Clinical Perspective of Sleep Cycle & Sleep Disorders

Question 1

What is the most common psychiatric disorder to present as insomnia?

Answer 1

Major Depressive Disorder

Question 2

What disorder is characterized by an overwhelming desire to sleep with sleep attacks?

Answer 2

Narcolepsy

Question 3

This sleep disorder is characterized by difficulty falling asleep, staying asleep, or waking early.

Answer 3

Insomnia Disorder

Question 4

What is the pathophysiology of narcolepsy?

Answer 4

Deficiency of orexin

Question 5

What are the stages of the sleep cycle?

Answer 5

N1, N2, N3, REM

Question 6

These waves generally signify active thinking and concentration.

Answer 6

Beta waves

Question 7

These neurotransmitters play an important role in wakefulness and the suppression of sleep.

Answer 7

Orexin, norepinephrine, acetylcholine, dopamine, serotonin, histamine

Question 8

Acetylcholine levels are lowest during which stage of sleep?

Answer 8

N3

Question 9

This sleep disorder is characterized by repeated interruptions in normal respiration.

Answer 9

Sleep apnea

Question 10

K-complexes and sleep spindles characterize what stage of sleep?

Answer 10

N2

Question 11

Night terrors and sleepwalking occur during this stage of sleep.

Answer 11

N3

Question 12

What are the types of sleep apnea?

Answer 12

Obstructive and central sleep apnea

Question 13

From where is melatonin secreted?

Answer 13

Pineal gland

Question 14

What drug is taken at night to prevent daytime sleep attacks associated with narcolepsy?

Answer 14

Sodium oxybate

Question 15

These neurotransmitters play an important role in the promotion of sleep.

Answer 15

GABA, melatonin

Question 16

These are visual images that occur upon waking.

Answer 16

Hypnopompic hallucinations

Question 17

What brain waves predominate during wakefulness?

Answer 17

Alpha & beta waves

Question 18

What is the difference between a sleep terror and a nightmare?

Answer 18

Sleep terrors occur during N3 sleep and are associated with sudden arousal, intense fear, and no recollection of the terror.

Nightmares occur during REM sleep and are remembered upon waking.

Question 19

What waves are present during N2 sleep?

Answer 19

K-complexes and sleep spindles

Question 20

What medications may be used for insomnia disorder?

Answer 20

Ramelteon, Suvorexant, anti-histamines

Question 21

These drugs are used to manage daytime sleepiness associated with narcolepsy.

Answer 21

Modafinil, amphetamines

Question 22

What structure is responsible for dictating the circadian rhythm?

Answer 22

Suprachiasmatic Nucleus

Question 23

What are the general types of sleep?

Answer 23

REM & non-REM sleep

Question 24

What physiologic changes occur during REM sleep?

Answer 24

Erections, increased HR & BP, loss of motor tone (except extraocular and respiratory muscles), increased brain O2 usage

Question 25

What is the difference between orexin and hypocretin?

Answer 25

Nothing, they are different names for the same molecule

Question 26

These are visual images that occur upon going to sleep.

Answer 26

Hypnagogic hallucinations

Question 27

What criteria are required for a diagnosis of hypersomnolence disorder?

Answer 27

Sleep lasting 9+ hours that is not restorative, multiple episodes of sleep during the day, or difficulty with arousal upon awakening 3 episodes/week for 3 months

Question 28

What is a common cause of obstructive sleep apnea in children?

Answer 28

Adenotonsillar hypertrophy

Question 29

This test is generally required to diagnose a sleep disorder.

Answer 29

Polysomnography

Question 30

How long must symptoms occur for a diagnosis of insomnia?

Answer 30

At least 3 nights/week for 3 months

Question 31

Most sleep is spent in this stage.

Answer 31

N2

Question 32

What is the first treatment for insomnia disorder?

Answer 32

Sleep hygiene - engaging in behaviors that promote restful sleep

Question 33

What are the major risk factors for obstructive sleep apnea?

Answer 33

Obesity, male, older age

Question 34

What waves are present during N1 sleep?

Answer 34

Theta waves

Question 35

What waves are present during REM sleep?

Answer 35

"Sawtooth" waves

Question 36

These disorders are characterized by a misalignment between desired and actual sleep patterns.

Answer 36

Circadian Rhythm Sleep-Wake Disorders

Question 37

True/False. Benzodiazepines promote sleep onset, but result in less sleep.

Answer 37

True - less REM sleep

Question 38

What waves are present during N3 sleep?

Answer 38

Delta waves

Question 39

What histamine receptor is implicated in wakefulness?

Answer 39

H1

Question 40

From where is orexin secreted?

Answer 40

Lateral hypothalamus

Question 41

What is the first-line treatment for sleep apnea?

Answer 41

Positive Airway Pressure

Question 42

What are the stages of non-REM sleep?

Answer 42

Light sleep - N1, N2 Deep sleep - N3

Question 43

Sleep is essential for what brain function?

Answer 43

Memory - synaptic growth and pruning