Sleep Disorders

Question 1

Short term insomnia lasts

Answer 1

Less than 3 months

Question 2

Chronic insomnia is characterized by symptoms that occur

Answer 2

> 3x/week for >3 months

Question 3

How many categories are there of sleep disorders?

Answer 3

7

Question 4

What are 6 priority differentials of sleep disorders?

Answer 4

Medical conditions, medications, chronic pain, CHF, OSA, chronic lung disease (asthma)

Question 5

CNS hypersomnies present with complaints of

Answer 5

Daytime sleepiness

Question 6

The older patient is more likely to

Answer 6

Have difficulty falling asleep or staying asleep (or both)

Question 7

What 2 H1 antagonists can contribute to insomnia?

Answer 7

Claritin and Allegra

Question 8

OSA/hypopnea syndrome signs may include

Answer 8

Large neck size (>17in in men), enlarged tonsils, mallampati airway score of 3 or 4, low-lying soft palate (patients with HTN or cardiac disease)

Question 9

A sleep log diary should be used over

Answer 9

1-2 weeks

Question 10

What diagnostic tool is often used?

Answer 10

Pittsburgh Sleep Quality Index (PSQI)

Question 11

What diagnostic labs should be ordered?

Answer 11

CBC, CMP or BMP, TSH with reflex to T4

Question 12

What is the gold standard diagnostic of sleep disorders?

Answer 12

Polysomnography (PSG) - sleep study

Question 13

Actigraphy may help document sleep patterns and circadian rhythms but is not ideal for

Answer 13

Insomnia

Question 14

A split night study is a combination of

Answer 14

A full polysomnography and CPAP trial

Question 15

What are 2 daytime studies?

Answer 15

Multiple sleep latency test (MSLT) and maintenance of wakefulness test (MWT)

Question 16

What drugs should be used for treatment of restless leg syndrome?

Answer 16

Antidepressants or dopamine agonists

Question 17

Alcohol, tobacco, and exercise should be avoided for at least how long before bedtime?

Answer 17

4 hours

Question 18

What drug is a melatonin agonist?

Answer 18

Ramelteon (Rozerem)

Question 19

What heterocyclic antidepressant can be used as treatment?

Answer 19

Doxepin (Silinor)

Question 20

What DEA class are medications used for treatment of sleep disorders?

Answer 20

DEA IV

Question 21

What are 5 other drugs used for treatment?

Answer 21

Zolpidem (Ambien), Eszopiclone (Lunesta), Triazolam (Halcion), Temazepam (Restoril), and Suvorexant (Belsomra)

Question 22

What are 4 benzodiazepines used for treatment?

Answer 22

Diazepam (Valium), Alprazolam (Xanax), Clonazepam (Klonopin), and Lorazepam (Ativan)

Question 23

What 6 drugs should not be used for treatment?

Answer 23

Trazodone, Tiagabine, Diphenhydramine, Melatonin, L-tryptophan, and Valerian

Question 24

What is a common risk factor for OSA?

Answer 24

Obesity

Question 25

What are the major impediments to successful CPAP therapy?

Answer 25

Comfort and acceptance

Question 26

OSA can cause risk for

Answer 26

MVAs

Question 27

OSA carries greater risk for increased morbidity/mortality than what other disorder?

Answer 27

Central sleep apnea

Question 28

What should be ruled out when restless leg syndrome is suspected?

Answer 28

Peripheral neuropathy, Parkinson disease, B12 deficiency

Question 29

What labs should be ordered for restless leg syndrome?

Answer 29

Vitamin B12, CBC, fasting serum iron level, TIBC, ferritin, transferrin saturation, CMP

Question 30

What are 4 differential diagnoses for restless leg syndrome?

Answer 30

Arthritis, neuropathy, leg cramps, and vascular disease (claudication)

Question 31

What 3 drugs are used to manage restless leg syndrome?

Answer 31

Carbidopa/Levodopa (Sinemet), Gabapentin (Neurontin), and Pregabalin (Lyrica)

Question 32

A low dose dopamine agonist should be prescribed for

Answer 32

Restless leg syndrome

Question 33

What drugs can be used in the treatment of sleep onset insomnia?

Answer 33

Triazolam, Temazepam, Ramelteon

Question 34

What drugs should be used in maintenance insomnia?

Answer 34

Temazepam, Suvorexant, Doxepin

Question 35

What drug can be used for both sleep onset and maintenance insomnia?

Answer 35

Temazepam

Question 36

What is the most common sleep-related breathing disorder?

Answer 36

OSA

Question 37

Diagnosis of sleep disorders should be performed with

Answer 37

Overnight sleep testing

Question 38

What is the most common and effective treatment of OSA?

Answer 38

CPAP

Question 39

Central sleep apnea is most common between

Answer 39

Young adulthood and middle age

Question 40

An intrinsic CNS deficit results in

Answer 40

Hypersomnolence

Question 41

What is a primary hypersonic that is characterized by EDS and inappropriate manifestations of REM sleep?

Answer 41

Narcolepsy