Chapter 8: Sleep-Wake Disorders

Question 1

Dyssomnia

Answer 1

all disordered sleeping that has to do with trouble getting to sleep, trouble maintaining sleep, or complaints about quality of sleep

Question 2

Parasomnia

Answer 2

all disordered sleeping that has to do with abnormal behaviour/physiological during sleep, like sleepwalking or sleep terrrors

Question 3

Chronotype

Answer 3

when you like to go to bed/whether you’re a night or morning person, which is heavily influenced by your environment and circadian rhythm

Question 4

Polysomnographic Evaluation

Answer 4

PSG; the clearest and most comprehensive test for sleep issues
sleep in the lab! :)

Question 5

Insomnia

Answer 5

characterised by complaint of sleep quality for 1/3 reasons
- difficulty initiating sleep
- difficulty maintaining sleep
- early morning awakenings
persisting for 3+mo, 3x a week

Question 6

Etiology for Insomnia

Answer 6

lack of temperature drop when drowsy
differences in usual environment
anxiety because of bedtime preventing sleep
sleep stress: negative pre-sleep routines

Question 7

Treatment for Insomnia

Answer 7

short acting drugs like triazolam and zaleplon
melatonin
benzodiazepines
CBT-I
progressive relaxation
graduated extinction
guided imagery relaxation

Question 8

Rebound Insomnia

Answer 8

when taking a sleeping aid and suddenly withdrawing, symptoms of insomnia return

Question 9

Hypersomnolence Disorders

Answer 9

characterised by a self proclamation of excessive sleepiness despite 7+ hr of sleep
1 of the following:
- recurring periods of sleep/lapses into sleep within the same day
- 9+hr of sleep that is nonrestorative
- Difficulty being fully awake after abruptly awakening
must persist 3x week for 3mo

Question 10

Treatent for Hypersomnolence Disorders

Answer 10

usually involves a stimulant drug
catalepsy can be treated with antidepressants

Question 11

Narcolepsy

Answer 11

characterised by a lapsing or uncontrollable need to sleep
1 of the following catalepsy categories:
- if long standing disease: loss of bilateral muscle tone following laughing or joking, but maintaining consciousness
- In children/people w/i 6mo of onset, spontaneous grimacing or jaw opening episodes with thrusting tongue, no triggers
hypocretin deficiency
REM latency lasts less than 15 minutes

Question 12

Catalepsy + REM

Answer 12

bypasses the sleep cycles and goes straight to REM sleep while fully awake
sleep paralysis also usually comes w/ catalepsy/narcolepsy

Question 13

Breathing Related Sleep Disorders (3)

Answer 13

obstructive sleep apnea hypopnea
central sleep apnea
sleep related hypoventilation

Question 14

Obstructive Sleep Apnea Hypopnea

Answer 14

characterised by 5 interruptions per hour of sleep
nocturnal breathing disturbances

Question 15

Treatment for Obstructive Sleep Apnea Hypopnea

Answer 15

CPAP (continuous positive air pressure machine)
weight loss

Question 16

Central Sleep Apnea

Answer 16

characterised by 5 interruptions per hour of sleep, with a paused respiratory rate that results in waking up
not characterised by daytime sleepiness like others

Question 17

Sleep Related Hypoventilation

Answer 17

characterised by a decreased breathing rate while sleeping, along with elevated CO2 levels, though breathing doesn’t stop

Question 18

Circadian Rhythm Sleep Disorder

Answer 18

characterised by disturbances in sleep due to inability to synchronise sleep patterns to match environmental cues of night and day
can lead to excessive sleepiness or insomnia (or both)

Question 19

Treatment for Circadian Rhythm Sleep Disorder

Answer 19

phase delays: moving bedtime later and later until it is the set time
phototherapy

Question 20

Parasomnia Disorders (3)

Answer 20

nightmare disorder
nonrapid eye movement sleep arousal disorder
rapid eye movement sleep behaviour disorder

Question 21

Nightmare Disorder

Answer 21

characterised by dreams that are usually about a threat to one’s safety, security, or survival, and occur in the second half of a major sleep episode
waking out of sleep alert and oriented

Question 22

Nonrapid Eye Movement Sleep Arousal Disorder

Answer 22

characterised by incomplete awakening followed by either night terrors or sleepwalking
not easily comforted after sleep terrors
sleep walkers are relatively unresponsive
no dream imagery
amnesia of the event

Question 23

Somnambulism

Answer 23

sleep walking

Question 24

Rapid Eye Movement Sleep Behaviour Disorder

Answer 24

characterised by repeated episodes of arousal during sleep with complex vocalisations/motor behaviour, occurring during REM sleep
alert when woken up
1 of the following
- REM sleep w/muscle tone (no atonia)
- history suggestive of REM sleep behaviour disorder

Question 25

Sleep Hygiene

Answer 25

healthy behaviours that prepares the mind and body to go to sleep at a set time
ex: not eating ~6 hours beforehand, not taking stimulants, noise/light reduction