HBM 08b: Sleep Flashcards
In active mental concentration, EEG, will show predominantly (X) waves.
X = beta
In awake, relaxed/drowsy person, EEG, will show predominantly (X) waves.
X = alpha
Fast-wave EEG characterizes which sleep state?
REM
Non-REM sleep makes up (X)% of sleep time. It has waves of (high/low) frequency and (high/low) amplitude.
X =75
Low; high
Stage 1 sleep lasts (X)% of sleep time and characterized by (Y) wave(s).
X = 5 (very short) Y = theta
Stage 2 sleep lasts (X)% of sleep time and characterized by (Y) wave(s).
X = 45 Y = spindle-shaped (sleep spindles) and K-complexes
Stages 3 and 4 are collectively called (X) sleep and lasts (Y)% of sleep time and characterized by (Z) wave(s).
X = delta/slow-wave Y = 25 Z = slow
Bruxism is (X) and usually occurs in (Y) sleep stage.
X = tooth grinding Y = Stage 2
Sleepwalking usually occurs in (X) sleep stage.
X = delta
Enuresis usually occurs in (X) sleep stage.
X = delta
Night terrors usually occurs in (X) sleep stage.
X = delta
Sawtooth waves in EEG indicate:
REM sleep
Dreaming occurs in which part of sleep time?
REM
REM takes up (X)% of sleep time.
X = 25
Average time until first REM, aka (X), is how long?
X = REM latency
90 minutes
Shortened REM latency can be seen in which disorders?
- MDD
2. Narcolepsy
Patients normally experience REM in periods of (X) minutes, occurring every (Y) minutes.
X = 10-40 Y = 90
Sympathetic activity is (activated/suppressed) in REM.
Suppressed
Penile/clitoral erection occur in which part of sleep?
REM
T/F: all skeletal muscles are completely paralyzed during REM sleep.
False - all skeletal muscles except those controlling respiration, eye movement, and middle ear ossicles
How does sleep latency change with age?
Prolonged
Total sleep time is (increased/decreased/unchanged) with aging.
Decreased
(Decrease/increase/unchanged) number of nighttime wakings in depression.
Increased
List the parasomnias.
- Bruxism
- Nightmare disorder
- Sleep terror
- Sleepwalking
- REM sleep behavior disorder
(X) agents can be beneficial for insomnia due to sedating side effects. Why should they be avoided in (Y) patients?
X = antihistamine (ex: diphenhydramine/benadryl) Y = elderly
Can provoke delirium
A 70-year old patient comes into clinic, requesting medication to relieve insomnia. What’s the best med to prescribe and why?
Trazodone (Desyrel), a sedating antidepressant; prescribing antihistamines in elderly can cause delirium
(X) meds can be useful for treating delta sleep disorders, such as (Y). Why?
X = benzodiazepines Y = night terrors and bedwetting
Reduce likelihood of delta sleep
Initial management of insomnia is:
caffeine avoidance and good sleep hygiene
Central sleep apnea can be described as:
Open airway, but little to no respiratory efforts
Obstructive sleep apnea can be described as:
Airway obstruction preventing air from reaching lungs, despite respiratory efforts
Central sleep apnea commonly found in:
Elderly
Obstructive sleep apnea commonly found in:
Male and obese patients (40-60 y.o.)
Daytime sleepiness resulting from airway obstruction is called (X) syndrome.
X = Pickwickian
CPAP stands for (X) and is used to treat (Y).
X = Continuous positive airway pressure (device) Y = obstructive sleep apnea
T/F: Antidepressants are used to treat sleep apnea.
True - act as respiratory stimulants
Cataplexy is (X) and seen in which disorder?
X = sudden physical collapse, due to loss of all muscle tone after strong emotional stimulus
Narcolepsy
Treatment for narcolepsy
Stimulant agents (ex: ritalin); timed daytime naps can also help
Sleep is regulated by which systems?
- Sleep drive
2. Body clock (circadian rhythm)
Sleep drive is a result of (X) build-up.
X = adenosine
Circadian rhythm is controlled by:
SCN (suprachiasmatic nucleus)
SCN is located in which part of brain?
Hypothalamus
SCN responds to (X) signals by controlling (Y).
X = Light/dark signals Y = release of melatonin (hormone)
List some dyssomnias.
- Insomnia
- Breathing-related disorders
- Narcolepsy
- Hypersomnias
- Circadian rhythm sleep disorder
Insomnia is seen in (X)% of population.
X = 30 (common)
Insomnia affects (males/females) more often.
Females (twice as often)
Patients with narcolepsy go right into which sleep stage during a sleep attack?
REM
T/F: Narcolepsy is a fairly common sleep disorder.
False - rare (0.03-0.16% of population)
Narcolepsy often seen in (males/females) and has an onset at which age range?
Seen in M/F equally; onset during adolescence
Hypnagogic hallucinations are associated features of:
Narcolepsy
Circadian rhythm disorders present with (insomnia/excessive sleepiness).
Either or
(Light/darkness) stimulates (X) hormone release from (Y).
Darkness;
X = melatonin
Y = SCN
Jet lag is a type of (X) disorder.
X = circadian rhythm
Combined treatments are useful for which dyssomnias?
Insomnia only (short-term med and psychotherapy)
Parasomnias occur during (REM/non-REM) sleep.
Could occur during either
Nightmare disorder occurs during which sleep stage?
REM
T/F: Nightmare disorder interfere with daily life functioning.
True
Nightmare disorder is more common in (children/adults/elderly).
Children
Treatment for nightmare disorder may involve:
Antidepressants and/or relaxation training
Piercing scream during sleep is often indicative of which disorder?
Night terror disorder
Night terror disorder is more common in (children/adults/elderly).
Children
In (night terror/nightmare) disorder, child can’t be easily awakened.
Night terror
In (X) disorder, a dyssomnia, patient has little memory of event the next day.
X = night terror
Usually, the best treatment(s) for sleep terror disorder involve:
Waiting (they go away on their own) and/or relaxation techniques
In severe sleep terror disorders, (X) used for treatment.
X = antidepressants or benzodiazepines
T/F: It’s both dangerous and difficult to wake a sleepwalker.
False - difficult, but not dangerous
