Sleep Disorders Flashcards by Blake Hollowoa

The percentage of time asleep while in bed is referred to as _______________.

Sleep efficiency

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A condition known as ___________ results when either sleep drives are too low or arousal levels are too high.

Insomnia

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_________________ is described as a condition in which the patient experiences difficulty initiating or maintaining sleep or non-restorative for at least 3 nights/week for three months. This results in significant distress or impairment in functioning.

Primary insomnia

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What are some of the most common treatments for chronic insomnia?

Cognitive Behavioral Therapy for Insomnia (CBT-I)
- Strengthens sleep drives
Trazodone
- Increases SWS (slow wave sleep)
Nonbenzodiazepines
Zolpidem (Ambien)

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Excessive amounts of sleep are referred to as a condition of _______________.

Hypersomnia

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_____________ is described as excessive daytime sleepiness for 3 days/week for three months that also may result in significant distress or impairment in function. It does not occur in relation to other sleep disorders, mental disorders, substance abuse, or general medical conditions.

Primary hypersomnia

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______________ is a condition in which strong emotions or laughter cause a person to suffer sudden physical collapse though remaining conscious.

Cataplexy

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Irresistible or unwanted periods of sleep in non-permissive (eating, talking, driving, during sex) or permissive settings that occur daily over a span of 3 days/week for three months are characteristic of ____________. The typical symptoms of this condition are cataplexy, hypocretin deficiency, and multiple sleep onset REM periods during a multiple sleep latency test (MSLT).

Narcolepsy

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The most specific symptom of narcolepsy is(are) (cataplexy/hypocretin deficiency/hallucinations/sleep paralysis).

Cataplexy

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(Hypnopompic/Hypnagogic) hallucinations are hallucinations seen upon drifting into sleep.

Hypnagogic

Hypna-going to sleep

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(Hypnopompic/Hypnagogic) hallucinations are hallucinations seen upon waking up from sleep.

Hypnopompic

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__________ is a neurotransmitter that regulates wakefulness and arousal.

Hypocretin (or Orexin)

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Narcoleptic sleep attacks typically occur __-__ times per day for a duration of __-__ minutes apiece.

2-6 times/day for a duration of 10-20 minutes

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(T/F) Narcolepsy has been linked to an overabundance of hypocretin neurotransmitter.

False. Narcolepsy has been linked to the deficiency of hypocretin.

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What are the most common treatments for narcolepsy?

Amphetamines (stimulant)
Modafinil (stimulant)
Sodium oxybate (non-stimulant)

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_____________ is a nonstimulant used in the treatment of narcolepsy. It serves to increase SWS (slow wave sleep), growth hormone production, and sleep consolidation. It is an agonist of the GABA_B receptor.

Sodium oxybate

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Sleep apnea accounts for more than __% of patients with EDS (excessive daytime sleepiness).

75%

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__________ is the temporary cessation of breathing during sleep, typically caused by closure of the airway.

Obstructive Sleep Apnea

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What are some of the common treatments for obstructive sleep apnea?

Continuous positive air pressure (CPAP)
Weight loss
Surgery
Dental appliances

____________________ sleep disorders result in persistent or recurrent patterns of sleep disruption leading to excessive daytime sleepiness or insomnia due to a mismatch between a patient’s required sleep-wake schedule and his/her sleep-wake pattern.

Circadian Rhythm Sleep Disorders

What are some of the common types of circadian rhythm sleep disorders?

Jet lag
Shift work
Delayed/advanced sleep phase

__________________ is a condition characterized by the desire to move one’s legs or arms due to uncomfortable sensations typically described as creeping, crawling, tingling, burning, or itching. This results in frequent movement of the limbs in order to relieve the uncomfortable sensations.

Restless leg syndrome

What are some of the common causes of restless leg syndrome?

Peripheral neuropathy
Depression
Pregnancy
Folate and iron deficiency
Reticular formation dysfunction

What are the typical treatments for restless leg syndrome?

Dopamine agonists
Iron or folate replacement

Levodopa, pramipexole, and ropinirole are examples of ______________ types of drugs.

Dopamine agonist types

\_\_\_\_\_\_\_\_\_\_\_\_\_ is a condition marked by **frightening dreams** that typically involve threats to survival, security, or self-esteem. These dreams usually occur in the **latter half** of the **night**.

Nightmare disorder

**Nightmare disorder** occurs during (non-REM/REM) sleep.

REM sleep

(REM/non-REM) suppressors, such as **antidepressants** and **alpha antagonists** (prazosin), are often used in the treatment of **nightmare disorders**.

REM suppressors

Recurrent episodes of **outward appearance** of intense fear and signs of autonomic arousal, such as tachycardia, rapid breathing, dilated pupils, and sweating, are hallmarks of the condition known as \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

Sleep Terror Disorder (Night Terrors)

**Sleep terror disorder** typically occurs in the (first third/middle third/second half) of the night.

First third

**Sleep terror disorder** occurs during (REM/non-REM) sleep.

non-REM

(T/F) Patients experiencing night terrors are inconsolable and have **no recall** of their dreams. The terrors abruptly terminate into a deep sleep.

True.

Treatment for night terrors is accomplished through methods that decrease (REM/non-REM) sleep, such as naps and benzodiazepines.

non-REM

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ is marked by repeated episodes of **rising from bed during sleep** and walking **about**. These patients have blank, staring faces and are relatively unresponsive to others. They can only be awakened through great difficulty and effort, after which they typically have no recollection of the event.

Sleepwalking Disorder (Somnambulism)

**Somnambulism** occurs in the (first third/middle third/second half) of the night during (REM/non-REM) sleep.

First third during non-REM

**Somnambulism** is more common in (males/females).

Males

Bedwetting, or enuresis, is considered abnormal in children over the age of __ years.

5 years

A(n) \_\_\_\_\_\_\_\_\_\_\_\_\_\_, or bedwetting alarm, is the best first-line treatment for enuresis.

Bell-pad

\_\_\_\_\_\_\_\_\_\_\_ and __________ are also used as second line treatments for **enuresis**.

**Imipramine** and **vasopressin**

**Loss of atonia** during REM sleep resulting in motor activity usually of a **violent nature** is common in _________________ disorders.

REM Behavior disorders

**REM behavior disorders** most often occur in the (first third/middle third/second half) of the night.

Second half

What medications can precipitate **REM behavior disorders**?

* Stimulants * Tricyclics * **SSRIs** or **SSNRIs**

What are the waves shown in the following stages of sleep: * NREM 1 * NREM 2 * NREM 3

* NREM 1 - Theta waves * NREM 2 - Sleep spindles and K complexes * NREM 3 - Delta waves (SWS)

What is the main mechanism that "**tells us we are sleepy**" in the **homeostatic** system (Process S - Sleep Load)?

**Adenosine** * Caffeine is an Adenosine receptor anatagonist

What genetic linkages could be linked to Narcolepsy?

* **HLA DQB1** * Deficiency of **Hypothalamic Peptide** (**Hypocretin**-1 or **Orexin**-1)