Sleep

Question 1

EEG wave when awake and alert

Answer 1

Beta

Question 2

EEG wave when awake, but eyes closed, relaxed

Answer 2

Alpha

Question 3

EEG wave during N1 stage of sleep

Answer 3

Theta

Question 4

EEG wave during Stage N2 sleep

Answer 4

Sleep spindles and K complexes

Question 5

Stage N3 EEG wave

Answer 5

Delta (lowest frequency, highest amplitude)

Question 6

EEG wave during REM sleep

Answer 6

Beta

Question 7

When does bruxism occur

Answer 7

Stage N2; is grinding teeth

Question 8

What is the deepest non-REM sleep

Answer 8

N3; 25% of sleep time in young adults

Question 9

longest phase of sleep (most time)

Answer 9

N2

Question 10

When do slepwalking, night terrors, and bedwetting occur (phase)

Answer 10

N3

Question 11

When does dreaming occur?

Answer 11

REM

*also boners, loss of motor tone

Question 12

Extraocular movements during REM due to activity of what

Answer 12

Paramedian pontine reticular formation (PPRF)

Question 13

Principal NT in REM sleep? What NT reduces REM sleep?

Answer 13

ACh is primary; NE reduces

Question 14

What two drugs shorten N3 sleep?

Answer 14

1. Imiprimine

2. Benzos

Question 15

What is the cause of cataplexy in narcoleptic pts?

Answer 15

They immediately go into REM sleep, so get muscle paralysis and fall where they stand

Question 16

What common drug for insomnia should be avoided in the elderly

Answer 16

Antihistamines

Question 17

What should be done before starting a pt on a TCA for insomnia?

Answer 17

Get EKG; risk of arrhythmias

Question 18

Which sleep med can be used long-term per FDA

Answer 18

Eszoplicone (lunesta)

Question 19

Difference between Zolpidem and Ramelteon MOA?

Answer 19

Zolpidem–> acts as benzo receptor, so rebound insomnia when withdrawn
Ramelteon–> works at melatonin receptor (non-addictive); but avoid w/ hepatic insufficiency

Question 20

1st line tx for narcolepsy

Answer 20

modafinil (stimulant)

Question 21

3 options for tx of cataplexy in narcoleptics

Answer 21

1. Venlafaxine
2. Fluoxetine
3. Atomoxetine (mild stim.)

*antidepressant work by increasing NE and helping prevent sudden onset of REM sleep and thus cataplexy