8. Sleep-Wake Disorders

Question 1

DF: An essential and naturally recurring state of mind and body, characterised by altered reduced consciousness, relatively inhibited sensory activity, and reduced muscle activity

Answer 1

Sleep

Question 2

Stages of sleep

Answer 2

Stage 1: Light sleep, drowsiness and sleep begin
Stage 2: Stable Sleep, brain chemicals block senses
Stage 3: Deep sleep, growth hormone released
Stage 4: REM sleep, revitalises memory, high activity and intense dreaming likely to occur

Question 3

Each cycle of stages of sleep lasts ___-___ minutes

Answer 3

90-120

Question 4

Measurement technologies for sleep

Answer 4

Polysomnography (PSG), Actigraphy, EEG

Question 5

Patterns of change in sleep cycles with age

Answer 5

Longer time to fall asleep,
Less total sleep time
Less time in regular/slow wave/REM sleep

Question 6

Sleep disorders classified by unusual behaviours during sleep

Answer 6

Parasomnias

Question 7

Sleep disorders classified by sleep quantity, quality and timing

Answer 7

Dyssomnias

Question 8

Nightmare Disorder, REM Behaviour Disorder, and NREM Arousal Disorders are classified as:

Answer 8

Parasomnias

Question 9

3 Types of Parasomnias:

Answer 9

1. Nightmare Disorder
2. REM Behaviour Disorder
3. NREM Arousal Disorders

Question 10

Insomnia disorder, Hypersomnolence disorders, Breathing-related sleep disorders, and Circadian rhythm disorders are examples of:

Answer 10

Dyssomnias

Question 11

4 Types of Dyssomnias

Answer 11

1. Insomnia disorder
2. Hypersomnolence disorders
3. Breathing-related sleep disorders
4. Circadian rhythm disorders

Question 12

Parasomnia:
1. Incomplete awakenings from deep sleep that involve motor movements
2. Most often in first third of the night
3. Often triggered by external stimulus which elicits partial awakening

Answer 12

NREM Arousal disorders

Question 13

Recurring episodes of sleepwalking, talking, eating, sex etc. With no/vague memory of episode in the morning are symptoms of:

Answer 13

NREM Parasomnias

Question 14

DF: Frightening experiences during sleep, may be accompanied by screaming, walking, sitting up, only a vague memory of the dream, and amnesia for the event next morning

Answer 14

Sleep terrors

Question 15

Treatments for NREM Arousal Disorders (5 Points)

Answer 15

1. Psycho education
2. Medications (Melatonin, Benzodiazepines)
3. Good sleep Hygiene
4. Stress management
5. Scheduled awakenings (esp. for adolescents)

Question 16

2 Types of REM Parasomnias

Answer 16

1. Nightmare disorder
2. REM-Sleep behaviour disorder

Question 17

Characteristics of REM-Sleep Behaviour Disorder

Answer 17

1. Movement/Vocalisation occurs during REM/dreaming (Typically 2nd half of night)
2. Movements are uncoordinated and aimless (thrashing, unintelligible speech/Vocalisation)
3. Mechanism of muscle atonia (paralysis) in REM sleep dysfunctional

Question 18

Characteristics of Nightmare disorder

Answer 18

1. Disturbing, vivid dreams that awaken the sleeper, 3+ times a week with stress and impairment
2. Typically 2nd half of sleep (REM)
3. Awakening following nightmare can be lengthy

Question 19

Imagery Rehearsal Therapy (IRT) treatment for chronic nightmares is based on the notion that:

Answer 19

Nightmares can become habitual

Question 20

1. Build relaxation/imagery/coping skills
2. Select nightmare to work on
3. Write description of the start fo nightmare
4. Select a way to change the nightmare
5. Write the nightmare with the change
6. Rehearsed the dream with change plus relaxation
7. Rehearsal before bed

Answer 20

Steps for Imagery Rehearsal Treatment (IRT)

Question 21

Dyssomnias: 2 Disorders of excessive daytime sleepiness

Answer 21

Narcolepsy and Hypersomnolence disorder

Question 22

Dyssomnia: Breathing-related sleep disorder

Answer 22

Obstructive Sleep Apnea

Question 23

Neurological disorder characterised by excessive daytime sleepiness, recurrent episodes of irrepressible need to sleep, and episodes of sleep and cataplexy triggered by strong emotion

Answer 23

Narcolepsy

Question 24

Treatments for narcolepsy

Answer 24

Stimulant medications
Psychological/behavioural interventions

Question 25

Like narcolepsy, experience excessive daytime sleepiness, lethargic despite normal or greater night-time sleep duration, unrefreshing sleep

Answer 25

Idiopathic Hypersomnia

Question 26

Blocked airway during sleep causes reduction in blood oxygen levels

Answer 26

Obstructive Sleep apnea

Question 27

DF: Dissatisfaction with sleep quantity/quality, which causes significant distress or impairment in social, occupational, behavioural or other important areas

Answer 27

Insomnia disorder