SLEEP

Question 1

adult time in REM?

NREM?

Answer 1

25%

75%

Question 2

Sleep promotingNT?

Answer 2

Ach

Question 3

NREM control?

REM control?

Answer 3

hpothalamus and other

Pons and other

Question 4

Klein Levin, runs in families?

Answer 4

NO

Question 5

Tx of these DO:
Hypersomnolence
narcolepsy attacks

all REM intrusion (sleep paralysis, cataplexy, hallucinations)
cataplexy

nightmare DO
NREM sleep arousal DO (night terror, walking)

REM sleep beh DO
RLS, PLMD

OSA
delayed phase
advanced phase

Answer 5

modafinil
modafinil

TCA, SSRI, Venlafaxine (REM suppressants)
soduim oxybate (will also decrease attacks, deep sleep)

TCA, SSRI, Venlafaxine (REM suppressants)
TCA, SSRI, (suppress non REM, too) benzos too, but can worsen

Clonazepam,DA agents second
dopaminergic agents , clonazepam 2nd

CPAP, avoid sedatves, wt loss
early light, melatonin at night
evening light

Question 6

% of narcolpesy patients who experience sleep paralysis and hallucinations

Answer 6

20-60%

Question 7

narcolepsy familial?

peaks?

Answer 7

yes, HLA
15-25, 30-35
mostly grade 9

Question 8

gold standard to dx narcolepsy:

Answer 8

low CSF hypocetin 1

Question 9

family hx in?

Answer 9

narcolepsy, HLA
NREM sleep arousal DO 60-80%
RLS 50%-90%
delayed sleep phase 40%
advanced sleep phase, AD circadian gene mutations

Question 10

PLMD and RLS

Answer 10

do not occur in REM cuz ur paralyzed
iron deficiency in basal ganglia
may predict synucleinopathies