Sleep Medicine

Question 1

Acetylcholine (ACh) is……. during REM sleep
(associated with erections in men)
while Norepinephrine (NE) is……… during REM sleep

Answer 1

Higher
Lower

Question 2

Serotonin helps to…… Sleep

Answer 2

Initiate

Question 3

NE pathway begins in the….. , which regulates REM
sleep

Answer 3

Pons

Question 4

Dopamine effect on sleeping

Answer 4

• Dopamine produces arousal and wakefulness

Question 5

Origin of melatonin

Answer 5

Pineal gland

Question 6

Melatonin production is inhibited by…

Answer 6

activation of
photoreceptors cells in the retina

Question 7

Melatonin secretion regulates the sleep-wake cycle by

Answer 7

inhibiting the circadian alerting system in the
suprachiasmatic nucleus

Question 8

Role of orexin in sleep

Answer 8

Orexin triggers wakefulness

Question 9

deficiency of orexin results in sleep- state
instability, leading to sleep disorders like

Answer 9

Narcolepsy

Question 10

EEG features in sleep stage 1

Answer 10

alpha dropout, vertex waves

Question 11

EEG features in sleep stage 2

Answer 11

Spindles, vertex waves, k complexes

Question 12

EEG features in sleep stage 3

Answer 12

Spindles, k complexes, delta waves, slow rhythm

Question 13

EEG features in sleep stage 4

Answer 13

K complexes, very slow rhythm, delta activity

Question 14

EEG features in REM sleep

Answer 14

Low amplitude, EMG flatness, intermittent EOG activity

Question 15

Benzodiazepines cause limited decrease in…. and
Stage…. sleep.

Answer 15

REM, STAGE 3

Question 16

Moderate alcohol consumption leads to
……. and increased wakefulness during…….

Answer 16

Early sleep onset, during the second half of the night

Question 17

Alcohol intoxication leads to…

Answer 17

Decreased REM sleep

Question 18

Barbiturates.(increase /decrease) REM sleep

Answer 18

Decrease

Question 19

Major depression (increase /decrease) REM sleep

Answer 19

Increase

Question 20

Tx of narcolepsy

Answer 20

Modafinil

Question 21

Disease characterized by recurrent episodes of
hypersomnia and hyperphagia psychiatric and
cognitive disturbance
• Lasts for weeks or months, alternating with
episodes of being normal

Answer 21

Kleine Levin Syndrome

Question 22

Management of insomnia

Answer 22

Antidepressants (SSRI)
BENZODIAZEPINES
Ramelteon
Z-drugs

Question 23

Tx of seasonal affective disorder

Answer 23

Bright light, CBT

Question 24

At which stage of sleep does night terror manifest?
Tx?

Answer 24

Stage 3 sleep
Tx is benzodiazepines

Question 25

At which stage of sleep do nightmares manifest?
Tx?

Answer 25

REM
Tx is antidepressants

Question 26

At which stage of sleep do sleepwalking (somnambulism) manifest?
Tx?

Answer 26

Stage 3
Tx is benzos

Question 27

At which stage of sleep do bruxism (teeth grinding) manifest?

Answer 27

Stage 2
Tx is teeth guards