Psych - Sleep Disorders

Front 1

What is the prevalence of occasional and chronic insomina? just chronic insomnia?

Back 1

Occasional and chronic insomnia - 45-55%

Chronic insomnia - 5-20%

Front 2

What is the multiple sleep latency test?

Back 2

Measures the time it takes for individuals to fall asleep in a sleep laboratory. It is administered during the waking hours. Usually 5 nap opportunities, each lasting approximately 20 minutes. Longer sleep latency implies lower levels of sleepiness.

Front 3

What are the polysomnographic alterations in sleep found in the elderly?

Back 3

Increased time spent in bed, increased awakenings and arousals, diminished total sleep time, diminished sleep efficiency, increased stage 1 sleep, decreased slow wave (delta) sleep, daytime somnolence and napping, and advance in the sleep/wake cycle.

Front 4

For the following arotic arch state the postnatal derivative: 2nd

Back 4

2nd

1. STAPEDIAL ARTERY
2. HYOID ARTERY

1st- part of MAXililary Artery (br. ext carotid)

Front 5

What are the narcolepsy tetrad?

Back 5

Excessive daytime somnolence, cataplexy, hypnagogic hallucinations, and sleep paralysis.

Front 6

What is the prevalence of narcolepsy?

Back 6

0.02 - 0.18% of the population

Front 7

What is the biologic basis of narcolepsy?

Back 7

Linked to dysfunction of hypocretin (HCRT) / orexin peptides

Front 8

What is cataplexy?

Back 8

Episodic weakness without altered consciousness lasting seconds to minutes and precipitated by excitement or emotion. Laughter is the most common precipitator.

Front 9

What are hypnagogic hallucinations?

Back 9

Vivid, "waking dreams" that occur during transitions between sleep and wakefulness. May accompany sleep paralysis or occur independently. May be tactile or auditory. Some awareness of surroundings is preserved.

Front 10

What is a normal sleep latency? What is considered pathological sleepiness?

Back 10

Normal: > 10 minutes
Pathologic: < 5 minutes

Front 11

What are the pharmacological treatments for EDS?

Back 11

Modafinil, dextroamphetamine, methylphenidate

Front 12

What is the pharmacological treatment for REM symptoms of narcolepsy?

Back 12

Antidepressants - Protriptyline (TCA), imipramine (TCA), clomipramine (TCA), desipramine (TCA), Fluoxetine (SSRI)

Front 13

Obstructive sleep apnea syndrome symptoms

Back 13

Unrefreshing sleep, daytime sleepiness, snoring, and weight gain

Front 14

Obstructive sleep apnea syndrome risk factors

Back 14

Middle-older age, male, obesity, use of CNS suppressants

Front 15

Obstructive sleep apnea syndrome treatments

Back 15

Weight loss (life style change?), avoidance of CNS depressants, continuous positive airway pressure (CPAP), dental devices, upper airway surgery, and medications

Front 16

Adjustment sleep disorder

Back 16

Usually short term; insomnia following stressor, which remits if stressor is removed or after adaptation.

Front 17

Psychophysiologic insomnia

Back 17

Sleep-preventing assocations and somatized tension perpetuate insomnia.

Front 18

DSM IV classification of insomnia

Back 18

Insomnia greater than 1 month with fatigue, distress, and/or impairment; no other primary disorders.

Includes psychophysiologic insomnia and adjustment sleep disorder.

Front 19

Restless leg syndrome

Back 19

Creepy, crawling sensations in legs that are relieved by movement. Generally idiopathic but can be secondary to uremia, anemia, and pregnancy. Often coexists with period limb movements in sleep (PLMS). Treatments include dopaminergic agents, benzodiazepines, opioids, anticonvulsants, vitamins, and iron.

Front 20

Advanced sleep phase syndrome

Back 20

Complaints of evening sleepiness, morning insomnia; normal sleep at early (advanced) hour; persistent and stable; responsive to AM phototherapy; more common in adolescents.

Front 21

Delayed sleep phase syndrome

Back 21

Complaints of evening insomnia, morning sleepiness; normal sleep at a delayed hour; responsive to AM phototherapy; more common in adolescents

Front 22

Sleepwalking

Back 22

Difficulty in arousal during episode; amnesia for the episode; usually occurs during the first third of night; usually in prepubertal children.

Sleepwalking occurs during delta sleep. Clonazepam is medical treatment.

Front 23

What is clonazepam?

Back 23

Benzodiazepine used for the treatment of absence seizures. And sleep walking, apparently.

Front 24

Sleep terror

Back 24

Sudden, intense scream during sleep. Evidence of intense fear occurs during delta sleep. Other features similar to sleepwalking.

Treatment includes stress reduction (beer), psychiatric evaluation for adults, and reassurance for parents.

Front 25

Nightmares

Back 25

Sudden awakening with intense fear. Tachycardia and tachypnea upon awakening. Usually occurs in the latter half of the night. Abrupt awakening from REM.

Treatment includes psychotherapy and hypnosis. Frequent nightmares can be indicative of psychiatric conditions.

Front 26

REM sleep disorder

Back 26

Movements, vocalizations ("I'd prefer not to be touched"), violent or injurious behavior secondary to dream enactment. Excessive EMG tone, body movements, vocalizations, or phasic twitching in REM.

Treatment is, you guessed it, clonazepam.

Front 27

Sleep bruxism

Back 27

Tooth grinding or clenching during sleep. Bursts of jaw EMG activity.