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w3- sleep disorders Flashcards

1
Q

“understanding “normal sleep”

What is normal sleep? What varies between people?

A

reversible state of unconscious mobile, vary in hrs, falling asleep easily, no frequent wakenings, refreshed

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2
Q

“understanding “normal sleep”

Which region of the brain contains wake promoting neurons?

A

ventrolateral nucleus (VLN)

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3
Q

Do young adults have more or less NREM and wakenings?

A

more NREM, less awakenings

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4
Q

Do elderly adults have more or less NREM and wakenings?

A

less NREM, more awakenings, lightening in sleep

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5
Q

Does REM sleep inc/dec in lifespan as age progresses?
What increases?

hint: REM is deep sleep- do babies have more or adults?

A

REM decreases
NREM 1-2 increases (lighter sleep)

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6
Q

sleep disorder #1 insomnia

What are the 3 main classifcation manuals for sleep disorders?

A
  • ICD-11 (disease)
  • ICD-SD (7 main/59 sleeping disorders)
  • DSM-5
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7
Q

sleep disorder #1 insomnia

What are the 7 main sleep disorders in the ICD-SD?

hint: 3 “soms”, eyes, nose, hands, others

A

insomnia, parasomnia, hypersomnolence
sleep-wake circadian,
breathing related, movement related
others

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8
Q

sleep disorder #1 insomnia

What’s the difference bewteen primary vs secondary insomnia?

A

primary = unassociated with psych/med disorder
secondary= comorbid to psych/physical state, other disorders

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9
Q

sleep disorder #1 insomnia

6+1 criteria for insomnia
min 1/3 symptoms include:

A

1) complaining dissatisfaction in sleep quantitiy/quality
2) symptoms - early awakenings, hard to intitate, hard to maintain sleep
3) occur despite adequate sleep
4) duration = min 3 months
5) freq = min 3 times weekly
6) causing sig distress
7) unexplained by med/substance

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10
Q

before 2015 –> post 2015 had some changes in insomnia criteria

What is insomnia now interpreted as?

A

co-exists with other conditions, but still address disorder individually accounting for other related factors

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11
Q

sleep disorder #1 insomnia

prevalence of insomnia more in ? gender? age?

A

women, older

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12
Q

sleep disorder #1 insomnia

predisposing factors?
precipitating factors?
perpetuating factors?

A

genetics, women, hgiher anxiety
trauma, work stress, sleep env, new medication
stress, worrying, staying in bed/daytime naps

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13
Q

sleep disorder #1 insomnia

How to diagnosis insomnia?

hint: s____ i_______

A

sleep interview
includes problems, narrative of bedtime, triggers, perception, other factors

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14
Q

sleep disorder #1 insomnias

Negative outcomes of insomnia?

A

dec mental wellbeing, energy, workplace productivity, general function, accident risk

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15
Q

sleep disorder #1 insomnias

Is medication or therapy more preferred for insomnia treatment?

A

CBT-I cognitive restructuring inaccurate sleep thoughts –> changing behaviors–> arousal/stimulus/relaxation techniques
psychoeducation

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16
Q

sleep disorder #1 insomnias

3 limitations of CBT-I

A

high cost
low usage
low trained sleep psychs

17
Q

sleep disorder #2 parasomnias

parasomnia “para” means ?
in which stages (2 types)
2 movement ex?
2 cognitive emotional ex?
3 sensory ex?

A

abnormal behaivors/experiences
in NREM (wake/transitions)
or REM (during slee)
movement = walking, paralysis
cognitive= nightmares, terrors
sensory = hallucinations, confusion, exploding head syndrome

18
Q

sleep disorder #2 parasomnias

prevalence of parasomnias more common in ? gender? age?

A

males, age ranges from child to adult

19
Q

sleep disorder #2 parasomnias

the first type of parasomnias occur in?
2 main disorders include?

hint: NREM - SWS TW

A

NREM 3/ short wave sleep SWS
sleep terrors
sleep walking

20
Q

type 1: NREM wake associations parasomnias

which period of sleep? first/mid/end?
dream imagery recalled?
amnesia?

A

first third of the night
SWS, NREM 3
cannot recall dream (hint: NREM no dreams, mostly recall in REM)
amnesia present
sig distress
unexpalined by other med/MD/substance

21
Q

type 1: NREM wake associations parasomnias

children and adults common older/younger age?
sleep terrors occur in first or end of night? symptoms?
awakening or recall present?
treatment?

A

children 4-12, adults 20-30 - younger age
occur first third of the night
abrupt terror, crying, sweat, autonomic nervous system aroused
not awakened, no recall
advised not to wake them up
treatment - avoid daytime sleepiness, over hyping, calming self

22
Q

type 1: NREM wake associations parasomnias

sleep walking occur in first or end of night?
is consciousness present?
walking responsibvely or hard to wake?
awakening or recall present?
treatment?

A

common in children 8-12 yrs
first third of night SWS, impaired consciousness, hard to wake, unresponsive, no awakening/amnesia recall absent
manage safe env

23
Q

type 2: REM wake associations parasomnias

nighmare disorder occur in which part of the night? wake or continues sleeping? recall present?

causes?
treatment?

A

second half of night REM< wake up, can recall dream, aroused/story like anxious
more distress

cause- stress, PTSD, medication
parental bedside behavior, CBT, reduce SNS meds, anti anxiety, SSRI

24
Q

type 2: REM wake associations parasomnias

REM sleep behavior disorder (RBD) occurs in which part of the night? episodes of A____ with complex ______ _______ ? that resembles scary _____
wake or continue sleeping?

neg outcomes?
diagnosis?
treatment?

A

REM, second half of night
episodes arousal with of VOCALIZATION, complex motor behaviors resembles dream enactment
violent behaviors from dream
will wake up

injuries, crimes, violent attack self/others
PSG, min 3 months
anti anxiety drugs

25
Q

type 2: REM wake associations parasomnias

sleep paralysis is what type of muscle movement?
occurs in ?
ventilation/breathing affected?
reasons for occuring?
treatment?

A

involuntary INHIBITED muscle movement
occurs in naps/sleep onset
ventilation unaffected
jetlag, shift work, lacking sleep, disturbed
anxiety management, sleep env

26
Q

disorder #3 circadian rhythm sleep wake disorder

X is misalligned with Y?
2 main symptoms?

A

circadian clokc misalligned with sleepp-wake pattern and env demands

insomnia and excessive sleepiness both

27
Q

disorder #3 circadian rhythm sleep wake disorder

What is delayed sleep wake phase? Is it more common in young/old people?

hint: sleep too ____, difficulty _____

A

1) sleep too late
2) difficulty waking
more in young adolescents

28
Q

disorder #3 circadian rhythm sleep wake disorder

What is advanced wake phase? Is it more common in young/old people?

hint: wake up too ____, difficulty _____

A

1) wake too early
2) difficult to maintain awake in daytime (want to nap)

more in elderly

29
Q

disorder #3 circadian rhythm sleep wake disorder

What are 3 examples of people who have disrupted circadian rhythm sleep wake disorder?

A

blind people, jetlag, shiftworkers

30
Q

disorder #4 sleep related movement disorders

What are 2 main examples of sleep related movement disorders?

Which is more common in day/night?

A

PLM - periodic limb movement (more in daytime sleepiness, cramps, movements DURING SLEEP)

RLS - restless leg syndrome (more at night), irrestible urge to move legs painful repetitively

31
Q

REM sleep behavior disorder (RBD) is liked to what age? what type of neurobiological/degenerative disorders? common in which gender?

A

older age, men
lewy bodies, PD, dementia

32
Q
A
33
Q
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psych disorders (7 decks)

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