Sleep Disorders Lecture Powerpoint

Question 1

Control center of sleep and 5 other anatomical structures involved

Answer 1

• Suprachiasmatic nucleus of hypothalaus

- brain stem, amygdala, thalamus, pineal gland, forebrain

Question 2

Circadian rhythm

Answer 2

Directs a wide variety of functions from daily fluctuations in wakefulness to body temp, metabolism, and release of hormones, synchronize the environmental cues with the actual time of day

Question 3

Factors that influence sleep-wake needs

Answer 3

• Exposure to light
• stress
• medical conditions

Question 4

NREM stage 1

Answer 4

Muscles are relaxed but can have hypnic contractions, consciousness is decreased yet easily awakened

Question 5

NREM stage 2

Answer 5

Muscles more relaxed and consciousness somewhat more decreased

Question 6

NREM stage 3

Answer 6

Muscles relaxed with no activity, very decreased consciousness and difficult to awaken, talk in sleep or sleep walk

Question 7

REM sleep

Answer 7

Majority of typical dreams, cycle thru night every 90-120 minutes, high frequency lower voltage brain activity theta waves, limbs are temporarily paralyzed

Question 8

Aging and percentage of sleep stages

Answer 8

Newborns sleep majority of day and enter REM first, changing by 3 months of age, middle aged and beyond percentage of REM is stable thru adulthood but percentage of N3 decreases and percentage of wake and N1 increases

Question 9

Dyssomnias

Answer 9

Abnormal amount, quality, or timing of sleep

Question 10

Parasomnias

Answer 10

Abnormal behavioral or physiological events occurring in association with sleep

Question 11

Insomnia

Answer 11

Very frequent medical complaint of poor sleep quality or insufficient quantity due to difficulty initiating or maintaining sleep (report taking 30 min or more to fall asleep) and have variable sleep with several nights of poor sleep followed by nights of better sleep, can be short term due to stress or chronic that has daytime consequences associated

Question 12

Treatment of insomnia (4)

Answer 12

• Sleep hygiene improvement
• Benzodiazepines (can cause residual drowsiness and is habit forming)
• melatonin agonists
• Orexin receptor agonists

Question 13

Valerian

Answer 13

The herbal version of valium (diazepam) that is highly addictive and can be overdosed on

Question 14

Hypoglossal nerve stimulator

Answer 14

Surgically implanted nerve stimulator that senses each breath and activities and sends pulses to tongue base causing it to lurch forward and open airway implanted on the right side to not be confused for a pacemaker for treatment of sleep apnea

Question 15

Cataplexy

Answer 15

Emotionally triggered transient muscle weakness often triggered by strong generally positive emotions

Question 16

Narcolepsy

Answer 16

Clinical syndrome of daytime sleepiness with cataplexy, hypnagogic hallucinations, and sleep paralysis

Question 17

Diagnosis of narcolepsy (2)

Answer 17

• Polysomnogram
• Multiple sleep latency test (seeing if REM sleep entered during nap and fall asleep in less than 8 min, essential features of narcolepsy)

Question 18

Kleine-levin syndrome

Answer 18

Sleeping beauty syndrome, recurrent episodes of severe hypersomnia associated with cognitive and behavioral disturbances, episodes last a few days to several weeks and are separated by weeks or months of normal sleep behavior, no treatment available

Question 19

Circadian rhythm sleep wake disorder

Answer 19

Chronic or recurrent sleep disturbance due to alteration of circadian rhythm or misallignment between environment and individual sleep wake cycle lasting 3 months in duration

Question 20

Delayed sleep wake phase disorder and advanced sleep wake phase disorder

Answer 20

• Night owl (stay up late and sleep in late)

- early bird (go to bed early and get up early)

Question 21

Sleep walking often occurs in ____ and is not distressing to the individual

Answer 21

children

Question 22

Sleep/night terrors

Answer 22

Usually occurring between 4-12 years of age involving awakening from a sleep with loud scream, sweating, etc despite not remembering episode later

Question 23

Restless leg syndrome treatment (2)

Answer 23

• Iron replacement

- behavioral modifications