Sleep Disorders Flashcards
Paradoxical insomnia
Complain of insomnia even when sleep studies reveal normal EEG sleep stages
Overestimate time to fall asleep
Underestimate total sleep time
Obstructive sleep apnea
Most common type of sleep disordered breathing
Narrow airway
Elevated BP
Central sleep apnea
Repetitive cessation or decrease of both airflow and ventilatory effort during sleep
Risk factors: >65 years Heart failure Stroke Long acting opioid disease
Central sleep apnea clinical findings
Daytime sleepiness Poor subjective sleep quality Insomnia Paroxysmal nocturnal dyspraxia Morning HAs
Narcolepsy
Disorder of sleep-wake control
Loss of orexin A and orexin B from lateral hypothalamus
No detectable orexin A in CSF
DQB1*0602 haplotype present in 95% of pats with cataplexy and 96% of pets with orexin deficiency
Orexin A and B
Excitatory, stabilize wakefulness, prevent inappropriate transitions to REM or NREM sleep
Cataplexy
Emotionally triggered transient muscle weakness often partial affecting face, neck, knees
Lasts less than 2 min
Narcolepsy
Hypnagogic hallucinations
Occur while falling asleep
Visual, tactile or auditory
Vivid, frightening
Sleep latency in narcoleptics
Less than 8 minutes
Sleep latency in healthy subjects
10-15 minutes
Secondary RLS associations
Iron deficiency End stage renal disease, hemodialysis DM MS Parkinson’s Pregnancy Drugs Venous insufficiency
Restless legs syndrome
Symptoms relieved by movement
Symptoms worsen as day progresses
Difficulty falling asleep
Frequent night awakenings
Traveling east to west
Easier for people with sleep wake cycle longer than 24 hours
Traveling west to east
Easier for individuals with sleep wake cycle shorter than 24 hours
