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23 Cards in this Set
- Front
- Back
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1. Normal Sleep-wake cycle?
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a. Defined in terms of several characteristic changes in several physiological parameters, including brain wave activity, eye movement, and motor activity.
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2. 2 stages of normal sleep?
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a. Rem and Non REM.
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3. How often does REM sleep alternate w/non REM?
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a. About every 90 minutes.
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4. What does NREM induce the transition of?
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a. Transition from the waking state to deep sleep.
b. Progression through NREM sleep results in slower brain wave patterns and higher arousal thresholds. |
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5. What does the EEG resemble in NREM sleep?
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a. That of an aroused person.
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6. Awakening from what time of sleep is associated w/vivid dream recall?
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a. REM sleep.
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7. Dyssomnia?
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a. Insufficient, excessive, or altered timing of sleep.
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8. Parasomnias?
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a. Unusual, sleep-related behaviours.
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9. Dyssomnia disorders?
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a. Disorders that make it difficult to fall or remain asleep (insomnias), or of excessive daytime sleepiness (hypersomnias).
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10. Primary insomnia?
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a. Refers to number of sx that interfere w/duration and/or quality of sleep despite adequate opportunity for sleep.
b. Sx may include: 1. Difficulty initiating sleep (sleep-onset insomnia) 2. Frequent nocturnal awakenings (middle-of-the night or sleep-maintenance insomnia. 3. Early morning awakenings (late night or sleep-offset insomnia). 4. Waking up feeling fatigued and unrefreshed (Non-restorative sleep) |
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11. Most common cause of the hypersomnias?
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a. Breathing-related disorders such as obstructive sleep apnea and central sleep apnea.
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12. Non-restorative sleep?
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a. Waking up feeling fatigued and unrefreshed.
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13. Late night or sleep-offset insomnia?
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a. Early morning awakenings.
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14. Acute insomnia?
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a. Between 1 and 4 weeks
b. Generally associated w/stress or changes in sleep schedule and usually resolves spontaneously. |
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15. Chronic insomnia?
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a. Lasts > 1 month to years and is associated w/reduced quality of life and ↑ risk of psychiatric illness.
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16. DSM criteria for Primary insomnia?
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a. Difficulty initiating or maintaining sleep, or non-restorative sleep, for at least 1 month.
b. Causes clinically significant distress or impairment in functioning c. Does no occur exclusively in the course of another sleep disorder d. Does not occur exclusively in the course of another mental disorder e. Not due to a substance or general medical condition. |
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17. Etiology of Primary insomnia?
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a. Subclinical mood and/or anxiety disorder
b. Preoccupation w/a perceived inability to sleep c. Bedtime behaviour no conducive to adequate sleep (poor sleep hygiene)! d. Idiopathic. |
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18. Non-Rx Tx of primary insomnia?
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a. Sleep hygiene measures
b. Cognitive-behavioural therapy (CBT). CBT is considered first-line therapy for chronic insomnia. |
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19. Rx Tx of primary insomnia?
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a. BZDs
b. Zolpidem (Ambien), eszopiclone (Lunesta), and Zaleplon (Sonata). c. Antidepressants: Trazodone, amitriptyline, doxepin (off-label use). |
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20. Effect of using Benzos for sleep?
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a. Reduce sleep latency and nocturnal awakening.
b. As effective as CBT during short periods of tx (4-8 wks); insufficient evidence to support long-term efficacy. |
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21. Side effects of using benzos for sleep?
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a. Development of tolerance and addiction
b. Daytime sleepiness c. Rebound insomnia. |
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22. What is concerning about the risk of using benzos in the elderly?
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a. Risk of falls, confusion, and dizziness.
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23. Use of zolpidem (Ambien), eszopiclone (Lunesta), and Zaleplon (sonata)?
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a. Effective for short-term tx.
b. Associated w/a low incidence of daytime sleepiness and orthostatic hypotension. c. In the elderly, zolpidem causes an ↑ risk of falls and may induce cognitive impairment. |
