Behavioral Science

46 Deja Review: Behavioral Science
What interventions other than
medications can be useful
in insomnia?
What is the subtype of recurrent
primary hypersomnia associated with
obesity, impulsivity, hyperphagia,
hypersexuality, and disorganized
thought called?
Other than daytime sleepiness and
“sleep attacks,” what symptoms are
classically associated with narcolepsy?
Which class of drugs is normally used
to treat narcolepsy?
Why are people with breathing-related
sleeping disorder chronically sleepy
during the day?
What is the most common cause
of breathing-related sleep disorder
and how is it treated?
In a patient with excessive fatigue,
what might the patients’ bed partner
tell you about their sleep that might
lead you to suspect obstructive sleep
apnea (OSA)?
What are the complications from
untreated OSA?
Set a regular bedtime, abstain from
caffeine and alcohol, use the bed only
for sleep and sex, and avoid daytime
naps and strenuous exercise or large
meals just before bedtime. Collectively,
this is referred to as sleep hygiene.
Kleine-Levin syndrome
Cataplexy: sudden loss of muscle
tone associated with strong emotions
Hypnagogic and hypnopompic
hallucinations: REM intrusions that
occur during the transition period
between sleep and wakefulness
(Hypnagogic symptoms occur when
going to sleep and hypnopompic occur
while waking up.)
Sleep paralysis: inability to move just
before going to sleep or awakening
Stimulants, eg, Ritalin
During the night they frequently stop
breathing and then are awoken by
hypoxia. These frequent arousals
prevent the patients from getting deep,
restful sleep.
Obstructive sleep apnea (OSA)
Treatment: continuous positive airway
pressure (CPAP) and possibly removal
of tonsils and adenoids (ideally weight
loss would be primary intervention
in the obese.)
Loud snoring and periods of time
where the patient appears to stop
breathing
Hypertension, pulmonary hypertension,
and increased all-cause mortality,
cardiovascular disease, and
cerebrovascular disease