Sleep Disorders (Part 2) Flashcards
What are parasomnias?
A group of sleep disorders that involve unwanted events or experiences while falling asleep, asleep or waking up
What is the persons awareness of parasomnias?
They are asleep throughout the event and often have no memory of it
Which type of parasomnias will involve a) narrative dreaming and b) non-narrative dreaming?
a) REM parasomnias b) non-REM parasomnias
Which type of parasomnias would cause sleep deprivation?
Non-REM
What are some examples of non-REM parasomnias?
Confusional arousals, sleep walking, sleep terrors, sleep paralysis, restless legs
Which type of parasomnias will involve a) complex behaviours? b) simple behaviours?
a) non-REM b) REM
When do non-REM parasomnias usually occur?
First 2/3rds of the night
When do sleep terrors usually occur?
Mainly in childhood
What happens in REM sleep behaviours?
You act out vivid dreams as you sleep
When do REM sleep behaviours usually occur?
The latter third of the night
Compared to non-REM parasomnias, is it harder or easier to wake up people during REM sleep behaviour?
Easier
What happens when people with REM sleep behaviour wake up with regards to memory?
They can recall clear details of the vivid dream
Does REM sleep behaviour have a cause?
No, usually idiopathic
REM sleep behaviour is often seen preceding what condition?
Parkinson’s disease
What is the sex distribution of narcolepsy? Describe the age of onset?
Equal, variable age of onset with two peaks at 15 and 36
What are the characteristic features of narcolepsy?
Daytime sleepiness, cataplexy, hypnagogic hallucination, sleep paralysis
Describe the daytime sleepiness in narcolepsy?
Involuntary solemnness during eating/talking, may be impossible to resist
What is cataplexy?
A loss of muscle tone, triggered by emotion
What is the patients awareness state during an attack of cataplexy?
Aware of what’s going on, can see and hear but can’t move
Cataplexy is present in what proportion of cases of narcolepsy?
70%
What are hypnagogic hallucinations?
Hallucinations occurring at sleep onset
What is the typical time between onset and diagnosis of narcolepsy?
10 years
When do symptoms of narcolepsy often begin?
As a teenager
What are the three main investigations for narcolepsy?
Overnight polysomnography, multiple sleep latency tests, lumbar puncture
What happens in multiple sleep latency tests?
4x25 minute naps are scheduled about 2 hours apart and EEG, muscle activity and eye movement are recorded
What does a sleep latency test measure?
The time from the start of a daytime nap to the first signs of sleep
Will narcolepsy patients fall asleep quickly or slowly? What is abnormal about how they fall asleep?
Quickly, go into REM sleep first which is abnormal
What is a lumbar puncture used for in the investigation of narcolepsy?
CSF hypocretin, low levels (< 110) are associated with narcolepsy
What are the rules with narcolepsy and driving?
Driving should be stopped until control is achieved, they will never be able to drive buses/lorries
What is insomnia?
Difficulty falling asleep or staying asleep for the desired amount of time
What are some symptoms of insomnia?
Daytime sleepiness, irritability, low energy, depressed mood
Describe what happens in confusional arousals?
People act in a strange and confused way as they wake up or just after - may appear that they don’t know where they are or what they are doing
Describe what happens in sleep terrors?
Wake up in intense fear with hardly any/no memory of having a bad dream
Describe what happens in sleep paralysis?
Causes you to be unable to move your body when you are falling asleep or waking up
