Sleep in Other Disorders Flashcards
What is another name for nocturnal frontal lobe epilepsy?
Nocturnal paroxysmal dystonia
EDS is found in what % of myotonic dystrophy Type I (DM1) patients?
Approximately 30% - 40%
Does the degree of sleepiness in DM1 correlate with the number of CTG repeats?
No, although it can with other parts of the disorder
What can the MSLT look like in DM1?
It can look like narcolepsy
Reduced mean sleep latency
SOREMs
Pediatric RBD can herald the onset of what disorder?
Narcolepsy. In adults it can preceed PD.
What 2 sleep disorders lead to an increased risk for stroke?
Habitual snoring and severe OSA
What % of acute stroke patients develop SDB and does it improve?
50% and it does improve some (central improves more than obstructive)
What is Peduncular hallucinosis of Llhermitte?
Hallucinations seen with some strokes involving the midbrain or pons
What is Charcot-Wilbrand syndrome?
Reduction or cessation of dreaming in some strokes that affect the cerebral cortex, especially the deep frontal white matter
What % of patients with generalized myasthenia gravis develop sleep apnea?
Approximately 60% with obstructive the most common
Tumors in what ventricle can cause narcolepsy?
3rd ventricle
What are common sleep findings in patients with narcolepsy?
- Severe insomnia
- Impaired sleep efficiency
- Decreased SWS
- Decreased REM latency
A schizophrenic in remission has worsening insomnia. Why is this concerning?
Worsening insomnia can indicate an impending relapse
Short REM latency can be seen in what psychiatric disorders?
- Borderline personality disorder
- Anxiety
- Depression
- Schizophrenia
- Anorexia nervosa
- Panic disorders
Name 2 atypical antipsychotics that increase SWS
- Risperidone
- Olanzapine
What is the best treatment for patients with hypothyroidism?
CPAP and low dose thyroxine
What adverse reaction can patients with hypothyroidism and OSA have with thyroid replacement alone?
Cardiovascular complications including nocturnal angina and cardiac arrhythmias
In patients with heart failure and CSB, when is an arousal most likely to occur?
During the peak of hyperpnea
3 causes of CSB related to heart failure
- Long circulation time
- Increased drive to breath
- Hypoxemia related to pulmonary edema
3 causes for nocturnal diarrhea
- Diabetic neuropathy affecting G.I. tract
- Neoplasia in G.I. tract
- Inflammatory bowel disease
G.I. changes that occur during sleep (4)
- Delayed gastric emptying
- Decreased upper esophageal sphincter pressure
- Decreased esophageal peristalsis
- Decreased salivary secretion
What will be seen on PSG in patients with insufficient sleep syndrome?
- Shortened sleep latency
- Improved sleep efficiency > 90%
- Increased total sleep
- Increased N3 and REM sleep
Bruxism is typically seen in what stages of sleep?
N1 & N2,
Can be seen less in REM
What medication is recommended for PTSD patients with nightmares?
Sertraline. In the past prazosin was recommended but it didn’t show any benefit in the VA cooperative study
The presence of RBD in parkinson’s disease can predict what symptom?
Cognitive dysfunction
