Sleep-Wake Disorders Flashcards
what are the disorders categorized under sleep-wake disorders?
- Insomnia
- Hypersomnolence
- Narcolepsy
- Obstructive Sleep Apnea Hypopnea
- Central Sleep Apnea
- Sleep-Related Hypoventilation
- Circadian Rhythm Sleep-Wake Disorders
- Non-Rapid Eye Movement Sleep Arousal Disorders
- Nightmare Disorder
- Rapid Eye Movement Sleep Behavior Disorder
- Restless Legs Syndrome
this refers to the stage of sleep where theta waves are prominent
stage 1 sleep
this stage of sleep involves sleep spindles and mixed EEG activity
stage 2
these stages of sleep involve progressively more delta waves
stage 3 and stage 4
what is the alternative name for stage 3 and stage 4 sleep?
slow-wave sleep
these waves involve hypnotic jerks when you are asleep
Theta Waves
this type of sleep involves low-voltage, high-frequency beta waves
REM sleep
this term refers to when you can still sense your environment
sleep spindles
these waves are low frequency and high amplitude, characterize slow-wave stage 3 sleep.
Delta Waves
what is paradoxical sleep?
even if a person is in a deep sleep, the eyes still move
what were sleep-wake disorders called in DSM I?
Somnambulism (sleep-walking disorder)
what were sleep-wake disorders called in DSM II?
disorder of sleep
what were the sleep-wake disorders added in the DSM III?
sleep-walking disorder and sleep terror
what were sleep-wake disorders called in DSM III part 2?
Sleep Disorders
what were the sleep-wake disorders added in the DSM IV?
Narcolepsy and breathing-related sleep disorder
what are the symptoms for insomnia disorder?
- Inability to fall asleep or remain asleep
- Waking-up not feeling restored or refreshed
- Most common sleep complaint
- Acute or chronic
what are the three types of insomnia?
- Onset Insomnia
- Maintenance Insomnia
- Terminal Insomnia
this type of insomnia is characterized by difficulty falling asleep at the beginning of the night.
onset insomnia
what was Insomnia called in the DSM IV?1
- Primary Insomnia
- Insomnia related to another mental disorder
- Sleep disorder due to another medical condition, Insomnia Type
this type of insomnia is where a person wakes up during the night and has difficulty falling back asleep
maintenance insomnia
this type of insomnia is characterized by waking up too early and being unable to fall back asleep
terminal insomnia
what is the frequency and duration for insomnia?
frequency: occurs 3 nights per week
duration: 3 months
what are the symptoms for hypersomnolence disorder?
- Symptoms not due to insufficient sleep or fatigue
- No difficulty falling asleep
- Confusional arousal during awakening
- Return to normal after 30 to 60 minutes
- Nonrestorative sleep (even if more than 9 hours)
what is confusional arousal?
confusional arousal refers to inappropriate behavior, memory deficits, disorientation in time and space, slow mentation and speech
what is the difference between hypersomnia and hypersomnolence?
hypersomnia refers to excessive amounts of sleep while hypersomnolence refers to excessive sleepiness
how long should the main sleep period last in hypersomnolence?
at least 7 hours
what is the frequency and duration for hypersomnolence?
3 times per week, for at least 3 months
what are the duration specifiers for hypersomnolence?
acute: duration of less than 1 month
subacute: duration of 1-3 months
persistent : duration of more than 3 months
what are the severity specifiers for hypersomnolence?
mild: difficulty maintaining daytime alertness 1-2 days/week
moderate: difficulty maintaining daytime alertness 3-4 days/week
severe: difficulty maintaining daytime alertness 5-7 days/week
what are the symptoms for narcolepsy?
- Excessive daytime sleepiness and sudden onsets of the REM sleep
- Inability to stay awake for long periods and bouts of sleeping
- Sleep paralysis
- Cataplexy
- Sleep attacks
this term refers to short attacks triggered by varying conditions such as eating large meals, moments of high stress or tension, or being awake for more than 4 hours
sleep attacks
when was narcolepsy first included?
it was first included in the DSM IV
what are the possible causes of narcolepsy?
- low levels of hypocretin
- autoimmune process
this term refers to a sudden, brief loss of muscle tone triggered by strong emotions, often laughter or excitement, and is a primary symptom of narcolepsy
cataplexy
what are the severity specifiers for narcolepsy?
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
what are the sleep-wake disorders categorized as breathing-related sleep disorders?
- Obstructive sleep apnea hypopnea
- Central sleep apnea
- Sleep-related hypoventilation
what is the difference between apnea and hypopnea?
apnea is a pause in breathing and involves less than 90% drop in airflow for 10 seconds hypopnea involves abnormally slow or shallow breathing and has a less than 30% drop in airflow for 10 seconds
what are the symptoms for obstructive sleep apnea hypopnea?
- Nocturnal breathing disturbances: snoring, snorting/gasping, or breathing pauses during sleep
- Daytime sleepiness or unrefreshing sleep
2.Evidence of 15 or more obstructive apneas and/or hypopneas per hour of sleep regardless of accompanying symptoms
what are the severity specifiers for obstructive sleep apnea hypopnea?
mild: apnea hypopnea index is less than 15
moderate: apnea hypopnea index is 15-30
severe: apnea hypopnea index is greater than 30
this breathing-related sleep disorder occurs when the brain’s area that controls your breathing does not function correctly during sleep
central sleep apnea
this breathing-related sleep disorder is caused by obstructions in the upper airway that restrict oxygen to the body
obstructive sleep apnea
what are the possible causes for central sleep apnea?
- problems that affect the brainstem
- severe obesity
- certain medicines, such as narcotic painkillers
what are the symptoms for central sleep apnea?
- Observed episodes of stopped breathing or abnormal breathing patterns during sleep
- Abrupt awakening accompanied by shortness of breath, shortness of breath relieved by sitting up
- Difficulty staying asleep
- Insomnia
- Hypersomnia
- Difficulty concentrating
- Morning headaches
- Snoring
what are subtypes for central sleep apnea?
- Idiopathic central sleep apnea
- Cheyn-Stokes breathing
- Central sleep apnea comorbid with opioid use
this subtype for central sleep apnea is characterized by repeated episodes of
apneas and hypopneas during sleep caused by variability in respiratory effort but
without evidence of airway obstruction
idiopathic central sleep apnea
this subtype of central sleep apnea involves a pattern of periodic crescendo-decrescendo variation in tidal volume that results in central apneas and hypopneas at a frequency of at least five events per hour, accompanied by frequent arousal.
cheyne-stokes breathing
what are the symptoms and causes for sleep-related hypoventilation?
- decreased respiration associated with elevated carbon dioxide levels during sleep
- shallow breathing lasting longer than 10 seconds during sleep
Causes: lung disease or neuromuscular or chest wall disorders or medication use
this subtype of sleep-related hypoventilation is not attributable to any readily identified condition
idiopathic hypoventilation
this subtype of sleep-related hypoventilation is a rare congenital disorder in which the individual typically presents in the perinatal period with shallow breathing, or cyanosis and apnea during sleep.
congenital central alveolar hypoventilation
this disorder is a persistent or recurring pattern of sleep disruption resulting either from an altered sleep-wake schedule or from an inequality between a person’s natural sleep-wake cycle and the sleep-related demands placed on him or her
circadian rhythm sleep-wake disorders
what are the subtypes for the circadian rhythm sleep-wake disorders?
- delayed sleep phase type
- Advanced sleep phase type
- Irregular sleep-wake type
- Non-24-hours sleep-wake type
- Shift work type
what were circadian rhythm sleep-wake disorders called in the DSM IV?
circadian rhythm sleep disorders with no specifiers
this subtype of circadian rhythm sleep-wake disorders involve a pattern of delayed sleep onset andawakening times, with an inability to fall asleep and awaken at a desired orconventionally acceptable earlier time
delayed sleep phase type
this subtype of circadian rhythm sleep-wake disorder involves a pattern of advanced sleep onset and awakening times, with an inability to remain awake or asleep until the desired or conventionally acceptable later sleep or wake times
advanced sleep phase type
this subtype of circadian rhythm sleep-wake disorder involves a temporally disorganized sleep-wake pattern, such that the timing of sleep and wake periods is variable throughout the 24-hour period.
irregular sleep-wake type
this subtype of circadian rhythm sleep-wake disorder involves a pattern of sleep-wake cycles that is not synchronized to the 24-hour environment, with a consistent daily drift (usually to later and later times) of sleep onset and wake times.
non-24-hour sleep-wake type
this subtype of circadian rhythm sleep-wake disorder involves insomnia during the major sleep period and/or excessive sleepiness (including inadvertent sleep) during the major awake period associated with a shift work schedule (i.e., requiring unconventional work hours)
shift work type
what are the duration specifiers for circadian rhythm sleep-wake 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 occur within the space of 1 year.
these sleep disorders are characterized by abnormal behavioral, experiential, or physiological events occurring in association with sleep, specific sleep stages, or sleep-wake transitions
parasomnias
these disorders represent variations of the simultaneous admixture of elements of both wakefulness and NREM sleep, a combination that results in the appearance of complex motor behavior without conscious awareness
Non-Rapid Eye Movement Sleep Arousal Disorders
this refers to repeated episodes of rising from bed during sleep and walking about.
during this, the individual has a blank, staring face; is relatively unresponsive to the efforts of others to communication with him or her; and can only be awakened with great difficulty
sleep walking
this disorder is characterized by recurrent dreams that feel threatening or frightening or cause dysphoria
should only be considered in cases where the nightmares are recurrent and results in significant impairment
nightmare disorder
what are the symptoms for NREM Sleep Arousal Disorders?
- Recurrent episodes of incomplete awakening from sleep
- Sleepwalking or Sleep Terrors
- No or little dream imagery is recalled
- Amnesia for the episodes is present
what are the severity specifiers (frequency) for nightmare disorder?
Mild: Less than one episode per week on average
Moderate: One or more episodes per week but less than nightly
Severe: Episodes nightly
what are the duration specifiers for nightmare disorder?
Acute: Duration of period of nightmares is 1 month or less.
Subacute: Duration of period of nightmares is greater than 1 month but less than 6 months.
Persistent: Duration of period of nightmares is 6 months or greater.
this disorder is a sensorimotor, neurological sleep disorder characterized by a desire to move the legs (or arms), usually associated with uncomfortable sensations typically described as creeping, crawling, tingling, burning, or itching.
restless leg syndrome
what is the frequency and duration for restless leg syndrome?
3 times per week, for at least 3 months
