Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Management of neuropsychiatric disorders > Sleep investigations > Flashcards

Sleep investigations Flashcards

1
Q

What is the utility of a sleep diary?

A

Allows you to determine a typical night’s sleep and see how much variability there is

Compared weekends and weekdays

Discern patterns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the scoring system of the Epwrtj sleepiness scale?

A

0-3 (never to high chance)
8 situations
11+ is excessively sleepy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is actigraphy?

A

Accelerometer worn on the wrist to collect continuous data on movements for several weeks

Translated into sleep-wake data

Can confirm circadian rhythm disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is actigraphy used for?

A

Determining the sleep pattern in insomnia

Measuring sleep fragmentation

Ensuring sleep is not restricted prior to multiple sleep latency test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the limitations of actigraphy?

A

Available only in specialist sleep clinics

Not validated with all sleep disorders and populations

Cannot measure sleep stages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is pulse oximetry used?

A

Measures O2 saturation and pulse rate

Used in diagnosis of obstructive sleep apnoeas
(From pulse oximeter and calculated oxygen destruction index)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the severity levels of OSA?

A

Oxygen saturation index

Mild 5-15
Moderate 15-30
Severe 30+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the limitations of pulse oximetry?

A

Unclear what percentage of desaturation should be used

High specificity but lower sensitivity

Will not detect apnoeas if there is arousal before oxygen saturation drops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does a respiratory study entail?

A

Pulse oximetry
Nasal airflow
Chest and abdomen respiratory movements

Can be done inpatient or at home

Inpatient may be split between diagnostic and CPAP titration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the advantages of respiratory study?

A

Detect apnoeas before desaturation

Detect mixed (central and obstructive) sleep apnoeas

All body positions are monitored

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the limitations of respiratory study?

A

Cannot detect the impact of respiration on sleep

Can miss respiratory effort arousal

Require more time and expertise to analyse

Home studies prone to technical problems

Cannot usually detect non respiratory sleep disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does a WatchPat do?

A

Measures
PAT signal
Heart ratpcimetry
Sctigrsohy
Body position
Snoring
Chest motion

Can detect OSA, sleep fragmentation, and sleep architecture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does a polysonogram include?

A

EEG
EOG
Submental EMG
Tibialis EMG
ECG
Video + Audio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a polysomnogram used to detect?

A

OSA
PLMS
Insomnia
Non rem parasomnias
REM behaviour disorder
Nocturnal epilepsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the gold standard method for sleep study?

A

Polysomnogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the advantages of polysomnogram?

A

Differentiates between sleep stages and wherein the disorder occurs

Can detect epileptic phenomena

Measures time awakenings and arousals

Can determine the impact of the disorder on sleep

17
Q

What are the limitations of polysomnograms?

A

Analysis is required by highly skilled professionals

Sleep may be affected by wires, awareness of video, sleeping in a strange environment

Only available in specialist sleep centres

18
Q

What is the multiple sleep latency test used for?

A

Measure the ability to initiate sleep

Measures sleepiness in hypersomnolence

Used to differentiate between narcolepsy and idiopathic hypersomnolence

May also be used for OSA with ongoing sleepiness

19
Q

What is the procedure for MSLT?

A

1 week actigraohy
Overnight polysomnogram with full array to ensure adequate sleep before test

Patient remains in the clinic the following day and is asked to try to nap every two hours - up to 5 trials

Nap trial ends after 20 mins of no sleep, or 15 mins after patient falls asleep

20
Q

What do results of MSLT indicate?

A

Normal subject sleep onset latency is 10-20 mins

Mean SOL less than 8 mins is excessive sleepiness

Mean SOL in narcoleptics is 3 mins

2 or more naps with REM - narcolepsy

SOL below 8 mins + less than 2 REM naps - idiopathic hypersomnolence

21
Q

What are the limitations of MSLT

A

False positive and false negatives common

Trial settings may change patients sleep behaviour

Antidepressants suppress REM and can give a false negative for narcolepsy

Withdrawal of antidepressants 2 weeks before test can lead to REM rebound giving a false positive

The protocol is not standardised between labs or between clinical and research

22
Q

What is the maintenance of wakefulness test?

A

Test ability to resist sleep

Can confirm if a person with sleep disorder is safe to drive or work

23
Q

What is the normal SOL for the maintenance of wakefulness test?

A

30 mins

24
Q

What is a big limitation of MWT in determining safety to drive?

A

Microsleeps below 15 seconds are not scored but can be fatal at 70mph+

25
Q

What is the Oxford Sleep Resistance test?

A

Light flashes every 3 seconds, subject presses button
7 consecutive misses is taken as sleep

Easy to administer and interpret

26
Q

What test should be requested for insomnia?

A

Actigraphy

27
Q

What test should be requested for hypersomnia?

A

Actigraphy
MSLT

28
Q

What test should be requested for parasomnias?

A

Polysomnogram

29
Q

What test should be requested for movement disorders in sleep?

A

Polysomnogram

30
Q

What test should be requested for sleep related breathing disorders?

A

Oximetry
Respiratory study
PSG
WatchPat

31
Q

What test should be requested for circadian rhythm disorders?

A

Actigraphy

32
Q

What test should be requested for fitness to drive?

A

MWT
OSLER

33
Q

What are the six categories of sleep disorders?

A

Breathing disorders
Insomnia
Movement disorders
Circadian rhythm disorder
Hyoersomnolence
Parasomnias

34
Q

What might be the underlying cause of REM sleep behaviour disorder?

A

Parkinson’s disease or Lewy body dementia

(Worsens on antidepressants)

Management of neuropsychiatric disorders (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions