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Psychiatry-M2 > Sleep Disorders > Flashcards

Sleep Disorders Flashcards

1
Q

How is sleep affected in the elderly?

A

Reduced REM and reduced Delta (Deep) Sleep

- increased awakenings - reduced efficiency

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2
Q

What stage of sleep is the majority of night?

A

Stage 2 – Sleep Spindles + K-Complexes

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3
Q

Where would you find theta waves?

A

Stage 1 Sleep

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4
Q

How does alcohol and benzodiazepines affect sleep efficiency and types of sleep?

A

Reduced REM and Delta Sleep

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5
Q

When is the most amount of Delta Sleep?

A
  • Younger

- Beginning half of the night of sleep

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6
Q

How does sleep different from regular adult and depressed adult?

A

Depressed Adult

  • Takes longer to fall asleep - increased latency
  • More REM (Less REM Latency)
  • Less Delta
  • Decreased Sleep Efficiency
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7
Q

What neurotransmitter is important for REM sleep?

A

ACh

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8
Q

What is the different between Dyssomnia and Parasomnias?

A

Dyssomnias – problems in timing, quality, and amount

Parasomnias – abnormal physiologic behavior associated with sleep.

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9
Q

What is the difference between Night Terrors and Nightmares?

A

Nightmare – During REM – cause awakenings and can remember the nightmare

Night Terror – Screaming in Fear, mostly children, during Stage 3/4, no memory, unable to be awakened

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10
Q

When does sleep walking generally occur?

A

Delta Sleep

- First Half of the Night

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11
Q

What is REM Sleep disorder usually associated with?

A
  • No paralysis during REM Sleep

- Parkinson Disease / Lewy Body Dementia

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12
Q

How is REM sleep different in depressed individuals?

A

Short REM Latency (takes less time to get into REM)
Increased REM in the sleep cycle
Increased Total REM
Reduced Delta Sleep Overall (since more REM)

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13
Q

What is most commonly associated with obstructive sleep apnea?

A
  • Daytime Sleepiness
  • Obesity
  • Respiratory Acidosis (increased pCO2)
  • Pulmonary Hypertension
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14
Q

What are the two types of sleep apnea?

A
  • Central Sleep Apnea = Elderly

- Obstructive Sleep Apnea = Obesity, Men, 40-60

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15
Q

If a patient has been diagnosed with daytime sleep attacks and is diagnosed with Narcolepsy, what might be the effect on sleep?

A
  • Very decreased sleep latency and REM latency
  • Fragmented REM Sleep
  • Less REM sleep
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16
Q

What kind of symptoms do Narcolepsy patients typically experience?

A
  • Hallucinations when falling asleep or waking up
  • Sudden Sleep Attacks – Cataplexy
  • Sleep paralysis when waking up
17
Q

What is the best way to treat Narcolepsy without medications for stimulation?

A

Schedule Naps during the day to increase total REM sleep and reduce number of sleep attacks

18
Q

If you are watching an EEG and see “Saw Tooth” waves, what might be the stage of sleep?

A

REM

19
Q

What are characteristics of REM sleep?

A
  • Penile/Clitoris stimulation
  • Paralysis of skeletal muscles
  • Increased BP
  • Increased Brain Oxygen use
  • Increased Pulse
20
Q

What stage of sleep would Bruxism be present during?

A

Stage 2

21
Q

Without light simulation, such as in blind people, what is their natural circadian rhythm to become?

A
    • Delayed Sleep Cycle

- - 25 hours

22
Q

A 13 year old experiences periods of excessive sleepiness during the day that is not relieved with increased sleep or naps and has bouts of binge eating during these periods of sleepiness. What is the most likely cause?

A

Klein-Levin Syndrome

23
Q

What is associated with hypocretin deficiency?

A

Necrolepsy

24
Q

Who would be susceptible to advanced sleep phase?

A
  • Depressed Individuals
25
Q

What kind of patients might be susceptible to delayed sleep phase?

A

Teenagers
Shift Work
Blind People

26
Q

What is the best remedy for advanced sleep phase?

A

Melatonin before desired bedtime

Light at desired wake time

27
Q

What are considered Dyssomnia sleep disorders?

A
  • Narcolepsy
  • Sleep Phase Cycle Disorder
  • Restless Leg Syndrome
  • Sleep Apnea
  • Insomnia/Hypersomnia
28
Q

What are examples of Parasomnias?

A
  • Bruxism
  • REM Sleep behavior disorder
  • Sleep walking
  • Night Terrors
29
Q

What are the best treatment options for Insomnia?

A
  • Avoid Stimulants like caffeine many hours before bed
  • Develop a sleep routine
  • Only exercise in the morning
  • Hypnotic Agent (however decreases REM sleep)
30
Q

If a patient is on an Anticholinergic agent, how might sleep be affected?

A
  • Decreases both sleep efficiency and REM sleep
31
Q

If a patient is taking Levodopa, how might it affect their sleep?

A

Increases Dopamine
- Decreases Sleep Efficiency
If a patient is on an Anti-psychotic, then it can block Dopamine receptors giving them better sleep.

32
Q

If a patient is on Fluorexitine how much their sleep change?

A
  • Increased Serotonin

- Increases Sleep Efficiency and Delta-sleep

Psychiatry-M2 (14 decks)

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