Sleep Disorders

Question 1

what is orexin/hypocretin?

Answer 1

balances sleep/wake

Question 2

what hormone regulates wake/sleep and REM/non REM?

Answer 2

Orexin/hypocretin

Question 3

how many sleep cycles per night usually?

Answer 3

4-5

Question 4

when do you have longer REM sleep?

Answer 4

later in the sleep cycle

Question 5

Melatonin increases when?

Answer 5

at night?

Question 6

difference between fatigue and sleepiness

Answer 6

post marathon = fatigue

sleepiness = falling asleep too easily

Question 7

elevated above epworth scale score is?

Answer 7

> 10

Question 8

OSA obstructs wherE?

Answer 8

obstruction of upper airways d/t tongue and airways

Question 9

snoring is what kind of obstruction?

Answer 9

incomplete obstruction

Question 10

cardinal symptoms of OSA?

Answer 10

heavy snoring
witnessed apnoeas
escessive daytime somnolence

Question 11

nocturnal symptoms of OSA?

Answer 11

nocturia
chocking/gasping
disrupted sleep

Question 12

stroke risk with OSA? who?

Answer 12

middle aged, less so elderly

Question 13

dementia with OSA?

Answer 13

yes, can happen

Question 14

cardioresp manifestations of OSA?

Answer 14

HTN
cor pulmonale
MI
arrythmias/sudden death
polycythaemia

Question 15

risk factors for OSA?

Answer 15

age 
male
obesity
alcohol
upper airway morphology

Question 16

tongue muscle called?

Answer 16

genioglossus

Question 17

how many events of OSA to be mild, mod, severe

Answer 17

5-15 mild
15-30 moderate
>30 severe

Question 18

what is hypopnoea

Answer 18

30% reduction in airflow with >3% O2 desat or arousal

Question 19

OSA management?

Answer 19

conservative Rx
CPAP
oral appliances
surgery

Question 20

who gets surgery for OSA?

Answer 20

children usually gets adenotonsillectomy

Question 21

if failed CPAP and has mild/mod OSA, then what do you do?

Answer 21

mandibular advancement splint

Question 22

what is Cheyne Stokes Respiration? when do you get it?

Answer 22

cardiac failure

Question 23

central sleep apnoea causes?

Answer 23

cardiac failure: cheyne-stokes
high altitudeCVA
idiopathic

Question 24

cheyne stokes pathological

Answer 24

may be more efficient in cardiac failure

Question 25

causes of hypoventilation?

Answer 25

``` reduced drive via drugs, trauma neuromuscular chest wall deformity obesity increased requirement ```

Question 26

who gets chronic insomnia?

Answer 26

women 2:1 usually post-menopause

Question 27

primary insomnia and arousal?

Answer 27

hyperarousal, anxiety, to sleep,

Question 28

types of acute insomnia meds?

Answer 28

benzos non-benzoes antidepressants, antihistas

Question 29

delayed sleep phase syndrome?

Answer 29

drive to fall asleep is later

Question 30

causes of secondary restless leg syndrome

Answer 30

Iron deficiency, renal failure, peripheral neuropathy, lubosacral rediculopathy

Question 31

watch out for what in dopamine agonist?

Answer 31

impulsive behaviours

Question 32

narcolepsy cause?

Answer 32

deficiency in orexin

Question 33

how to dx narcoloepsy?

Answer 33

mean sleep latency

Question 34

cataplexy is?

Answer 34

loss of muscle tone from dropping into REM

Question 35

stimulants for narcolepsy?

Answer 35

modafinil | amphetamines

Question 36

what is parasomnias?

Answer 36

sleep talking sleep walking sleep eating

Question 37

what is REM parasomnia?

Answer 37

act out dreams

Question 38

3 states of sleep

Answer 38

wakeful non-REM REM