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Pulmonary > Sleep Disorders > Flashcards

Sleep Disorders Flashcards

Module 2B

1
Q

Short term insomnia lasts

A

Less than 3 months

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2
Q

Chronic insomnia is characterized by symptoms that occur

A

> 3x/week for >3 months

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3
Q

How many categories are there of sleep disorders?

A

7

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4
Q

What are 6 priority differentials of sleep disorders?

A

Medical conditions, medications, chronic pain, CHF, OSA, chronic lung disease (asthma)

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5
Q

CNS hypersomnies present with complaints of

A

Daytime sleepiness

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6
Q

The older patient is more likely to

A

Have difficulty falling asleep or staying asleep (or both)

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7
Q

What 2 H1 antagonists can contribute to insomnia?

A

Claritin and Allegra

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8
Q

OSA/hypopnea syndrome signs may include

A

Large neck size (>17in in men), enlarged tonsils, mallampati airway score of 3 or 4, low-lying soft palate (patients with HTN or cardiac disease)

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9
Q

A sleep log diary should be used over

A

1-2 weeks

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10
Q

What diagnostic tool is often used?

A

Pittsburgh Sleep Quality Index (PSQI)

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11
Q

What diagnostic labs should be ordered?

A

CBC, CMP or BMP, TSH with reflex to T4

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12
Q

What is the gold standard diagnostic of sleep disorders?

A

Polysomnography (PSG) - sleep study

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13
Q

Actigraphy may help document sleep patterns and circadian rhythms but is not ideal for

A

Insomnia

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14
Q

A split night study is a combination of

A

A full polysomnography and CPAP trial

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15
Q

What are 2 daytime studies?

A

Multiple sleep latency test (MSLT) and maintenance of wakefulness test (MWT)

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16
Q

What drugs should be used for treatment of restless leg syndrome?

A

Antidepressants or dopamine agonists

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17
Q

Alcohol, tobacco, and exercise should be avoided for at least how long before bedtime?

A

4 hours

18
Q

What drug is a melatonin agonist?

A

Ramelteon (Rozerem)

19
Q

What heterocyclic antidepressant can be used as treatment?

A

Doxepin (Silinor)

20
Q

What DEA class are medications used for treatment of sleep disorders?

A

DEA IV

21
Q

What are 5 other drugs used for treatment?

A

Zolpidem (Ambien), Eszopiclone (Lunesta), Triazolam (Halcion), Temazepam (Restoril), and Suvorexant (Belsomra)

22
Q

What are 4 benzodiazepines used for treatment?

A

Diazepam (Valium), Alprazolam (Xanax), Clonazepam (Klonopin), and Lorazepam (Ativan)

23
Q

What 6 drugs should not be used for treatment?

A

Trazodone, Tiagabine, Diphenhydramine, Melatonin, L-tryptophan, and Valerian

24
Q

What is a common risk factor for OSA?

A

Obesity

25
Q

What are the major impediments to successful CPAP therapy?

A

Comfort and acceptance

26
Q

OSA can cause risk for

A

MVAs

27
Q

OSA carries greater risk for increased morbidity/mortality than what other disorder?

A

Central sleep apnea

28
Q

What should be ruled out when restless leg syndrome is suspected?

A

Peripheral neuropathy, Parkinson disease, B12 deficiency

29
Q

What labs should be ordered for restless leg syndrome?

A

Vitamin B12, CBC, fasting serum iron level, TIBC, ferritin, transferrin saturation, CMP

30
Q

What are 4 differential diagnoses for restless leg syndrome?

A

Arthritis, neuropathy, leg cramps, and vascular disease (claudication)

31
Q

What 3 drugs are used to manage restless leg syndrome?

A

Carbidopa/Levodopa (Sinemet), Gabapentin (Neurontin), and Pregabalin (Lyrica)

32
Q

A low dose dopamine agonist should be prescribed for

A

Restless leg syndrome

33
Q

What drugs can be used in the treatment of sleep onset insomnia?

A

Triazolam, Temazepam, Ramelteon

34
Q

What drugs should be used in maintenance insomnia?

A

Temazepam, Suvorexant, Doxepin

35
Q

What drug can be used for both sleep onset and maintenance insomnia?

A

Temazepam

36
Q

What is the most common sleep-related breathing disorder?

A

OSA

37
Q

Diagnosis of sleep disorders should be performed with

A

Overnight sleep testing

38
Q

What is the most common and effective treatment of OSA?

A

CPAP

39
Q

Central sleep apnea is most common between

A

Young adulthood and middle age

40
Q

An intrinsic CNS deficit results in

A

Hypersomnolence

41
Q

What is a primary hypersonic that is characterized by EDS and inappropriate manifestations of REM sleep?

A

Narcolepsy

Pulmonary (9 decks)

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