Flashcards in Sleep Disorders Deck (22)
What is the definition of sleep apnea?
cessation of respirations for more than 10 secons and abnormal respiratory patterns during sleep leading to sleep disruption and alveolar hypoxemia
What is the difference between obstructive and central sleep apnea?
obstructive: cessation of airflow with maintained ventilatory effort
central: cessation of airflow due to cessation in ventilatoy effort.
What are common symptoms of sleep apnea?
snoring. ppl also complain of daytime hypersomnia, fatigue, and headache
obesity is a major risk factor for sleep apnea.
What is the best treatment for obstructive sleep apnea?
What is central sleep apnea? How do you treat?
diminished sensitivity to chemoreceptor stimuli that delays the initiation of respiration.
treat with positive airway pressure therapy to stimulate the ventilaotry drive or with caffeine derivatives, progesterone, and phrenic nerve pacers.
What is narcolepsy?
alterned sleep regulation for REM. there is excessive daytime sleepiness and intrusions of REM sleep during wakefulness.
What is the classic tetrad of symptoms for narcolepsy and what percentage of narcoleptics has this tetrad?
excessive daytime sleepiness (requisite symptom)
cataplexy (unilateral, focal and subtle- full loss of muscle tone without loss of consciousness, often triggered by emotion. Most narcoleptics have this), sleep paralysis (can't move as they fall asleep or after they wake up), and hypnagogic/hypnopompic hallucinations
What is the typical age of onset for narcolepsy? How is the diagnosis made?
before age 25
made by polysonogram without evidence of any other primary sleep disorder and REM onset sleep on a series of nap studies called a multiple sleep latency test during the day after the night sleep study
What are potential causes of narcolepsy?
may be autoimmune. many people have low or no detectable hypocretin in CSF- may be due to destruction of hypocretin neurons in the hypothalamus
How might you treat cataplexy?
3 drugs- protriptyline, imipramine, gama hydroxyburyrate
What is primary vs. secondary insomnia? What is most common?
primary: learned insomnia is the most common type of primary insomnia. paradoxical insomnia is also primary insomnia. defined as the perception of minimal/poor quality sleep even when we have objective evidence to the contrary
secondary insomnia: insomnia due to other cuases like psychiatric concerns, pain, meds, etc.
What are the only FDA approved drugs for insomnia?
What is delayed sleep phase syndrome?
Circadian rhythm problem: delay in sleep onset time. if given the chance they have normal sleep duration but they get reduced sleep if they have early commitments. often seen in adolescents
What is advanced sleep phase syndrome?
ppl sleep and wake early. they have trouble staying awake for evening commitments- often seen in the elderly.
What is hypernychthemeral syndrome?
cyclic pattern of sleep greater than 24 hrs. natural clock is abut 25 hours but most people readjust with environmental cues. may be seen in he blind or in those without cues to maintain a 24 hr clock.
When is jet lag the worst?
when traveling east. harder to get up early than stay up late.
What are parasomnias?
abnormal arousals during sleep resulting in abnormal behaviors. divided by NREM and REM parasomnias.
What are some NREM parasomnias?
seen during slow wave sleepL
walking, talking, confusional arousal, night terrors, rhythmic movements, enuresis
What are REM sleep parasomnias?
REM sleep behavior disorder: absence of atonia during REM- act out dreams. Many of these pts (50%) have an underlying neuro disorder.
also nightmares and isolated sleep paralysis
Most effective druge for REM sleep behavior disorder?
What is restless limb syndrome?
primary or secondary. dysesthetic sensations (sensations without stimuli) in the legs that are worse in the evenings and prohibit sleep.