Sleep disorders + Transient LOC Flashcards
specific hormones increase during sleep?
growth hormone and melatonin
how many stages of sleep
stages 1-4 and REM
what stage does sleepwalking, bedwetting, or terrors occur?
stage 3
how much time do children stay in REM sleep?
up to 50%
sleep hygiene def
practices and habits that are significant to achieve nighttime sleep quality and full daytime alertness.
signs of poor sleep hygiene
- frequent slepe disturbances
- daytime sleepiness
- Too long to fall asleep
- Poor sleep routine
what sleep questionnaire could you use?
Epworth Sleep Scale (over 11 means go see a sleep specialist)
Sleep Deprivation Def
Not obtaining adequate total sleep.
Chronic sleep-restricted state they’ll notice excessive daytime sleepiness, fatigue, clumsiness, and weight gain or weight loss.
Sleep-deprived affects both the brain and cognitive function
common cause for headaches related to sleep?
Morning headaches (not sleeping fulfilled
Morning Headaches - What should you be nervous about?
High BP, sleep apnea
Definition of short sleeper syndrome
consistent under 7 hours of night
Types of Narcolepsy
- Narcolepsy with Cataplexy
2. Narcolepsy without Cataplexy
Circadian rhythm disorders
- Jet Lag
- Sleep Shift Disorder
- Delayed Sleep Phase Syndrome
- Advanced Sleep Phase Disorder
- Non-24 Sleep-Wake Disorder
Symptoms of Circadian Rhythm sleep disorders
problems falling asleep daytime sleepiness headaches difficulty concentrating decreased cognitive performance fatigue
confounders with delayed sleep phase syndrome (DSPS)
50% also have depresison
sleeping compensation at other times
Delayed Sleep Phase Syndrome
Circadian rhythm disorders are caused by the body’s internal clock not resetting and adapting to changes in sleeping patterns, or doing so slowly.
types of sleep apnea
obstruction (OSA)
Central (CSA) - 1:5 cases
sleep apnea risks
heart attack high blood pressure obesity stroke diabetes driving or work related accident
sleep apnea def
- Repetitive pauses in breathing during sleep.
- Frequency?…may occur several times per hour and last for over 10 seconds.
- In pause -> blood-oxygen levels decrease -> the brain awakens the individual which often leads to a loud gasp or snort.
- Sleep apnea is associated
measuring sleep apnea?
Apnea-hypopnea Index (AHI)
Effective treatments for Insomnia
1.Healthy sleep habits -> maintaining a regular sleep schedule; Creating a conducive sleep environment; Incorporating healthy habits into your lifestyle.
1.Behavioral therapy -> sleep program, restricting time in bed to only when sleepy, relaxation training, reducing anxiety and developing positive attitudes about sleep, etc.
●
1.Medications -> Hypnotic drugs
●
2.Wellness therapies -> Nutritional management for caloric control; melatonin, valerian and herbal products
First thing to assess with a transient loss of consciousness
any cardiac history, then posture, then vaso-vagal, then seizure
what happens in orthostatic hypotension
systolic BP drops over 20 mmHg after 1-5 mins standing
vaso-vagal cause of transient loss of conscious - what to expect
under 35, prodrome of sweating and nausea
provoked by pain, fear, warm environment
(these are same data for Seizure)
Syncope def
Faiont due to diminisehd CNS function (syncope is a symptom)
what does syncope look like?
rapid onset (seconds) w/ loss of consciousness, ita loss of muscle tone (A GRACEFULL FALL)
recovery is usually quick and complete awareness gained in seconds to minutes
Mechanism of syncope?
hypo-perfusion of brain resulting in transient global cerebral effect
Orthostatic Hypotention def…
decrease in systolic bp of 20 mmHg OR a decrease in diastolic BP of 10 mm Hg
when does orthostatic hypotension occur?
within three minutes of standing due to inadequate physiologic response to postural changes in blood pressure
vasovagal syncope criteria
postural changes
prodrome of “graceful fall/greying out”
Precipitating factors –> anything that causes a fight/flight episode
cardiovascular reflexes are mediated by?
autonomic based and important for establshing BP and controling vasovagal control of blood flow
What is Elderly Dysautonomic Pattern?
a slow fall in blood pressure after assuming upright position
exacerbated by medication
some patients will have immediate postural hypotension that recovers within seconds
who to suspect elderly dysautonomic pattern in?
older adults with low bp, history of syncope/falls
events after standing for a while
may describe postural hypotension symptoms
