BM Sleeping Disorders
Help!
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| how to validate a person | re-use their words!
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| Abnormal Sleep events | Parasomnias (sleep walk, grind teeth, acting out dreams)
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| DIMS | Disorders or initiation and maintenance of sleep. INSOMNIA
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| DOES | disorders of excessive daytime sleepiness.
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| What do you need for parasomnia evaluation? | EEG (to know sleep stage and level of consciousness) and a video
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| What do you need for disorders of Circadian Rhythm? | Sleep diary
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| How do you diagnose DIMS? | Sleep diary. This is a subjective complaint. Don't send them to a sleep lab.
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| How do you diagnose DOES? | Sleep lab. Also send to a sleep lab is you think there is an overlap of DIMS and DOES
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| 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.
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| True primary insomniac express | difficulty staying asleep.
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| Transient insomniacs have difficulty | falling asleep
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| Great question to ask up front: | okay, you don't sleep well, but do you have an adequate opportunity for sleep?
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| Bulk of insomnia is associated with | psychiatric disorder (50%:anxiety or depression)
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| what percentage of all insomnias are primary insomnia? | 15%.
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| Polysomnography measures | eye movement and muscle movement and tone and HR
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| Consider polysomnography if | there is a suspicion of sleep apnea or periodic limb movements, or treatment failure
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| Greatest comorbidity of insomnia | Depression (anxiety is a close second)
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| Long half life FDA approved treatments of insomnia | Lunesta, Sustained release ambien
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| Ramelteon (Rozerem) is a | Melatonin agonist, licensed in the US for sleep onset insomnia
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| If the diagnosis is primary insomnia or inadequate sleep hygiene _______ is the mainstay of treatment | behavioral therapy
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| half life of caffeine | 6 hours
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| If a patient sleeps 12 hours at night, yet feels they are going to fall asleep at the wheel, consider | sleep apnea
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| 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
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