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Psych > Sleep Wake > Flashcards

Sleep Wake Flashcards

1
Q

Briefly describe NREM sleep

A
  • slower brain waves on EEG

- harder to arouse

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2
Q

Briefly describe REM sleep

A
  • faster waves on EEG
  • atonia, eye movements
  • lower arousal threshold
  • waking during REM= memory of dreams
  • higher HR, BP, RR
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3
Q

Two types of sleep disorders

A
  • parasomnia: unusual sleep-related behavior

- dyssomnia: insufficient/excessive/altered sleep

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4
Q

MC sleep related disorders

A

-assc with breathing OSA/CSA

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5
Q

When should insomnia disorder be ruled out?

A

If it is part of another psych disorder (ie anxiety)

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6
Q

Contrast acute and chronic insomnia disorder

A
  • acute: less than 3 months

- chronic: more than 3 months

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7
Q

Treatment for insomnia

A
  • CBT

- Benzos, Z drugs, antidepressants

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8
Q

What antidepressants are used in the treatment of insomnia

A
  • mirtazapine
  • trazadone
  • amitryptiline, doxepin
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9
Q

What are the three Z drugs?

A
  • zaleplon (sonata)
  • zolpidem (ambien)
  • eszopiclone (lunesta)
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10
Q

Risk assc with zolpidem

A

more than 10mg can cause increased cognitive impairment in women

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11
Q

Effects of zolpidem in eldery

A

falls + cog impairment

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12
Q

In what ways are Z drugs better than benzos?

A

-lower incidence of orthostatic hypotension and daytime sleepiness

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13
Q

Hypersomnolence disorder description

A

excessive daytime sleepiness despite getting 7+ hours of sleep

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14
Q

Causes of hypersomnolence disorder

A
  • viral infections
  • head trauma
  • genetic
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15
Q

Treatment for hypersomnolence disorder

A

-modafinil
-stimulants
-atomextine
(+/- scheduled naps)

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16
Q

Dx of OSA

A
  • excessive daytime sleepiness

- apneic episodes (more than 15/hour)

17
Q

CSA causes

A
  • idiopathic
  • with Cheyne Strokes Breathing
  • assc with opioid use
18
Q

Describe Cheyne Strokes breathing

A
  • periodic crescendo decrescendo breathing

- heart/renal failure, stroke, DKA assc

19
Q

Sleep related hypoventilation:

  • polysomnography finding
  • common physical complaint
A
  • poly: descreased breathing, elevated CO2

- morning headaches

20
Q

What is the narcolepsy tetrad?

A
  • daytime sleepiness
  • hallucinations (hypnogognic/pompic)
  • cataplexy
  • REM related parasomnias
21
Q

CSF finding in Narcolepsy?

A

-low hypocretin

22
Q

Cause of narcolepsy

A

loss of hypothalamic neurons +/- autoimmune component

23
Q

Treatment of daytime sleepiness in narcolepsy

A
  • modafinil, methylphenidate, sodium oxybate

- amphetamines

24
Q

Treatment of cataplexy in narcolepsy:

A
  • sodium oxybate
  • TCAs
  • SSRIs
  • SNRIs
25
Q

What is the DOC for cataplexy, which also treats daytime sleepiness?

A

-sodium oxybate

26
Q

Sleep disorder assc with recurrent patterns of sleep disruption due to alteration between circadian rhythym and individuals environment/work schedule

A

-circadian rhythm sleep wake disorders

27
Q

Part of brain responsible circadian rhythym

A

suprachiasmatic nucleus

28
Q

Non-REM sleep arousal D/O:

characteristics

A

-non-conscious arousal during first third of sleep leading to sleep walking/ sleep terrors

29
Q

How to treat refractory cases of sleep walking

A

-low dose BDZ

30
Q

Are sleep terrors remembered?

A

No, occur during NREM sleep

31
Q

Autonomic signs of sleep terrors

A
  • tachycardia
  • tachypnea
  • diaphoresis
  • mydriasis
32
Q

Nightmare D/O treatment

A
  • desensitization/imagery rehearsal therapy

- prazosin/SSRIs if assc with PTSD

33
Q

REM sleep behavior disorder cause

A

loss of muscle atonia during REM sleep

34
Q

Coniditions assc with sleep behavior disorder

A
  • neurodegenerative disorders
  • parkinsons
  • lewey body
  • multiple systems atrophy
35
Q

Treatment of REM sleep behavior d/o

A
  • clonazepam

- melatonin

36
Q

Screen for _____ always in restless leg

A
  • iron deficiency anemia

- drug related cause

37
Q

First line treatment for RLS

A
  • dopamine agonists

- BDZ

Psych (16 decks)

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