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Sleep Disorders (Insomnia (Treatment: CBI (highly effective, reduces…

- - - - What is it: Episodes of sudden loss of muscle tone lasting under 2 min Triggers - laughter/ joking in those with N for a long time. They drop objects, knee buckling. Rare: spontaneous grimacing/ jaw opening episodes - occurs in CHILDREN who develop common symptoms later
      - Treatment: Sodium oxybate + setegiline reduces cataplexy, halluciniations, sleep paralysis in N
    - - Narcolepsy with Cataplexy - lack of cells in hypothalamus that secrete n.t. hypocretin
      - Narcolepsy without cataplexy - (minority), show low levels of hypocretin #
- - - - What is it: No breathing for brief periods (20s+), no frequent awakening, no tired tendency
      - why it happens: Brain does not send signal to breath due to CNS disorders
      - Facts: occurs in premature infants
      - Treatment: treat the unedrlying disorder or using CPAP
    - - What is it: episodes of decreased breathing, associated with high levels of CO2
      - Associated with lung disease and chest wall diseases
    - - What is it: abornomally shallow breathing/ low respiratory rates
      - Criteria: Must have evidence from polysomnograph tests showing freq. apneas/ hypoapneas: Mild = <15,* Moderate *= 15-30,* High *= >30
      - Why it happens: airway is stopped due to narrow airway/ obstruction in the airway
      - associated with diabetes/ obesity/ hypertension
      - Facts: 10% of population at ANYTIME
      - Treatment: using continuous positive air pressure (CPAP) machine. Medicine: Drugs that affect the seratonin system (SRI's) = mixed effect in treatment of OSA/H. Surgery can be done in extreme cases (not very effective)
        
        20-25% reject this because it is uncomfortable and does not provide enough relief
- - - - What is it: delayed sleep onset and inability to go to sleep earlier
      - Most common diagnosis for this disorder
    - - What is it: sleep onset and awakenings are 2h earlier than desired
      - they show evidence for early timing and biomarkers
    - - What is it: no discernable sleep-wake rhythm, fragmented into 3 periods per 24 hours
      - associated with neurological disorders
    - - Symptoms: complain sleepiness during daytime + deficits in cognitions and functioning
      - Facts: frequent in those who can't see
      - What is it: a free running sleep-wake schedule not determined by light-dark cycle
    - - What is it: sleep-wake schedule of irregular hours
      - Facts: 31% of nightworkers + 26% of rotating shifts met criteria
- - - - Facts: often occurs in children during NREM. 2.7% of adults experience at least once in last 3 months --> 1% 1x a week
      - Symptoms: cannot easily be awakened and has no recollection
    - - Facts: common in children occurs during NREM. 15-30% experience at least once.
      - Symptoms: can answer questions and demands but not hold conversation. Difficult to wake and no recall
    - - Facts: common in adults; 7% in previous 3 months, 2% exp 1x per week
      - symptoms: episodes of incomplete awakening during NREM, no involvement of (1) or (2)