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BMSleeping Disorders
BM Sleeping Disorders
| Question | Answer |
|---|---|
| how to validate a person | re-use their words! |
| Abnormal Sleep events | Parasomnias (sleep walk, grind teeth, acting out dreams) |
| DIMS | Disorders or initiation and maintenance of sleep. INSOMNIA |
| DOES | disorders of excessive daytime sleepiness. |
| What do you need for parasomnia evaluation? | EEG (to know sleep stage and level of consciousness) and a video |
| What do you need for disorders of Circadian Rhythm? | Sleep diary |
| How do you diagnose DIMS? | Sleep diary. This is a subjective complaint. Don't send them to a sleep lab. |
| How do you diagnose DOES? | Sleep lab. Also send to a sleep lab is you think there is an overlap of DIMS and DOES |
| Normal people report what number on an Epworth Sleepiness Scale? | 5. Insomniacs score less than normal (2). Insomnia is not a disorder of sleep, but of too much activity. Ask about caffeine usage. |
| True primary insomniac express | difficulty staying asleep. |
| Transient insomniacs have difficulty | falling asleep |
| Great question to ask up front: | okay, you don't sleep well, but do you have an adequate opportunity for sleep? |
| Bulk of insomnia is associated with | psychiatric disorder (50%:anxiety or depression) |
| what percentage of all insomnias are primary insomnia? | 15%. |
| Polysomnography measures | eye movement and muscle movement and tone and HR |
| Consider polysomnography if | there is a suspicion of sleep apnea or periodic limb movements, or treatment failure |
| Greatest comorbidity of insomnia | Depression (anxiety is a close second) |
| Long half life FDA approved treatments of insomnia | Lunesta, Sustained release ambien |
| Ramelteon (Rozerem) is a | Melatonin agonist, licensed in the US for sleep onset insomnia |
| If the diagnosis is primary insomnia or inadequate sleep hygiene _______ is the mainstay of treatment | behavioral therapy |
| half life of caffeine | 6 hours |
| If a patient sleeps 12 hours at night, yet feels they are going to fall asleep at the wheel, consider | sleep apnea |
| Can't stay asleep and can't nap during the day? Consider: | Sleep restriction. Counterintuitive. Increase sleep drive by increasing time out of bed. No naps! Cut average sleep time by 1 hour |
Created by:
ltm12