Sleep Disorders (Part 2)

Question 1

What are parasomnias?

Answer 1

A group of sleep disorders that involve unwanted events or experiences while falling asleep, asleep or waking up

Question 2

What is the persons awareness of parasomnias?

Answer 2

They are asleep throughout the event and often have no memory of it

Question 3

Which type of parasomnias will involve a) narrative dreaming and b) non-narrative dreaming?

Answer 3

a) REM parasomnias b) non-REM parasomnias

Question 4

Which type of parasomnias would cause sleep deprivation?

Answer 4

Non-REM

Question 5

What are some examples of non-REM parasomnias?

Answer 5

Confusional arousals, sleep walking, sleep terrors, sleep paralysis, restless legs

Question 6

Which type of parasomnias will involve a) complex behaviours? b) simple behaviours?

Answer 6

a) non-REM b) REM

Question 7

When do non-REM parasomnias usually occur?

Answer 7

First 2/3rds of the night

Question 8

When do sleep terrors usually occur?

Answer 8

Mainly in childhood

Question 9

What happens in REM sleep behaviours?

Answer 9

You act out vivid dreams as you sleep

Question 10

When do REM sleep behaviours usually occur?

Answer 10

The latter third of the night

Question 11

Compared to non-REM parasomnias, is it harder or easier to wake up people during REM sleep behaviour?

Answer 11

Easier

Question 12

What happens when people with REM sleep behaviour wake up with regards to memory?

Answer 12

They can recall clear details of the vivid dream

Question 13

Does REM sleep behaviour have a cause?

Answer 13

No, usually idiopathic

Question 14

REM sleep behaviour is often seen preceding what condition?

Answer 14

Parkinson’s disease

Question 15

What is the sex distribution of narcolepsy? Describe the age of onset?

Answer 15

Equal, variable age of onset with two peaks at 15 and 36

Question 16

What are the characteristic features of narcolepsy?

Answer 16

Daytime sleepiness, cataplexy, hypnagogic hallucination, sleep paralysis

Question 17

Describe the daytime sleepiness in narcolepsy?

Answer 17

Involuntary solemnness during eating/talking, may be impossible to resist

Question 18

What is cataplexy?

Answer 18

A loss of muscle tone, triggered by emotion

Question 19

What is the patients awareness state during an attack of cataplexy?

Answer 19

Aware of what’s going on, can see and hear but can’t move

Question 20

Cataplexy is present in what proportion of cases of narcolepsy?

Answer 20

70%

Question 21

What are hypnagogic hallucinations?

Answer 21

Hallucinations occurring at sleep onset

Question 22

What is the typical time between onset and diagnosis of narcolepsy?

Answer 22

10 years

Question 23

When do symptoms of narcolepsy often begin?

Answer 23

As a teenager

Question 24

What are the three main investigations for narcolepsy?

Answer 24

Overnight polysomnography, multiple sleep latency tests, lumbar puncture

Question 25

What happens in multiple sleep latency tests?

Answer 25

4x25 minute naps are scheduled about 2 hours apart and EEG, muscle activity and eye movement are recorded

Question 26

What does a sleep latency test measure?

Answer 26

The time from the start of a daytime nap to the first signs of sleep

Question 27

Will narcolepsy patients fall asleep quickly or slowly? What is abnormal about how they fall asleep?

Answer 27

Quickly, go into REM sleep first which is abnormal

Question 28

What is a lumbar puncture used for in the investigation of narcolepsy?

Answer 28

CSF hypocretin, low levels (< 110) are associated with narcolepsy

Question 29

What are the rules with narcolepsy and driving?

Answer 29

Driving should be stopped until control is achieved, they will never be able to drive buses/lorries

Question 30

What is insomnia?

Answer 30

Difficulty falling asleep or staying asleep for the desired amount of time

Question 31

What are some symptoms of insomnia?

Answer 31

Daytime sleepiness, irritability, low energy, depressed mood

Question 32

Describe what happens in confusional arousals?

Answer 32

People act in a strange and confused way as they wake up or just after - may appear that they don’t know where they are or what they are doing

Question 33

Describe what happens in sleep terrors?

Answer 33

Wake up in intense fear with hardly any/no memory of having a bad dream

Question 34

Describe what happens in sleep paralysis?

Answer 34

Causes you to be unable to move your body when you are falling asleep or waking up