Flashcards in Insomnia/TIA, CVA, Parkinson's Overview Deck (30):
what stages do elderly not spend as much time in later in life?
Stage 3 and 4
Do elderly get the same amount of sleep?
Yes, but have decreased sleep efficiency (time in bed increases)
Are insomnia or excessive daytime somnolence a normal part of aging?
what should you ask patient/ sleep partner about?
Night time coughing
SOB when supine/ awakens patient from sleep
will patients always know they are waking up?
If patients report excessive daytime sleepiness what should you do?
Still evaluate and get a sleep study
may have sleep apnea, etc.
2 main type of treatments for insomnia
Pharmocologic (best for primary)
if insomnia is due to acute distress what should you start with?
what can happen with benzos when they stop taking them?
falls and fractures are less likely with what types of benzos
episodes of either cessation or marked decreased airflow during sleep. Caused by upper airway obstruction or central (mor uncommon)
risk factors of OSA
large neck circumference
structural factors related to nasal obstruction
3 cardinal symptoms of OSA
noticed by bed partner
Diagnosis for OSA
should you treat a patient with OSA without symptoms?
treatment for OSA
discontinue sedative- hypnotics
avoidance of alcohol/ sedative use
non-supine sleeping position
itchy, scratchy, crawly sensation of legs so they can't sleep
Restless leg syndrome
fall asleep and then do the "river dance", leg jerks around patients from sleep
tx for RLS
dopamine agonists (pramipexole, ropinirole)
what are some types of embolisms
most common places for a clot to get stucks
contralateral hemiparesis/ leg, UI, confusion, poor judgement, mutism
contralateral hemiparesis/ arm and face, aphasia/dominant hemisphere or apraxia
monocular blindness (amaurosis)
ophthalmic (MCA branch)
U/L or B/L CN deficits (Nystamgus, vertigo, dysarthria, diploplia) ataxia, limbs, sensroya nd motor deficits, altereted consciousness
motor hemiparesis, sensory hemianthestsia
aneurysm found, will often present later 30s early 40s, will often present in coma
most people with TIAs will have a stroke within what time?
6 month to a year
presents with thunderclap HA w/ altered consciousness