abuse

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23
Q

Manifestations of insomnia include

  1. Difficulty falling asleep. AKA ______
  2. Frequent awakenings. AKA ______
  3. Prolonged awakenings or awakening too early and not being able to ______ ______ to ______.
  4. Feeling unrefreshed on awakening. AKA ______
A

Long sleep latency
Fragmented sleep
Fall Back to Sleep
Nonrestorative sleep

24
Q

Diagnostic studies.
Self report made on the basis of subjective ______ and on a 1-2 week ______ ______. An ______ that measures gross motor activity. Also a _______ can be done only if there are symptoms or signs of a sleep disorder.

A

Complaints, Sleep Diary

Actigraphy

Polysomnography

25
Q

Cognitive-Behavioral therapies are effective and should be the ______ line of therapy. These methods inlcude

A

First

Relaxation training, Guided imagery, Cognitive strategies to address dysfunctional ideas about sleep, Behavioral strategies that target an individuals poor sleep habits, Education about good sleep hygiene practices, Regular exercise

26
Q

______ and ______ medications are effective for the short-term management of insomnia

A

Hypnotic

Anxiolytic

27
Q

______ insomnia is common with abrupt withdrawal of hypnotic medications

A

Rebound

28
Q

______ work by activating the GABA receptors to promote sleep

A

Benzodiazepines

29
Q

Benzodiazepine-Receptor-Like agents like ______ , ______ , and ______ are the drugs of first choice for insomnia

A

Ambien, Sonata, Lunesta

30
Q

Melatonin receptor agonists (Ramelton (Rozerem)) do not appear to cause ______. Antidepressants like Trazodone (Deseryl) have ______ properties. Many individuals self medicate with OTC sleep aids like ______ but tolerance develops quickly.

A

Tolerance

Sedative

Antihistamines like Diphenhydramine (Benadryl)

31
Q

Complementary and Alternative therapies include ______ and ______.

A

Melatonin

Valerian

32
Q

Define narcolepsy

The behavioral therapies for insomnia are also used for patients with narcolepsy

A

A chronic neurologic disorder caused by the brains inability tto regulate sleep-wake cycles normally

33
Q

What are the two categories of narcolepsy

A

With or without cataplexy

34
Q

Define cataplexy

A

a brief and sudden loss of skeletal muscle tone

35
Q

Narcolepsy ______ be cured, but excessive daytime sleepiness and cataplexy can be controlled in most paitents by ______ treatment.

A

Cannot

Drug

36
Q

Drug management of narcolepsy includes ______ like stimulants for daytime sleepiness and ______ drug therapy to control cataplexy.

A

Amphetamine

Antidepressant

37
Q

Circadian rhythm disorders can occur when the circadian time-keeping system loses synchrony with the ______. The two most common symptoms are ______ and ______.

A

Environment

Insomnia, Excessive sleepiness

38
Q

______ ______ disorder is when an individuals travel results in the crossing of multiple time zones and ones body time is not synchronized with environmental time.

A

Jet lag

39
Q

Define sleep-disordered breathing (SDB)

A

Abnormal respiratory patterns associated with sleep. (Snoring, apnea, hypopnea)

40
Q

Obstructive sleep apnea (OSA) is characterized by ______ or ______ ______ ______ during sleep.

A

Partial

Complete airway obstruction

41
Q

______ is the cessation of spontaneous respirations lasting longer than 10 seconds

A

Apnea

42
Q

______ is a condition characterized by shallow respirations (30-50% reduction in airflow)

A

Hypopnea

43
Q

During the apnic period the patient can experinence ______ and ______.

A

Hypercapnia - Increased PaCO2

Hypoxemia - Decreased PaO2 or SpO2

44
Q

______ sleep apnea (5-10 apnea/hypopnea events per hour) may respond to simple measures like ______ on ones side, elevating _______, Avodiing ______ and consumption of ______ 3-4 hours prior to sleep. Sleep meds often make OSA worse, ______ loss reduces sleep apnea.

A 
Mild
Sleeping
Head of Bed
Sedatives
Alcohol
Weight
45
Q

Sx may resolve in up to half of patients with OSA who use a special mouth guard called an ______ ______.

A

Oral Appliance

46
Q

In patients with more severe Sx (more than 15 apnea/hypopnea events per hour) ______ ______ ______ ______ by mask is the treatment of choice.

A

Continuous Positive Airway Pressure (CPAP)

47
Q

Bilevel positive airway pressure (BiPAP) can deliver a ______ ______ pressure and a ______ ______ during expiration.

A

Higher inspiration

Lower pressure

48
Q

______ ______ ______ ______ is characterized by involuntary, continual movement of the legs and/or arms that only affects people during sleep

A

Periodic limb movement disorder (PLMD)

49
Q

PLMD and ______ ______ syndrome often occur simultaneously, but they are distinct disorders

A

Restless leg syndrome

50
Q

______ are defined as unusual and often undesirable behaviors that occur with sleep or during arousal from sleep

A

Parasomnias

51
Q

Enuresis, hallucinations, and eating are parasomnias that occur during ______ sleep

A

REM

52
Q

Sleepwalking and sleep terrors are ______ parasomnias that occur during ______ sleep

A

Arousal

NREM

53
Q

______ behaviors range from sitting up in bed, moving objects, and walking around the room to driving a car

A

Sleepwalking

54
Q

______ ______ are characterized by a sudden awakening from sleep along with a loud cry and signs of panic

A

Sleep terrors

55
Q

______ are a parasomnia characterized by recurrent awakening with recall of the frightful or disturbing dream

A

Nightmares

N420 Flashcards (21 decks)

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