Sleep Disorders Flashcards
Stage of sleep resembling an awake state
REM Sleep
Structure that secretes melatonin into the bloodstream
Pineal Gland
Core Features of all Sleep – Wake Disorders
Daytime distress and impairment
It is defined as disorder of the quantity or timing of sleep.
Dyssomnia
T or F: In Dyssomnia there is difficulty in the initiation, maintenance, timing and quality of sleep
True
It is defined as abnormal behaviors that disturb ongoing sleep
Parasomnia
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
(Valdoxan) 25 mg
Most common cause of secondary hypersomnia
Obstructive Sleep Apnea
Body’s Master Internal Clock
Suprachiasmatic Nucleus
Derivative of melatonin and serotonin
Tryptophan
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
False. The statement is true except that accompanying REM makes walking unlikely.
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.
True
It is defined as an awakening from REM sleep to full consciousness with detailed dream recall ability. It occurs late in the sleep cycle
Nightmare
Drug of choice for Narcolepsy
Methylphenidate
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
At least 3 times per week and have persisted for at least 3 months
Periodic Limb Movement Disorder which is characterized by repeated twitches of legs during sleep could be attributed to this underlying condition
Vitamin B12 Deficiency or Iron Deficiency
Also Chronic Renal Disease and Parkinson’s Disease
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.
False. Persons with REM Sleep Behavior usually wakes up fully awake and alert. The rest of the statement is true.
These are people who are most active and productive in the morning
Larks
People who are more productive at night
Night Owl
Most Restorative stage of sleep
Stage 4 NREM Sleep
Magic 3 in the diagnosis of Insomnia means
Sleep difficulties should occur at least 3 nights per week, for the past 3 months
Neurotransmitter for the initiation of sleep. Located in the median raphe nuclei
Serotonin
Neurotransmitter that maintains sleep. Located mainly in the locus coeruleus
Norepinephrine
- 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
Hydroxyzine (Atarax) 25 – 50 mg
Main side effect of Hydroxyzine
Drowsiness in the morning
This drug has central presynaptic α2 adrenergic antagonist effects. IT stimulates norepinephrine and serotonin release
Mirtazapine (Remeron) 15 mg
Main side effect of Mirtazapine
Weight Gain
Drug that modulates benzodiazepine receptors with half – life of 6 hours and barbiturate – like properties
Zopiclone (Imovane) 7.5 – 15 mg
Main side effect of Zopiclone
Metallic Taste
Drug that modulates ω-1 type
GABA receptor via selective antagonism producing sedative effects
Zolpidem CR (Stilnox CR) 10 mg
First line treatment for Hypersomnia
Modafinil
Drug which depresses all levels of
CNS by increasing membrane permeability to chloride ions
Temazepam or Estazolam
One or more episodes per week of nightmare is considered to have what level of severity
Moderate
Nightly episode of nightmare is considered to be
Severe
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
True
