W7_02 Abnormal Sleep Flashcards
what are three subtypes of insomnia?
psychophysiologic;
paradoxical insomnia;
fatal familial insomnia (prion)
what’s the mechanism for sleep apnea and morning headaches?
increased CO2 causes vasodilation and increased ICP
definition of apnea?
absent airflow for >10 seconds
DDx of central sleep apnea?
synringobulbia; lateral medullary syndrome; other brainstem issues; atlantoaxial subluxation; myotonic dystrophy;
how is restless legs syndrome differentiated from a peripheral nerve syndrome?
because of the movement and the circadian rhythm components
what aggravates restless syndrome?
begins/worsens with rest?
difference of restless leg syndrome and periodic limb movement disorder?
RLS is the sensation and PLMD is the manifestation;
90% of RLS ppl have PLMD
50% of PLMD ppl have RLS
what are causes of restless leg syndrome?
CNS (spasticity) or PNS (neuropathy); alcohol use; pregnancy; iron deficiency; ferritin issues
how to treat restless leg syndrome/period limb movement disorder?
iron and folate supplementation;
dopaminergic agonists before bed
what is the classic tetrad to diagnose narcolepsy?
1-excessive daytime sleepiness;
2-cataplexy;
3-hypnagogic hallucinations;
4-sleep paralysis
what gene is correlated to narcolepsy?
HLA DQB1*0602 (suggests autoimmune issue)
what are modafinil, methylphenidate, and other amphetamine-like drugs used for?
narcolepsy treatment
anticholinergics, SSRIs, methylphenidate, sodium oxygate/GHB are examples of what kinds of drugs?
anticataplectic, for treatment of narcolepsy (cataplexy)
orexin and hypocretin are what?
genes responsible for narcolepsy in dogs and mice
where is preprohypocretin synthesized?
lateral/posterior hypothalamus
night terrors, confusional arousals, somnambulism, sexsomia, somniloquy are examples of what?
slow wave sleep arousals; usually in first third of sleep
what is REM sleep behaviour disorder?
loss of normal descending spinal inhibition in REM sleep; last third of sleep.
idiopathic REM sleep behaviour patients go on to develop which disease?
parkinsonism
which stage of sleep are epileptiform spikes most localizable?
REM
which stage of sleep do most epileptic discharges occur?
NREM
how does REM sleep and depression relate?
depression linked with shorter REM latency
how long is a sleep cycle?
~90 minutes
