Chapter_10 sleep disorders_Q&A Flashcards
What are the two main types of sleep?
Non-REM sleep and REM sleep.
What are the four stages of sleep?
Stage 1, Stage 2, Stages 3 & 4 (Delta sleep), and REM sleep.
Which stage of sleep is associated with sleep spindles and K-complexes?
Stage 2.
Which sleep stage is the deepest and most restorative?
Stages 3 & 4 (Delta sleep).
What is the typical duration of a sleep cycle?
Approximately 90 minutes.
How does sleep architecture change with aging?
Elderly individuals have reduced REM and delta sleep.
Which neurotransmitter increases REM sleep?
Acetylcholine.
Which neurotransmitter decreases REM and sleep efficiency?
Norepinephrine.
Which neurotransmitter is responsible for increasing sleep efficiency and delta sleep?
Serotonin.
What are the three main categories of sleep disorders in DSM-5?
Sleep-wake disorders, breathing-related sleep disorders, and parasomnias.
What is the definition of insomnia?
Difficulty initiating or maintaining sleep for more than one month.
What are common causes of insomnia?
Psychiatric conditions (depression, anxiety), medical conditions, and medication use.
What is the primary non-pharmacological treatment for insomnia?
Cognitive-behavioral therapy (CBT) and sleep hygiene.
What are the hallmark symptoms of narcolepsy?
Key Features (Mnemonic: “CHESS”)
1. Cataplexy – Sudden loss of muscle tone triggered by strong emotions (e.g., laughter). 2. Hypocretin deficiency – Found in cerebrospinal fluid (CSF) of narcolepsy type 1. 3. Excessive daytime sleepiness (EDS) – Persistent sleepiness despite sufficient sleep. 4. Sleep paralysis – Temporary inability to move upon waking or falling asleep. 5. Sleep-related hallucinations – Hypnagogic (while falling asleep) or hypnopompic (while waking up).
Which test is used to diagnose narcolepsy?
Diagnosis
1. Polysomnography (PSG) – Rules out other sleep disorders. 2. Multiple Sleep Latency Test (MSLT) – Measures sleep onset REM periods (SOREMPs). • Narcolepsy criteria: ≤ 8-minute sleep latency and ≥ 2 SOREMPs. 3. CSF Hypocretin-1 levels – Decreased in Type 1 narcolepsy.
Which drugs are used to treat narcolepsy?
Stimulants (modafinil, methylphenidate) and sodium oxybate.
Detailed::: Treatment (Mnemonic: “WISE”)
• Wake-promoting agents (Modafinil, Armodafinil, Solriamfetol).
• Impulse-control medications (Sodium oxybate for cataplexy and EDS).
• Stimulants (Amphetamines, Methylphenidate).
• Emotional stability (Antidepressants like SSRIs, SNRIs, or TCAs for cataplexy).
What is the difference between obstructive and central sleep apnea?
Obstructive sleep apnea involves upper airway obstruction, while central sleep apnea results from impaired brainstem control.
What is the primary treatment for obstructive sleep apnea?
Continuous positive airway pressure (CPAP).
What lifestyle modification is recommended for sleep apnea?
Weight loss and avoiding alcohol/sedatives.
What are the key features of sleep terrors?
Sudden fear episodes, no recall, occurs in non-REM sleep.
How do nightmares differ from sleep terrors?
Nightmares occur in REM sleep and are vividly recalled, while sleep terrors occur in non-REM sleep and are not recalled.
What is sleepwalking and when does it occur?
Ambulation during sleep, occurring in delta (slow-wave) sleep.
Which disorder involves acting out dreams due to loss of muscle atonia?
REM Sleep Behavior Disorder (RBD).
Which neurological condition is associated with REM Sleep Behavior Disorder?
Parkinson’s disease.
What is the first-line treatment for REM Sleep Behavior Disorder?
Clonazepam and melatonin.
Which disorder is characterized by excessive daytime sleepiness without cataplexy?
Hypersomnolence disorder.
Which neurotransmitter is deficient in narcolepsy with cataplexy?
Hypocretin (Orexin).
What is delayed sleep phase syndrome?
A circadian rhythm disorder where individuals have a sleep onset much later than normal.
What is the first-line treatment for delayed sleep phase syndrome?
Chronotherapy and light therapy.
What medication is commonly used for shift work sleep disorder?
Modafinil.
Which sleep disorder is associated with profound snoring and daytime fatigue?
Obstructive sleep apnea.
What are some common sleep hygiene recommendations?
Regular sleep schedule, avoiding caffeine before bedtime, and reducing screen time before sleep.
What is the gold standard test for diagnosing sleep apnea?
Polysomnography (sleep study).
What is the treatment for circadian rhythm disorders?
Bright light therapy, sleep schedule regulation, and melatonin.
