Sleep Disorders Flashcards
what is orexin/hypocretin?
balances sleep/wake
what hormone regulates wake/sleep and REM/non REM?
Orexin/hypocretin
how many sleep cycles per night usually?
4-5
when do you have longer REM sleep?
later in the sleep cycle
Melatonin increases when?
at night?
difference between fatigue and sleepiness
post marathon = fatigue
sleepiness = falling asleep too easily
elevated above epworth scale score is?
> 10
OSA obstructs wherE?
obstruction of upper airways d/t tongue and airways
snoring is what kind of obstruction?
incomplete obstruction
cardinal symptoms of OSA?
heavy snoring
witnessed apnoeas
escessive daytime somnolence
nocturnal symptoms of OSA?
nocturia
chocking/gasping
disrupted sleep
stroke risk with OSA? who?
middle aged, less so elderly
dementia with OSA?
yes, can happen
cardioresp manifestations of OSA?
HTN cor pulmonale MI arrythmias/sudden death polycythaemia
risk factors for OSA?
age male obesity alcohol upper airway morphology
tongue muscle called?
genioglossus
how many events of OSA to be mild, mod, severe
5-15 mild
15-30 moderate
>30 severe
what is hypopnoea
30% reduction in airflow with >3% O2 desat or arousal
OSA management?
conservative Rx
CPAP
oral appliances
surgery
who gets surgery for OSA?
children usually gets adenotonsillectomy
if failed CPAP and has mild/mod OSA, then what do you do?
mandibular advancement splint
what is Cheyne Stokes Respiration? when do you get it?
cardiac failure
central sleep apnoea causes?
cardiac failure: cheyne-stokes
high altitudeCVA
idiopathic
cheyne stokes pathological
may be more efficient in cardiac failure
causes of hypoventilation?
reduced drive via drugs, trauma neuromuscular chest wall deformity obesity increased requirement
who gets chronic insomnia?
women 2:1 usually post-menopause
primary insomnia and arousal?
hyperarousal, anxiety, to sleep,
types of acute insomnia meds?
benzos
non-benzoes
antidepressants, antihistas
delayed sleep phase syndrome?
drive to fall asleep is later
causes of secondary restless leg syndrome
Iron deficiency, renal failure, peripheral neuropathy, lubosacral rediculopathy
watch out for what in dopamine agonist?
impulsive behaviours
narcolepsy cause?
deficiency in orexin
how to dx narcoloepsy?
mean sleep latency
cataplexy is?
loss of muscle tone from dropping into REM
stimulants for narcolepsy?
modafinil
amphetamines
what is parasomnias?
sleep talking
sleep walking
sleep eating
what is REM parasomnia?
act out dreams
3 states of sleep
wakeful
non-REM
REM
