Sleep Disorders (Insomnia, RBD, Sonmalbulism, sleep apnea, nacelepsy)

Primary Insomnia

Sleep difficulty that is not caused by any other underlying health, psychiatric, or environmental condition.

Secondary (Comorbid) Insomnia

Sleep difficulty that is a symptom of another specific medical issue (e.g., pain, depression, medication side effect).

CBT-I (Treatment)

Cognitive-Behavioral Therapy for Insomnia—the gold-standard, long-term, non-medication treatment.

Stimulus Control Therapy (SCT)

A behavioral CBT-I technique designed to extinguish the conditioned link between the bed/bedroom and wakefulness/anxiety. (Rule: Get out of bed if awake for 20 minutes.)

Sleep Restriction Therapy (SRT)

A behavioral CBT-I technique that limits time in bed to build up the homeostatic sleep drive (sleep pressure), improving sleep efficiency.

Sleep Efficiency (SE)

The percentage of time spent in bed that a person is actually sleeping. SRT aims to increase this number.

Night Terror

NREM Stage 3 (SWS) (Deep Sleep) Partial arousal, intense fear/screaming, Amnesia (no memory of the event). Typically benign; common in children.

Sleepwalking (Somnambulism)

NREM Stage 3 (SWS) (Deep Sleep) Body can move because atonia is not active in this stage. Behaviors are simple and routine (cerebellum/subcortical-driven). Low danger, but poses risk of accidental injury.

Nightmare

Ocurrs in REM Body is paralyzed by atonia. Wakes easily, with clear memory of the frightening dream.

REM Sleep Behavior Disorder (RBD)

Ocurrs in REM, Atonia failure; the person physically acts out complex dreams. High long-term risk; a powerful early sign of neurodegenerative disease.

Lewy Bodies

Specific protein clumps that first damage the brainstem (causing RBD) and later spread to the substantia nigra (causing Parkinson's). Shared pathology makes RBD a strong predictor of Parkinson's.

Core physical problem in Obstructive Sleep Apnea (OSA)

The upper airway collapses or is obstructed during sleep.

Three most noticeable nighttime symptoms of OSA

1. Loud, chronic Snoring. 2. Breathing Pauses. 3. Forceful Gagging/Gasping/Choking to reopen the airway.

Most significant consequence of fragmented sleep during the day

Excessive Daytime Sleepiness (EDS), leading to fatigue, irritability, and poor concentration.

Chronic health condition most directly linked to OSA

Hypertension (High Blood Pressure).

Two most serious life-threatening events linked to untreated OSA/Hypertension

Stroke and Heart Attack (or heart failure).

Most common and effective treatment device for OSA

CPAP (Continuous Positive Airway Pressure) machine.

Orexin (or Hypocretin)

The chemical that stabilizes wakefulness, missing in Type 1 Narcolepsy (NT1).

Cataplexy

The sudden loss of muscle tone triggered by a strong emotion (like laughter or surprise).

Narcolepsy Tetrad

The four major symptoms of NT1: 1. Excessive Daytime Sleepiness (EDS) 2. Cataplexy 3. Sleep Paralysis 4. Hypnagogic Hallucinations.

Multiple Sleep Latency Test (MSLT)

The full name of the test used to diagnose narcolepsy by measuring how quickly a person enters REM sleep.

Stimulants

The primary class of medication used to treat the EDS symptom by compensating for the lack of Orexin by boosting dopamine and norepinephrine.