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21 Cards in this Set
- Front
- Back
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54. Idiopathic Hypersomnia (IH)?
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a. Rare disorder characterized by excessive daytime sleepiness, prolonged nocturnal sleep episodes, and frequent irresistible urges to nap.
b. IH can be mild or as debilitating as narcolepsy. |
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55. Kleine-Levin syndrome?
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a. A rare disorder characterized by recurrent hypersomnia w/episodes of daytime sleepiness w/hyperphagia, hypersexuality, and aggression.
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56. Circadian Rhythm Sleep Disorders?
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a. Circadian rhythm sleep disorders are caused by either intrinsic defects in the circadian pacemaker or impaired entrainment (absence of light or other time-signalling stimuli).
b. Subtypes include delayed sleep phase disorder, shift-work disorder, and jet lag disorder. |
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57. Sx of Circadian Rhythm Sleep Disorder?
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a. Excessive daytime sleepiness
b. Insomnia c. Sleep inertia d. Headaches e. Difficulty concentrating f. ↑ reaction times and frequent performance errors. g. Irritability h. Waking up at inappropriate times. |
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58. What area of the brain coordinates 24-hour circadian rhythmicity?
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a. The suprachiasmatic nucleus (SCN) in the hypothalamus.
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59. Parasomnias?
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a. Abnormal behaviours or experiences that occur during sleep and are often associated w/sleep disruption.
b. Sx may include abnormal movements, emotions, dreams, and autonomic activity. c. Common in childhood and adolescence. |
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60. Sleepwalking Features?
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a. Characterized by simple to complex behaviours that are initiated during slow-wave sleep and result in walking during sleep.
b. Behaviours may include sitting up in bed, eating, and in some cases “escaping” outdoors. c. Eyes are usually open w/a “glassy look”. d. Difficulty arousing the sleepwalker during an episode. e. Confusion on awakening, amnesia for episode. f. Episodes usually end w/pts returning to bed or awakening confused and disoriented. g. Rare cases associated w/violent behaviour, especially upon forced awakening. |
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61. Epidemiology of sleepwalking?
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a. 1-4% of adults.
b. 10-20% in children and adolescents. c. Occurs more often in children w/obstructive sleep apnea. |
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62. Risk factors for Sleepwalking?
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a. Sleep deprivation
b. Irregular sleep schedules. c. Stress d. Hyperthyroidism e. Seizures f. Migraines g. Meds, including sedative/hypnotics, lithium, and anticholinergics. h. Magnesium deficiency. |
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63. Tx of sleep walking?
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a. Pts benefit from addressing precipitating factors, ensuring a safe environment, and proper sleep hygiene.
b. Refractory cases may respond to clonazepam other benzodiazepine receptor agonist, or TCA. |
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64. Sleep Terrors?
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a. Episodes or sudden arousal w/screaming from slow-wave sleep in what appears to be a state of complete terror.
b. Sympathetic hyperactivation, including tachycardia, tachypnea, diaphoresis, and ↑ muscle tone. c. After episode, pts usually return to sleep w/out awakening. d. Usually amnesic about episode. e. Confused and disoriented upon forced awakening f. In rare cases, awakening elicits aggressive behaviour. |
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65. Epidemiology of sleep terrors?
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a. 1-6% of children
b. 1-2% of adults. c. High comorbidity w/sleepwalking. |
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66. Risk factors for Sleep Terrors?
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a. Fever
b. Nocturnal asthma c. GERD d. Sleep deprivation e. CNS-stimulating meds. f. Other sleep disorders such as sleep apnea. |
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67. Tx of sleep terrors?
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a. Reassurance that the condition is benign and self-limited.
b. Consider a low-dose, short-acting BZD (clonazepam, diazepam) in adults w/refractory cases. c. Sleep hygiene, psychotherapy. |
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68. Nightmare Disorder?
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a. Recurrent frightening dreams that tend to terminate in awakening w/vivid recall.
b. No confusion or disorientation upon awakening. c. Can -> significant distress and anxiety. |
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69. In what condition are nightmares seen in at least 50% of pts?
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a. PTSD.
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70. Tx of Nightmare Disorder?
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a. Imagery rehearsal therapy (IRT) involves the use of mental imagery to modify the outcome of a recurrent nightmare, writing down the improved outcome, and then mentally rehearsing it in a relaxed state.
b. Severe cases may benefit from use of antidepressants. |
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71. REM Sleep Behaviour Disorder (RBD) is characterized by?
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a. Muscle atonia during REM sleep and complex motor activity associated w/dream mentation (dream enactment).
b. Dream-enacting behaviours, which may include: 1. Sleep talking 2. Yelling 3. Limb jerking 4. Walking and/or running. 5. Punching and/or other violent behaviour. c. Presenting complain is often violent behaviours during sleep resulting in injury to the pt and/or the bed partner. |
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72. Risk factors for REM Sleep Behaviour Disorder (RBD)?
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a. Older age, generally between 60-70
b. Psychiatric meds such as TCAs, SSRIs, and MAOIs. c. Narcolepsy d. Brain Stem lesions e. Dementias such as olivopontocerebellar atrophy and diffuse Lewy body disease. |
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73. Tx for REM Sleep Behaviour Disorder (RBD)?
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a. Clonazepam is efficacious in 90% of pts.
b. Other agents that may be helpful include imipramine (Tofranil), carbamazepine (Tegretol), pramipexole (Mirapex-potentiates antidepressants), or levodopa. c. Ensure environmental safety such as removing potentially dangerous objects from the bedroom and sleeping on the ground until behaviours can be managed effectively. |
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74. Complete
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74. Complete
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