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Decreased energy needs (HR, RR) Increased human growth hormone Cognitive restoration (REM) |
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Sleep restores biological and psychological process by... |
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Significant lack of sleep |
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Controls sleep regulation |
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Intrinsic sleep disorders Extrinsic sleep disorders Circadian rhythm sleep disorders |
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Psychological insomnia Narcolepsy Periodic limb movement disorder Sleep apnea syndromes |
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Intrensic sleep disorders |
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Inadequate sleep hygiene Insufficient sleep syndrome Hypnotic-dependent sleep disorders Alcohol-dependent sleep disorders |
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Extrinsic sleep disorders |
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Time-zone change (jet lag) syndrome Shift-work sleep disorder Delayed sleep phase syndrome |
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Circahian rhythm sleep disorders |
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Arousal disorders Sleep-wake transition disorders |
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Sleepwalking Sleep terrors |
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Sleeptalking Sleep starts Nocturnal leg cramps |
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Sleep-wake transition disorders |
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Nightmares REM sleep behavior disorder Sleep paralysis |
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Parasomnias associated with REM sleep |
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Sleep bruxism (teeth griding) Sleep enuresis (bedwetting) Sudden infant death syndrome |
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Mood disorders Anxiety disorders Psychoses Alcoholism |
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Sleep disorders associated with psychiatric disorders |
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Dementia Parkinson's Central degenerative disorders |
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Sleep disorders associated with neurological disorders |
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Nocturnal cardiac ischemia COPD Peptic ulcer disease |
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Sleep disorders associated with medical disorders |
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Menstruation Pregnancy Sleep choking |
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Evacuation of sleep staging, airflow and ventilatory efforts, arterial O2 sat, EKG, body positioning, and periodic limb movements |
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Multiple sleep latency test (MSLT) |
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Test done during the day during 4 different naps |
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Wrist device to monitor activity, naps, etc. |
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Cause nightmares Cause insomnia Cause awakening from sleep |
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Decrease REM time May cause daytime drowsiness |
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Interfere with reaching deeper sleep stages |
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Nighttime awakening due to nocturia |
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Suppress REM sleep Decrease total sleep time |
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Antidepressants and stimulants |
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Disrupts restless sleep (sleep isn't as effective) |
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Prevents person from falling asleep May cause person to awaken during the night Interferes with REM sleep |
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Alters REM sleep Increased daytime sleepiness Increased sleep time |
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Suppress REM sleep Cause increased daytime drowsiness |
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Test, caffeine Lasting 1 night in 2 weeks (20-30% of adults in a given year) |
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Lasting 3 nights a week for a month or more (10-15% of adults in a given year) |
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Delayed sleep pattern syndrome |
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Problems getting to sleep and messed up pattern (not enough REM) |
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Emotional or physical discomfort |
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Acute insomnia is often caused by... |
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Chronic insomnia is most common in... |
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Serious, life-threatening condition characterized by repeated collapse of the upper airway during sleep, with consistent cessation of breathing lasting 10 seconds or more |
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No ventilation despite absent obstruction (edema of cerebrum, problems with pons or medulla) |
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Upper airway, ventilation efforts persist Most common Snoring, pharyngeal, tonsilar, nasal |
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Pickwickian syndrome (Obesity-hypoventilation syndrome) |
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Morbidly obese people who have unnecessary pressure on their diaphragm Diminished breath sounds and lung capacity |
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Physiological goals of sleep apnea treatment |
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Definition
Eliminating sleep fragmentation, apneas and hypopneas, and O2 desaturation |
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Symptomatic goals of sleep apnea treatment |
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Eliminating snoring and sleepiness, improving QOL, reducing or eliminating comorbidities |
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Weight loss Avoidance of alcohol Avoidance of supine sleeping position |
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Behavioral modifications to help sleep apnea |
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Continuous oral pressure Non-invasive, very effective, but adherence is variable |
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May be used for mild to moderate cases, not uniformly effective |
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May be used alone or in conjunction with other procedures, rarely curative alone |
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Most effective in children, may even be curative |
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Essentially works to correct an overbite in order to open the airway (breaking the jaw, wired shut) |
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UPPP (Uvulopalatopharyngoplasty) |
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Definition
Uvula and portions of the soft palate are resected to widen the oropharyngeal airway, snoring usually resolved but apnea may persist |
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High successful in many cases when other treatments fail |
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Pharmacological treatments for sleep apnea |
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Second leading cause of daytime sleepiness |
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Brain's inability to regulate sleep-wake cycles |
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Definition
Narcolepsy is caused by... |
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Complex experience involving physical, emotional, and cognitive components Subjective and highly individualized Stimulus can by physical or emotional |
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Normal processing of stimuli that damages normal tissues or has the potential to do so if prolonged Usually responsive to nonopioids and/or opioids |
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Arises from bone, joint, muscle, skin, or connective tissue Usually aching or throbbing in quality and is well localized |
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Arises from a visceral organ such as the GI tract and pancreas |
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Abnormal processing of sensory input by the peripheral or central nervous system Treatment usually includes adjunctive analgesics |
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Centrally generated pain Deafferentation pain |
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Injury to either the peripheral or central nervous system |
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Centrally generated pain Sympathetically maintained pain |
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Associated with dysregulation of the autonomic nervous system |
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Peripherally generated pain Paniful polyneuropathies |
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Pain is felt along the distribution of many peripheral nerves |
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Peripherally generated pain Painful mononeuropathies |
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Usually associated with a known peripheral nerve injury and pain is felt at least partly along the distribution of damaged nerve |
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Groaning Moaning Crying Grunting |
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Biting lip Grimace Clenched teeth Wrinkled forehead Tightly closed or wide opened eyes or mouth |
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Facial expressions of pain |
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Restlessness Immobilization Muscle tension Increased hand and finger movements Pacing activities Rhythmic or rubbing motions Protective movement of body parts |
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Avoidance or conversation Focus on activities for pain relief Avoidance of social contact Reduced attention span |
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Social interaction of pain |
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