Sleep disorders

Question 1

Discuss insomnia.

Answer 1

difficulties falling asleep (>30min)
trouble staying asleep
waking well
ahead of desired time
3 or more nights a week

Acute less than 3 months
chronic more than 3 months

Question 2

what are the effects of insomnia.

Answer 2

Concentration and cognition ( e.g.
memory, multitasking, inhibition,
problem-solving, productivity)
* Moody, irritable,
* Low energy, high fatigue
* Absenteeism
* Accidents due to fatigue

Question 3

What are the differences in the causes of transient and persistent insomnia?

Answer 3

Transient: Hyperarousal (often due to
stress, worry);
Time zone (i.e. jet lag) and
schedule changes (e.g. shift
work);
Sleep environment (e.g. noise,
mosquitos)

Persistent: Circadian rhythm problem (e.g.
delayed sleep-phase syndrome
– sleep onset insomnia;
advanced sleep phase disorder
– early awakenings);
Biological problem (e.g. restless
leg syndrome,
gastroesophageal reflux,
fibromyalgia); Psychological
problem (e.g. depression,
phobias, anxieties, neuroses

Question 4

Discuss sleep apnoea.

Answer 4

sleep-related breathing disorder

Central sleep apnoea: diaphragm, brain, or
related neural pathways fail to pull air into
lungs
Obstructive sleep apnoea: upper airways
collapse and prevent air from passing to the lungs

Deadly

Question 5

What are the causes of Restless legs syndrome?

Answer 5

Low iron stores (especially serum ferritin levels)
* Central dopaminergic neurotransmission (low dopamine levels) – basal ganglia
use dopamine to help control muscle activity and movement, reduced
dopamine can cause muscle spasms and involuntary movements, dopamine
levels do fall naturally towards the end of the day which may explain why
symptoms are worse at night
* Genetics - Approximately 50% of patients have a positive family history of RLS
(especially if onset is <40y).

Question 6

What is narcolepsy?

Answer 6

Chronic neurologic disorder
characterized by a decreased
ability to regulate sleep-wake
cycles
* Features are excessive daytime
sleepiness and uncontrollable
bouts of sleep

Question 7

Which Neurotransmitter is low in Narcolepsy, explain the mechanism.

Answer 7

Orexin
or a mutation in the gene, leading to hyperexcitability of neurons that generate REM sleep