Sleep

Question 0

Purpose of Pittsburgh sleep quality inventory

Answer 0

overall sleep functioning questionnaire

Question 1

Purpose of Berlin and Stop BANG questionnaires?

Answer 1

OSA sx checklist

Question 2

Epworth questionnaire used for what?

What is the scale cut offs

Answer 2

subjective sleepiness,

scale > 10 sleepy; >18 very sleepy

Question 3

Name the four sleep phases

Answer 3

Stage R (REM)
Stage N1 (drowsy twilight: stage 1)
Stage N2: light NREM
Stage N3/4: deep slow wave NREM sleep

Question 4

What happens to REM sleep and slow wave stage N3 sleep throughout the night?

Answer 4

Increased REM time, decreased N3

Question 5

BMI with increased risk of OSA?

Answer 5

BMI > 30 (mild obesity)

Question 6

biochemical issue in narcolepsy

Genetic finding in narcolepsy/cataplexy?

Answer 6

decreased hypocretin (orexin)
genetics: HLA-DQB1-0602 (85% n/c pts are pos, so are 20% controls)

Question 7

major sx of narcolepsy is ____ NOT ____

Answer 7

excessive daytime sleepiness NOT sleep attacks

Question 8

what is cataplexy?

Answer 8

episodic weakness / loss of tone esp when excited / laughing

Question 9

Abnormal levels on multiple sleep latency test for narcolepsy?

Answer 9

1. < 8 min to fall asleep is pathological sleepiness

2. SOREM: number of REM onset sleep periods > 2 (of 5 naps)

Question 10

What is the maintenance of wakefulness test used for?

Answer 10

Test of treatment effectiveness in narcolepsy: 40 min staying awake w/ eyes closed in chair x 4

Question 11

Drugs for narcolepsy? (3)

Answer 11

Armodafinil (long acting), Modafinil, stimulants

Question 12

Tx for cataplexy (2)

Answer 12

SSRI or Sodium oxybate

Question 13

What is Kleine-Levin syndrome?

Answer 13

hypersomnolence disorder with hypersexuality, intermittent/periodic

Question 14

What terrible disease can be assoc w/insomnia?

Answer 14

fatal familial insomnia: prion dz

Question 15

REstless leg syndrome mainly a problem with what and what is tx besides iron supp

Answer 15

DA issue. use Dopamine agonists like Ropinirole, Pramipexole, Carbidopa/levodopa

Question 16

REM behavior disorder assoc w/ what?

Answer 16

alpha synucleinopathies: PD, Lewy body dementia, multiple system atrophy

Question 17

REM behavior disorder occurs in what % of pts w/ narcolepsy/cataplexy?

Answer 17

1/3

Question 18

Rem behavior sleep disorder MEDICINE caution in narcolepsy?

Answer 18

TCA, SSRI, MAOI can exacerbate RBD in narcolepsy

Question 19

Possible medication treatments for REM behavior sleep disorder?

Answer 19

1. Clonopin
2. Melatonin
3. Pramipexole

Question 20

Med that sleepwalking is associated with

Answer 20

Zolpidem (Ambien)

Question 21

What stage of sleep does sleepwalking occur in?

Answer 21

nonREM: Stage 2/3

Question 22

Medicine with success in sleepwalking?

Answer 22

clonopin

Question 23

sleep terrors arise from what stage of sleep?

Answer 23

Stage N3 (beginning of slow wave sleep)