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48 Cards in this Set
- Front
- Back
sleep disorder classifications:
dyssomnias parasomnias secondary proposed |
disturbed sleep or wakefulness
undesirable events or movements to medical or psychiatric disorders insufficient evidence to classify |
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3 types of dyssomnia `
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extrinsic
intrinsic circadian rhythm |
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extrinsic dyssomnia
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causes of disorder due to causes outside of body ex) alcohol dependant, mountain sickness etc
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circadian rhythm dyssomnias
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Misalignment between physiological timing and
environmental cues or social norm and demands ex) jet lag, |
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insomnia complaints (2)
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difficult initiating sleep (result=bedtime resistance)
maintaing sleep (result=inability to sleep independently) |
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insomnia impairs daytime resulting in inattention, mood affected, memory/conc problems, impaired ___
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performance
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patter of Behavioral Insomnia of Childhood consistent with either:
1) or 2) |
Sleep-onset association type
Limit-setting type |
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Sleep-onset association type-
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Child associates sleep onset with circumstances that are problematic/demanding of the caregiver
unable to fall asleep without these associations |
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to treat sleep onset ass. you tell parents it (3)
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normal (awakenings at night normal)
ass. not abnormal, they are learned new ass. can be taught |
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to manage behavioral sleep disorders use (5)
which most effective? |
-extinction: cry it out
graduated extinction: timed "checks" scheduled awakenings systematic desensitization for fears preventative education for parents -*extinction |
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limit setting type
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-refuse to go to bed at good time/after awakening
-inappropriate/insufficient limit setting shown by caregiver |
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treatment for limit setting (4)
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-educate importance
-teach guidelines -specific/individualized techniques -positive reinforcement |
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Circadian Sleep Disorders- ICSD-2*:
Delayed Sleep Phase Disorder -SW delayed by __or more hours conflicts with ADL -symptoms |
2
hard to initiate, impaired alertness during waking |
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Circadian Sleep Disorders- ICSD-2*:
Advanced Sleep Phase Disorder -body clock set too____ -symptoms -sleep quality/during are___if uninterrupted |
early
insomnia, excessive sleepiness normal |
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Circadian Sleep Disorders- ICSD-2*:
Free-Running Circadian Rhythm -SW variable due to -symptoms -SW pattern becomes |
-circadian pacemaker unable to get/is insensitive to info about light dark cycle
-insomnia, excessive sleepiness -later each day, period longer than 24hr |
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Nonpharmacologic Therapy to entrain circadian rhythm(2)
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light therapy
behavioral methods |
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light therapy
give morning light for____ give evening light for___ |
delayed sleep phase
advanced sleep phase |
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behaviroal methods (3)
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establish regular wake up time
chronotherapy (extreme cases) structured/successive delay of bedtime (2-3hours) |
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can also use light therapy for people with
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adhd
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intrinisic dyssomnias
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causes within body
ex) restless leg syndrome, narcolepsy, sleep breathing disorder |
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type of sleep disordered breathing based on
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amount of upper airway obstruction
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4 types of sleep disordered breathing:
primary snoring upper airway resistance syndrome (UARS) obstructive hypoventiliation obstructive sleep apnea |
-noisy breathing
-noisy breathing+disturbed sleep -NOISY BREATHING ± DISTURBED SLEEP +increase CO2 and/or decrease SaO2 -" "+absence of airflow |
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order of increasing airway obstruction for sleep disordered breathing
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ps>uars>OH>OSA
*double check this may be wrong |
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OSA epidemiology:
snoring in children -____% habitual snorers -____% intermittent snorers -___% of preschool children have -peaks from age___to___ -M:F ratio is |
7-10
20 1-3 2-5 approx equal |
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for OSA if took cross section of oropharynx youd see (3)
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nasal obstruction
tonsilar hypertrophy large tongue |
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OSA shows ___symtoms
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diurnal
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PSG used to determine if have OSA
it differentiates OSA from_____ helps define and evaluate |
primary snoring
severity success of treatment |
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(3) main Consequences of Pediatric OSA
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-effect growth
-neurocognitive morbidity -cardiovascular consequences |
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Neurocognitive Morbidity result in (4)
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depression
hyperactive/inattention/aggression daytime sleepiness impaired school performance |
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OSA's cardiovascluar consequences involve (2)
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pulmonary hypertension
systemic hypertension |
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below are surgical treatments for
Adenotonsillectomy Uvulopalatopharyngoplasty Craniofacial surgery Tracheostomy |
pediatric osa
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below are medical treatments for
Continuous positive airway pressure(CPAP mask) Weight loss if obese Intranasal steroids |
pediatric osa
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childhood parasomnias occur during (3)
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entry into sleep
in sleep during arousal from sleep |
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3 types of parasomnia
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disorders of arousal from NREMS
parasomnia associated with REMS other |
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common words of confusional arousal
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no, no!
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sleep terrors:
peak age____ most will later____ begin abruptly from |
5-7
sleepwalk NREMS |
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clinical characteristics of sleepwalking
-____wandering (2) -___behaviors -most have few___effects |
-quiet&agitated
-inappropriate/variable complexity -daytime |
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disorders of arousal have ___basis
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family
60% of children have positive family history 10-fold increased prevalence in first degree relatives of an affected individual |
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when evaluating disorders of arousal
video psg needed if (3) PSG needed if |
-spells stereotypes/atypical features, potential injury
-if OSA suspected |
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treat disorders of arousal with (4)
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time
emphasize sleep hygiene secure bedroom to prevent injury medication in severe cases |
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get (3) with Parasomnias Associated with REM
Sleep |
nightmares
sleep paralysis rem sleep behaviour disorder |
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___%experiance nightmares
peak ages of children reporting |
75
6-10yrs (after this they decrease) |
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nightmares:
usually occur during |
last half night
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anxiety/stress
personality PTSD all possible |
factors for nightmares
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for PTSD most common problem is
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trauma related nightmares (80% of PTSD have)
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can treat nightmares with(3)
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explanation/reassurance
sleep hygiene behavioral therapies |
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nightmare occur during__sleep
most common____ ___return to sleep __comforted ___recall __autonomic activity ___upon awakening |
rem
parasomnia delayed easily detailed mild alert |
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sleep terrors:
-___sleep -___prevalence -___half of night -___return of sleep -__comforting -____recall -___autonomic activity -___upon awakening |
NREM
2-6.5% 1st rapid resists intense confusion |