sleep

Question 1

sleep is

a) a rapid reversible state of altered consciousness.
b) rapid irreversible state of altered consciousness.
c) state unconsciousness
d) none of the above

Answer 1

A

Question 2

@wakefulness, brain stem’s arousal centres project to the _________

Answer 2

thalamus+ CX

Question 3

@night, ___________ signals for the arousal systems to stop

Answer 3

ventralateral preoptical area

Question 4

The homeostatic sleep load _________ throughout the day and peaks at________

Answer 4

increases; 9pm ish to signal sleepiness

Question 5

the circadian process promotes__________ . After peaking it produces________

Answer 5

wakefulness; melatonin

Question 6

Stage 3+ 4 sleep were combined to being labelled_________

Answer 6

SWS

Question 7

Sleep disorders can be diagnosed with___________

Answer 7

DSM or ICD

Question 8

The broad categories of sleep disorders are__________

Answer 8

Insomnia disorder
nightmare disorder
REM sleep behaviour disorder

Question 9

Diagnostic features of insomnia disorder

Answer 9

o early morning awakening
o Sleep Initiation problems
o Poor sleep quality 
o Daytime impairment
Clinically significant distress/impairment 
Occur DESPITE opportunities for sleep

Question 10

Insomnia disorder symptoms must be present for ___________

Answer 10

3+ times a week for 3+ months

Question 11

The INCORRECT statement is;

a) Insomnia may be caused by offset body clock which causes hyperarousal
b) may be caused by Extrinsic factors i.e. noise
c) Insomnia is underdiagnosed
d) none of the above

Answer 11

D - all true

Question 12

Insomnia is more common in females, why might this be

Answer 12

Different lifestyle factors i.e. waking children for school BUT may just be bc seek help more

Question 13

Sleep is most likely to occur when core body temperature is_________

Answer 13

at its lowest

Question 14

NORMAL sleep efficiency is__________

Answer 14

85-95%

Question 15

Sleep efficiency refers to_______

Answer 15

the amount of time SPENT IN BED that is actually used for sleep i.e. in bed @9 but sleeping @11:30

Question 16

The MOST common type of insomnia is________ and is caused by

Answer 16

Psychophysiological insomnia; hyperarousal-person gets preoccupied with sleep, anx means even less sleep

Question 17

Paradoxical insomnia refers to________

Answer 17

self reported insomnia in the absence of objective markers of insomnia, inv day time disturbances

Question 18

The ICD-10 outlines ______ types of insomnias

Answer 18

6

Question 19

Idiopathic insomnia refers to

Answer 19

Insomnia with no real cause, most common in childhood. Long lasting

Question 20

Sleep hygeine refers to

Answer 20

irregularities in sleep/wake cycles because they don’t have routines i.e. on phone/ caffeine,

Question 21

Behavioural insomnia is associated with _______ stage of development and caused by_________

Answer 21

Childhood;

wrongly learns incorrect indicators of sleep. i.e. only falls asleep when being rocked, gets used to such sleep cues

Question 22

Spielman (1987) model of insomnia dictates that we have 3 pillars influencing insomnia expression

Answer 22

Predisposing- female, anxiety, hyperarousal,
Precipitating - medical psychological enviro events that triggers insomnia
Perpetuating -caffeine, naps etc., other factors that exacerbateing insomnia

Question 23

What was the 2015 change in insomnia classification

Answer 23

BEFORE
•Primary insomnia – insomnia that is not associated with a known physical Or psychological disorder
•Secondary insomnia – where insomnia is considered second to another disorder i.e. MDD, where primary one is treated first
AFTER
insomnia considered as standalone illness

Question 24

Some CBTi treatments for insomnia are____________

Answer 24

• Sleep restriction
• Stimulus control
• Relaxation techniques
• Cognitive therapy
• Improve sleep hygiene

Question 25

Sleep restriction refers to____________

Answer 25

strengthen relationship between being in bed and ‘sleeping’ i.e. only use bed for SLEEPING not studying etc.,

Question 26

the difference between relaxation and cognitive therapy is

Answer 26

a) shift attention away from conscious sleep | b) ease anxiety associated with sleep, reduce stress

Question 27

Are meds recommended for insomnia? why?

Answer 27

Only for SHORT term, because get dependent, tolerant.

Question 28

Insomnia is most often comorbid with___________

Answer 28

MDD

Question 29

Narcolepsy requires recurrent periods of irrepressible need to sleep ______a week, for ______period

Answer 29

3+; 3+ months

Question 30

Cataplexy refers to____________

Answer 30

losing all muscle tone

Question 31

Narcolepsy is associated with deficiency of; a) orexin b) serotonin c) hypocretin d) both A and C

Answer 31

D

Question 32

Narcolepsy requires patients have sleep latency _________ minutes or 2 REM periods in under__________ minutes

Answer 32

15; 8

Question 33

Multiple sleep latency test (MSLT) measures day time sleepiness by_______________

Answer 33

electrodes on scalp, measure ‘fall asleep as fast as you can’ The longer it takes to fall asleep=more awake you are. Narcoleptics need LESS than 15mins

Question 34

Orexin is a neuropeptide that is important for______________

Answer 34

feeding + capacity to stay awake = low in narcolepsy

Question 35

Narcoleptic episode may be induced by_________ and

Answer 35

strong emotions

Question 36

due to orexin loss there is _________stimulation to areas that_______sleep

Answer 36

LESS; INHIBIT

Question 37

Possible biological causes for narcolepsy are

Answer 37

Swine flu injection, HLA gene presence. | Both NOT causal but strong links

Question 38

The 2 types of narcolepsy are

Answer 38

Orexin depletion WITH cataplexy | Orexin depletion WITHOUT cataplexy

Question 39

hypnagogic hallucinations are

Answer 39

vivid DREAMS

Question 40

Which class of drugs can be used for narcolepsy

Answer 40

STIMULANTS -for day time sleepiness. Ritalin, modafinil/nuvigil , or sleeping meds to increase sleep regularity. Xyrem - highly controlled drug.

Question 41

Parasomnia refers to______________

Answer 41

abnormal behavioural, experiential or physiological events associated with sleep specific sleep stages, or sleep-wake transitions

Question 42

Parasomnia is more common in __________whereas insomnia is more common in____________

Answer 42

MALES; FEMALES

Question 43

Parasomnia is likely to occur in____________ part of the night and includes __________ symptoms of which the client __________ aware of

Answer 43

first THIRD of the night sleep walking/ terrors is NOT aware of

Question 44

Sleep terrors are associated with _________ age and linked with __________of the CNS

Answer 44

3-8; IMMATURITY

Question 45

Which is INCORRECT of sleep terrors; a) you should wake someone out of one b) they occur in SWS and so can be recalled c) has an onset of 4-12 yo d) associated with increased autonomic arousal

Answer 45

B - DOES occur in SWS but child does NOT recall the dream

Question 46

Sleep terror is different to nightmare because____________

Answer 46

Sleep Terror- typically in kids, ND – chronic + wider age gap; Sleep Terror-NREM, ND-REM, Sleep Terror-no arousal, ND- wake up and recall dream.

Question 47

Which is INCORRECT regarding sleep terror tmt; a) involves counselling parents as they are mostly traumatised b) proposes scheduled awakenings c) recommends excessive play / excess heat to wear child down d) recommends harm reduction in the room

Answer 47

C - excessive tiredness NOT recommended

Question 48

Sleep walking is triggered by _____________. TMT's include

Answer 48

Excessive sleep deprivation; | harm reduction, scheduled awakenings

Question 49

REM disorders ____________

Answer 49

``` Nightmare disorder REM sleep behaviour disorder Sleep paralysis Child head banging Restless leg syndrome Confusional arousal Bruxism – teeth grinding Enuresis – bedwetting ```

Question 50

Nightmare disorder typically occurs _____________ of the night and is ____________ remembered

Answer 50

second half of night or after 90 mins of sleep; WELL

Question 51

Nightmares are often caused by____________ and occur in ________ of the population annually

Answer 51

stress, anxiety, PTSD, meds ; 85%

Question 52

Nightmares may begin in childhood and are likely to go away by _______ age or otherwise persist. Treatment invovles__________

Answer 52

10; therapy changing the end of the dream

Question 53

REM sleep behaviour disorder is diagnosed with_________ and associated with_____________muscle tone

Answer 53

PSG; abnormally preserved muscle tone in REM sleep

Question 54

REM sleep behaviour disorder is present in _____________ population

Answer 54

middle aged / elderly / those with a neurological disorder. Onset age 52-62

Question 55

REM sleep behaviour disorder may be a prodromal stage of ___________ as it has an onset 5-10 years before disease onset

Answer 55

AD/PD

Question 56

Treatment of REM sleep BD is __________ which controls symptoms but does NOT control______

Answer 56

diazepines; likelyhood of later developing neurodegenerative diseases

Question 57

Sleep paralysis is when___________ is inhibited but ___________are intact

Answer 57

voluntary muscle tone; ocular +respiratory

Question 58

Sleep paralysis is associated with________sleeping position and is likely to occur ___________time

Answer 58

Lying flat on back; sleep onset or offset

Question 59

Hypnagogic ___________ whereas hypnopompic___________

Answer 59

sleep ONSET; sleep OFFSET

Question 60

We used to think sleep disturbances were secondary to psychiatric illnesses, NOW we think_____________

Answer 60

that because they often co-occur with other shit, they may share similar aetiology