Sleep Medicine Flashcards Preview

Social/Behavioral > Sleep Medicine > Flashcards

Flashcards in Sleep Medicine Deck (20):
1

Sleep

1/3 of our time spent sleeping
- lack of sleep can lead to physical disease/mental illness
- one of highest reported diseases in population

2

REM Sleep

neurological recovery (Rapid Eye Movement)
- BP and breathing fluctuate -> shuffle and organize days events
- Dreaming
- easiest to awaken from
- erections occur
- paralysis and increased brain O2 use
*beta waves

3

Non-REM Sleep

bones and muscle recovery
- stages 1, 2, and 3 (slow wave)

4

Stage 1 Non-REM

transition from wakefulness to sleep
*twilight sleep*
Theta Waves

5

Stage 2 Non-REM

bridge from stage 1 to slow wave
- sleep spindles and K complexes

6

Slow wave sleep Non-REM (3 & 4)

restorative to bones/muscles -> deepest non-REM sleep
- consistent breathing and BP (low)
- most difficult to awake from
- sleepwalking, bed-wetting, sleep talking occur
*delta waves

7

Sleep Architecture

cycle through stages every 90 minutes
- more slow wave in early night
- more REM sleep at end of night

8

Good sleep hygiene

use bed for sleep and sex only
downtime routine before bed
maintain consistent rise time
daily exercise
make time to worry/meditate
alcohol, caffeine, smoking

9

Sleep physiology

regulated by circadian rhythm --> driven by suprachiasmatic nucleus of hypothalamus --> NE release --> pineal gland --> melatonin

10

Sleeping and increasing age

Still need same amount of sleep --> but sleep is more fragmented in elderly --> need naps

11

Who needs a sleep study?

loud snorers, witnessed apneas, daytime somnolence, lifelong sleepiness with adequate sleep

12

Excessive Daytime Sleepiness

persistent and unremitting sleepiness
increasing sleep time may not solve it
loss of energy, motivation, memory loss and fatigue
*it is a serious problem --> affects life!!

13

4 General Causes of EDS

1. Quality/quantity
2. Circadian Rhythm
3. Drugs
4. CNS pathology

14

Obstructive sleep apnea

- excessive sleepiness after adequate sleep
- loud snoring and witnessed apnea
- irritability and memory loss
- morning headaches
- impotence

15

Cardiac changes with abnormal sleep

Increased HR, BP, HRV, arrhythmias
- surge in catecholamines from decreased O2
- the worse the OSA --> more severe the BP
*OSA is commonest, treatable form of secondary HTN

16

Cure of OSA

Positive Airway Pressure device
Surgery
Oral Appliances --> less effective than CPAP
Weight loss

17

Narcolepsy

deficiency in the hypothalamus (decreased orexin)
- either awakeness intruding sleep or REM intruding awake state
- REALLY sleepy --> pathologic
- instantly become paralyzed (cataplexy)
- sleep paralysis (can't move after nap)

18

Hypnic jerk

excessive reaction to minimal external stimuli (stage 1 phenomena)

19

Restless leg syndrome

problem in the substantia nigra
- uncomfortable feeling you can't hold legs still

20

REM behavior disorder

acting out dreams --> area in the pons has to be stimulated for paralysis to occur
50% of these individuals can develop Parkinson's or Lewy Body dementia