Sleep Disorders

Question 1

Findings on polysomnography for REM sleep behavior disorder

Answer 1

Absence of muscle atonia during REM sleep

Question 2

[Medication] is helpful for hypersomnolence disorder

Answer 2

Modafanil

Question 3

Hypersomnolence disorder involves excessive day time sleepiness despite sleeping ___ hours at night

Answer 3

7

Question 4

Paradoxical intention with individual with insomnia

Answer 4

Asking them to remain awake despite need for sleep (intentionally engaging in opposite of desired outcome)

Question 5

Behavioral technique where individuals delay their sleep times successively for 3 hours every day until they reach the sleep window they desire

Answer 5

Chronotherapy

Question 6

Therapy for circadian rhythm sleep-wake disorder (CRSD) delayed sleep phase type

Answer 6

Chronotherapy

Question 7

Disorder with inability to fall asleep before early morning, usually after 2am, which can be more than 3 hours later than the conventional sleep time of the general population

Answer 7

Delayed sleep-wake phase disorder

Question 8

Which medication for sleep has shortest half-life (1 hour) and therefore has lowest risk of daytime grogginess?

Answer 8

Zaleplon

Question 9

Diminished orexin (hypocretin) transmission in the lateral hypothalamus describes pathology of this disorder

Answer 9

Narcolepsy

Question 10

K complexes with background sleep bundles are seen in this stage of sleep

Answer 10

N2 NREM
(Remember K2 for K bundles in N2 REM)

Question 11

Alpha activity is seen during this stage of sleep

Answer 11

N1 of NREM

Question 12

Delta waves are seen in this stage of sleep

Answer 12

N3 of NREM

Question 13

Would administer this first prior to sleep study for patient with excessive daytime sedation

Answer 13

Epworth Sleepiness Scale

Question 14

If Epworth sleepiness scale is above [ ] would refer to a sleep specialist

Answer 14

10

Question 15

Decreased breathing efforts during sleep leads to this type of apnea

Answer 15

Central Sleep Apnea

Question 16

Those with Alzheimer’s have ___ times higher incidence of obstructive sleep apnea than those without cognitive difficulties of similar age

Answer 16

5

Question 17

Benzos can increase/decrease stages N1 and N2 sleep, and increase/decrease stages N3 and REM sleep

Answer 17

Increase, decrease

Question 18

Zaleplon is FDA approved for only sleep ____

Answer 18

initiation (due to short half-life)

Question 19

On polysomnography, bipolar patients have increased ____ density across all stages of the illness

Answer 19

REM

Question 20

There is increased/decreased latency in sleep onset and wake after sleep onset in bipolar disorder patients

Answer 20

Increased

Question 21

The Multiple Sleep Latency Test is used to confirm this diagnosis

Answer 21

Narcolepsy

Question 22

Stage N3 duration is around __% in patients with depression

Answer 22

5

Question 23

T/F: Zaleplon can be used during nighttime awakenings to help patients fall back asleep.

Answer 23

True

Is good for this purpose due to shorter half-life

Question 24

Procedure where there is objective measurements of movement over time and involves wearing a watch-like device during sleep

Answer 24

Actigraphy

Question 25

Slow-wave or NREM stage 3 sleep increases/decreases with age

Answer 25

Decreases

Question 26

Medication with the most evidence for being effective at increasing slow-wave sleep and improving wellbeing in individuals with chronically nonrestorative sleep with excessive daytime sleepiness

Answer 26

Sodium Oxybate (a salt of GHB)

Question 27

Hypnogogic hallucinations occur when you _____ to sleep

Answer 27

GO
hypnogogic = hypnoGO to sleep

Question 28

Hypnopompic hallucinations occur when you ____ from sleep

Answer 28

Awaken from sleep

Question 29

Eszopiclone is FDA approved for ___ ___ ___ due to its longer half life

Answer 29

Sleep maintenance insomnia

Question 30

Patients with narcolepsy with cataplexy would have benefit from this medication

Answer 30

Sodium Oxybate (will be strong enough to allow them to sleep at night)

Question 31

low-voltage mixed frequency activity with saw-toothed waves, theta activity, and slow alpha activity is seen in patients under ____ sleep.

Answer 31

REM

Question 32

Tx for pt whose root cause of her insomnia seems to be the fact that she is over-thinking about sleep problems

Answer 32

Biofeedback