ABOHNS Sleep Medicine flashcards

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

Slow-wave sleep

NREM stage N3, defined by high-amplitude delta waves; it predominates in the first third of the night and is linked to restoration and memory consolidation.

Orexin (hypocretin)

Lateral hypothalamic neuropeptide that stabilizes wakefulness; its deficiency causes narcolepsy type 1 with cataplexy and low CSF hypocretin-1.

Process S and Process C

Two-process model in which homeostatic sleep pressure (Process S) and circadian timing (Process C) interact to determine sleep propensity and timing.

K-complex

A high-amplitude biphasic EEG wave that, along with sleep spindles, defines NREM stage N2 sleep.

Apnea-hypopnea index

Number of apneas plus hypopneas per hour of sleep; severity is mild 5-14.9, moderate 15-29.9, and severe 30 or more.

STOP-BANG questionnaire

Eight-item screening tool for OSA risk; a score of 3 or more suggests elevated risk and supports further testing.

Home sleep apnea testing

Limited-channel testing used for adults with high pretest probability of moderate-to-severe OSA; negative results in high-risk patients warrant in-lab polysomnography.

Multiple sleep latency test

Daytime nap study measuring sleep latency and REM onset; mean latency of 8 minutes or less with two or more SOREMPs supports narcolepsy.

Maintenance of wakefulness test

Objective test of ability to remain awake in a quiet setting; used to assess treatment response and fitness for duty, not to diagnose narcolepsy.

Actigraphy

Wrist-worn movement monitor that estimates sleep-wake patterns over days to weeks; useful for circadian disorders and insomnia patterns, not apnea scoring.

Cheyne-Stokes respiration

Crescendo-decrescendo breathing with central apneas, classically seen in heart failure with reduced ejection fraction.

Obesity hypoventilation syndrome

BMI of 30 or more with daytime PaCO2 of 45 mmHg or more and sleep-disordered breathing, without another cause of hypoventilation.

Adaptive servo-ventilation

Positive pressure device that adjusts support to stabilize ventilation in central sleep apnea; contraindicated in symptomatic heart failure with LVEF 45% or less.

Congenital central hypoventilation

Disorder linked to PHOX2B mutations causing inadequate automatic breathing during sleep; requires lifelong ventilatory support.

Pediatric OSA severity

In children, AHI 1-4.9 is mild, 5-9.9 moderate, and 10 or more severe; adenotonsillar hypertrophy is the most common cause.

Adenotonsillectomy

First-line surgical treatment for pediatric OSA with adenotonsillar hypertrophy; residual disease can persist, especially in obese children.

CBT-I

First-line insomnia treatment combining sleep restriction, stimulus control, cognitive restructuring, and relaxation; it outperforms hypnotics in the long term.

Stimulus control

Behavioral insomnia therapy using the bed only for sleep and intimacy, leaving bed when awake, and keeping a fixed wake time.

Delayed sleep-wake phase

Circadian disorder with late sleep onset and late awakening; treated with morning bright light and timed evening melatonin.

Cataplexy

Sudden emotion-triggered loss of muscle tone without loss of consciousness; its presence defines narcolepsy type 1.

SOREMP

Sleep-onset REM period occurring within about 15 minutes of sleep onset; two or more on MSLT support narcolepsy.

Sodium oxybate

Nightly divided-dose medication that treats cataplexy and excessive daytime sleepiness in narcolepsy.

REM sleep behavior disorder

Dream enactment with loss of REM atonia, often later in the night; associated with synucleinopathies and treated with melatonin or clonazepam.

Restless legs syndrome

Urge to move the legs that worsens at rest and in the evening and is relieved by movement; associated with iron deficiency.

Periodic limb movements

Repetitive limb movements lasting 0.5-10 seconds in sequences of four or more; scored during polysomnography and often seen with restless legs syndrome.

Sleep terror

NREM parasomnia arising from slow-wave sleep with abrupt arousal, autonomic surge, and amnesia for the event; common in children.

Depression sleep findings

Major depression is associated with reduced REM latency, increased REM density, and reduced slow-wave sleep; insomnia also predicts relapse.

Prazosin

Alpha-1 antagonist sometimes used for trauma-related nightmares in post-traumatic stress disorder, alongside imagery rehearsal therapy.

Mandibular advancement device

Oral appliance that advances the mandible to reduce upper airway collapse; useful for mild-to-moderate OSA and CPAP-intolerant patients.

Maxillomandibular advancement

Surgery that advances both jaws to enlarge the pharyngeal airway; among the most effective surgical options for selected OSA patients.

Drug-induced sleep endoscopy

Sedated endoscopy used to map levels of upper airway obstruction and guide surgical planning in OSA.

PAP adherence threshold

Common insurance criterion of CPAP use for 4 or more hours per night on 70% or more of nights over a defined period.