TOPIC 14 - sleep/wake disorders Flashcards
causes related to sleep related disorders
physical, psychological, or social causes
affected by external phenomena, illness, and meds or substances
impaired sleep can contribute to what other types of disorders
depression, bipolar disorder, obesity, immune system dysfunction
types of sleep-wake disorders
insomnia disorder
hypersomnolence disorder
narcolepsy
breathing related sleep disorders
circadian rhythm sleep wake disorder
non REM sleep arousal disorder
nightmare disorder
REM sleep behavior disorder
restless leg syndrome
substance/med induced sleep disorder
persistent sleep disturbances are risk factors for the development of what kinds of disorders
mental illness or substance use
how much sleep does an adult need every night
7-9 hours
insomnia can result in
perception of inefficient amount of sleep
perception of sufficient amount of sleep without feeling rested
non pharmacological interventions for insomnia
Improving sleep hygiene
Shutting off electronics
Timing of exercise and meals (not immediately prior to sleep)
Relaxation techniques
Cognitive behavioral therapy
pharmacologic interventions for insomnia
antihistamines
sedative hypnotics
melatonin
melatonin agonist
examples of sedative hypnotics
used for short term
zolpidem tartrate
eszopiclone
zaleplon
what does ramelteon do
increase the body’s melatonin production
severity of obstructive sleep apnea is rated by what
apnea hypopnea index : the total number of breathing related interruptions per hour of sleep
what is a polysomnography
an overnight sleep study
can be done at home or in a sleep center
assess clients sleep symptoms related to
excessive daytime sleepiness
snoring
waking with choking/gasping
non pharmacologic interventions for obstructive sleep apnea
Continuous positive airway pressure (CPAP) or
Bilevel positive airway pressure (BiPAP)
Semi-recumbent sleeping position
“Anti-snoring” mouthpieces
what do CPAP or BiPAP do
use positive airflow to keep the airway open when it would otherwise obstruct
CPAP vs BiPAP
CPAP is constant pressure
BiPAP adjusts pressure for inhalation and exhalation
five symptoms of narcolepsy
Excessive daytime sleepiness (EDS) – present in all persons with narcolepsy
Cataplexy – in all persons with Type 1 narcolepsy (Type 2 is diagnosed if client does not experience cataplexy)
Disrupted nighttime sleep
Sleep paralysis
Hypnagogic / hypnopompic hallucinations
sleep latency definition
amount of time it takes the client to go from wakefulness to being asleep
REM latency definition
amount of time it takes the client to enter REM stage of sleep (the final stage) after initially falling asleep.
MSLT tests for what
excessive daytime sleepiness by measuring how quickly you fall asleep in a quiet environment during the day
STANDARD TOOL
five scheduled naps separated by two hour breaks
measures how long it takes to fall asleep
non pharmacological interventions for narcolepsy
scheduled daytime naps
avoid heavy meals
similar sleep hygiene recommendations as for insomnia
pharmacological interventions for narcolepsy
sodium oxybate
CNS stimulants
SNRI’s
examples of CNS stimulants
modafinil
armodafinil
methylphenidate
what do SNRI’s treat with narcolepsy
cataplexy
shift work disorder treatments
bright light therapy : enhances wakefulness and decreases melatonin production
remaining on alternative schedule even on off days from work
medications
