Sommeil Flashcards

Question

Composantes de la TCC insomnie?

Answer 1

Sleep hygiene & education Stimulus control therapy Sleep restriction therapy Cognitive therapy Relaxation training London 2024

Answer 2

diphenhydramine, melatonin, trazodone, tryptophan, valerian

Answer 3

A. Plainte de somnolence excessive malgré plus de 7h de sommeil/nuit avec 1/3 ou + parmi: - Périodes récurrentes de sommeil diurne - Sommeil prolongé de plus de 9h non récupérateur - Difficulté à être bien réveillé après réveil brusque B. Au moins 3x/semaine x 3 mois minimum C. Détresse significative ou altération fonctionnement D. Pas mieux expliqué et ne se présente pas exclusivement au cours d'un autre trb du sommeil E. Pas mieux expliqué par les effets physiologiques d'une substance F, Si trb mental comorbide, n'explique pas la plainte prédominante d'hypersomnolence

Answer 4

Avec trb mental Avec condition médicale Avec autre trb du sommeil Aigu moins de 1 mois Subaigu 1-3 mois Persistant plus de 3 mois Sévérité: léger, modéré, sévère

Answer 5

Epworth Sleepiness Scale Plus de 11 hommes Plus de 9 femmes

Answer 6

Épisode de sommeil 18-20h, dure qq jours/semaines, survient 1-10x/an. Avec hypersexualité, hyperphagie, désinhibition. 3H:1F. Début ado, évolution fluctuante. Plus de HLA-DQB1-02

Answer 7

- Modafinil - Méthylphenidate/amphétamines

Answer 8

Endormissement et réveils tardifs persistants. Incapacité à s'endormir ou se réveiller à un moment plus précoce. Rythme endogène affecté (T, mélatonine plasmatique). Sommeil lorsque initié. Prévalence 0,1-4%, ad 7% ado

Answer 9

Chronothérapie Mélatonine tôt en soirée (18h) Luminothérapie au réveil

Answer 10

Luminothérapie tôt en soirée Mélatonine AM

Answer 11

Repas avant dormir Sieste avant travail Maximiser lumière durant travail de nuit Minimiser lumière avant coucher Modafinil PRN pour diminuer somnolence

Answer 12

Cataplexy defined as either (a) or (b), occurring at least a few times/month - In individuals with longstanding disease, brief episode of sudden bilateral loss of muscle tone w/ maintained consciousness that are precipitated by laughter or joking - In children or in individuals w/in 6mos of onset, spontaneous grimaces or jaw-opening episodes with tongue thrusting or a global hypotonia, without obvious emotional trigger

Answer 13

Sans cataplexie avec déficience en hypocrétine. Avec cataplexie sans déficience em hypocrétine (rare) Ataxie cérébelleuse autosomique dominante avec surdité et narcolepsie Narcolepsie autosomique dominante avec obésité et Db type 2 Secondaire à autre affection médicale (sarcoidose, whipple, tumeur) Légère: moins de 1x/sem et sieste 1-2x/sem Modéré: 1x/j et aux qq jours, multiples siestes/j, sommeil perturbé Sévère: cataplexie résistante au Tx, multiples attaques/j, fatigue constante, sommeil perturbé

Answer 14

Hormone excitatoire sécrétée par hypothalamus, nécessaire au maintien de l'éveil

Answer 15

0,02-0,04%

Answer 16

A. Either (1) or (2): Evidence by PSG of at least 5 obstructive apneas or hypopneas/hr sleep and either of the following sx: Nocturnal breathing disturbances: snoring, snorting/gasping, or pauses during sleep Daytime sleepiness, fatigue, or unrefreshing sleep despite sufficient opportunities to sleep that is not better explained by another mental, sleep, or medical disorder Evidence by PSG of 15 or more obstructive apneas and/or hypopneas/hr sleep regardless of accompanying sx

Answer 17

Evidence by PSG of 5 or more central apneas/hr sleep The disorder is not better explained by another current sleep disorder Specify: Idiopathic, Cheyne-Stokes, Comorbid with Opioid use

Answer 18

2-15% adultes, voire plus de 20% des adultes plus âgés 1-2% enfants

Answer 19

A. Recurrent episodes of incomplete awakening from sleep, usually during first 1/3 of major sleep episode, accompanied by either one of the following 1. Sleepwalking: Repeated episodes of rising from bed during sleep and walking . While sleepwalking, the individual has a blank, staring face; is relatively unresponsive to the efforts of others to communicate with him or her; and can be awakened with only great difficulty 2. Sleep Terrors: Recurrent episodes of abrupt terror arousals from sleep, usually beginning with a panicky scream. There is intense fear and signs of autonomic arousal, such as mydriasis, tachycardia, rapid breathing, and sweating, during each episode. There is relative unresponsiveness to efforts of others to comfort the individual during the episodes B. No or little dream imagery is recalled C. Amnesia for the episode is present D. The episodes cause clinically sig. distress or impairment in important areas of functioning E. The disturbance is not attributable to the physiological effects of a substance F. Coexisting mental and medical disorders do not explain the episodes

Answer 20

With sleep-related eating With sleep-related sexual behavior (sexsomnia)

Answer 21

1er tier de la nuit SWS

Answer 22

1-7% Associé à dépression et TOC

Answer 23

Max 10 minutes en général

Answer 24

Confus Amnésie de l'épisode

Answer 25

Family history for sleepwalk/terrors in 80% of individuals who sleepwalk Up to 60% risk if both parents have a history of the disorder For sleep terror, some studies indicate a 10-fold ↑ in prevalence among 1˚ relatives London 2024

Answer 26

A. Repeated occurrences of extended, extremely dysphoric, and well-remembered dreams that usually involve efforts to avoid threats to survival, security, or physical integrity and that generally occur during 2nd half of sleep episode B. On awakening, person rapidly becomes alert and oriented C. The sleep disturbance cause significant distress in important areas of fxn D. The nightmare sx are not attributable to the physiological effects of a substance E. Coexisting mental and medical disorders do not adequately explain the predominant complaint

Answer 27

Specify if: - With associated non-sleep disorder - With associated other medical condition - With associated other sleep disorder Specify if: - Acute: 1 mos or less - Subacute: >1mos but <6mos - Persistent: 6mos or greater Specify current severity: - Mild: <1 episode/wk - Moderate: 1 or more episodes/wk - Severe: episodes nightly

Answer 28

2e moitié

Answer 29

fin de nuit

Answer 30

1-2% adulte (fréquent) 1,3-3,9% enfant âge scolaire

Answer 31

A. Repeated episodes of arousal during sleep associated with vocalization and/or complex motor behaviors B. These behaviors arise during REM sleep and therefore usually occur more than 90min after sleep onset, are more frequent during the later portions of the sleep period, and uncommonly during daytime naps C. Upon awakening from these episodes, the individual is completely awake, alert, and not confused or disoriented D. Either of the following: 1. REM sleep w/out atonia on PSG 2. Hx suggestive of REM sleep behavior disorder and an established synucleinopathy diagnosis E.The behaviors cause clinically sig distress or impairment in important areas of functioning F.The disturbance is not attributable to the physiological effects of a substance or medical condition G.Coexisting mental and medical disorders do not explain the episodes

Answer 32

0,38-0,5% population générale Plus fréquent homme âgé London 2024

Answer 33

A. An urge to move the legs, usually accompanied by or in response to uncomfortable and unpleasant sensations in the legs, characterized by all of the following: 1. The urge to move the legs begins or worsens during periods of rest or inactivity 2. The urge to move the legs is partially or totally relieved by movement 3. The urge to move the legs is worse in the evening or at night than during the day, or occurs only in the evening or night B. The sx in Criterion A occur at least 3x/week and have persisted for at least 3 mos C. The sx in Criterion A are accompanied by sig. distress or impairment in important areas of functioning D. The sx in Criterion A are not attributable to another mental disorder or medical condition or behavioral condition E. The sx are not attributable to the physiological effects of a substance

Answer 34

Anemia / ↓ iron stores Normal pregnancy Renal failure Rheumatoid Arthritis Diabetes Thyroid Abnormalities Peripheral nerve dysfunction Alcohol, caffeine, nicotine Most antidepressants, antipsychotics, antihistamines, Mirtazapine Ménopause PAS une étiologie reconnue.

Answer 35

International Restless Legs Scale

Answer 36

Clonazepam Melatonine Agoniste DA Seroquel

Answer 37

FeSO4 si déplétion Non-pharmaco: diminution nicotine/drogue/café, bain chaud, compresse chaude ou froide, massage, bonne hygiène sommeil, exercice physique, acupuncture, relaxis (vibrations externes MI) Pharmaco: lorsque Sx nuisent au sommeil plus de 2 nuits/semaine Agoniste DA (Pramipexole, L-Dopa), anticonvulsivant (Gabapentin, Pregabalin), benzo, opioides (faible dose oxycodone)

Answer 38

A. A prominent and severe disturbance in sleep B. There is evidence from the history, PE, or lab findings of both 1. The sx in criterion A developed during or soon after substance intoxication or after w/drawal from or exposure to a medication 2. The involved substance/medication is capable of producing the sx in criterion A C. Disturbance is not better explained by a sleep disorder that is not substance/medication induced D. Disturbance does not occur exclusively during a delirium E. Disturbance causes clinically significant distress or impairment in functioning

Answer 39

Severe sleep disturbances can occur in association with intoxication of the following classes of substances: Alcohol, caffeine, cannabis, opioids, sedatives, hypnotics, anxiolytics, stimulants (including cocaine) Severe sleep disturbances can occur in association with withdrawal of the following substances: Alcohol, caffeine, cannabis, opioids, sedatives, hypnotics, anxiolytics, stimulants (including cocaine), tobacco

Answer 40

Adrenergic agonists and antagonists Dopamine agonists and antagonists Cholinergic agonists and antagonists Serotonergic agonists and antagonists Antihistamines corticosteroids

Answer 41

Condensation – one dream object stands for several associations and ideas Displacement – a dream object's emotional significance is separated from its real object or content and attached to an entirely different one that does not raise the censor's suspicions Visualization – a thought is translated to visual images Symbolism – a symbol replaces an action, person, or idea