Sleep Disorders Lecture Powerpoint Flashcards
Control center of sleep and 5 other anatomical structures involved
- Suprachiasmatic nucleus of hypothalaus
- brain stem, amygdala, thalamus, pineal gland, forebrain
Circadian rhythm
Directs a wide variety of functions from daily fluctuations in wakefulness to body temp, metabolism, and release of hormones, synchronize the environmental cues with the actual time of day
Factors that influence sleep-wake needs
- Exposure to light
- stress
- medical conditions
NREM stage 1
Muscles are relaxed but can have hypnic contractions, consciousness is decreased yet easily awakened
NREM stage 2
Muscles more relaxed and consciousness somewhat more decreased
NREM stage 3
Muscles relaxed with no activity, very decreased consciousness and difficult to awaken, talk in sleep or sleep walk
REM sleep
Majority of typical dreams, cycle thru night every 90-120 minutes, high frequency lower voltage brain activity theta waves, limbs are temporarily paralyzed
Aging and percentage of sleep stages
Newborns sleep majority of day and enter REM first, changing by 3 months of age, middle aged and beyond percentage of REM is stable thru adulthood but percentage of N3 decreases and percentage of wake and N1 increases
Dyssomnias
Abnormal amount, quality, or timing of sleep
Parasomnias
Abnormal behavioral or physiological events occurring in association with sleep
Insomnia
Very frequent medical complaint of poor sleep quality or insufficient quantity due to difficulty initiating or maintaining sleep (report taking 30 min or more to fall asleep) and have variable sleep with several nights of poor sleep followed by nights of better sleep, can be short term due to stress or chronic that has daytime consequences associated
Treatment of insomnia (4)
- Sleep hygiene improvement
- Benzodiazepines (can cause residual drowsiness and is habit forming)
- melatonin agonists
- Orexin receptor agonists
Valerian
The herbal version of valium (diazepam) that is highly addictive and can be overdosed on
Hypoglossal nerve stimulator
Surgically implanted nerve stimulator that senses each breath and activities and sends pulses to tongue base causing it to lurch forward and open airway implanted on the right side to not be confused for a pacemaker for treatment of sleep apnea
Cataplexy
Emotionally triggered transient muscle weakness often triggered by strong generally positive emotions
Narcolepsy
Clinical syndrome of daytime sleepiness with cataplexy, hypnagogic hallucinations, and sleep paralysis
Diagnosis of narcolepsy (2)
- Polysomnogram
- Multiple sleep latency test (seeing if REM sleep entered during nap and fall asleep in less than 8 min, essential features of narcolepsy)
Kleine-levin syndrome
Sleeping beauty syndrome, recurrent episodes of severe hypersomnia associated with cognitive and behavioral disturbances, episodes last a few days to several weeks and are separated by weeks or months of normal sleep behavior, no treatment available
Circadian rhythm sleep wake disorder
Chronic or recurrent sleep disturbance due to alteration of circadian rhythm or misallignment between environment and individual sleep wake cycle lasting 3 months in duration
Delayed sleep wake phase disorder and advanced sleep wake phase disorder
- Night owl (stay up late and sleep in late)
- early bird (go to bed early and get up early)
Sleep walking often occurs in ____ and is not distressing to the individual
children
Sleep/night terrors
Usually occurring between 4-12 years of age involving awakening from a sleep with loud scream, sweating, etc despite not remembering episode later
Restless leg syndrome treatment (2)
- Iron replacement
- behavioral modifications
