Sleep DIsorders Flashcards

1
Q

“Attenuation of the posterior dominant background rhythm” is the buzz phrase for which stage of sleep?

A

N1

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2
Q

What are the buzz word characteristics for N2?

A

sleep spindles and K complexes

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3
Q

What’s the buzz phrase for N3?

A

background consisting of more than 20% in delta frequency (0.5 to 2 Hz range)

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4
Q

What stage of sleep is suppressed by benzos?

A

N2

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5
Q

What stage of sleep is suppressed by antidepressants and alcohol?

A

REM

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6
Q

What percentage of time is spent in REM sleep for adults?

A

20-25%

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7
Q

What part of the brain controls circadian rhythms?

A

suprachiasmatic nucleus of the hypothalamus (with inputs from the pineal gland via melatonin)

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8
Q

What can be seen in someone with restless leg syndrome while they’re asleep?

A

periodic limb movements of sleep - repetitive involuntary movements of the lower extremity that last 2-3 seconds and then are followed by a slow recovery of the normal leg position

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9
Q

What should lab evaluation of RLS include?

A

ferritin and iron levels because many patients with RLS have iron deficiency

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10
Q

What are the treatments of choice for RLS?

A

dopamine agonists - ropinirole and pramipexole preferred over levodopa

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11
Q

What does augmentation mean in the setting of RLS?

A

it’s the occurrence of RLS symptoms earlier in the day in response to dopamine agonists

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12
Q

What are the four components of narcolepsy?

A

narcolepsy
cataplexy
sleep paralysis
hypnagogic hallucinations

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13
Q

What is the pathophysiology of narcolepsy?

A

loss of hypocretin-secreting neurons in the hypothalamus

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14
Q

What would you see in the CSF in narcolepsy?

A

a hypocretin level less than 110 pg/mL

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15
Q

What’s the typical diagnostic test for narcolepsy though?

A

a multiple sleep latency test that involves several short naps and monitoring of the latency to sleep onset and latency to REM onset.

sleep latency of less than 8 minutes with more than two episodes of REM at sleep onset is diagnostic for narcolepsy

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16
Q

What is the agent of choice for treatment of narcolepsy?

A

modafinil

17
Q

What agents are used to treat the cataplexy component?

A

TCAs, fluoxetine, venlafaxine and sodium oxybate (a GABA metabolite)

18
Q

Describe a sleep terror. How are they distinguished from nightmares?

A

rapid awakening from sleep with fearful behavior like screaming, associated with autonomic hyperactivity

a lack of memory for the event distinguishes sleep terrors from nightmares

19
Q

What is the preferred treatment for REM sleep behavior disorder?

A

clonazepam

20
Q

Nocturnal cramps are painfultightness of the lower extremity muscles ocurring at night. What’s the most effective medication for this?

A

quinine

21
Q

What is the most common sleep disorder?

A

insomnia

22
Q

What is the first step in treating insomnia?

A

behavioral changes - sleep hygiene