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Flashcards in sleep Deck (32):
1

EEG in the awake (eyes open, alert) stage

beta (highest frequency, lowest amplitude)

2

EEG in the awake (eyes closed, relaxed) stage

alpha

3

EEG in stage 1 NREM (light sleep) stage

theta

4

EEG in stage 2 NREM (bruxism) stage

sleep spindles + K complexes

5

EEG in stage 3 NREM (slow-wave sleep, deepest NREM sleep, sleepwalking, night terrors, nocturnal enuresis) state

delta (opposite beta, lowest frequency, highest amplitude)

6

conditions with a ↓ stage 3 NREM

BZD
TCA (treat nocturnal enuresis)
alcohol
elderly

7

EEG in REM (atonia, dreaming, penile erection, memory processing, ↑brain O2 use, occurs in 90 min intervals) stage

beta

8

what causes the REM in REM stage

PPRF

9

change in normal sleeping pattern through night

first half: go through all stages
second half: stage 2 NREM → REM

10

who exhibits these changes:
↓ stage 3 NREM (slow-wave) - stay in stage 1/2 (light sleep)
↓ total REM
↑ REM sleep latency
↑ night time awakenings, early awakenings

sleep changes in elderly

11

unpleasant parasthesia causing voluntary continuous leg movements through night

restless leg syndrome

12

secondary causes of restless leg syndrome

iron deficiency
end-stage renal disease
diabetic neuropathy
parkinson disease
pregnancy
RA
caffeine
varicose veins

13

conditions with a ↓ stage 3 NREM

BZD (treat night terrors)
TCA (treat nocturnal enuresis)
alcohol
elderly

14

night terrors (screaming, speak) occur in

stage 3 NREM sleep (slow-wave)
no memory of dream vs REM nightmares
tx: BZD (↓ stage 3)

15

condition that causes
collapse of airway (obstruction) during sleep
associated with obesity, loud snoring, short/thick necks
may occur during REM sleep (muscle atonia)

obstructive sleep apnea

16

condition that causes no respiratory effort during sleep

central sleep apnea

17

↓ orexin in lateral hypothalamus causes this condition

narcolepsy

18

excessive daytime sleepiness
hallucinations (hypnaGOgic - GOing to sleep or hypnoPOmpic - POst-sleep; like REM dreams)
sleep episodes: awake → REM right away
cataplexy (atonia (REM finding) following sadness, laughter)

narcolepsy

19

who exhibits this sleep pattern:
↓ stage 3 NREM (slow-wave) - stay in stage 1/2 (light sleep)
*↓ total REM
*↑ REM sleep latency
↑ night time awakenings, early awakenings

sleep changes in elderly

20

treatment for nocturnal enuresis

only consider if >7 yo
↓ fluid intake
enuresis startle - alarm
↑ risk of reocurrence after discontinuation of drug:
imipramine (TCA): ↓ stage 3, short-term use
desmopressin (DDAVP, anti-diuretic): oral, ↓urination
indomethacin: ↓ renal blood flow →↓GFR →↓urine output

21

what age can you diagnose nocturnal enuresis

>5 yo

22

who exhibits these sleep patterns:
↓ stage 3 (slow-wave)
*↓ REM latency
*↑ total REM, ↑ REM early in sleep cycle
↑ nighttime awakenings, early-morning

sleep changes of depression

23

treatment of narcolepsy

avoid drugs that cause sleepiness
scheduled naps to maintain energy level (1-2x/day, 10-20 min)
modafinil (stimulant): DOC
if cataplexy (atonia): venlafaxine, fluoxetine (antidepressant) or atomexetine (stimulant, ADHD) or sodium oxybate/GHB (treats atonia + sleep)

24

melatonin

tx: insomnia
non-addictive
vivid dreams
safe for

25

valerian

tx: insomnia
herbal remedy
no benefit

26

antihistamines: diphenhydramine (benadryl, tylenol PM), doxylamine

tx: insomnia (first-line by patients)
poor sleep quality
short-term use only
SE: anticholinergic SE - avoid in elderly

27

trazadone (antidepressant)

tx: insomnia
↑ REM sleep
SE: small risk of priapism

28

TCA (amitriptyline, doxepin)

tx: insomnia
SE: risk of arrhythmias - need EKG before use
SE: anticholinergic SE - avoid in elderly

29

long-acting BZD (temazepam, lorazepam, clonazepam, diazepam, chlordiazepoxide)

tx: insomnia
addictive - act at GABA R
short-term use only (

30

zolpidem (ambien) or zaleplon (sonata)

tx: insomnia
act at BZD R on GABA R - not as addictive as BZDs
short term use only (

31

eszopiclone (lunesta)

tx: insomnia
may be used long term

32

ramelteon (rozerem)

tx: insomnia
act at melatonin R instead of GABA/BZD R
non-addictive
contraindication: hepatic insufficiency

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