12 sleep med Flashcards Preview

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Flashcards in 12 sleep med Deck (21)
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1
Q

why take a sleep history

A

sleep disorders are: common, serious, treatable and underdiagnosed

2
Q

sleep history: BEARS stands for?

A

bedtime, excessive daytime sleepiness, awakenings, regularity/duration of sleep, snoring

3
Q

3 things leading to excessive daytime somnolence (EDS)

A

sleep deprivation. sleep disruption (fragmented sleep). primary disorders of sleep.

4
Q

EDS leads to? (aka what clinical impacts)

A

neurobehavioural deficits = performance deficits, decreased quality of life, increased morbidity and mortality

5
Q

4 levels of EDS

A

mild: falls asleep in quiet environments. moderate: social settings. severe: public settings, work. most severe: dangerous environments, red lights, etc.

6
Q

diagnose sleep disorders with what?

A

polysomnography: an overnight sleep study. will record sleep stage, breathing, oxygen, heart rate, leg movements, ECG, and video

7
Q

etiology of excessive daytime somnolence (sleepiness): 5?

A

drugs. respiratory induced (snoring, sleep apnea, upper airway resistance syndrome, periodic breathing). periodic leg mvts. narcolepsy. idiopathic hypersomnolence.

8
Q

hypopnea? apena?

A

when ventilation decreases ~50%, then starts again (Vs. apnea = complete cessation of breathing)

9
Q

upper airway resistance syndrome

A

lying down = collapses airways a bit = higher resistance = higher amount of work needed to maintain airflow = jars them to lower level of sleep.

10
Q

obstructive apnea: def

A

complete blockage of airway despite efforts to breathe (thoracic effort still there, but air flow decreases)

11
Q

normal # obstructions per hour

A

fewer than 5 apneas and hypopneas per hour

12
Q

cause of sleep apnea

A

imbalance in pressures keeping airway open so pharynx collapses with breath

13
Q

what makes sleep apnea more likely

A

anything which narrows airway, or anything which causes loss muscle tone

14
Q

anatomical causes of sleep apnea

A

abnormal anatomy of head/neck. retrognathia. obesity. family history. ethnicity.

15
Q

symptoms of sleep apnea

A

daytime sleepiness. waking at night choking. intellectual impairment. increased irritability. sexual impairment. mood changes: aggressive, irritable, bursts of anxiety, depression

16
Q

heart complications of sleep apnea

A

increased risk of hypertension, MI, stroke –> excess mortality is due to cardiovascular causes

17
Q

treatment: reversible risks for sleep apnea

A

excess alcohol consumption. smoking. medications. obesity

18
Q

treatments for obstructive sleep apnea

A

nasal CPAP = gold standard. can also have:dental applicances, surgery

19
Q

central apnea definition

A

complete cessation of airflow resulting from a reduction in respiratory effort –> upper airway patent, but resp. center temporarily fails to trigger

20
Q

central sleep apnea treatment

A

identify and treat reversible risk factors. biPAP with back up rate

21
Q

PLMS definition? stands for? diagnosed by?

A

periodic leg movements: repetitive stereotypic uncontrollable mvts of lower limbs; diagnosed with polysomnography EMG