circadian rhythm disorders

Question 1

what is delayed sleep phase disorder

Answer 1

chronic or recurrent delay in sleep onset and awakening times with preserved quality and duration.

Question 2

what are the risk factors for DSPD

Answer 2

puberty secondary to temporal changes in melatonin secretion. caffeine and nicotine use. irregular sleep schedules.

Question 3

what is the treatment for DSPD

Answer 3

timed bright light during the early morning. administration of melatonin in the evening or chronotherapy –delaying bedtime by a few hours each night.

Question 4

what is advance sleep phase disorder

Answer 4

normal duration and quality of sleep with sleep onset and awakening times earlier than desired.

Question 5

what is the risk factors for ASPD

Answer 5

old age.

Question 6

what are the treatments for ASPD

Answer 6

timed phototherapy prior to bed time. can give melatonin in the morning, but this is not recommended because it can cause day time sedation in the elderly.

Question 7

what is shift-work disorder

Answer 7

sleep deprivation and misaligned of circadian rhythm secondary to ontraditional workhours.

Question 8

what are the risk factors for SWD

Answer 8

night shift work, rotating shifts, shifts > 16hours, being a medical/psychiatry resident.

Question 9

what are the treatments for SWD

Answer 9

avoid risk factors, bright light therapy to facilitate rapid adaptation to night shift, modafinil

Question 10

what is jet lag disorder

Answer 10

sleep disturbances associated with travel across multiple time zones.

Question 11

what are the risk factors for jet lag disorder

Answer 11

recent sleep deprivation.

Question 12

what is the treatment for jet lag disorder

Answer 12

disorder is usually self limiting and generally resolve 2-3 days after travel.

Question 13

what are the features of sleep walking

Answer 13

during slow-wave sleep, complex behaviors.

Question 14

are the dreams in sleep walking remembered

Answer 14

NO. there is usually amnesia of the event.

Question 15

what are the treatments for sleep walking

Answer 15

Nothing. reassurance. this is self-limited. and usually not associated with any underlying psychological or psychiatric disease.

Question 16

sleep terrors features

Answer 16

sudden terror arousals usually beginning with screaming or crying that occur in slow wave sleep. there are signs of autonomic arousal including tachycardia, tachypnea, diaphoresis, mydriasis.

Question 17

are the dreams in sleep terrors remembered?

Answer 17

NO.

Question 18

what are the treatments for sleep terrors

Answer 18

reassurance, this is usually self-limited,. same as sleep walking.

Question 19

nightmare disorder features

Answer 19

frightening dreams that occur in the second half of the sleep episode. terminate in awakening with vivid recall. no confusion or disorientation when awakened. causes clinically significant distress or impairment of functioning

Question 20

what is the treatment for nightmare disorder

Answer 20

desensitization.image reversal therapy. prazosin or antidepressants can be used.

Question 21

REM sleep behavior disorder

Answer 21

arousals with vocalization or complex motor behavior more common in the second half os the sleep episode. lack of muscle atonia in REM. no confusion of disorientation when awoken. presenting compliant is often violent behaviors resulting in injury to partner.

Question 22

what are the risk factors for REM

Answer 22

older age, use of psychiatric medications, neurodegenerative diseases especially Parkinson’s, multiple system atrophy, neurocognitive disorder and Lewy body.

Question 23

what is the treatment for REM sleep behavior

Answer 23

clonazepam