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Feeding/Eating and Sleep-Wake Disorders: Alyson Morgan, MS3 Ross University School of Medicine
Feeding/Eating and Sleep-Wake Disorders: Alyson Morgan, MS3 Ross University School of Medicine
Sleep-Wake Disorders
Alyson Morgan, MS3
Ross University School of Medicine
Feeding and Eating Disorders
Anorexia Nervosa
▪ Electrolyte and fluid shifts when severely malnourished pts are refed
– Fluid retention, decreased phosphorus, magnesium, and calcium
▪ REM
– Waking = vivid dream recall
Sleep Disorders
▪ Dyssomnias
– Insufficient, excessive, or altered timing of sleep
▪ Parasomnias
– Unusual sleep-related behaviors
▪ Hx: be sure to ask about Activities prior to bedtime, Bed partner hx,
Consequence on waking function/quality of life, Drug regimen,
Exacerbating/relieving factors, Frequency/duration, Genetic
factor/FHx, Habits (alcohol, caffeine, nicotine, illicit substances,
hypnotics)
Dyssomnias
▪ Insomnia disorder
– Acute (<3 months) or chronic (>3 months
– Change in duration and/or quality of sleep
▪ Sleep-onset, Sleep-maintenance insomnia or Non-restorative sleep
– Tx: sleep hygiene, CBT, pharmacotherapy
▪ BZs, non-BZs (ambien, lunesta, sonata), antidepressants (trazodone, amitriptyline,
doxepin)
▪ Hypersomnolence disorder
– Excessive quantity of sleep, reduced wakefulness, and sleep drunkenness
– Tx: life-long therapy w/ modafinil or stimulants (atomoxetine second-line) and
scheduled napping
Dyssomnias
▪ Sleep-related hypoventilation
– Decreased respiration w/ increased CO2
– Sxs: frequent arousals, morning HA, insomnia, excessive daytime sleepiness
– Tx: CPAP/BiPAP, breathing promoters (bronchodilators, theophylline), treat
underlying condition
▪ Narcolepsy
– Recurrent need to sleep, lapsing into sleep, or daytime napping ≥3 times/wk for
≥3 months w/ one of following: cataplexy, hypocretin deficiency, reduced REM
– Associated w/ hypnagogic and hypnopompic hallucinations
– Tx: sleep hygiene, scheduled naps, avoidance of shift work, supportive
▪ Daytime sleepiness (stimulants), cataplexy (SSRIs/SNRIs)
Dyssomnias