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PHR 936 Neurology B1 > Sleep Disorders > Flashcards

Sleep Disorders Flashcards

1
Q

Biological functions of sleep include physical restoration, ______, and ______ consolidation.

A

Brain development, memory

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2
Q

The physiologic effects of sleep deprivation include ______, cognitive impairment, and emotional distress.

A

Obesity

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3
Q

______ sleep accounts for 75-80% of total sleep time, while ______ sleep accounts for 20-25%.

A

NREM, REM

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4
Q

During NREM sleep, the brain is quiet, but the body is ______.

A

Active

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5
Q

REM sleep is driven by ______ pressure, while NREM sleep is driven by ______ pressure.

A

Circadian, homeostatic

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6
Q

The neurotransmitter ______ reduces wakefulness and is promoted by drugs like melatonin agonists.

A

Adenosine

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7
Q

The circadian drive for sleep resides in the ______ of the brain and is influenced by light and dark.

A

Suprachiasmatic nucleus

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8
Q

Neurotransmitters that promote wakefulness include ______, dopamine, and norepinephrine.

A

Acetylcholine

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9
Q

Antihistamines, which block ______ receptors, are commonly used to promote sleep.

A

H1

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10
Q

GABAergic drugs like benzodiazepines and Z-drugs enhance the activity of ______, which inhibits arousal.

A

GABA

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11
Q

Dyssomnias include disorders like ______, ______, and narcolepsy, which involve difficulty falling or staying asleep.

A

Insomnia, obstructive sleep apnea

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12
Q

Parasomnias include abnormal behaviors during sleep, such as nightmares and ______.

A

Sleepwalking

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13
Q

The most common sleep disorder is ______, affecting 10-30% of adults.

A

Insomnia

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14
Q

Insomnia is characterized by difficulty falling asleep, staying asleep, or experiencing ______ sleep.

A

Nonrestorative

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15
Q

For a diagnosis of chronic insomnia, sleep disturbances must occur at least ______ nights per week for ______ months.

A

Three, three

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16
Q

Risk factors for insomnia include comorbid conditions such as chronic pain, ______, and anxiety.

A

Depression

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17
Q

Patients with insomnia may benefit from cognitive behavioral therapy, which includes techniques such as ______ control and sleep ______.

A

Stimulus, restriction

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18
Q

Common sleep hygiene practices include going to bed and waking up at the same time and avoiding ______ before bedtime.

A

Caffeine

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19
Q

The pharmacologic treatment of insomnia often begins with low-dose ______ antidepressants, such as trazodone.

A

Sedating

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20
Q

______ are often used to treat insomnia but carry a risk of dependence and cognitive impairment.

A

Benzodiazepines

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21
Q

Z-hypnotics like zolpidem and zaleplon target the ______ receptor and are used for sleep onset insomnia.

A

GABA-A

22
Q

Ramelteon is a selective ______ receptor agonist used to treat sleep onset insomnia.

A

Melatonin

23
Q

Orexin receptor antagonists, such as suvorexant, are useful for both sleep ______ and ______.

A

Initiation, maintenance

24
Q

Antihistamines like diphenhydramine are commonly used as sleep aids but have significant ______ side effects.

A

Anticholinergic

25
Q

The ______ scale is used to assess excessive daytime sleepiness in patients with narcolepsy.

A

Epworth Sleepiness

26
Q

Restless leg syndrome is characterized by an urge to move the legs and is often worse during ______.

A

Inactivity

27
Q

Dopamine agonists, such as pramipexole and ropinirole, are commonly used to treat ______.

A

Restless leg syndrome

28
Q

______ is a GABA analog that is used to treat restless leg syndrome by reducing excitatory neurotransmission.

A

Gabapentin

29
Q

Obstructive sleep apnea occurs when the ______ collapses during sleep, causing periods of apnea and hypopnea.

A

Airway

30
Q

Common risk factors for obstructive sleep apnea include a BMI greater than ______ and a neck circumference greater than ______ inches in men.

A

25, 17

31
Q

Continuous positive airway pressure (CPAP) is the first-line treatment for ______.

A

Obstructive sleep apnea

32
Q

Daytime drowsiness that persists despite CPAP therapy may be treated with ______ or ______.

A

Modafinil, armodafinil

33
Q

Narcolepsy is characterized by excessive daytime sleepiness and sudden episodes of muscle weakness known as ______.

A

Cataplexy

34
Q

Patients with narcolepsy may experience vivid dream-like hallucinations, known as ______ hallucinations, while falling asleep.

A

Hypnagogic

35
Q

Sodium oxybate (Xyrem) is used to treat cataplexy and excessive daytime sleepiness by increasing ______ sleep.

A

REM

36
Q

Suvorexant is an orexin receptor antagonist that should be taken within ______ minutes of bedtime.

A

30

37
Q

Patients using Z-hypnotics should be advised to avoid ______ due to the risk of cognitive impairment and falls.

A

Alcohol

38
Q

The use of ______ is contraindicated in patients with narcolepsy, as it can worsen symptoms.

A

Orexin receptor antagonists

39
Q

Melatonin supplements are commonly used for ______ disorders, such as jet lag.

A

Circadian rhythm

40
Q

Iron supplementation may be beneficial for patients with restless leg syndrome and low serum ______ levels.

A

Ferritin

41
Q

The treatment of insomnia with Z-hypnotics carries a boxed warning for complex ______ behaviors, such as sleepwalking.

A

Sleep

42
Q

The ultrashort-acting Z-hypnotic ______ can be taken during the night for middle-of-the-night awakenings.

A

Zaleplon

43
Q

______ is the only antidepressant FDA-approved for the treatment of insomnia.

A

Doxepin

44
Q

NREM sleep is primarily responsible for ______ restoration, while REM sleep is associated with ______ restoration.

A

Physical, mental

45
Q

The brain exhibits ______ waves during deep NREM sleep, which are associated with memory consolidation.

A

Delta

46
Q

During REM sleep, the body is ______, but the brain is highly active.

A

Paralyzed

47
Q

A normal sleep cycle alternates between NREM and REM sleep approximately every ______ minutes.

A

90

48
Q

Patients with obstructive sleep apnea may exhibit ______, a cessation of airflow for more than 10 seconds.

A

Apnea

49
Q

Modafinil and armodafinil work by inhibiting the reuptake of ______ to promote wakefulness in patients with narcolepsy.

A

Dopamine

50
Q

Patients with narcolepsy and cataplexy may benefit from REM-suppressing drugs such as ______ and SSRIs.

A

Tricyclic antidepressants

51
Q

The medication ______, which is used for narcolepsy, is available only through a restricted access program due to its risk of abuse.

A

Sodium oxybate

52
Q

Patients with narcolepsy may experience sleep ______, a temporary inability to move or speak upon waking.

A

Paralysis

PHR 936 Neurology B1 (6 decks)

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