Sleep Disorders Flashcards
actigraphy particularly usefulf or
confirming sleep quantity prior to MSLT
child or cognitively impaired
pathogenesis cheyne stokes
PCO2 climbs, sensory info from peripheral receptors don’t reach heart fast enough because of heart failure
HF > still lungs > oversensitive sensors > breathe longer, deepr, overshoot needed > overcompensate and CO2 gets too low > cycle repeats
parasominias arising from REM sleep
nightmare
sleep paralysis
REM behavior disorder
impact of OSA on heart
hypoxic PA vasoconstriction
exagerated negative intrathoracic pressure
increased venous return
(LV underfilled > diastolic dysfunction)
sign of mixed sleep apnea
signs of effort before flow
impact of REM intrusion into wakefullness seen in narcolepsy
dreaming
paralysis - limbic discharge, halucination, feelings of psychosis
cataplexi
exagerated limb movements in sleep
sleep walking symptoms
REM behavior disorder
non-24hr-circadian-disorder
seen in retinally blind
sleep cycles advance day to day
allowable levels of REM in MSLT
1 or fewer
actigraphy reinforces/compliments
sleep diary
sleep diaries most helpful for
hypersomnia
pathologically sleep on MSLT if
<8min latency
cheyene stokes pattern
crescendo decrescendo respiration
determine if shallow breathing effort is obstruction driven vs centrally driven by
measuring intrathoracic pressure (larger change = obstructive event)
____ cell loss seen in narcolepsy with cataplexy
hypocretin cell loss
polysomnography indications
OSA
periodic limb movement disorder
actigraphy not useful for
insomnia (lying awake, still)
action of hypothalamus in sleep
Suprachiastmatic nucleus communicates time info to dorsomedial nucleus
>venterolateral preoptic nuclues > sleep promoting
>lateral hypothalamus > hypocretin neurons > wake promoting
worsening HF in central sleep apnea due to
driving up of sympathetic activiity
EEGfindings night terrors
associations
“tight” EEG activity
brief detla discharge preceding episode
arises from slowwave delta sleep
increased heart rate
associated with fam hx of sleep walking
environmental factors in narcolepsy
antigen binding HLA DQB1*0602
head trauma, virus, toxins
sleep changes
causal factors in periodic limb movement disorder
sleep pattern
iron deficiency
nerve damage (low back injury)
diabetic neuropathy
restless leg syndrome
little delta sleep, little/no REM sleep