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Flashcards in Sleep Deck (34):
1

Two forces that impact sleep

-circadian rhythm
-sleep debt

2

Three characteristics of NREM sleep

-decrease in muscle tone
-slow eye movements
-loss of alpha rhythm

3

REM sleep

-muscle atonia
-rapid eye movement
-B waves like awake state

4

Stages of wake --> sleep

1)wake
2) NREM 1-3/4
3) REM

5

Longest stage of sleep

-Stage 2 NREM = 45-55%
(followed by REM at 20-25%)

6

When does NREM sleep predominate?

-NREM first 2/3 of night; REM last 1/3

7

Adult criteria for OSA:

-more than 90% decrease in airflow
-event lasts 10 seconds or greater
-continued respiratory effort

8

Child criteria for OSA:

same as adult except timing= 2 breath cycles

9

Most common complaint assc with OSA in adults

daytime sleepiness

10

Way to improve patient compliance with CPAP

-will increase libido

11

Med types for OSA

-antidepressants
-nasal steroids
-stimulants

12

Three common secondary causes of Hypersomnolence

-OSA
-PLMD
-Narcolepsy

13

Common primary causes of hypersomnolence

-inadequate sleep
-drugs
-chronobiologic

14

Cause of narcolepsy

-2 hit hypothesis
(genetic predisposition, environmental trigger)

15

Definition narcolepsy

-excessive daytime sleepiness + abnormal REM sleep

16

Diagnostic criteria for Type 1 narcolepsy:

1) excess need to sleep during daytime for at least 3 months
2) cataplexy, sleep latency less than 8 mins, 2 + SOREMP

... or low hypocretin 1 in CSF

17

Common precipitant of cataplexy in children

-anticipation of a reward

18

Define cataplexy

Sudden loss of muscle tone with retained consciousness

19

Diagnostic criteria for Type 2 narcolepsy:

Type 1 minus cataplexy

symptoms not better explained by other causes

20

Location of hypocretin

perifronical cells of the posterior hypothalamus

21

Function hypocretin 1

stimulates wakefulness and suppresses REM sleep

22

Three REM phenomenon that protrude into wakefulness in narcolepsy

hallucinations
sleep paralysis
cataplexy

23

Three treatments for sleepiness in narcolepsy

-modafinal
-amphetamines
-atomoxetine

24

Treatment for cataplexy

sodium oxybutate
SSRIs

25

Parasomnias assc with REM

-REM behavior disorder
-Sleep related painful erections

26

Define somniloquy

Sleep talking

27

What causes REM behavior disorder?

-loss of REM atonia

28

Acute Causes of REM behavior disorder:

-ETOH w/draw
-nitrazepam withdraw
-biperiden intoxication

29

Disease states assc with chronic REM behavior disorder:

-narcolepsy
-NPH
-extrapyramidal, mitochondrial disease

30

NREM parasomnias

-confusional arousals
-sleep walking
-sleep terrors

31

When are NREM parasomnias most common?

-most common in first third of night

32

Symptom MOST specific for narcolepsy?

-cataplexy

33

Drug that treats both cataplexy and daytime sleepiness?

-sodium oxybutate

34

DRug Treatment of enuresis

TCAs (imipramine) or desmopressin