Sleep Flashcards
Sleep is NREM 75% of the time T/F
T
Alpha waves predominate when the eyes are open T/F
F awake is beta waves
Which type of brainwaves predominate when?
Awake eyes open - beta Awake eyes closed - alpha N1/Stage 1 - theta N2/Stage 2 - sleep spindles & K complexes N3/ Stages 3&4 - delta “slow wave sleep”
When after falling asleep does REM usually occur?
After 90 minutes
Which part of the brain is crucial for REM sleep?
The pons
REM sleep mostly occurs when in the sleep period?
Last 1/3
Insomnia disorder has to persist for how long in DSM V?
Three nights a week for three months
Insomnia disorder affects men more than women T/F
F women predominate
Prevalence of insomnia disorder in a) adults and b) elderly
a) 6-10% gen pop, b) 25% elderly
Most insomnia disorder has a sudden onset precipitated by a stressor T/F
T
Strongest RF for insomnia
Previous insomnia
Having a regular waking time strengthens circadian synchrony T/F
T
Having a light bedtime snack can promote sleep by reducing hypoglycaemia T/F
T
In sleep restriction bedtime is constant and wake time are adjusted T/F
F it’s the other way round
Pharmacological therapy is only indicated for short term insomnia less than 2/52 T/F
T
Zopiclone is a benzodiazepine receptor agonist T/F
T
There is an association between hypersomnolence and Raynauds T/F
T apparently
What is the gold standard measure of daytime sleepiness?
The MLST multiple sleep latency test
Modafinil can be used to treat hypersomnolence disorder T/F
T less potential for abuse. 100-400mg qam
In Kleine-Levin syndrome periods of sleepiness are associated with what?
Disinhibition, derealisation, hypersexuality, compulsive overeating, poss irritability and confusion in some
K-L syndrome is M:F = 3:1 T/F
T
K-L syndrome shows familial aggregation T/F
F
Narcolepsy definition
Recurrent periods of irrepressible need to sleep, or napping in the same day, 3/week for 3/12
DSM V criteria for narcolepsy (3)
- Cataplexy at least a few a month
- Hypocretin deficiency measured by CSF Hypocretin (it can’t be due to brain injury, inflammation or infection
- Nocturnal sleep PSG demonstrates REM latency
Dreaming in narcoleptic sleep attacks is rare T/F
F it’s the norm
Cataplexy in narcolepsy is usually a presenting feature T/F
F it usually starts several years after the sleepiness onset
In cataplexy full consciousness and alertness is preserved during the episode T/F
T
Cataplexy is usually triggered by strong emotions T/F
T
Prev of hypnogogic and hypnopompic hallucinations in the genpop
10-15%
Sleep paralysis affects 20-60% of narcoleptics T/F
T
Narcolepsy prevalence
0.02-0.04%, poss slight male preponderance
Which HLA marker do almost all narcoleptics have?
HLA-DQB1*0602
Gold standard for diagnosis of narcolepsy
CSF Hypocretin
In narcolepsy paralysis/ hallucinations and cataplexy can be treated with what?
REM suppressants like TCAs and SSRIs
You need PSG to diagnose OSA T/F
T
OSA diagnostic criteria
Either 1) PSG évidence of 5 episodes/hour of apnea with breathing disturbances or 2) PSG 15 episodes/ hour with no sx
OSA has a strong genetic basis T/F
T
Define NREM sleep arousal disorder according to DSM
Recurrent episodes of incomplete awakening from sleep, usu in the first 1/3 of sleep, accompanied by one of the following: 1) sleepwalking 2) sleep terrors
NREM sleep arousal disorders are usually accompanied by amnesia T/F
T
Peak prevalence of sleep walking
4-8 years
Sleepwalking F>M in childhood and M>F in adulthood T/F
T
80% of sleepwalkers/terrors have a family history T/F
T
Sleepwalking in adults is associated with MDE and OCD T/F
T
Nightmares occur during REM T/F
T
Treatment for PTSD nightmares
Prazosin
Image rehearsal therapy is a treatment for nightmares T/F
T
What is this: repeated episodes of arousal during REM sleep associated with vocalisations and/or complex (often violent) motor behaviours
REM sleep behaviour disorder
RSBD most common in whom?
Old men
Diagnostic test for RSBD
Polysomnography
Things associated with restless leg syndrome
- Anemia/ low iron stores
- Pregnancy
- Renal failure
- Rheumatoid arthritis
- Diabetes
- Thyroid abnormalities
- Peripheral nerve dysfunction
- Alcohol, caffeine, nicotine
- Most antidepressants, antipsychotics and antihistamines
There is a family history in 50-90% of cases of restless leg syndrome T/F
T
Alcohol decreases sleep latency T/F
T
Chronic alcohol is associated with increased SL sleep T/F
T
Depression is associated with reduced rem latency T/F
T
MDE is associated with increased REM density T/F
T
Reduced slow wave sleep and REM in dementia T/F
T
According to Freud what is the name of the phenomenon when one’s dream object stands for several associations and ideas?
Condensation
Chronic alcohol is associated with decreased REM T/F
T
