RPSGT
Central Alveolar Hypoventilation Syndrome
Impaired ventilatory control, characterized by low arterial oxygen levels and hypoventilation without apnea or hypopnea. Hypoventilation periods may persist for several minutes with sustained arterial oxygen desaturation and increased levels of carbon dioxide.
Circadian Rhythm Sleep Disorder
Altered functioning of the circadian sleep-wake system or imposed mismatch between the Pt.'s natural sleep-wake system and required sleep-wake system. (Common in Shift Workers)
atEMGs
Anterior Tibialis Electromyograms
AI
Apnea Index
AHI
Apnea-Hypopnea Index
Central Sleep Apnea
Apneic and hypopneic episodes without obstruction and usually results from cardiac or neurological disorders that cause impairment of ventilation.
Sedative/Hypnotic Chronic Use/Withdrawal - Mixed Insomnia and Hypersomnia
As the Pt. develops a tolerance for the drug, sedative effects decrease, and insomnia occurs. If the Pt. increases the dose of medication to compensate, then hypersomnia recurs. Withdrawal often results in insomnia with a decrease in sleep duration and an increased disruption of sleep and stage R sleep rebound as well as anxiety, tremors, and ataxia.
Maintenance of Wakefulness Test (MWT)
Assesses sleepiness and effectiveness of treatment, determines the Pt.'s ability to stay awake in the daytime. The MWT may be done with the multiple sleep latency test (MSLT)
Spinal Cord Injury
Bilateral diaphragmatic paralysis
Psychiatric Disorders
Bipolar Disorder, depression, PTSD & schizophrenia
Blockers - Insomnia
Blockers decrease sleep, increase disruption of sleep, and increase nightmares.
Respiratory Disorders
COPD, cystic fibrosis, restrictive lung diseases & asthma.
Hypersomnia
Characterized by increased sleepiness, prolonged nocturnal sleep (8-12 hours) and daytime sleepiness with intentional or unintentional napping on a daily basis for at least 1 month with difficulty awakening, resulting in social , occupational, and other impairment, and related to psychiatric & mental disorders. Can be caused by medical disorders or substance abuse
Secondary Enuresis
Child has had long periods (6-12 months) without any instances of nocturnal incontinence
Primary Enuresis
Child has never been dry at night, and incontinence is associated with delay in maturation and small functional bladder rather than stress or psychiatric disorders.
Sleep-Wake Activity Inventory
Comprehensive instrument that includes subscales the measure a number of different aspects of sleep disorders: EDS, nocturnal sleep, relaxing ability, energy, social desireability, and psychological distress.
CAP
Cyclic Alternating Pattern
Diuretics - Insomnia
Decreasing potassuim levels may cause leg cramps that interfere with sleeping, and the increase in urinary output may cause nocturnia, interrupting sleep.
ECGs
Electrocardiogram
EEGs
Electroencephalogram
EOG
Electrooculogram
Kidney/Urinary Disorders
End-Stage renal disease & Urinary Frequency
Epworth Sleepiness Scale
Evaluates how likely a person is to fall asleep during a number of different activities.
EPAP
Expiratory Positive Airway Pressure
Fatal Familial insomnia
Fatal neurologic disorder in which the Pt. has difficulty falling asleep, progressing to the inability to sleep. A desynchronized EEG and an absence of slow-wave sleep characterize this disorder.
Gastrointestinal Disorders
GERD & functional bowel disorders
Fatigue
General feeling of tiredness, weakness, or lack of energy and may be related to physical or emotional problems.
Alcohol Withdrawal - Insomnia
Gross disturbance of sleep with an increase in the amount of stage R sleep, often with vivid dreams. After withdrawal, insomnia with a light restless sleep may persist for weeks to years with a deficit in slow-wave sleep.
Infectious Diseases
HIV/AIDS, Lyme Disease & Human African Trypanosomiasis
Cardiovascular Disorders
Heart Block, dysrhythmias, congestive heart failure, coronary artery disease & atrial fibrillation
Bronchodiators (theophylline) - Insomnia
High doses of some bronchodilators may cause nervousness, muscle cramping, twitching, and sleep disruption.
Thyroid Hormone (Synthroid) - Insomnia
High doses of thyroid hormone may cause nervousness, tremors, heart palpitations, and disruption of sleep.
Endocrine Disorders
Hypothyroidism, acromegaly, Cushing's syndrome, Addison's disease, diabetes mellitus & diabetes insipidus.
Sleep-state Misperception
PSG shows normal sleep, but the Pt. reports reduced or no sleep and often does not believe contrary lab results.
Rheumatologic Disorders
Pain syndromes & Fibromyalgia
Nicotine Patches - Insomnia
Patches may interfere with falling asleep and duration of sleep and cause vivid dreams or nightmares.
PRC
Phase Response Curve
Amphetamines/Related Drugs: Withdrawal - Hypersomnia
Prolonged sleeping during the night. REM and slow-wave sleep may increase above baseline. MSLT shows increased sleepiness during the daytime as well.
Hypnotic dependent sleep disorder
Pt is unable to sleep w/o sleep medication - resulting in a tolerance requiring ever increasing doses; withdrawal results in insomnia, nervousness, and agitation.
Sleep-related Eating
Pt. eats during the night and has no recollection of doing so. This is distinct from night eating syndrome.
Night Eating Syndrome
Pt. is aware of eating, but is unable to go back to sleep without eating.
Jet Lag
Pt.'s travel to different time zones and cannot adapt their sleep-wake cycle resulting in fatigue, disorientation, and lack of adequate sleep with a degree of symptoms related to the number of time zones.
RBD
REM Behavior Disorder
Electrocardiograms
Record and show a graphic display of the electrical activity of the heart through a number of different waveforms, complexes, and intervals.
Nightmare Disorder
Repeated nightmares (sometimes associate with PTSD) that cause the Pt. to awaken fully alert, interrupting the normal sleep cycle. -Nightmares occur during REM sleep and tend to occur in the second half of the night when these periods are longer. The Pt. may suffer from fatigue from lack of sleep caused by frequent awakening or may avoid sleeping because of fear of the nightmares.
Narcolepsy
Repeated periods of falling asleep during waking hours daily for at least 3 months.
Enuresis
Repeated, involuntary, urinary incontinence in children old enough to have bladder control, usually about 5-6 years old. Most common in the first third of the night with the child awakening after urinating.
U Wave
Represents repolarization (return to resting state)of the Purkinje fibers.
P Wave
Represents the beginning of the electrical impulses which spread through the atria (this is the atrial depolarization/muscle contraction)
QRS complex
Represents the ventricular muscle depolarization (contraction) and atrial repolarization (return to resting state)
T Wave
Represents ventricular muscle repolarization (resting state) as cells regain negative charge.
RDI
Respiratory Disturbance Index
Alcohol Intoxication - Insomnia
Sedation occurs during acute intoxications with increased sleeping and decreased wakefulness for 3-4 hours with increased stage N3 sleep and reduced stage R sleep. After this period, the Pt. experiences decreased stage N3 sleep, increased wakefulness, and increased stage R sleep with restlessness and sometimes vivid dreams.
SPT
Short Period Time
SWS
Short- Wave Sleep
SE
Sleep Efficiency
SOL
Sleep Onset Latency
Cocaine Withdrawal - Hypersomnia
Sleep is markedly prolonged
Opioid Withdrawal - Hypersomnia
Sleep is prolonged.
Cocaine Intoxication - Insomnia
Sleep is severely compromised, and the Pt. may sleep only for short, disrupted periods.
SWAI
Sleep-Wake Activity Inventory
Antihistamines (diphenhydramine, Benadryl) - Hypersomnia
Some drugs may produce a sedative effect, causing increased sleeping during the night and increased sleepiness during the daytime.
Selective serotonin reuptake inhibitors (SSRIs) - Insomnia
Some individuals experience sleep disruption and sleepiness during waking hours when taking SSRIs.
Corticosteriods - Insomnia
Steroids may markedly decrease sleep time and increase time needed to fall asleep as well as cause fatigue and jitters during the day.
Sleep Paralysis
The Pt. can see and breathe but is not able to move for periods of seconds to minutes - occurs during onset of sleep (hypnagogic) or upon on waking (hypnopompic).
Antiarrhythmics (quinidine procainamide) - Insomnia
These drugs may cause disruption of sleep during the night and increased sleepiness in the waking hours.
TSP
Total Sleep Period
TST
Total Sleep Time
TWT
Total Wake Time
Amphetamines Related Drugs: Intoxication - Insomnia
Total sleep is reduced with increased sleep latency and sleep disturbance. EMG shows increased muscular activity. Stage R sleep and slow-wave sleep decrease.
Caffeine Withdrawal - Hypersomnia
Increased sleeping and daytime sleepiness are common.
Caffeine Use - Insomnia
Increased wakefulness and decreased sleep are does dependent. Polysomnography shows increased sleep latency and wakefulness and decreased slow-wave sleep.
Excessive Daytime Sleepiness
Increasing societal problem related to lack of adequate sleep, causes the Pt. to feel sleepy during waking hours to the point at which the person may fall asleep or feel the need to nap.
Sedative/Hypnotic Intoxication - Hypersomnia
Initial sedative effects result in an increase in sleepiness, decreased wakefulness, and a decrease in stage R sleep with an increase in sleep-spindle activity.
IPAP
Inspiratory Positive Airway Pressure
IEA
Interictal Epileptiform Activity
Substance-induced sleep disorder
Intoxication and withdrawal from alcohol as well as many other different drugs.
Neuromuscular Diseases
MS, amyotrophic lateral sclerosis, myasthenia gravis, poliomyelitis & myotonic dystrophy.
Electroencephalograms
Measure the electrical activity within the brain through scalp electrodes to rule out seizure disorders and to determine the characteristics of the sleep-wake state.
Multiple Sleep Latency Test (MSLT)
Measures sleepiness during waking hours and then tendency of a person to fall asleep. (May diagnose narcolepsy and idiopathic hypersomnia and determine the effectiveness of therapy)
Anterior Tibialis Electromyograms
Monitor the electrical activity in the leg muscles, allowing for monitoring of periodic leg movement during the polysomnogram because electrical activity is absent when the muscle is relaxed and increases with movement.
Sleep Walking Disorder
Motor activity during sleep including sitting up, picking at bedding, talking, walking, running, operating machinery, and eating. Pt. may respond verbally to others, but speech may not be clear because of reduced alertness. The Pt.'s eyes are usually open. Typically, the Pt. does not awaken easily and is confused if awakened and has little or no memory of the episode.
Sleep Disorders
OSA, CSA, narcolepsy, circadian rhythm disorders, RLS , PLMs, parasomnias & insomnia.
Sleep-related groaning
Occurs during exhalation, primarily during REM. The respirations become slow, and the groaning exhalation may persist for 30 - 40 seconds, usually concluding with a grunting or sighing sound.
Periodic Leg Movements
Occurs during sleep and are often associated with RLS (occuring in about 80% of patients with RLS) with five or more PLMS usually within the first half of the night.
Berlin Questionnaire
Often used for screening those at risk for obstructive sleep apnea, but it is also occationally used to determine progress after the onset of treatment with positive airway pressure.
Exploding Head Syndrome
Upon awakening, the Pt. perceives a sudden (imaginary) noise or explosion, sometimes accompanied by a flash of light, jerking and fright.
Stanford Sleepiness Scale
Used to determine if people have excessive daytime sleepiness.
Sleep-related Hallucinations
Visual, auditory, or tactile hallucinations occur during onset of sleep (hypnagogic) or on waking (hypnopompic) sometimes associated with sleep paralysis. Images tend to be stationary and disappear if the light is switched on.
Opioid Use (Chronic) - Insomnia
While acute use of opioids may result in increased sleepiness with reduced stage R sleep, chronic use may cause insomnia with increased wakefulness and decreased sleep time.
Unspecified/advanced delay:
a circadian rhythm disorder: increasing of sleep onset latency resulting in changes in sleeping patterns over time with sleep onset occuring at increasingly later hours.
Chronic Insomnia
difficulty initiating & maintaining sleep over prolonged periods of time - has several forms: psychological, sleep-state misperception, hypnotic dependent sleep disorder & fatal familial insomnia.
Primary Insomnia
difficulty initiating and/or maintaining sleep, or having non-refreshing sleep for at least 1 month with onset usually after a stressful episode resulting in impairment of work, study, and social activities.
Cataplexy
sudden and uncontrollable muscle weakness or paralysis that is triggered by a strong emotion such as excitement or laughter; associated with narcolepsy - person is awake and aware of what is happeniing, but cannot move; episodes last up to 2 min: occurs because of the inability to regulate sleep & awake states
Shift Work
work requirements force person to sleep outside the their normal sleep cycle, often resulting in shorter periods of sleep and chronic fatigue.
Alpha
8-13 Hz - Pt is awake w/ eyes closed
Delta
<0.5-4 Hz - NREM 3
Theta
>4-7 Hz - NREM 2
Cheyne - Stokes
10-60 seconds of hyperventilation followed by another period of apnea
Beta
13-30 Hz - Pt is awake w/ eyes open