sleep

Question 1

can’t initate (> 30 min) or maintain sleep (

Answer 1

insomnia

Question 2

secondary insomnia

Answer 2

depression: early morning wakening
anxiety: initiate or maintain
shift work: initate
caffeine/diet pills/alcohol
sleep disorder

Question 3

crawling or aching sensation of legs at night
relieved with movement or stretching legs
associations: iron deficiency, anxiety, depression, PD, pregnancy, CKD, spinal cord injury, RA
meds: SSRI, antihistamine, antipsychotic, lithium, TCA, caffeine

Answer 3

RLS

Question 4

daytime drowsiness, fatigue
overweight
loud snoring
HTN due to chronic hypoxemia
edema from cor pulmonale

Answer 4

OSA

Question 5

severity of OSA

Answer 5

apnea-hyponpnea index

number apnea events or hypopnea (reduction in airflow)

Question 6

falling asleep during day

Answer 6

OSA

narcolepsy

Question 7

if think RLS then order

Answer 7

serum ferritin to r/o IDA

Question 8

if think narcolepsy need

Answer 8

smultipleep l leatency test

Question 9

if think OSA need

Answer 9

polysomnography

Question 10

treatment of acute insomnia

Answer 10

non-BZD: zolpidem

Question 11

treatment of chronic insomnia

Answer 11

CBT

Question 12

treatment of narcolepsy

Answer 12

stimulant: modafinil

if mod-severe: daytime naps