Sleep

Question 0

Stage of sleep absent after first cycle?

Answer 0

1st

Question 1

Four stages of sleep?

Answer 1

1 - theta (1/2 slow waves)
2 - spindles and K complexes
3 - delta (slow waves)
4 - delta (slow waves)
REM

Question 2

REM in infants vs adults?

Answer 2

50% vs 20%

Question 3

Effect of benzodiazepines on sleep? EtOH? Antidepressants?

Answer 3

Suppress stage 3&4

Suppress REM

Question 4

Evaluate sleep disorder with? Monitors?

Answer 4

Polysomnography

EEG, EOMs, air flow, oxygenation

Question 5

Circadian rhythms controlled by?

Answer 5

Suprachiasmatic nucleus of hypothalamus

Question 6

Pathological circadian rhythms? Tx?

Answer 6

#Advanced-sleep phase disorders (sleep/wake early)
#delayed sleep phase disorder (sleep/wake late)

Melatonin/bright light therapy

Question 7

restless leg syndrome associated with what deficiency?

Answer 7

Fe deficiency

Question 8

Treatment of restless legs syndrome? Don’t use? (Why?)

Answer 8

Dopamine agonists (ripoinirole, pramipexole)

Levodopa - augmentation of symptoms (progressively earlier onset)

Question 9

Components of narcolepsy?

Answer 9

Daytime sleepiness with:
#narcolepsy 
#cataplexy (sudden loss of muscle tone with laughter or emotions)
#sleep paralysis
#hypnagogic hallucinations (immediately upon sleeping)

Question 10

Pathophysiology of narcolepsy/cataplexy?

Test?

Answer 10

Loss of hypocretin-secreting cells in hypothalamus

Multiple sleep latency test (MSLT) - positive if latency under 8 min or 2+ REM episodes early

Question 11

Treatment of narcolepsy? Cataplexy?

Answer 11

Modafinil

Clomipiramine or sodium oxabate

Question 12

Somnambulism?

Answer 12

Sleepwalking, -eating, -dressing

Question 13

REM sleep disorders associated with?

Answer 13

PD, Lewy-body, multiple systems atrophy

Question 14

Bruxism?

Answer 14

Teeth grinding during sleep

Question 15

Drug for enuresis?

Answer 15

Imipramine