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91 Cards in this Set
- Front
- Back
What are the three behavioral factors in the model of insomnia?
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Predisposing, precipitating, and perpetuating
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What are the predisposing factors in the model of insomnia?
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somatic and cognitive hyperarousal and decreased homeostatic sleep drive...ruminate...worry
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What are the precipitating factors in the model of insomnia?
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Medical or psychiatric disorders, medicines, stressfull life situations, drugs, circadian disorders
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What are the perpetuating factors in the model of insomnia?
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cognitive and behavioral factors (ie staying in bed awake, sleeping in)
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What predisposes an individual to insomnia?
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Sleep hygeine
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What does cognitive behavioral therapy treat for insomnia? How?
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the perpetuating factors in the model of insomnia.
stimulus control and sleep restriction |
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What are four respiratory depressents?
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Alcohol, opitates, barbituates, benzodiazapines, and other tranquilizers.
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primary hypersomnia
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EDS over a long period of time. Symptoms are present nearly all the time
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recurring hypersomnia
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periods of EDS
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What type of syndrome is Klein Levin?
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recurring hypersomnia
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What are characteristics of Klein Levin?
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recurring hypersomnia and excessive eating or sexuality
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People with hypersomnia have ______ nights of sleep?
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Regular
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What differentiates hypersomnia from narcolepsy symtomology?
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People with narcolepsy have a sudden onset of sleepiness, hypersomniacs experience the symptoms all the time
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Three types of primary insomnia:
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psychophysiological, idiopathic, sleep state misperception
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Psychophysiological insomnia symptoms
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1.Mild to severe sleepiness
2.Difficulty falling or staying asleep 3.Can sleep well anywhere but in their bed |
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Idiopathic insomnia symptoms
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1.Long term insomnia
2.Difficulties with attention or concentration 3.Atypical reactions to medications |
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Sleep state misperception symptoms
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Complaining of insomnia while sleep durations and quality are normal.
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Five symptoms of narcolepsy:
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EDS, cataplexy, sleep paralysis, hyonogogic hallucinations, and automatic behavior
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Symptoms of primary RLS:
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Begins before 40, slow onset, can come and go, progressively gets worse
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Symptoms of secondary RLS:
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Sudden onset of symptoms, after age 40, most associated with medical conditions or drugs.
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Two proposed mechanisms of RLS
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Dopamine and Iron system
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Two RLS drugs. Which is better?
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Ropinirole and Pramipexole.
Pramipexole has less side effects |
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What sets PLMD from RLS?
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PLMD happens at night while sleeping and movements are involuntary
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____patients with RLS have PLMD. ____patients with PLMD have RLS
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Most
None |
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Diagnostic critera for PLMD
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5 PLMs per hour or more
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Food allergy insomnia
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Symptoms such as rash, SOB, and GI upset can cause comprimised sleep
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Limit setting sleep disorder
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Parent's inability to enforce a consistent bedtime, child sleeps adequately after falling asleep
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Altitude insomnia
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People who travel to high altitudes can experience acute insomnia
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Sleep onset assiciation disorder
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When a child (mostly) needs a set of cues to fall asleep..tv, rocking, pacifier
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Three disorders of arousal
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confusional arousals, sleep terrors, and sleepwalking
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Three conditions that are associated with chronic REM behavior disorder
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Parkinsons, dementia, and narcolepsy
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Primary parasomnias
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disorders of sleep states
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Secondary parasomnias
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Disorders of other organ systems that arise during sleep
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Nocturnal paroxysmal dystonia
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seizure like episodes during NREM
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Patients with fibromyalgia have _____ serotonin
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low
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What sets PLMD from RLS?
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PLMD happens at night while sleeping and movements are involuntary
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____patients with RLS have PLMD. ____patients with PLMD have RLS
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Most
None |
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Diagnostic critera for PLMD
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5 PLMs per hour or more
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Food allergy insomnia
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Symptoms such as rash, SOB, and GI upset can cause comprimised sleep
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Limit setting sleep disorder
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Parent's inability to enforce a consistent bedtime, child sleeps adequately after falling asleep
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Altitude insomnia
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People who travel to high altitudes can experience acute insomnia
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Sleep onset assiciation disorder
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When a child (mostly) needs a set of cues to fall asleep..tv, rocking, pacifier
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Three disorders of arousal
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confusional arousals, sleep terrors, and sleepwalking
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Three conditions that are associated with chronic REM behavior disorder
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Parkinsons, dementia, and narcolepsy
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Primary parasomnias
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disorders of sleep states
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Secondary parasomnias
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Disorders of other organ systems that arise during sleep
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Nocturnal paroxysmal dystonia
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seizure like episodes during NREM
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Patients with fibromyalgia have _____ serotonin
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low
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Assessing Movement Disorders
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Assessing Movement Disorders
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Hypnagogia
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vivid dreams accompanied by sleep paralysis
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Microsleep
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episode of sleep lasting from a fraction of a second to seconds
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Causes of microsleep
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sleep deprivation, mental fatigue, sleep apnea, narcolepsy, hypersomnia
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Polyuria
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passage of large volumes of urine
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sleep intertia
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a physiological state characterized by a decline in motor activity and subjective feelings of grogginess immediately following awakening from deep sleep (desire to fall asleep)
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What is IED
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Interictal epileptiform discharge, common in drousiness and NREM sleep
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What stage and time of sleep do NREM disorders occur?
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Delta, first 1/3rd
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What stage and time of sleep do REM disorders occur?
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REM! last 1/3 of the night
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Seizures occur during...
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NREM
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Rhythmic movement disorders occur...
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during sleep/wake transitions
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Dissociative episodes occur...
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from wakefullness, can remember, can be awakened
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Nocturnal panic attacks happen during what stage?
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1st transition from stage 2 to stage 3
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What are two contraindications of light therapy?
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cataracts and gylcoma
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Side effects of evening light timed too late
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insomnia and hyperactivation
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Side effects of morning light timed too early
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awaken premature and cant fall back asleep
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Typical intensities and timing of light therapy
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10,000 lux 30 min
or 2,500 lux 2 hours |
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Factors influencing light therapy
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Diffuse or focused
Indirect or direct Angle of incidence to the eyes |
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Delayed Sleep Phase Syndrome
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hard time initiating sleep before 1-3am and hard time awakening early
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How does a person with Delayed Sleep Phase Syndrome feel once awake?
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Alert and energized if schedule maintained
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What phase syndrome is comorbid with mood and personality disorders?
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Delayed Sleep Phase Syndrome
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Light Therapy for Delayed Sleep Phase Syndrome
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Start lights 8.5h after melatonin onset (morning)
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Advanced Sleep Phase Syndrome
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go to bed early evening and awaken too early
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Light Therapy for Advanced Sleep Phase Syndrome
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Treat with evening light, delays melatonin secretion and decrease of body temp
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Seasonal affective disorder characteristics
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increased appetite for carbs, weight gain, EDS, anxiety, hypersomnia
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Light therapy for Seasonal affective disorder
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bright light early morning 10,000lux for 30 min 75% remission
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Intrinsic dyssomnias
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originate within the body or from causes inside the body
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Extrinsic dyssomnias
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develop from causes outside of the body
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How much time do premature infants spend in REM?
term? Age 1? Age 5-adults? |
90%
50% 30% 20-25% |
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When do sleep spindles become evident?
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3 months
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When do K complexes and delta waves appear?
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at 6 months
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What is an infants sleep latency?
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REM onset
(pass through wake to active sleep via drousy state) |
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How long is an infants sleep cycle?
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1 hour
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How an infant central apnea is scored
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1. 20 sec of central
2. <20sec/2 missed breaths with a 4% desat |
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How an infant mixed apnea is scored
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10 sec or longer begining with a central
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What does reflux do to infant respiration?
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Greater obstructive component
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How an infant obstructive apnea is scored
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2 missed breaths (6sec)
and 4% desat or <92% or CO2 increase by 10mm/Hg or CO2 above 53mm/Hg or bradycardia |
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How an infant hypopnea is scored
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50% reduction in flow and 4% desat
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Cor Pulmonale
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Low oxygen when asleep
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Apnea of prematurity
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imcomplete development of respiratory control mechanisms, pathological periodic breathing
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Bruxism comes from what stage?
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Stage 2
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PLMDs appear, most frequent, reduced, and absent during what stages?
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stage 1, 2, sws, REM
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Sleep wake transition disorders (4)
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rhythmic movement, sleep starts, sleep talking, nocturnal leg cramps
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