SM_88b: Sleep Disorders Flashcards
Describe history for sleep disorders
History for sleep disorders
- Patient and bed partner
- Bedtime / awak (week and weekend)
- Time to fall asleep
- Nocturnal awakening
- Daytime memory
- Daytime activities
- Medical conditions
- Medications: narcotics, SSRI, non-prescription meds/herbs, illicits
- Social history: alcohol, caffeine, illicts, work schedule
- Family history: narcolepsy, parasomnia, OSA have genetic influence
Describe medical conditions associated with sleep disorders
Medical conditions associated with sleep disorders
- Anemia / renal disease - restless leg syndrome
- Acromegaly / Cushing - OSA
- Heart failure - central sleep apnea
- Anxiety / depression - insomnia
- Parkinson’s disease - REM behavior disorder
____, ____, and ____ are sleep disorders with genetic influences
Narcolepsy, parasomnia, and OSA are sleep disorders with genetic influences
Describe social history factors related to sleep disorders
Social history factors related to sleep disorders
- Alcohol consumption: worsening OSA / insomnia
- Caffeine: stimulants contribute to insomnia
- Illicit drugs: alter sleep architecture
- Work schedule: shift work / nocturnal disruption
____ is when an individual has trouble getting sleep / staying asleep for 3 nights/week for ≥ 3 months
Chronic insomnia is when an individual has trouble getting sleep / staying asleep for 3 nights/week for ≥ 3 months
Describe the pathophysiology model of insomnia
Describe CBT for insomnia
CBT for insomnia
____ and ____ are commonly used medications for chronic insomnia
GABAA agonists and orexin antagonists are commonly used medications for chronic insomnia
____ is a condition when breathing stops involuntarily for brief periods of time during sleep
OSA is a condition when breathing stops involuntarily for brief periods of time during sleep
Mallampati score is used to ____ and ____
Mallampati score is used to assess ease of intubation and predict OSA
Someone with OSA will have ____, ____, and ____
Someone with OSA will have mouth open, tongue out, and no vocalization
____ and ____ can lead to breathing difficulties during sleep such as in OSA
Micro / retrognathia and macroglossia / tonsils can lead to breathing difficulties during sleep such as in OSA
___ is most effective treatment for OSA
CPAP is most effective treatment for OSA
____ is when breathing stops and starts during sleep due to failure of brain to send signals to muscles that control breathing
Central sleep apnea is when breathing stops and starts during sleep due to failure of brain to send signals to muscles that control breathing
CSA is treated with ____ or ____
CSA is treated with phrenic nerve stimulation or adaptive servo-ventilation
_____ is excessive daytime sleepiness
Hypersomnia is excessive daytime sleepiness
____ is overwhelming daytime drowsiness and sudden attacks of sleep
Narcolepsy is overwhelming daytime drowsiness and sudden attacks of sleep
Hypersomnia has ___ and ___
Hypersomnia has excessive daytime sleepiness and sleep drunkenness
Narcolepsy may have ____, ____, ____, ____, and ____
Narcolepsy may have excessive daytime sleepoiness, sleep paralysis / hallucinations, cataplexy, difficulty staying asleep during night, and refreshing night-time sleep and naps
Restless leg syndrome is ____
Restless leg syndrome is a condition that causes an uncontrollable urge to move the legs, typically in the evening or night hours when sitting / lying down
____ is the unusual behaviors people experience prior to falling asleep, when asleep, or during arousal period between sleep and wakefulness
Parasomnia is the unusual behaviors people experience prior to falling asleep, when asleep, or during arousal period between sleep and wakefulness
Describe parasomnia examples
Parasomnias
- Disorders of NREM sleep: confusional arousals, sleep walking, sleep terrors, and sleep related eating disorder
- Disorders of REM sleep: nightmares, REM behavior disorder, and recurrent isolated sleep paralysis
Insomnia is best treated with ____
Insomnia is best treated with CBT ± short term use of hypnotic
Most effective treatment for OSA is ____
Most effective treatment for OSA is CPAP
Narcolpesy is ____ associated with low ____ levels
Narcolpesy is cataplexy associated with low hypocretin/orexin levels
Restless leg syndrome is treated with ____, ____, and ____
Restless leg syndrome is treated with iron supplements, dopamine agonists, or pregabalin/gabapentin
REM behavior disorder is ____ and often an early symptom of a ____
REM behavior disorder is loss of muscle tone during REM sleep and often an early symptom of a synucleinopathy
