Sleep Disorders Flashcards Preview

Neurology > Sleep Disorders > Flashcards

Flashcards in Sleep Disorders Deck (32)
Loading flashcards...
1
Q

the body’s anatomic timekeeper triggering the release of melatonin from the pineal gland

A

suprachiasmatic nucleus (SCN) is located in the hypothalamus

2
Q

Measures and records the electrical activity of the brain

A

EEG

3
Q

Where melatonin is released from

A

pineal gland

4
Q

Tx of circadian rhythm disorders

A

Sleep Hygiene. Bright Light Therapy/. Chronotherapy. Ramelteon (Rozerem). Provigil/ Nuvigil (shift work 150mg/day)

5
Q

Widely used in the field of sleep medicine as a subjective measure of a patient’s sleepiness and test of how likely a patient is to doze off or fall asleep

A

Epworth Sleepiness Scale. 0 would never doze or sleep to 3 which is high chance of dozing/sleeping

6
Q

First step in management of insomnia

A

maintain a sleep log for 2-4 weeks

7
Q

First line meds for insomnia

A

Melatonin 1 hr before and 1 right before bed. Atarax/Hydroxyzine at night x 2 wks

8
Q

Sedative hypnotics for insomnia

A

Zaleplon (Sonata). Zolpidem (Ambien). Ambien Cr . Lunesta (eszopiclone)

9
Q

Only sedative hypnotic that is category B for pregnancy.

A

Ambien Cr

10
Q

Name the benzodiazepine hypnotics: more useful in sleep maintenance insomnia

A

estazolam (ProSom). Temazepam (Restoril)

11
Q

Antidepressant that has the least anticholinergic effects best for elderly

A

nortriptyline

12
Q

Name the 3 TCA’s used in sleep disorders

A

trazodone (desyrel), amitriptyline (elavil), nortriptyline

13
Q

What two TCAs are also commonly used for back pain associated with nerve pain

A

amitriptyline and nortriptyline

14
Q

CI to melatonin agonists

A

severe hepatic impairment

15
Q

Name the melatonin agonist

A

ramelteon (Rozerem)

16
Q

When do narcoleptics generally experience REM?

A

within 5 minutes while most people 1hr

17
Q

Sx include periods of extreme drowsiness during the day often followed by a sleep attack, sleep paralysis, cataplexy

A

narcolepsy

18
Q

define sleep paralysis

A

Pt cannot move as they start falling asleep or when they first wake up

19
Q

define cataplexy

A

sudden loss of muscle tone while awake that makes them unable to move

20
Q

cause of narcolepsy

A

low levels of Hypocretin

21
Q

medications for narcolepsy

A

modafinil (Provigil)***, Armodafinil (Nuvigil), Methylphenidate (Ritalin)

22
Q

Sx include jaw soreness, flattening of teeth and radiating AM headaches

A

bruxism

23
Q

Sx include sensation of wanting to move legs while awake, “heebie jeebies” or “creepy crawler” sensations

A

Restless Leg Syndrome

24
Q

Risk factors for sleep apnea

A

BMI > 30, neck circumference > 17”, narrow airway, large tongue

25
Q

Tx for obstructive sleep apnea

A

weight loss, smoking cessation, CPAP

26
Q

Tx for pickwickian syndrome

A

weight loss, BiPAP, O2, tracheostomy if severe

27
Q

Non-REM parasomnias

A

sleep walking/eating, night terrors

28
Q

REM parasomnias

A

sleep paralysis, nightmare disorder

29
Q

Tx for night terrors

A

benzos, psychotherapy

30
Q

Tx for sleep paralysis

A

clonazepam taken at night

31
Q

Name the theory of sleep: neurotoxins are neutralized during sleep. cells divide, tissue synthesizes and growth hormones are released

A

Restorative Theory

32
Q

Name the theory of sleep: Unimportant information is “erased”, important information is locked into more permanent memory

A

Programming-Reprogramming Theory