Sleep Related Disorders

Question 1

Define Sleep

Answer 1

• Reversible Behavioral state of Perceptual disengagement and unresponsiveness to the enviroment

Question 2

Normal Sleep: Affect on Body functions

Answer 2

• Drecreases:
  Body temp
  BP
  Breathing rate
• Brain=same activity when awake

Question 3

What are the Functions of Sleep

Answer 3

• Fatigue reversal
• Biochemical refreshment
• Immune function
• Memory
• PSych well being

Question 4

What are the stages of the sleep cycle?

Answer 4

• NREM (non Rapid Eye Movement)
  Stage1-3
• REM (Rapid eye movement)

Question 5

NREM Stage 1

Answer 5

• Brief transitional stage
• Brief time b/w awake and sleep (5-10 mins )
• Easily aroused from sleep
• High amplitude theta waves=very slow brain waves
• Muscle twitching

Question 6

NREM Stage 2

Answer 6

• Less aware of surroundings
• 50% of sleep
• Body temp and Heart Rate Decrease
• sleep spindles (Rapid rhythmic)
• K Complex

Question 7

NREM Stage 3

Answer 7

• Aka Delta Sleep
• Delta Waves
• Muscles Relax
• BP and Breathing rate drop
• Deepest Sleep

Question 8

REM Sleep

Answer 8

• 20% of sleep
• eye moevment
• increased
  respiration rate
  increased brain activity
• Dreams

Question 9

REM vs nREM sleep

Answer 9

• nREM: Physical Restoration
  Synchornous brain waves
  Mental inactivity
  Physiological stability
  Muscular activity
• REM: Psychic restoration
  Asynchronous Brain waves
  Active brain
  Physiological instability
  Muscular inactivity

Question 10

Fragmented Sleep Symptoms

Answer 10

• Altered Mood
• Decreased alertness
• Poor concentration
• Body pain
• Depression
• Increased risk of
  car accidents
  cardiovascular disease
  diabetes
  obesity
  cancer

Question 11

Sleep-related breathing disorders (SRBD): General

Answer 11

• Spectrum of clinical entities
• Variations in:
  Sleep structure
  respiration
  Blood O2 saturatoin

Question 12

Sleep-related breathing disorders: Types

Answer 12

• Intermittent Snoring
• Chronic Snoring
• UARS
• Mild OSA
• Moderate OSA
• Severe OSA

Question 13

Snoring

Answer 13

Intermittent or Chronic
* Benign
* upper airway soft tissue vibrations during inspiration
* No Abnormal ventilation
disrupted sleep
complains of daytime sleepiness
* Common in both genders & all age groups
* Most don’t have OSA
* Increases during pregnancy

Question 14

UARs

Answer 14

• Increase in ventilatory efforts, but not OSA
• No apnea
• complaints of:
  excessive daytime sleepiness
  fatigue
  insomnia
  depression
• Sleep fragmentation w/o waking

Question 15

OSA

Answer 15

• Increased resistance to airflow-> Stop breathing even when trying to breathe
• results in:
  Partial Obstruction(hypopnea)
  Complete Obstruction(apnea)
• Arouses CNS -> lighter stage of sleep (nREM stage 1 or 2)
  causes: partial awake, obstruction relief, resume breathing
• Fragmented Sleep: depending on frequency

Question 16

Apnea

Answer 16

• Cessation or near-complete cessation (> 70%) of oronasal airflow
• at least 10 seconds

Question 17

Hypopnea

Answer 17

• 30% drop in oronasal airflow from baseline
  4% decrease in oxyhemoglobin saturation
• 50% drop in oronasal airflow from baseline
  3% decrease in oxyhemoglobin saturation