Sleep disorders

Question 1

Stage I of sleep is characterized by?

Answer 1

• theta waves

Question 2

When one is awake, which two waves predominate on EEG?

Answer 2

• alpha and beta waves

Question 3

State II of sleep is characterized by?

Answer 3

• k complexes and sleep spindles

Question 4

Stage III of sleep is characterized by?

Answer 4

• delta waves

Question 5

Describe how a patient would present in REM sleep

Answer 5

• loss of tone, rapid eye movement, brain is awake but body is paralyzed

Question 6

Which stage of sleep is where the most restful sleep occurs?

Answer 6

• stage III

Question 7

Define sleep latency

Answer 7

• the time it takes for the patient to go from awake to stage I of sleep

Question 8

Define REM latency

Answer 8

• the time it takes for a patient to go from stage III to REM sleep.

Question 9

Sleep latency is ____ in insomnia

Answer 9

increased

Question 10

REM latency is ____ in narcolepsy

Answer 10

decreased

Question 11

REM latency _____ in the elderly

Answer 11

decreases

Question 12

REM latency ___ in both obstructive sleep apnea and alcohol use.

Answer 12

decreases

Question 13

dreams gone bad in REM; patient will remember the dreams and they are easy to awake

Answer 13

nightmares

Question 14

patient experiences active behaviors while asleep; the patient appears awake but they are asleep

Answer 14

night terrors

Question 15

Nightmares are usually associated with ____ (caused by)

Answer 15

some sort of stressor

Question 16

Treatment for night terrors

Answer 16

Reassurance; the child will grow out of it (reassure parents)

Question 17

Define obstructed sleep apnea (OSA)

Answer 17

Something causes obstruction or collapse of airway while the patient is sleeping and as a result, they wake up and will not get rested sleep.

• Being overweight (large neck), large tongue can cause obstruction.
• In children–> enlarged adenoids can cause this

Question 18

Diagnose of OSA

Answer 18

polysomnogram

Question 19

Define central sleep apnea CSA

Answer 19

• patient forgets to breathe during sleep. This can be caused by drugs, like opioids. Patients with COPD or stroke are also at an increased risk.

Question 20

Tx for OSA

Answer 20

CPAP

Question 21

Dx of CSA

Answer 21

polysomnogram

Question 22

Tx for CSA

Answer 22

BIPAP

Question 23

What are the criteria to diagnose narcolepsy?

Answer 23

• Patient needs to experience rapid REM by going right to sleep at least 3x/wk for at least 3 months.

Question 24

___ is loss of tone

Answer 24

cataplexy

Question 25

Cataplexy is associated with ___

Answer 25

narcolepsy

Question 26

Dx for narcolepsy

Answer 26

polysomnogram

Question 27

Tx for narcolepsy

Answer 27

• scheduled naps and or use of amphetamines (to stimulate them to stay awake)

Question 28

What are the criteria to diagnose primary insomnia?

Answer 28

• must have either trouble staying asleep or falling asleep for at least 3x/wk for 6 months.
• Primary insomnia is not due to another disorder/problem going on.

Question 29

A patient who has jet lag may benefit from ____ therapy

Answer 29

phototherapy

Question 30

What are some ways to practice good sleep hygiene?

Answer 30

• use the bedroom for sex and sleep only
• keep lights off in bedroom
• avoid stimulants and exercise a couple of hours before bedtime

Question 31

What are some medications used for insomnia?

Answer 31

• diphenhydramine
• quetiapine
• trazodone
• BZD-1, like zolpidem (ambien)

Question 32

Ist line treatment for primary insomnia

Answer 32

• sleep hygiene