Ch. 28: Sleep-Wake Disorders

Question 1

What is sleep and its two stages?

Answer 1

Sleep is a behavioural & physiologic state of temporary disconnection from the environment.
Two stages:
1. Non-rapid eye movement (sleep architecture, sleep hypnogram, sleet efficiency)
2. Rapid Eye movement

Question 2

What is the two-process model that describes the sleep-wake cycle?

Answer 2

Process C & Process S oppose each other.
Process S - sleep need
Process C - circadian timing

Question 3

What are the most common primary sleep disorders in older adults?

Answer 3

Insomnia
Sleep disordered breathing
REM sleep behaviour disorder
Restless legs syndome

Question 4

Sleep disturbances are commonly seen in which psychiatric illnesses?

Answer 4

PTSD - insomnia & nightmares
Depression
Panic disorder - awakened by panic attack

Question 5

What are biologic factors that predispose an individual to chronic insomnia?

Answer 5

Genetics
Hyperactivity
Hypervigilance
Increased metabolic rate
Chronically elevated cortisol or reduced melatonin levels

Question 6

What is most commonly used medication for treatment of insomnia?

Answer 6

Benzodiazepines (lorazapam) and Benzodiazepine receptor agonist (zoplicone)

Question 7

What is the most common sleep-related breathing disorder?

Answer 7

Obstructive sleep apnea
Signs & symptoms:
snoring, witnessed apneas, and restless sleep

Risk factors for developing OSA: 
Body mass index (>35) 
Age (>50)
Neck size (>40cm)
Gender (male)

Question 8

What is treatments for OSA?

Answer 8

Continuous positive airway pressure therapy
surgical treatments
oral appliances
weight loss

Question 9

What is jet lag?

Answer 9

occurs when a person travels by air across several time zones in short period of time. Person’s internal clock is out of phase with light-dark cycle of the destination.