Sleep Disorders

Question 1

Stage of sleep resembling an awake state

Answer 1

REM Sleep

Question 2

Structure that secretes melatonin into the bloodstream

Answer 2

Pineal Gland

Question 3

Core Features of all Sleep – Wake Disorders

Answer 3

Daytime distress and impairment

Question 4

It is defined as disorder of the quantity or timing of sleep.

Answer 4

Dyssomnia

Question 5

T or F: In Dyssomnia there is difficulty in the initiation, maintenance, timing and quality of sleep

Answer 5

True

Question 6

It is defined as abnormal behaviors that disturb ongoing sleep

Answer 6

Parasomnia

Question 7

One of the first line treatment for insomnia which acts as selective agonist at melatonin receptors and selective antagonist at serotonin 5HT – 2C receptors. Main side effect is giddiness Agomelatine

Answer 7

(Valdoxan) 25 mg

Question 8

Most common cause of secondary hypersomnia

Answer 8

Obstructive Sleep Apnea

Question 9

Body’s Master Internal Clock

Answer 9

Suprachiasmatic Nucleus

Question 10

Derivative of melatonin and serotonin

Answer 10

Tryptophan

Question 11

T or F: Somnambulism or Sleep Walking is a deep NREM phenomenon occurring during the first three hours of sleep and the accompanying REM makes walking during this stage likely

Answer 11

False. The statement is true except that accompanying REM makes walking unlikely.

Question 12

T or F: Sleep Terrors is NREM Sleep Arousal Disorder occurring during stage 3 and stage 4 of sleep characterized by sudden awakening during sleep with loud terrified screaming. Physiological changes includes tachycardia, diaphoresis and mydriasis.

Answer 12

True

Question 13

It is defined as an awakening from REM sleep to full consciousness with detailed dream recall ability. It occurs late in the sleep cycle

Answer 13

Nightmare

Question 14

Drug of choice for Narcolepsy

Answer 14

Methylphenidate

Question 15

In Restless Legs Syndrome the urge to move the legs which begins or worsens during periods of rest or inactivity and partially or totally relieved by movement should have occurred for how many times for it to be diagnosed

Answer 15

At least 3 times per week and have persisted for at least 3 months

Question 16

Periodic Limb Movement Disorder which is characterized by repeated twitches of legs during sleep could be attributed to this underlying condition

Answer 16

Vitamin B12 Deficiency or Iron Deficiency

Also Chronic Renal Disease and Parkinson’s Disease

Question 17

T or F: To diagnose a person with REM Sleep Behavior Disorder there should be repeated episodes of arousal associated with vocalization and complex motor behaviors occurring in the later stage of sleep usually 50 minutes after sleep onset and patients are usually confused and disoriented upon waking up.

Answer 17

False. Persons with REM Sleep Behavior usually wakes up fully awake and alert. The rest of the statement is true.

Question 18

These are people who are most active and productive in the morning

Answer 18

Larks

Question 19

People who are more productive at night

Answer 19

Night Owl

Question 20

Most Restorative stage of sleep

Answer 20

Stage 4 NREM Sleep

Question 21

Magic 3 in the diagnosis of Insomnia means

Answer 21

Sleep difficulties should occur at least 3 nights per week, for the past 3 months

Question 22

Neurotransmitter for the initiation of sleep. Located in the median raphe nuclei

Answer 22

Serotonin

Question 23

Neurotransmitter that maintains sleep. Located mainly in the locus coeruleus

Answer 23

Norepinephrine

Question 24

24. first line treatment for insomnia which is an H1 receptor antagonist with low to moderate antihistaminic properties. It inhibits respiratory, vascular and GI smooth muscle contraction

Answer 24

Hydroxyzine (Atarax) 25 – 50 mg

Question 25

Main side effect of Hydroxyzine

Answer 25

Drowsiness in the morning

Question 26

This drug has central presynaptic α2 adrenergic antagonist effects. IT stimulates norepinephrine and serotonin release

Answer 26

Mirtazapine (Remeron) 15 mg

Question 27

Main side effect of Mirtazapine

Answer 27

Weight Gain

Question 28

Drug that modulates benzodiazepine receptors with half – life of 6 hours and barbiturate – like properties

Answer 28

Zopiclone (Imovane) 7.5 – 15 mg

Question 29

Main side effect of Zopiclone

Answer 29

Metallic Taste

Question 30

Drug that modulates ω-1 type

GABA receptor via selective antagonism producing sedative effects

Answer 30

Zolpidem CR (Stilnox CR) 10 mg

Question 31

First line treatment for Hypersomnia

Answer 31

Modafinil

Question 32

Drug which depresses all levels of

CNS by increasing membrane permeability to chloride ions

Answer 32

Temazepam or Estazolam

Question 33

One or more episodes per week of nightmare is considered to have what level of severity

Answer 33

Moderate

Question 34

Nightly episode of nightmare is considered to be

Answer 34

Severe

Question 35

Advanced sleep phase syndrome is defined as an early onset of sleep with resultant early morning awakening while Delayed sleep phase syndrome is delayed onset of sleep, usually at 2am but total
number of sleep time is still normal

Answer 35

True