The Sleep Technician's Flash Cards: William H. Spriggs- Section 10: Sleep Disorders-Sleep Related Breathing Disorders

Front 1

High Altitude Periodic Breathing

Back 1

This disorder is characterized by central apneas and hypopneas occurring during a recent ascent to at least 4000 meters, or approx. 12,000 ft. The events occur at least 5 times per hour of sleep.

Front 2

Adult Obstructive Sleep Apnea

Back 2

This includes repeated apneas and hypopneas with continued respiratory effort. Diagnostic criteria include an RDI > 5 with complaints of EDS, choking, gasping, or snoring, or and RDI > 15 without these complaints.

Front 3

Pediatric Obstructive Sleep Apnea

Back 3

Diagnostic criteria for this disorder include at least 1 obstructive apnea or hypopnea per hour of sleep. It may sometimes be associated with Sudden Infant Death Syndrome (SIDS).

Front 4

Sleep Related Nonobstructive Alveolar Hypoventilation

Back 4

This disorder is characterized by periods of shallow breathing or decreased airflow associated with O2 desaturation. These periods last at least 10 seconds and are often associated w/ EEG arousals.

Front 5

Primary Central Sleep Apnea

Back 5

This is characterized by cessations of airflow and concurrent cessations of respiratory effort. It is often seen in the elderly. Diagnostic features include an average of at least 5 of these events per hour.

Front 6

Cheyne Stokes Breathing Pattern

Back 6

In this disorder, the airflow shows distinct waning and waxing patterns, usually seen during NREM. Diagnostic criteria includes 10 central apneas/hypopneas per hour, and a crescendo-decrescendo pattern.

Front 7

Congenital Central Alveolar Hypoventilation Syndrome

Back 7

This disorder is similar to Sleep Related Nonobstructive Alveolar Hypoventilation, but occurs in infants. Those affected by it experience severe oxygen desaturation in hypercapnia.

Front 8

Sleep Related Hypoventilation Due to Pulmonary Parenchymal or Vascular Pathology

Back 8

This disorder is characterized by breathing difficulties related to lung diseases such as interstitial pneumonitis or forms of pulmonary hypertension.

Front 9

Paradoxical Insomnia

Back 9

a.k.a. "Sleep State Misperception", this consists of a complaint of insomnia without any evidence. Use of a sleep diary or sleep log may be appropriate.

Front 10

Idiopathic Insomnia

Back 10

a.k.a. "Life-long insomnia", this is identified at infancy and persists throughout the life. Appears to be no external cause for this, and no other sleep disorder exists as a contributing factor.

Front 11

Sleep Related Dissociative Disorders

Back 11

These are characterized by dissociative disorders that exist during wakefulness bu are carried out during the sleep period. These patients are often victims of abuse or rape, and may act out the abuse during sleep.

Front 12

Sleep Enuresis

Back 12

This includes repeated episodes of involuntary urination during sleep. Diagnostic criteria require the patient to be at least 5 years of age and wet the bed at least twice a week. PTSD is often associated.

Front 13

Adjustment Insomnia

Back 13

a.k.a. "Acute Insomnia", this is a short term insomnia that is associated with a specific stressor. It is very common but typically corrects itself when the stressor becomes absent.

Front 14

Psychophysiological Insomnia

Back 14

A common type of insomnia that lasts at least one month. Is not associated with a stressor. Caused by a learned response to not fall asleep when planned. Falling asleep at normal bedtimes is difficult.

Front 15

Restless Legs Syndrome (RLS)

Back 15

This is characterized by the irresistible urge to move the body in an effort to stop uncomfortable or odd sensations often described as creeping, crawling feelings in the legs. It often leads to insomnia.

Front 16

Periodic Limb Movement Disorder (PLMD)

Back 16

Formerly known as Nocturnal Myoclonus, this affects 1/3 of adults over 60 and causes involuntary limb movements during sleep in series of at least 4 events within 5 to 90 seconds of each other.

Front 17

Snoring

Back 17

This characteristic is classified as audible vibrations of the upper airway during respirations in sleep. This is caused by a partial obstruction of the upper airway, often including nasal obstruction

Front 18

Sleep Talking

Back 18

This characteristic can occur at any age and in any stage of sleep and occurs when a person talks during sleep. It is usually considered benign unless it disturbs the sleep of the individual talking or the bed partner.

Front 19

Long Sleeper

Back 19

This symptom occurs when a person sleeps >10 hours per 24 hours, and is not explainable by another sleep disorder. The requirements change according to age, since infants need this much sleep normally

Front 20

Short Sleeper

Back 20

This symptom occurs when a person sleeps <5 hours per 24 hours, and is able to maintain normal functionality and wakefulness. This type of individual does not require the normal amount of sleep.

Front 21

Propriospinal Myoclonus at Sleep Onset (PSM)

Back 21

These events are similar to sleep starts, but mailny involve body movements in the trunk and neck areas. They typically occur at sleep onset or during brief arousals from sleep.

Front 22

Excessive Fragmentary Myoclonus

Back 22

These events are characterized by frequent small twitches of fingers, toes, or muscles of the mouth during wake or sleep. They are typically benign, occur in NREM sleep, and persist for >20 minutes.

Front 23

Sleep Starts (Hypnic Jerks)

Back 23

These are sudden muscle jerks or movements at sleep onset, often accompanied by feelings of surprise or fear. They are usually benign, although they can disturb the sleep of the bed partner,

Front 24

Hypnagogic Foot Tremor ( HFT) and Alternating Leg Muscle Activation (ALMA)

Back 24

These are rhythmic leg or foot movements at sleep onset. The latter is characterized by movement in one leg followed by movement in the other leg. They are typically benign but can cause brief arousals.

Front 25

Sleep Related Hypoventilation Due to Lower Airway Obstructions

Back 25

This disorder refers to obstructions in the airway below the laryngeal apparatus. This obstruction is determined by a Pulmonary Function Test (PFT) showing a vital capacity ratio <70%

Front 26

Sleep Related Hypoventilation Due to Neuromuscular & Chest Wall Disorders

Back 26

This disorder refers to patients who have difficulty breathing as a result of a chest wall or neuromuscular disorder such as muscular dystrophy or Eaton-Lambert syndrome.

Front 27

Narcolepsy with Cataplexy

Back 27

This is characterized by EDS and cataplexy, and often includes sleep paralysis and hypnagogic hallucinations. Diagnostic criteria include a mean sleep latency < 8 min and 2 REM onsets during an MSLT.

Front 28

Recurrent Hypersomnia

Back 28

This is a rare disorder that is usually a case of Klein-Levin syndrome and includes repeating episodes of Hypersomnia. Patients may sleep 16-18 hours a day during these periods, which may last as long as 4 weeks.

Front 29

Idiopathic Hypersomnia with Long Sleep Time

Back 29

This disorder is characterized primarily by sleeping periods lasting more than 10 hours in duration, EDS, and short sleep latency.

Front 30

Behaviorally Induced Insufficient Sleep Syndrome

Back 30

This is more commonly known as sleep deprivation or sleep restriction, and is self-induced. These lifestyle choices often result in EDS and longer sleep periods on weekends.

Front 31

Delayed Sleep Phase Disorder

Back 31

This is characterized by a later sleep time than expected. Patients with this disorder are usually adolescents or young adults, and tend to stay up late at night and wake up late in the morning.

Front 32

Advanced Sleep Phase Disorder

Back 32

This is characterized by an earlier sleep time than expected. Patients with this disorder are usually elderly, and tend to go to bed early at night and wake up early in the morning.

Front 33

Irregular Sleep-Wake Rhythm

Back 33

This disorder is characterized by abnormal sleep and wake times. Although the total sleep time during the 24 hour period may be normal, the sleep periods may come in the form of several naps.

Front 34

Free-Running Circadian Rhythm Sleep Disorder

Back 34

This is a circadian rhythm that is not consistent with the 24 hour clock. The patient's circadian rhythm is often longer than 24 hours, and does not seem to be related to the light-dark cycle.

Front 35

Jet Lag Disorder

Back 35

This occurs when a person travels across two or more time zones, resulting in EDS or insomnia. Other symptoms such as gastrointestinal disturbances or poor performance often occur.

Front 36

Shift Work Disorder

Back 36

Patients with this disorder are assigned to work a shift that causes them to work a shift that causes them to sleep during hours other than the typical nighttime hours. As a result, the patient often experiences EDS and poor performance and judgment.

Front 37

Confusional Arousals

Back 37

This occurs when a person awakens in a confused state, usually when awakening from slow wave sleep. The person may not know who they are or what is happening. Speech may be slurred and mentation slow.

Front 38

Sleepwalking

Back 38

This is characterized by certain behaviors during slow wave sleep such as sitting up, walking, jumping, or even violent behaviors. This is considered normal in most prepubescent cases.

Front 39

Sleep Terrors

Back 39

These are awakenings from slow wave sleep with feelings of intense fear, a loud scream, and often violent behaviors. After the event, the patient returns to slow wave sleep and has no recollection in the morning.

Front 40

REM Sleep Behavior Disorder (RBD)

Back 40

This consists of physical activities during REM sleep. Normal muscle atonia does not occur in REM in these patients. Upon awakening, the patient is likely to remember the associated dream.

Front 41

Recurrent Isolated Sleep Paralysis

Back 41

This includes episodes of the inability to move during sleep onset (hypnagogic) or awakening (hypnopompic). These periods last a few seconds to several minutes. This disorder occurs in the absence of narcolepsy.

Front 42

Nightmare Disorder

Back 42

Common in young children and patients with post traumatic stress disorder (PTSD), this disorder includes repeated frightening or intense dreams, causing persistent fear after awakening.

Front 43

Sleep Related Groaning

Back 43

a.k.a. "catathrenia", this consists of groaning during exhalation, mainly during REM sleep. This is more common in males that in females, and usually disturbs the bed partner more than the patient.

Front 44

Exploding Head Syndrome

Back 44

This is a sleep disorder in which the patient is awakened by an imagined loud noise or sense of explosion in the head while falling asleep or awakening. This is malignant other than occasional pain in the head.

Front 45

Sleep Related Hallucinations

Back 45

These are hallucinations either at sleep onset or upon awakening, often associated with sleep onset REM periods (SOREMP's), and may be frightening to the patient. These occur in the absence of narcolepsy.

Front 46

Sleep Related Eating Disorder

Back 46

This disorder includes repeated episodes of eating and/or drinking during arousals from sleep. This often occurs on a nightly basis, or several times a night. The patient usually chooses junk foods.

Front 47

Sleep Related Bruxism

Back 47

This disorder is often discovered by the dentist and is characterized by the repeated grinding of teeth or clenching of the jaw. This is more common in children and teens, and is often the result of stress.

Front 48

Sleep Related Rhythmic Movement Disorder (RMD)

Back 48

a.k.a. "body rocking" or "head banging", this is characterized by repetitive body movements during drowsiness or sleep. This is most common in infants and children under the age of 5 years.

Front 49

Inadequate Sleep Hygiene

Back 49

This disorder consists of practices that encourage poor sleep, such as watching TV in bed, frequently altering bedtimes, not blocking out light and noise during sleep, drinking alcohol before sleep, etc.

Front 50

Behavioral Insomnia of Childhood

Back 50

a.k.a. "Limit-setting disorder", this disorder is characterized by a parent promoting poor sleep hygiene techniques in a child, such as putting toys in the crib or frequently altering feeding times.