circadian rhythm disorders Flashcards
(23 cards)
what is delayed sleep phase disorder
chronic or recurrent delay in sleep onset and awakening times with preserved quality and duration.
what are the risk factors for DSPD
puberty secondary to temporal changes in melatonin secretion. caffeine and nicotine use. irregular sleep schedules.
what is the treatment for DSPD
timed bright light during the early morning. administration of melatonin in the evening or chronotherapy –delaying bedtime by a few hours each night.
what is advance sleep phase disorder
normal duration and quality of sleep with sleep onset and awakening times earlier than desired.
what is the risk factors for ASPD
old age.
what are the treatments for ASPD
timed phototherapy prior to bed time. can give melatonin in the morning, but this is not recommended because it can cause day time sedation in the elderly.
what is shift-work disorder
sleep deprivation and misaligned of circadian rhythm secondary to ontraditional workhours.
what are the risk factors for SWD
night shift work, rotating shifts, shifts > 16hours, being a medical/psychiatry resident.
what are the treatments for SWD
avoid risk factors, bright light therapy to facilitate rapid adaptation to night shift, modafinil
what is jet lag disorder
sleep disturbances associated with travel across multiple time zones.
what are the risk factors for jet lag disorder
recent sleep deprivation.
what is the treatment for jet lag disorder
disorder is usually self limiting and generally resolve 2-3 days after travel.
what are the features of sleep walking
during slow-wave sleep, complex behaviors.
are the dreams in sleep walking remembered
NO. there is usually amnesia of the event.
what are the treatments for sleep walking
Nothing. reassurance. this is self-limited. and usually not associated with any underlying psychological or psychiatric disease.
sleep terrors features
sudden terror arousals usually beginning with screaming or crying that occur in slow wave sleep. there are signs of autonomic arousal including tachycardia, tachypnea, diaphoresis, mydriasis.
are the dreams in sleep terrors remembered?
NO.
what are the treatments for sleep terrors
reassurance, this is usually self-limited,. same as sleep walking.
nightmare disorder features
frightening dreams that occur in the second half of the sleep episode. terminate in awakening with vivid recall. no confusion or disorientation when awakened. causes clinically significant distress or impairment of functioning
what is the treatment for nightmare disorder
desensitization.image reversal therapy. prazosin or antidepressants can be used.
REM sleep behavior disorder
arousals with vocalization or complex motor behavior more common in the second half os the sleep episode. lack of muscle atonia in REM. no confusion of disorientation when awoken. presenting compliant is often violent behaviors resulting in injury to partner.
what are the risk factors for REM
older age, use of psychiatric medications, neurodegenerative diseases especially Parkinson’s, multiple system atrophy, neurocognitive disorder and Lewy body.
what is the treatment for REM sleep behavior
clonazepam
