Module 18: Sleeping Disorders

Question 1

Dyssomnia

Answer 1

difficulties in getting enough sleep, problems with sleeping when you want to and complaints about the quality of sleep

Question 2

Parasomnia

Answer 2

characterized by abnormal behavior or physiological events that occur during sleep

Question 3

REM Sleep

Answer 3

during which the majority of typical story like dreams occur (20%-25% of total sleep)

Question 4

How many stages are there in REM sleep?

Answer 4

3 stages

Question 5

NREM Sleep Stage 1 (N1)

Answer 5

transition from wakefulness to sleep and occupies about 5% of time spent asleep in healthy adults

Question 6

NREM Sleep Stage 2 (N2)

Answer 6

characterized by specific electroencephalographic waveforms (sleep spindles and K complexes), occupies about 50% of time spent sleep

Question 7

NREM Sleep Stage 3 (N3)

Answer 7

slow wave sleep; deepest level of sleep

Question 8

Sleep Continuity

Answer 8

overall balance of sleep and wakefulness during night of sleep

Question 9

Sleep Latency

Answer 9

amount of time required to fall asleep

Question 10

Wake after Asleep onset

Answer 10

the amount of awake time between initial sleep onset and final awakening

Question 11

Sleep Efficiency

Answer 11

ratio of actual time spent asleep to time spent in bed

Question 12

Sleep Architecture

Answer 12

+ amount and distribution of specific sleep stages
+ measures the amount of REM sleep and each NREM sleep stage, relative amount of REM sleep and NREM sleep stages, and latency between sleep onset and the first REM period

Question 13

What are the different sleeping disorders?

Answer 13

1. Insomnia
2. Hypersomnolence Disorder
3. Narcolepsy
4. Obstructive Sleep Apnea Hypopnea
5. Central Sleep Apnea
6. Sleep-Related Hypoventilation
7. Circadian Rhythm Sleep-Wake Disorders
8. Non-REM Sleep Arousal Disorders
9. Nightmare Disorder
10. REM Sleep Behavior Disorder
11. Restless Legs Disorder

Question 14

Insomnia

Answer 14

+ difficulty initiating and maintaining sleep
+ early-morning awakening with inability to return to sleep
+ situational, persistent, or recurrent, episodic

Question 15

How long should the symptoms of insomnia be before diagnosis?

Answer 15

at least 3 nights/week, for at least 3 months

Question 16

Rebound Insomnia

Answer 16

sleep problems re-appearing, but sometimes worst

Question 17

Hypersomnolence Disorder

Answer 17

+ excessive sleepiness despite having at least 7 hours of main sleep
+ recurrent periods of sleep or lapses into sleep within the same day
+ take longer naps, have trouble waking from naps, and do not feel alert afterward

Question 18

How long should the symptoms of hypersomnolence disorder be before diagnosis?

Answer 18

at least 3x/week, for at least 3 months

Question 19

Narcolepsy

Answer 19

recurrent episodes of irrepressible need to sleep, lapsing into sleep, or napping with cataplexy, hypocretin deficiency, and evidence from polysomnography showing REM sleep latency less than or equal to 15 mins

Question 20

How long should the symptoms of narcolepsy be before diagnosis?

Answer 20

3x/week, for at least 3 months

Question 21

Obstructive Sleep Apnea Hypopnea

Answer 21

at least 4 obstructive apneas or hypopneas per hour of sleep or evidence from polysomnography of 15 or more obstructive apneas and/or hypopneas per hour of sleep

Question 22

Apnea

Answer 22

absence of airflow

Question 23

Hypopnea

Answer 23

reduction in airflow

Question 24

Sleep-Related Hypoventilation

Answer 24

Polysomnography demonstrates episodes of decreased respiration associated with elevated CO2 levels

Question 25

Circadian Rhythm Sleep-Wake Disorders

Answer 25

persistent or recurrent pattern of sleep disruption due to alteration of the circadian system or misalignment between the endogenous circadian rhythm

Question 26

What does Circadian Rhythm Sleep-Wake Disorders lead to?

Answer 26

leads to excessive sleepiness or insomnia, or both

Question 27

Non-REM Sleep Arousal Disorders

Answer 27

+ incomplete awakening from sleep: sleepwalking or sleep terrors + cannot remember anything when they woke up + produce rapid and complete awakening without confusion, amnesia, or motor activity

Question 28

When does Non-REM Sleep Arousal Disorders usually occur?

Answer 28

occur mostly in childhood and non-rem sleeps

Question 29

Nightmare Disorder

Answer 29

repeated occurrences of extended, extremely dysphoric, and well remembered dreams that usually involve efforts to avoid threats to survival, security, or physical integrity

Question 30

What happens to an individual with nightmare disorder when they wake up?

Answer 30

upon awakening, they become oriented and alert

Question 31

Who are the children/individuals who are most likely to experience nightmare disorder?

Answer 31

appear in children exposed to acute or chronic psychosocial stressors

Question 32

When does nightmare disorder usually occur?

Answer 32

occur during REM Sleep

Question 33

REM Sleep Behavior Disorder

Answer 33

repeated episodes of arousal during sleep associated with vocalization and/or complex motor behaviors

Question 34

When does REM Sleep Behavior Disorder usually occur?

Answer 34

during REM sleep

Question 35

What happens to an individual with REM Sleep Behavior Disorder when they wake up?

Answer 35

upon awakening, the individual is completely awake, alert, and not confused

Question 36

Restless Legs Disorder

Answer 36

urge to move the legs, usually accompanied or in response to uncomfortable and unpleasant sensations of the legs

Question 37

When does restless legs disorder usually occur?

Answer 37

during rests

Question 38

What do individuals with restless legs disorder feel during the movement?

Answer 38

sense of relief during the movement

Question 39

When is restless legs disorder the most uncomfortable?

Answer 39

worse in evening

Question 40

How long should the symptoms of restless legs disorder be before diagnosis?

Answer 40

3x/week, for at least 3 months