ABA Sleep Medicine flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Sleep efficiency

Total sleep time divided by time in bed, multiplied by 100 to give a percentage; values below about 85% suggest poor sleep continuity.

Slow-wave sleep

Stage N3 sleep, defined by >20% of an epoch containing 0.5-2 Hz waves with amplitude >75 µV; predominates early in the night.

REM sleep features

Mixed-frequency low-amplitude EEG, rapid eye movements, and lowest chin EMG tone; REM periods lengthen toward morning.

Sleep spindle

A train of 11-16 Hz waves lasting ≥0.5 seconds, a hallmark of stage N2 sleep; helps define N2 onset.

K-complex

A well-delineated negative sharp wave followed by a positive component lasting ≥0.5 seconds; marks stage N2 sleep.

Dim light melatonin onset

The time melatonin rises in dim light, marking circadian phase; typically occurs 2-3 hours before habitual sleep onset.

Delayed sleep phase disorder

Sleep-wake timing delayed >2 hours relative to desired schedule, with normal sleep duration when unconstrained; common in adolescents.

Advanced sleep phase disorder

Sleep onset and wake times shifted earlier than desired, often in older adults, with early evening sleepiness and early morning awakening.

Non-24-hour rhythm disorder

A circadian rhythm slightly longer than 24 hours causing progressive drift in sleep timing; most common in totally blind individuals.

Apnea-hypopnea index

The number of apneas plus hypopneas per hour of sleep; ≥5 with symptoms or ≥15 alone diagnoses obstructive sleep apnea.

Cheyne-Stokes respiration

Cyclical crescendo-decrescendo breathing with central apneas, often seen in heart failure and associated with poor prognosis.

Obesity hypoventilation syndrome

BMI ≥30 with awake PaCO2 >45 mmHg and no other cause of hypoventilation; often coexists with obstructive sleep apnea.

CPAP adherence threshold

Commonly defined as CPAP use ≥4 hours per night on ≥70% of nights; below this, benefit and reimbursement criteria may not be met.

STOP-BANG questionnaire

An eight-item screening tool for OSA risk; a score ≥3 indicates elevated risk and warrants further evaluation.

Chronic insomnia disorder

Difficulty initiating or maintaining sleep ≥3 nights per week for ≥3 months with associated daytime impairment.

CBT-I components

Cognitive behavioral therapy for insomnia includes stimulus control, sleep restriction, cognitive restructuring, and relaxation; first-line for chronic insomnia.

Narcolepsy type 1

Excessive daytime sleepiness with cataplexy and/or CSF hypocretin-1 ≤110 pg/mL, reflecting orexin neuron loss.

Multiple sleep latency test

Four to five nap opportunities after overnight polysomnography; mean sleep latency ≤8 minutes plus ≥2 sleep-onset REM periods supports narcolepsy.

Idiopathic hypersomnia

Excessive daytime sleepiness with long unrefreshing naps and no sleep-onset REM periods; hypocretin is normal.

Restless legs syndrome

An urge to move the legs, worse at rest and in the evening, relieved by movement; diagnosis is clinical.

Periodic limb movements

Repetitive limb movements lasting 0.5-10 seconds, often in series of ≥4, scored during polysomnography.

REM sleep behavior disorder

Dream enactment with loss of normal REM atonia; strongly associated with later synucleinopathies such as Parkinson disease.

Disorders of arousal

NREM parasomnias including confusional arousals, sleepwalking, and sleep terrors, arising mainly from slow-wave sleep.

Polysomnography channels

Standard recording includes EEG, EOG, chin EMG, ECG, airflow, respiratory effort, oxygen saturation, and limb EMG.

Home sleep apnea test

A limited-channel study used in adults with high pretest probability of moderate to severe OSA and no major comorbidity.

Arousal scoring rule

An abrupt EEG frequency shift lasting ≥3 seconds, with or without increased EMG, used to score arousals.

Maintenance of wakefulness test

Measures ability to remain awake in a quiet, dimly lit setting; used in safety-sensitive and treatment-response contexts.

Perioperative OSA risk

Untreated OSA increases difficult airway, postoperative desaturation, and cardiopulmonary complications; CPAP should generally continue when feasible.

ICU sleep disruption

Critical illness causes fragmented sleep with reduced REM and circadian disruption due to noise, light, and frequent interruptions.

Opioid effects on breathing

Opioids depress ventilatory drive and airway tone, potentially causing central apnea and ataxic breathing patterns.

Pediatric OSA causes

Adenotonsillar hypertrophy is the most common cause; adenotonsillectomy is often first-line treatment in children.

OSA comorbidities

Obstructive sleep apnea is associated with resistant hypertension, atrial fibrillation, stroke, and heart failure.