sleep disorders Flashcards
dyssomnias
insufficient, excessive, or altered timing of sleep
disorders that make it difficult to fall or remain asleep, orr of excessive daytime sleepiness (hypersomnias)
parasomnias
unusual sleep related behaviors
late night or sleep offset insomnia
early morning awakenings
dyssomnia diagnosis
pg 155
tx for dyssomnias
sleep hygiene
CBT
pharm:
- benzos
- zolpidem, eszopiclone, zaleplon
- antidepres (trazodone, amitriptyline, doxepin-TCA)
benzos effect on sleep
reduce sleep latency and noctunral awakening
side effects: tolerance, addic, daytime sleepiness, rebound insomnia (and in elderly: falls, confusion, dizziness)
zolpidem, eszopiclone, and zaleplon’s use for dyssomnia
short term tx
assoc w low incidence of daytime sleepiness and orthostatic hypotension
in elderly, causes increased risk of falls and may induce cognitive impariment
antidepressants’ use for dyssomnia
trazodone, amitripytline, doxepin
side effects of sedation, dizziness, psychomotor impairment
trazodone most prescribed sedating antidepress for pts w chronic insomnia and depressive symptoms
first line therapy for chronic insomnia
CBT
most common approved and accepted reason to put pt on long term benzos
insomnia
tx for narcolepsy
schedule daytime naps, maintaine regular sleep sched
phamr: methylphenidate, antidepressants, modafinil, sodium oxybate
pathophysiology of narcolepsy
loss of hypothalamic neurons that contain hypocretin
advanced sleep phase disorder
sleep onset and awakening times earlier than desired
risk factor: older age
Klein Levin syndrome
rare-recurrent hyposeromnia w episodes of daytime sleepiness w hyperphagia, hypersexuality, aggression
REM sleep behavior d/o
muscle atonia during REM sleep and complex motor activity assoc w dream mentation (dream enactoment)
dream enacting behaviors may include: sleep talking, yelling, limb jerking, walking and/or running, punching and/or other violent bheaviors
