Sleep Disorders Flashcards
where does the suprachiasmatic nucleus receive direct input?
retina
what does the SCN control secretion of?
melatonin
what are two types of sleep?
NREM and REM
how many stages of NREM?
4
what is sleep cycle order?
NREM 1,2,3,4 then REM
does REM increase or decrease through the night?
increase
NREM 1 is what wave?
theta
NREM 2 has what on EEG/
sleep spindles and K complexes
NREM 3 is what wave?
delta
REM sleep is what wave?
beta wave
what happens in NREM 3?
sleepwalking/night terrors/bed wetting
what happens in REM?
muscle tone loss..dreams
awake with eyes closed has what waves?
alpha waves
totally awake has what waves?
beta waves
what is most common sleep disorder?
insomnia
how long must you have difficulty staying or falling asleep for insomni?
over 1 month
what are three common comorbidities with insomnia?
mood disorders
anxiety
pain
what happens in narcolepsy?
drop into REM sleep during wakefulness
what are the four main features of narcolepsy?
excess sleepiness, cataplexy
sleep paralysis
hypnogogic hallucination
what is sleep paralysis?
mind awake but unable to move
what is at onset of sleep study in narcolepsy?
REM sleep
what is restless leg syndrome?
urge to move legs with uncomfortable crawling sensations
when does RLS most commonly occur?
evening at night
what is RLS treated with?
dopamine agonist
what is RLS associated with?
iron deficiency anemia
what happens in the REM sleep disorder
loss of normal skeletal muscle atonia…
what does person do in REM sleep behavior disorder since they lost their normal skeletal muscle atonia?
they act out dreams
when do night terrors occur in sleep?
stage 3/4
who gets night terrors
children
how long do night terrors last?
10 minutes
what is a night terror?
unexplained bouts of terror/fear about 70 minutes into sleep
can you awake a child having night terror?
no
when does sleep wlalking occur in sleep?
stage 3/4
who gets sleep walking?
children mainly
do you have memor/y of sleep walking
no you dont
what is bruxism?
grinding of the teeth during sleep
when does bruxism occur?
during sleep
if problem is getting to sleep, what do we give for Rx?
a hypnotic
if problem is getting to sleep, what do we give for Rx?
a hypnotic
what are the three long acting Benzos?
temazepam
lorazepam
diazepam
what are the four short acting benzos?
Alprazolam
Triazolam
Oxazepam
Midazolam
what three benzos to give with liver failure?
Lorazepam
Oxazepam
Temazepam
what is antidote of benzo?
flumazenil
name the Z drugs
zolpidem
eszopiclone
zalpelon
what is MoA of Z drugs?
bind to GABA a1 receptor that modulates sleep
what are Z drugs antidote?
flumazenil too
what is MoA of remelteon?
activated maltonin receptors in the suprhiasmatic nucleus of the hypothalamus
what is ramelteon used for?
insomnia rx
what is MoA of suvoxerant?
orexin receptor antagonist
what is suvoxerant contraindicated in?
liver disease, narcolepsy
what are the anti depressants commonly used for sedation side effect profile?
TCA and trazodone
