Sleep

Question 1

What are the two main phases of sleep?

Answer 1

The two main phases are Rapid Eye Movement (REM) sleep and Non-Rapid Eye Movement (NREM) sleep.

Question 2

What are the stages of NREM sleep?

Answer 2

NREM sleep is divided into three stages: N1 (light sleep), N2 (deeper sleep), and N3 (deepest sleep or slow-wave sleep).

Question 3

What percentage of sleep is spent in NREM sleep?

Answer 3

Approximately 75% of sleep is spent in NREM stages.

Question 4

What EEG pattern is seen during wakefulness with eyes open?

Answer 4

Beta waves – highest frequency, lowest amplitude.

Question 5

Which EEG pattern is predominant during drowsiness with closed eyes?

Answer 5

Alpha waves.

Question 6

What are sleep spindles and K-complexes, and in which stage do they occur?

Answer 6

Sleep spindles are bursts of neuronal activity, and K-complexes are large delta waves. They occur in N2 sleep.

Question 7

What stage of sleep is associated with dreaming and nightmares?

Answer 7

REM sleep.

Question 8

What stage of sleep is known as slow-wave sleep (SWS)?

Answer 8

N3 sleep.

Question 9

What physiological changes occur during REM sleep?

Answer 9

Loss of skeletal muscle tone, erratic breathing, and penile/clitoral tumescence.

Question 10

How does sleep progress through the night?

Answer 10

Progression: N1 → N2 → N3 → N2 → REM.

Question 11

What are the main classifications of sleep disorders?

Answer 11

Insomnia, sleep-related breathing disorders, hypersomnolence disorders, circadian rhythm disorders, parasomnias, and sleep-related movement disorders.

Question 12

What is insomnia?

Answer 12

A sleep disorder characterized by difficulty falling or staying asleep, leading to daytime impairment.

Question 13

What are the risk factors for insomnia?

Answer 13

Older age, female sex, chronic pain, psychiatric disorders, stress, alcohol, caffeine, and certain medications.

Question 14

What is the gold standard test for diagnosing sleep-related breathing disorders?

Answer 14

Polysomnography (PSG).

Question 15

What non-pharmacologic treatment is first-line for chronic insomnia?

Answer 15

Cognitive Behavioral Therapy for Insomnia (CBT-I).

Question 16

What medication class is commonly used for short-term insomnia management?

Answer 16

Benzodiazepines and non-benzodiazepine receptor agonists (BZRAs).

Question 17

Which hormone is primarily responsible for regulating the sleep-wake cycle?

Answer 17

Melatonin.

Question 18

What is obstructive sleep apnea (OSA)?

Answer 18

A sleep disorder characterized by upper airway obstruction leading to intermittent hypoxia and sleep fragmentation.

Question 19

What is the first-line treatment for obstructive sleep apnea?

Answer 19

Continuous Positive Airway Pressure (CPAP) therapy.

Question 20

What is narcolepsy?

Answer 20

A sleep disorder with excessive daytime sleepiness, cataplexy, and abnormal REM sleep transitions.

Question 21

What is cataplexy?

Answer 21

Sudden loss of muscle tone triggered by strong emotions, commonly seen in narcolepsy type 1.

Question 22

What is the key diagnostic test for narcolepsy?

Answer 22

Multiple Sleep Latency Test (MSLT).

Question 23

What neurotransmitter deficiency is associated with narcolepsy type 1?

Answer 23

Orexin (hypocretin) deficiency.

Question 24

What are common REM-related parasomnias?

Answer 24

Nightmare disorder, REM sleep behavior disorder, and sleep paralysis.

Question 25

What is REM sleep behavior disorder?

Answer 25

A condition where muscle atonia is absent during REM sleep, leading to dream enactment behaviors.

Question 26

What neurodegenerative diseases are associated with REM sleep behavior disorder?

Answer 26

Parkinson’s disease and Lewy body dementia.

Question 27

What are NREM-related parasomnias?

Answer 27

Sleepwalking, night terrors, and confusional arousals.

Question 28

What stage of sleep is associated with night terrors and sleepwalking?

Answer 28

N3 (slow-wave sleep).

Question 29

What is restless leg syndrome (RLS)?

Answer 29

A sleep-related movement disorder characterized by an irresistible urge to move the legs, often relieved by movement.

Question 30

What deficiency is commonly associated with restless leg syndrome?

Answer 30

Iron deficiency.

Question 31

What pharmacologic treatment is used for restless leg syndrome?

Answer 31

Dopamine agonists (e.g., pramipexole, ropinirole).

Question 32

What is circadian rhythm sleep-wake disorder?

Answer 32

A disorder characterized by misalignment between the endogenous circadian rhythm and sleep-wake schedules.

Question 33

What are common types of circadian rhythm sleep-wake disorders?

Answer 33

Shift work disorder, jet lag disorder, delayed and advanced sleep phase disorders.

Question 34

Which population is most affected by delayed sleep phase disorder?

Answer 34

Adolescents and young adults.

Question 35

What is the primary treatment for shift work sleep disorder?

Answer 35

Light therapy and melatonin supplementation.

Question 36

What is Kleine-Levin syndrome?

Answer 36

A rare hypersomnia disorder characterized by recurrent episodes of excessive sleep, hyperphagia, and hypersexuality.

Question 37

What is sleep paralysis?

Answer 37

A transient inability to move or speak while falling asleep or waking up, often with hallucinations.

Question 38

What is the function of sleep spindles?

Answer 38

They aid in memory consolidation and sensory processing during sleep.

Question 39

What is advanced sleep phase disorder?

Answer 39

A circadian rhythm disorder where sleep onset and wake-up times are earlier than desired, common in older adults.

Question 40

What is polysomnography (PSG) used to diagnose?

Answer 40

Sleep apnea, periodic limb movement disorder, REM sleep behavior disorder, and nocturnal seizures.

Question 41

What is actigraphy?

Answer 41

A non-invasive method to assess sleep patterns by recording body movements.

Question 42

Which sleep disorder is commonly associated with depression?

Answer 42

Insomnia.

Question 43

What cardiovascular risk is associated with obstructive sleep apnea?

Answer 43

Hypertension, atrial fibrillation, and stroke.

Question 44

Which sleep stage is most important for physical restoration?

Answer 44

N3 (slow-wave sleep).

Question 45

Which sleep stage is most important for cognitive function and memory consolidation?

Answer 45

REM sleep.

Question 46

How does aging affect sleep architecture?

Answer 46

Increased sleep latency, more nighttime awakenings, and reduced slow-wave sleep (N3).

Question 47

What is the effect of alcohol on sleep?

Answer 47

Disrupts REM sleep and increases sleep fragmentation.

Question 48

What is paradoxical sleep?

Answer 48

Another name for REM sleep due to its EEG resemblance to wakefulness.

Question 49

What is the first-line treatment for nightmare disorder?

Answer 49

Cognitive behavioral therapy and imagery rehearsal therapy.

Question 50

What is the difference between sleep terrors and nightmares?

Answer 50

Sleep terrors occur in N3 sleep and lack recall, while nightmares occur in REM sleep and are vividly remembered.

Question 51

What are common medications that disrupt sleep?

Answer 51

Caffeine, beta-blockers, SSRIs, corticosteroids, and stimulants.

Question 52

What is sleep inertia?

Answer 52

A state of grogginess and reduced alertness upon waking from deep sleep.

Question 53

How long does a typical sleep cycle last?

Answer 53

Approximately 90 minutes.

Question 54

What is the function of K-complexes?

Answer 54

They help suppress arousal and promote sleep continuity.

Question 55

What is the treatment for severe chronic insomnia?

Answer 55

Cognitive behavioral therapy combined with pharmacologic therapy (e.g., sedative-hypnotics).