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46 Cards in this Set
- Front
- Back
What stage of sleep reduced with aging? |
N3 More N1 sleep |
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what does tidal volume do during sleep? |
Reduced tidal volume, RR stay the same |
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What define hyponea? |
decreased in nasal pressure by >30% x 10 sec with >4% SpO2 drop. |
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True/False: Home sleep apnea testing is the stardard method for diagnosing uncomplicated OSA (no comorbities) |
True |
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What defines apnea? |
90% reduction of peak thermal sensor amplitude x 10 secs and no inspiratory effort |
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What is biot's breathing pattern? |
small bouts of central apneas. central apnea on long acting narcotic doe not go away when discontinue narcotics |
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Which neurotransmitter s release from the pineal gland to regular circadian rhythms in humans? |
Melatonin |
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What gene is involved in advance sleep syndrome? |
Per2 Gene Early risers |
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What is free-running circadian disorder? |
Non 24hr sleep Usually occur in blind patients |
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Which hypersomina disorder is due to lack of hypocretin? |
Narcolepsy type I |
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What HLA typing is seen in narcolepsy with cataplexy? |
DQB1 type |
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WHich med use to treat narcolepsy reduces the effective of the OCP? |
Modafinil |
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What's is difference between IH and narcolepsy? |
IH doesn't get refreshed after napping |
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Which hypnotic medication effect the melatonin? |
Ramelteon Has no respiratory depression symptoms |
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Which hypnotics are orexin antagonist? |
Suvorexin |
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REM sleep behavior is a risk factor of type of dementia? |
Lewy body dementia |
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Which population has the lowest prevalence of OSA? A. Premenopausal females B. Postmenopausal females C. Adult males < age 50 D. Adult males > age 50 |
Premenopausal females |
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When is home sleep apnea (HSAT) indicated? |
simple OSA w/o significant medical disorder: -CHF -COPD -Stroke -Hypoventiliation syndrome W/o other sleep disorders: RLS, narcolepsy, insomnia |
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True/False: Continual use of CPAP following bariatric surgery will help maintaining long-term weight loss |
True |
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True/False: Patient with cheyne stokes has decreased chemoreceptor responsives to CO2 |
False, hyper-responsive to CO2. The problem is in decreased circulatory time. |
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True/False: Patient with cheyne stokes has increased ventilatory drive |
True. |
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What's the finding of the SERVE-HF study 2015? |
ASV is associated with increase all-cause mortality in HF patients. (HR 1.28) studied patients: Ef < 45% with central AHI >15. |
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What structure in the brain acts as the master cicadian rhythm generator in mammals? |
Suprchiasmatic nucleus in the anterior hypothalamus |
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When is the two circadian peaks of alertness? |
Late morning Early evenining |
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When is the two circadian troughs of alertness? |
Early morning Early afternoon |
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How does caffeine work? |
It increases wakefulness by blocking adenosine receptor (CNS neurotransmitter) |
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Which neurotransmitter is responsible for REM? |
Acetylcholine |
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What does the HR, cardiac output, and BP do during NREM sleep? |
HR decrease CO decrease BP decrease |
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What does the HR, cardiac output, and BP do during REM sleep? |
HR increase CO increase BP increase |
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What are the effect of REM sleep compared to NREM on the autonomic nervous system? |
Brief sympathetic surge during REM sleep. |
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Which sleep stage do see K complex and spindles? |
N2 |
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Which sleep stage do you see delta waves? |
N3 |
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Which sleep stage do you see slow eye rolling and diminished alpha waves? |
N1 |
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Which sleep stage do you see Beta waves? |
AWAKE |
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Which neurotransmitter is affected in narcolepsy type I? |
Lack of hypocretin |
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Aside from clinical criteria, which lab is also diagnostic for narcolepsy type I? |
Low CSF hypocretin/orexin level, <110pg/ml |
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True/False: Modafinil reduces the effectiveness of OCP |
True |
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What are the REM suppressing drugs? this can be used for cataplexy |
SSRI TCA MAOI Venlafaxine (SNRI) Sodium oxybate |
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What is Ramelteon? |
Melatonin agonist short half-life, used for sleep onset insomnia Contraindication: liver dysfunction, fluvoxamine use |
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What are the nonbenzo benzodiazepine agonist? |
eszopiclone (Lunesta) zaleplon (Sonata) zolpidem (Ambien) |
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What is suvorexant? |
Orexin receptor antagonist side effect: cataplexy |
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What are the two short half life hyponotics use for sleep onset insomnia? |
Ramelteon Zaleplon |
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What are the NREM parasomnias? |
Confusional arousals Sleep terrors Sleepwalking |
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What are the REM parasomnias? |
Nightmares REM sleep behavior disorder |
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What pharmacologic therapy can be used for minimize parasomnia? |
First line: clonazepam Then try melatonin |
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What is diagnostic of PML? |
PML index > 15/hr. But no need to treat if not symptomatic. |