Week 11

Question 1

Promoting sleep state

Answer 1

VLPO sends inhibitory signals to the rest of areas to promote sleep state

Question 2

DSM-5 Primary insomnia disorder

Answer 2

predominant complaint of initiation/maintenance/early morning awakening
significant distress/function impairment
sleep difficulty at least 3 times a week
at least 3 MO
despite adequate sleep opportunity
not due to another sleep disorder, mental disorder, substance or medical condition

Question 3

psychophysiological insomnia

Answer 3

heightened arousal and learned sleep association of not being able to sleep
over concerned with inability to sleep

Question 4

sleep state misperception/paradoxical insomnia

Answer 4

overconcerned with sleep inability but no physiological sleep disorder

Question 5

idiopathic insomnia

Answer 5

cause unknown

Question 6

adjustment sleep disorder

Answer 6

insomnia in response to a stressor

Question 7

CBT-I

Answer 7

sleep restriction
stimulus drive
relaxation techniques
cognitive therapy
sleep hygiene

Question 8

DSM5 Narcolepsy

Answer 8

recurrent periods of irrepressible need to sleep/lapse into sleep
at least 3x weekk for 3MO
one of: cataplexy, hypocretin/orexin deficiency, REM sleep latency < 15 OR MSLT <8min + 2 SOREMPs

Question 9

3 defining features of narcolepsy

Answer 9

EDS
Orexin deficiency
cataplexy

Question 10

type 2 narcolepsy

Answer 10

normal orexin and no cataplexy

Question 11

gene narcolepsy

Answer 11

HLA-DQB1

Question 12

Arousal/NREM disorders

Answer 12

sleepwalking
night terrors

Question 13

REM disorders

Answer 13

REM sleep behaviour disorder
nightmare disorder
sleep paralysis

Question 14

DSM5 NREM/sleep arousal disorders

Answer 14

recurrent incomplete awakening from sleep in 1/3 of sleep episode with: sleep walking, sleep terror
no/little dream recall
episode amnesia
cause distress/function impairment
not explained by substance or other coexisting condition

Question 15

nightmares vs night terrors

Answer 15

nightmares: all through life; REM; can wake; can recall
night terrors: 3-8 mainly; NREM; no arousal; no recall

Question 16

sleep walking diagnostic criteria

Answer 16

complex motor movement during SWS
reduced alertness and responsiveness
limited recall of events

Question 17

nightmare disorder

Answer 17

well remembered dreams repeatedly occur during second half of night
rapidly awake and alert if awakened
significant distress
not due to another condition

Question 18

REM sleep behaviour disorder

Answer 18

Episodes of arousal during sleep with vocalisation and complex motor behaviours
REM, more than 90mins after sleep onset, later in sleep episode, uncommon during naps
awake and alert, not confused or disoriented
either: REM without atonia on PSG OR history suggestive of REM sleep BD and/or established disorders
distress+impairment
not explained by other disorder