Sleep Flashcards

Question

assessing sleep disorders

Answer 1

inquire into chief complaint assess impact on patients life ask about caffeine intake, alcohol and nicotine use, use of illicit drugs any family history of sleep disorders complete 2 week sleep log complete sleep scales: stanford sleepiness scale/ epworth sleepiness scale

Answer 2

lab sleep study evaluates oxygen levels, body movements, brain waves diagnose sleep apnea

Answer 3

assess electrical activity detects any potential problems part of polysomnography

Answer 4

day time nap study used in conjunction with PSG at night to diagnose narcolepsy

Answer 5

sleep meds and melatonin CBT allergy or cold meds meds for underlying health issues assistive breathing or surgery (CPAP, BiPAP) dental guard lifestyle changes increasing vegetables and fish in diet and reducing sugar exercise establishing regular sleep schedule drinking less water before bed limiting caffeine late afternoon or evening cutting back on tobacco and alcohol use eat smaller, low carb meals before bed

Answer 6

have a fixed wake up time prioritize sleep make gradual adjustments don't overdo it with naps keep routine consistent budget 30 min for winding down dim lights unplug from electronics test methods of relaxation dont toss and turn

Answer 7

dissatisfaction with quality of sleep most common sleep disorder females more frequently affected difficulty initiating sleep, maintaining sleep, frequent awakenings, early morning awakening and inability to return to sleep non refreshing/restorative sleep at least 3 nights per week present for at least 3 months

Answer 8

predisposing factors - prior hx of quality sleep ( depression and anxiety) precipitating factors- external events ( divorce, role change, retirement, grief) perpetuating factors - Sleep practices that maintain sleep complaints (excessive naps, caffeine)

Answer 9

effectively treated without meds with CBT, sleep restriction, stimulus control, and attention to sleep hygiene long term meds still are not required

Answer 10

excessive sleepiness despite a main sleep period of 7 hours with one of the following recurrent periods of sleep or lapses into sleep within same day, a prolonged main sleep episode of more than 9 hours that is nonrestorative, difficulty being fully awake after abrupt awakening occurs at least 3 times in the last 3 months hyper somnolence is accompanied by significant distress or impairment in cognitive, social, occupational, or other areas of functioning

Answer 11

maintaining a regular sleep wake cycle allow for an extended sleep opportunity of 10 hours o more treated with long acting amphetamine based stimulants such as methylphenidate and nonamphetamine based stimulants such as modafinil (provigil)

Answer 12

uncontrollable urge to sleep relatively rare frequent in men begins young adulthood and persist throughout lifespan hypnagogic hallucinations- false auditory, visual and tactile hallucinations that occur at transition from wakefulness to sleep sleep paralysis- inability to move or speak during transition from sleep to wakefulness disturbed nighttime sleep with middle of the night awakenings and memory lapses feel refreshed upon awaking and feel sleepy within 2-3 hours later

Answer 13

brief episodes of bilateral loss of muscle tone while maintaining consciousness triggered by strong emotions may last seconds to several minutes, recovery is generally immediate occurs with half the population of narcolepsy some have 1-2 episodes in lifetime, others have up to 20 per day treat with sodium oxybate (xyrem) may take up to 8 weeks to see effect

Answer 14

lifestyle modifications (naps, exercise, and balanced diet) modafinil (provigil) armodafinil (nuvigil) methylphenidate amphetamine sodium oxybate (xyrem)

Answer 15

men associated with obesity repeated episodes of upper airway collapse and obstruction resulting in fragmented sleep unable to sleep and breathe at same time loud disruptive snoring, apnea episodes, excessive daytime sleepiness diagnosed by clinical evaluation and polysomnography treated with CPAP

Answer 16

cessation of respirations during sleep instability of the respiratory control system seen in older adults, advanced cardiac or pulmonary diseases, or other neurological disorders treatment: treat existing conditions, using a device to assist breathing or use supplemental oxygen.

Answer 17

too slow or shallow hypoventilation, carbon dioxide levels rise in body while blood oxygen level lower disrupts quality of sleep, leading to feelings of tiredness during day NO apnea or respiratory events associated with morbid obesity, lung parenchymal disease, or pulmonary vascular pathology treatment with CPAP or BiPAP

Answer 18

misalignment between the patients sleep pattern and the sleep pattern that is desired or regarded as the societal norm characterized by irregular sleep/wake cycle AED insomnia and hypersomnia causes significant distress in at least one area of functioning treatment: bright light therapy, sleep hygiene, medications, behavioral therapy and lifestyle changes

Answer 19

reduce circadian misalignment improve sleep improve alertness short naps frequent sleep avoid working multiple days in a row sufficient time off between shifts dark room/dark glasses to aid in sleep a short modification of 2-4 hours in the cycle can make a big difference

Answer 20

have an increased risk of accidents at work, work related errors, irritability, mood problems, poor coping skills, impaired social functioning, health related complaints (GI, cardiac) drug and ETOH dependency

Answer 21

get at least 7-8 hours of sleep make sleep priority minimize exposure to light on the way home follow bedtime rituals create a quiet, dark and peaceful setting during sleep ask family members to wear headphones to listen to music or watch TV avoid vacuuming, dish washer, or other noisy activities while you sleep

Answer 22

rising from bed, walking about awakened with great difficulty runs in families rare in adults, common in children age 4-8 high risk for injury amnesia treatment: Safety measures, stress reduction, and benzo's benzo's are habit forming so used only briefly, low doses and monitored closely

Answer 23

sudden terrified near-awakenings, sitting up in bed followed by panicked scream abruptly exhibit behaviors of fear, panic, confusion no response to soothing from others not fully awake, often returns to normal sleep without ever fully waking up amnesia treatment: exploring stress, sleep hygiene, medication is rarely used, but benzo's can be used

Answer 24

generally occur in second half of major sleep episode rapidly become oriented and alert significant distress or impairment cannot be explained by the effects of a drug abuse or medication nightmares cannot be attributed to another mental health disorder or medical condition can be triggered by stress or anxiety, trauma, sleep deprivation, medications, substance misuse, scary books and movies treatment for nightmares isn't usually necessary

Answer 25

voluntary response and urge/need to move legs to stop sensations of creeping, crawling, aching, pulling, searing, tingling, bubbling, pain, cramping or itching symptoms increase with rest middle age older adults pregnant women stress makes it worse familial link results in insomnia

Answer 26

muscle relaxation, stress reduction, understand etiology no test or cure various meds may treat movement helps to relieve symptoms

Answer 27

decreases deep sleep and REM sleep responsible for middle of the night awakenings with difficulty returning to sleep

Answer 28

CNS stimulant, increasing heart rate, blood pressure, and respirations individuals wake in response to mild withdraw

Answer 29

blocks adenosine promoting wakefulness

Answer 30

less than 6 hours of sleep per night increases risk to cardiovascular, endocrine, immune, and neurological function short sleep duration less than 7 hours lack of sleep causes obesity, cardiovascular disease, HTN, impaired glucose tolerance, DM, and mood disturbance increased risk of HTN, DM, cardiovascular disease and stroke

Answer 31

sleep problems are common in patients with depression, bipolar disorder, and anxiety increased risk of developing mental illness treating sleep disorder may help alleviate the symptoms of the mental health problem

Answer 32

insomnia and hypersomnia are part of the diagnostic criteria for depression symptoms include difficulty falling asleep, frequent nighttime awakenings, early morning awakenings, and non-restorative sleep some MDD suffer from obstructive sleep disorder depressed patients with insomnia are less likely to respond to treatment for MDD than those with sleep problems

Answer 33

insomnia or report less need for sleep during manic episode or hypersomnia, insomnia or restless sleep insomnia worsens before manic episode lack of sleep triggers episode adversely affects mood and contributes to relapse

Answer 34

GAD have prolonged sleep latency and frequent nighttime awakenings, worry, anxiety, thinking about problems, stressors, have difficulty initiating and falling asleep sleep panic attacks are possible

Answer 35

initiation and maintenance sleep problems

Answer 36

nightmares; almost a universal finding

Sleep Flashcards

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