sleep disorders Flashcards
what are parasomnias
abnormal behaviours, movements or dreams that occur during sleep or sleep transitions
what are the 2 main types of parasomnias
REM and non-REM
who is likely to present with non-REM parasomnias
children
give 3 examples of non-REM parasomnias
sleepwalking
sleep terrors
confusional arousals
what is somnambulism
sleep walking
who is commonly affected by REM parasomnias
men in their 50s/60s
what are often associated with REM parasomnias
neurodegenerative disorders
clinical presentation of an REM parasomnia
enactment of the experience of dreams during REM sleep
what is narcolepsy
chronic condition producing disruption to normal sleep pattern - producing excessive sleepiness
what is cataplexy
sudden loss of muscle tone and power in response to a strong emotion
when does cataplexy occur
ONLY as part of narcolepsy
what causes narcolepsy
hypocretin deficiency - neurotransmitter responsible for maintaining wakefulness
what are hypnagogic hallucinations
hallucinations occurring at sleep onset
investigations for narcolepsy
overnight polysomnography
multiple sleep latency test
lumbar puncture: low CSF hypocretin levels
what happens in a multiple sleep latency test
4 naps 2 hours apart
EEG, muscle activity and eye movement recorded
measures time from start of the nap to the first signs of sleep
first line medical management of narcolepsy
modafinil
what can be prescribed to help reduce cataplexy attacks
SSRIs or SNRIs, sodium oxybate
describe the 3 main types of insomnia
initial: difficulty getting to sleep
middle: waking up in the middle of the night
late: early morning wakening
name some causes of insomnia
psych conditions e.g. depression
chronic pain
neurodegenerative disorders
medications
poor sleep hygiene
name some medications that can cause insomnia
stimulants, beta blockers, corticosteroids, SSRIs and recreational drugs
first line management of insomnia
CBT-I
