Clinical Care-Sleep Disorder

Question 1

This stage of sleep is beginning of sleep cycle. light stage that is the transition between wakefulness and sleep

Answer 1

Stage 1

Question 2

This stage of sleep you become less aware of surroundings; breathing and heart rate becomes more regular; people spend ~50% in this stage

Answer 2

Stage 2

Question 3

This stage of sleep is the deepest sleep stage; muscles relax and people are less responsive to noise and activity; delta wave sleep

Answer 3

Stage 3

Question 4

This stage of sleep is when dreams occur in this stage and brain is more active; eyes move rapidly;
“paradoxical sleep”

Answer 4

REM

Question 5

How many REM periods in an average sleep cycle?

Answer 5

4 or 5. one-fourth of the total night’s sleep (1.5-2 hours).

Question 6

When does the first REM period start

Answer 6

The first REM period occurs about 80-120 minutes after onset of sleep and lasts about 10 minutes.

Question 7

How long are later REM cycles ?

Answer 7

Later REM periods are longer (15-40 minutes) and occur mostly in the last several hours of sleep. Most stage 4 (deepest) sleep occurs in the first several hours.

Question 8

this sleep disorder is characterized by Difficulty initiating or maintaining sleep
(a) Common complaints of poor sleep quality or insufficient quantity due to difficulty initiating sleep or maintaining sleep

Answer 8

insomnia

Question 9

what are some factors that lead to sleep issues

Answer 9

(a) Alcohol abuse – alcohol decreases REM sleep
(b) Stimulant abuse – preworkout or caffeine
(c) Tobacco abuse
(d) Psychiatric comorbidities

Question 10

how is insomnia diagnosed

Answer 10

chronic diagnosis established by history and patient report.

Question 11

diagnostic criteria requires the following 4 criteria are met

Answer 11

difficulty initiating sleep, maintaining sleep or waking up too early

sleep difficulties occur despite adequate opportunity

patient has daytime impairment that is attributable to sleep difficulty.

sleep difficulty is not better explained by another sleep disorder or substance abuse

Question 12

DDX of insomnia

Answer 12

(1) Restless legs syndrome
(2) Sleep apnea
(3) Depression

Question 13

TX or short term insomnia (less that one month in duration)

Answer 13

educate and reassurance may be all that is needed.

Question 14

Treatment of chronic insomnia

Answer 14

psychological sleep referral for cognitive behavior therapy.

Question 15

what have been the most widely prescribed true sedative-hypnotic, being safer than barbiturates though they are best for short term use

Answer 15

benzos