Task 4 Flashcards
1
Q
Parasomnia
- what is it
- Manber
A
- parasomnia is abnormal behavior or perception associated with CNS activation that occurs during sleep or transitions into or out of sleep
- NREM parasomnia occur during partial arousal from SWS (N3)
- REM parasomnia occur during second half of the night
- NREM eyes are open and when awakened reorientation is difficult
2
Q
Parasomnia
- NREM sleep arousal disorder
- Manber
A
- NREM sleep arousal disorder is parasomnia from stage N3
- Not fully awake (partial arousal)
- amnesia for the episode is common
- Sleep walking type
- sleep terror type starts with scream, abruptly sit up in state of high arousal, no recall
- more time in stage N3 avoid awakening
3
Q
Parasomnia
- Nightmare disorder
- Manber
A
- REM sleep disorder during second half of night
- vivid, frightening and well-remembered dream from which a sleep wakes up and is oriented
- loss of muscle tone
- PSG reveals reduced efficiency and longer sleep latency and less SWS
- nightmares occur repeatedl and high distress and impairment in functioning
- difference with nocturnal panic is nightmare is not associated with dream content
- difference sleep paralysis is nightmare is not aware of being fully awake when experiencing frightful imagery
4
Q
Parasomnia
- REM sleep behavior disorder
- Manber
A
- RSBD is characterized by dream enactment during sleep
- loss of muscle atonia
- individuals engage in complex behavioral consequences
- if woken quickly oriented
- latter half of the night
5
Q
Somnambulism
- what is it
- Zadra
A
- defined as a series of complex behaviors during arousals from SWS (N3) and culminate in walking around with an altered state of consciousness and impaired judgement
- episoded last from few seconds to more than 30 min
- more common in childhood
- excessive daytime somnolance (sleepiness) characteristic somnambulism
- 70% recalled short, unpleasant, dreamlike mentations associated with sleepwalking episodes
- eyes usually open to navigate
- first third of the night
6
Q
Somnambulism
- Diagnosis and clinical management
- Zadra
A
- nocturnal frontal lobe epilepsy and RSBD can be confused with somnambulism
- nocturnal N2 sleep, cannot get out of bed
- RSBD last half of night, REM sleep, awakened fully awake and functional, vivid dream recall
- disorders that ease dissociation or induce confusional states can trigger somnambulism
7
Q
Somnambulism
- as a disorder of slow-wave sleep
- Zadra
A
- presence of intrinsic abnormalities in SWS and atypical response that sleepwalkers have to sleep deprivation
- decrease in slow-wave activity
- sleep deprivation results in more awakenings from SWS during recovery sleep
- response to sleep deprivation are highly sensitive and specific
- sleep deprivation increased activation of amygdala and decrease in connectivity with the PFC
8
Q
Somnambulism
- as a disorder of arousal
- Zadra
A
- delta activity recorder in half of all episoded during SWS –>sleepwalkers caught between NREM sleep and full EEG arousal and thus neither awake or asleep
- arousal from SWS can induce sleepwalking episodes
- sleepwalkers have abnormal arousal reactions
9
Q
Homocidal somnambulism
- case report
- broughton
A
- Kenneth Parks 23 difficult relationship (step)father
- married and good relationship parents in law
- bet at horseraces–> severe stress on mariage
- problems getting asleep, completely sleepless nights and daytime headaches
- gamblers anonymous telling grandmother and family
- delay telling grandmother –>argument wife
- no alcohol or drugs
- did not recall seeing marks or blood on her face
10
Q
Homocidal somnambulism
- medical investigation of the patient
- broughton
A
- drug-related received no support
- no suggestion of motivational or personal gain
- severe bedwetter, deep sleeper, rare dream recall, chronic sleep talker and occasional sleepwalker
- state instability, direcht SWS to wake arousals and high amount of SWS
11
Q
Homocidal somnambulism
- diagnosis and legal argument
- broughton
A
- absence of motive, affection, grief, lack of evidence during sleepwalking
- somnambulism represents state of consciousness and sleep, along with organized behaviors
- legal theory of continuing danger; condition with recurrent danger to public should be treated as insanity
- legal theory of internal causes or disease of mind; sleepwalking is not a disease but a disorder of sleep
12
Q
Parsomnias in childhood
- What is parasomnia, wat provokes parasomnia
- Kotagal
A
- Parasomnias are consequence of dissociation between wakefulness, NREM or REM sleep
- Down-regulation of descending GABAergic projections or diminished serotonergic inhibition may play a role in pathogenesis of sleep-wake transition parasomnias and arousal parasomnia
13
Q
Parasomnias in childhood
- Sleep-wake transition parasomnias
- Kotagal
A
- Hypnic starts
- Benign neonatal sleep myclonus
- isolated sleep paralysis (ISP)
- rhythmic movement disorder
14
Q
Parasomnias in childhood
- Hypnic starts
- Kotagal
A
- isolated, quick jerks of the upper or lower extremities that occur at sleep onset
- feeling of falling, dream-like feeling or flashing sensation
- benign and occur in 70% of all ages
15
Q
Parasomnias in childhood
- benign neonatal sleep myclonus
- Kotagal
A
- symmetric or asymmetric, repetitive jerks of extremities during sleep in first month of life
- benign and resolve spontaneously over weeks
