Sleep Disorders

Question 1

Biological functions of sleep include physical restoration, ______, and ______ consolidation.

Answer 1

Brain development, memory

Question 2

The physiologic effects of sleep deprivation include ______, cognitive impairment, and emotional distress.

Answer 2

Obesity

Question 3

______ sleep accounts for 75-80% of total sleep time, while ______ sleep accounts for 20-25%.

Answer 3

NREM, REM

Question 4

During NREM sleep, the brain is quiet, but the body is ______.

Answer 4

Active

Question 5

REM sleep is driven by ______ pressure, while NREM sleep is driven by ______ pressure.

Answer 5

Circadian, homeostatic

Question 6

The neurotransmitter ______ reduces wakefulness and is promoted by drugs like melatonin agonists.

Answer 6

Adenosine

Question 7

The circadian drive for sleep resides in the ______ of the brain and is influenced by light and dark.

Answer 7

Suprachiasmatic nucleus

Question 8

Neurotransmitters that promote wakefulness include ______, dopamine, and norepinephrine.

Answer 8

Acetylcholine

Question 9

Antihistamines, which block ______ receptors, are commonly used to promote sleep.

Answer 9

H1

Question 10

GABAergic drugs like benzodiazepines and Z-drugs enhance the activity of ______, which inhibits arousal.

Answer 10

GABA

Question 11

Dyssomnias include disorders like ______, ______, and narcolepsy, which involve difficulty falling or staying asleep.

Answer 11

Insomnia, obstructive sleep apnea

Question 12

Parasomnias include abnormal behaviors during sleep, such as nightmares and ______.

Answer 12

Sleepwalking

Question 13

The most common sleep disorder is ______, affecting 10-30% of adults.

Answer 13

Insomnia

Question 14

Insomnia is characterized by difficulty falling asleep, staying asleep, or experiencing ______ sleep.

Answer 14

Nonrestorative

Question 15

For a diagnosis of chronic insomnia, sleep disturbances must occur at least ______ nights per week for ______ months.

Answer 15

Three, three

Question 16

Risk factors for insomnia include comorbid conditions such as chronic pain, ______, and anxiety.

Answer 16

Depression

Question 17

Patients with insomnia may benefit from cognitive behavioral therapy, which includes techniques such as ______ control and sleep ______.

Answer 17

Stimulus, restriction

Question 18

Common sleep hygiene practices include going to bed and waking up at the same time and avoiding ______ before bedtime.

Answer 18

Caffeine

Question 19

The pharmacologic treatment of insomnia often begins with low-dose ______ antidepressants, such as trazodone.

Answer 19

Sedating

Question 20

______ are often used to treat insomnia but carry a risk of dependence and cognitive impairment.

Answer 20

Benzodiazepines

Question 21

Z-hypnotics like zolpidem and zaleplon target the ______ receptor and are used for sleep onset insomnia.

Answer 21

GABA-A

Question 22

Ramelteon is a selective ______ receptor agonist used to treat sleep onset insomnia.

Answer 22

Melatonin

Question 23

Orexin receptor antagonists, such as suvorexant, are useful for both sleep ______ and ______.

Answer 23

Initiation, maintenance

Question 24

Antihistamines like diphenhydramine are commonly used as sleep aids but have significant ______ side effects.

Answer 24

Anticholinergic

Question 25

The ______ scale is used to assess excessive daytime sleepiness in patients with narcolepsy.

Answer 25

Epworth Sleepiness

Question 26

Restless leg syndrome is characterized by an urge to move the legs and is often worse during ______.

Answer 26

Inactivity

Question 27

Dopamine agonists, such as pramipexole and ropinirole, are commonly used to treat ______.

Answer 27

Restless leg syndrome

Question 28

______ is a GABA analog that is used to treat restless leg syndrome by reducing excitatory neurotransmission.

Answer 28

Gabapentin

Question 29

Obstructive sleep apnea occurs when the ______ collapses during sleep, causing periods of apnea and hypopnea.

Answer 29

Airway

Question 30

Common risk factors for obstructive sleep apnea include a BMI greater than ______ and a neck circumference greater than ______ inches in men.

Answer 30

25, 17

Question 31

Continuous positive airway pressure (CPAP) is the first-line treatment for ______.

Answer 31

Obstructive sleep apnea

Question 32

Daytime drowsiness that persists despite CPAP therapy may be treated with ______ or ______.

Answer 32

Modafinil, armodafinil

Question 33

Narcolepsy is characterized by excessive daytime sleepiness and sudden episodes of muscle weakness known as ______.

Answer 33

Cataplexy

Question 34

Patients with narcolepsy may experience vivid dream-like hallucinations, known as ______ hallucinations, while falling asleep.

Answer 34

Hypnagogic

Question 35

Sodium oxybate (Xyrem) is used to treat cataplexy and excessive daytime sleepiness by increasing ______ sleep.

Answer 35

REM

Question 36

Suvorexant is an orexin receptor antagonist that should be taken within ______ minutes of bedtime.

Answer 36

30

Question 37

Patients using Z-hypnotics should be advised to avoid ______ due to the risk of cognitive impairment and falls.

Answer 37

Alcohol

Question 38

The use of ______ is contraindicated in patients with narcolepsy, as it can worsen symptoms.

Answer 38

Orexin receptor antagonists

Question 39

Melatonin supplements are commonly used for ______ disorders, such as jet lag.

Answer 39

Circadian rhythm

Question 40

Iron supplementation may be beneficial for patients with restless leg syndrome and low serum ______ levels.

Answer 40

Ferritin

Question 41

The treatment of insomnia with Z-hypnotics carries a boxed warning for complex ______ behaviors, such as sleepwalking.

Answer 41

Sleep

Question 42

The ultrashort-acting Z-hypnotic ______ can be taken during the night for middle-of-the-night awakenings.

Answer 42

Zaleplon

Question 43

______ is the only antidepressant FDA-approved for the treatment of insomnia.

Answer 43

Doxepin

Question 44

NREM sleep is primarily responsible for ______ restoration, while REM sleep is associated with ______ restoration.

Answer 44

Physical, mental

Question 45

The brain exhibits ______ waves during deep NREM sleep, which are associated with memory consolidation.

Answer 45

Delta

Question 46

During REM sleep, the body is ______, but the brain is highly active.

Answer 46

Paralyzed

Question 47

A normal sleep cycle alternates between NREM and REM sleep approximately every ______ minutes.

Answer 47

90

Question 48

Patients with obstructive sleep apnea may exhibit ______, a cessation of airflow for more than 10 seconds.

Answer 48

Apnea

Question 49

Modafinil and armodafinil work by inhibiting the reuptake of ______ to promote wakefulness in patients with narcolepsy.

Answer 49

Dopamine

Question 50

Patients with narcolepsy and cataplexy may benefit from REM-suppressing drugs such as ______ and SSRIs.

Answer 50

Tricyclic antidepressants

Question 51

The medication ______, which is used for narcolepsy, is available only through a restricted access program due to its risk of abuse.

Answer 51

Sodium oxybate

Question 52

Patients with narcolepsy may experience sleep ______, a temporary inability to move or speak upon waking.

Answer 52

Paralysis