sleep disorders Flashcards
1 List symptoms and treatment of narcolepsy 2 Describe the DSM IV classification of sleep disorders 3 Describe origins and treatment of insomni a4 Appreciate Sleep Apnea and Circadian Disorders 5 Delineate REM vs. NREM parasomnias 6 State the classic sleep findings in Major Depression
primary sleep disorders
dyssomnias and parasomnias
sleep disorders related to another mental disorders
insomnia, hyersomnia
dyssomnias
primary insomnia primary hypersomnia narcopelsy sleep related breathing disorders circadian rhythm disorders dyssomnia NOS
NREM parasomnias
sleep terrors
somnoabulism
somniloquy (sleepwalking)
bruxism
REM parasomnias
nighmare disorder
REM behavior disorders
dx criteria
difficulty maintaining sleep for at least one month, causing significant distress or impairment
ddx of primary insomnia
other sleep disorders
mental disorders
general medical condition)
drug induced
cause of primary chronic insomnia
circadian and homeostatic systems out of whack
treatment for chronic insomnia
CBT for insomnia, (s;eep hygiene, sleep restriction, stimulus control, muscle relaxation)
meds for chronic insomnia
trazodone, zolpidem
ddx for hypersomnia
primary hypersomnia, sleep apnea, narcolepsy
diagnostic criteria for prymary hypersomnia
EDS for 1 month, causes cliniclly significant distress or impairment, does not occur in rekation to other sleep/mental disorders, medical conditions or drug sue
narcolepsy dioagnostic criteria
irrestible attacks of refeshing sleep daily over 3 months, not due to any other casue, usually cataplexy
diagnostic for narcolepsy
cataplexy
REM phenomena seen with narcopelsy
cataplexy, hallucinations, sleep paralysis
sleep onset REM periods on the MLST mean
narcolepsy
treatment for narcolepsy
stimulants, sodium oxybate
MOA of sodium oxybate
works at GAMA
accounts for most excessive daytime sleepiness
sleep apnea
“knock-on” effects of sleep apnea
mental issue, metabolic issues, heart problems, inflamation/accelerated atherosclerosis
most effective treatment for sleep apnea
surgery (50% effective)
causes of circadian rhythm sleep disorder
shift work, jet lag, delayed/advanced sleep [hase
possible causes of restless legs
depression, folate/Fe deficiency
treatment for RLS
dopamine agonists or clomazepam
differences between nightmare disorder and night terror
night terror does not recall dreams, occurs early in the night, inconsolable. shows outward signs of intense fear and automnomic arousal
can casue nightmare disprder
L-dopa, drug/EtOH withdrawal
treatment for nightmare disorder
antidepressent, prazosin
treatment for night terrors
naps and benzos (decrease SWS)
time that sleep walking occurs
1st 1/3 of night
occurs with sleep walking
enuresis, tourette’s sleep onset seizuers, childhood migraine,
age that betwetting becomes pathological
age 5
best treatment for enuresis
bell pad
sx of REM behavior disorder
loss of atonia during sleep, violent motor activity associated with vivid dream recall
drugs that can cause REM behavior disorder
stimulants, TCA, SSRI
REM disorder can be harbringer of
neurodegenerative disease
treatment of REM disorder
safety precautions, discontinuation of drugs, cloznazepam or melatonin
sleep problems found in depression
difficulty maintaing sleep, early morning wakenings, decreased REM latency, increased REM density, decreased REM latency/SWS/decreased Slep effciency
