Sleep-Wake Disorders Flashcards
Which group do these diagnoses belong to?
- Insomnia Disorder
- Hypersomnolence Disorder
- Narcolepsy
- Breathing Related Sleep Disorders
- Circadian Rhythm Sleep Disorders
Sleep-Wake Disorders
A. A predominant complaint of dissatisfaction with sleep quantity or quality, associated with one (or more) of the following symptoms:
1. Difficulty initiating sleep.
2. Difficulty maintaining sleep, characterized by frequent awakenings or problems returning to sleep after awakenings.
3. Early-morning awakening with inability to return to sleep.
B. The sleep disturbance causes clinically significant distress or impairment in social, occupational, educational, academic, behavioral, or other important areas of functioning.
C. The sleep difficulty occurs at least 3 nights per week.
D. The sleep difficulty is present for at least 3 months.
E. The sleep difficulty occurs despite adequate opportunity for sleep.
F. The insomnia is not better explained by and does not occur exclusively during the course of another sleep-wake disorder (e.g., narcolepsy, a breathing-related sleep disorder, a circadian rhythm sleep-wake disorder, a parasomnia).
G. The insomnia is not attributable to the physiological effects of a substance.
H. Coexisting mental disorders and medical conditions do not adequately explain the predominant complaint of insomnia.
Insomnia Disorder
Which diagnosis do these specifiers belong to?
- With non-sleep disorder mental comorbidity, including substance use disorders
- With other medical comorbidity
- With other sleep disorder
- Episodic: Symptoms last at least 1 month but less than 3 months.
- Persistent: Symptoms last 3 months or longer.
- Recurrent: Two (or more) episodes within the space of 1 year
Insomnia Disorder
Which diagnosis do these differential diagnoses belong to?
- Normal sleep variations
- Situational/acute insomnia
- Delayed sleep phase and shift work types of circadian rhythm sleep-wake disorder
- Restless legs syndrome.
- Breathing-related sleep disorders.
- Narcolepsy
- Parasomnias
- Substance/medication-induced sleep disorder, insomnia type
Insomnia Disorder
A. Self-reported excessive sleepiness despite a main sleep period lasting at least 7 hours, with at least one of the following symptoms:
1. Recurrent periods of sleep or lapses into sleep within the same day.
2. A prolonged main sleep episode of more than 9 hours per day that is nonrestorative
3. Difficulty being fully awake after abrupt awakening.
B. The hypersomnolence occurs at least three times per week, for at least 3 months.
C. The hypersomnolence is accompanied by significant distress or impairment in cognitive, social, occupational, or other important areas of functioning.
D. The hypersomnolence is not better explained by and does not occur exclusively during the course of another sleep disorder
E. The hypersomnolence is not attributable to the physiological effects of a substance
F. Coexisting mental and medical disorders do not adequately explain the predominant complaint of hypersomnolence.
Hypersomnolence Disorder
A. Recurrent periods of an irrepressible need to sleep, lapsing into sleep, or napping occurring within the same day. These must have been occurring at least three times per week over the past 3 months.
B. The presence of at least one of the following:
1. Episodes of cataplexy, defined as either (a) or (b), occurring at least a few times per month:
a. In individuals with long-standing disease, brief (seconds to minutes) episodes of sudden bilateral loss of muscle tone with maintained consciousness that are precipitated by laughter or joking.
b. In children or in individuals within 6 months of onset, spontaneous grimaces or jaw-opening episodes with tongue thrusting or global hypotonia, without any obvious emotional triggers.
2. Hypocretin deficiency, as measured using cerebrospinal fluid (CSF) hypocretin-1 immunoreactivity values (less than or equal to one-third of values obtained in healthy subjects tested using the same assay, or less than or equal to 110 pg/mL). Low CSF levels of hypocretin-1 must not be observed in the context of acute brain injury, inflammation, or infection.
3. Nocturnal sleep polysomnography showing rapid eye movement (REM) sleep latency less than or equal to 15 minutes, or a multiple sleep latency test showing a
mean sleep latency less than or equal to 8 minutes and two or more sleep-onset REM periods.
Narcolepsy
Which diagnosis do these specifiers belong?
Mild: Infrequent cataplexy (less than once per week), need for naps only once or twice per day, and less disturbed nocturnal sleep.
Moderate: Cataplexy once daily or every few days, disturbed nocturnal sleep, and need for multiple naps daily.
Severe: Drug-resistant cataplexy with multiple attacks daily, nearly constant sleepiness, and disturbed nocturnal sleep (i.e., movements, insomnia, and vivid dreaming)
Narcolepsy
Which group of disorders do these belong?
Obstructive Sleep Apnea Hypopnea
Central Sleep Apnea
Sleep-Related Hypoventilation
Circadian Rhythm Sleep-Wake Disorders
Breathing-Related Sleep Disorders
