Sleep Disorders

Question 1

what are 3 criteria for sleep

Answer 1

1. difficulty initiating and/or maintaining sleep. waking too early
2. sleep difficulty persists even with adequate opportunity
3. daytime complaints

Question 2

what defines acute insomnia

Answer 2

less than 3 months duration

related to identifiable stressor

Question 3

what are 5 inadequate sleep hygiene

Answer 3

1. Irregular sleep schedule
2. use of sleep disturbing substance before bedtime
3. mentally or physically stimulating activities before bed
4. Frequent use of bed or bedroom activities unrelated to sleep
5. uncomfortable sleep envirnment

Question 4

what is psychophysiological insomnia

Answer 4

learned sleep-preventing insomnia

- racing thoughts, anxiety

Question 5

idiopathic insomnia when does it begin

Answer 5

infancy or early childhood

Question 6

what might idiopathic insomnia be related to

Answer 6

ADHD

Question 7

Paradoxical insomnia

Answer 7

normal EEG
overestimate time to fall asleep
underestimate total sleep time

Question 8

what are some medical conditions assoicated with insomina

Answer 8

pulmonary
heart
depression, anxiety
caffeine

Question 9

what happens to prevalence of insomnia with age

Answer 9

increases

Question 10

what gender gets insomnia more

Answer 10

women

Question 11

what is a clinical feature of insomnia

Answer 11

difficulty falling asleep greater than 30 min
staying sleep for less than 6 hours
on three or more nights per week
-DAYTIME SLEEPINESS

Question 12

what are 2 situations in which they are not insomnia

Answer 12

short duration sleep ( no daytime complaints)

Sleep deprivation

Question 13

obstructive sleep apnea

Answer 13

recurrent episodes of upper airway collapse during sleep

-associated with recurrent oxyhemoglobin desaturations

Question 14

clinical features of obstructive sleep apnea

Answer 14

daytime sleepiness
sensation of choking
snoring

Question 15

physical exam findings for obstructive sleep apnea

Answer 15

narrow airway
large neck
elevated blood pressure

Question 16

treatment for obstructive sleep apnea

Answer 16

positive airway pressure therapy

Question 17

how does doctor diagnose obstructive sleep apnea

Answer 17

polysomnography

asymptomatic: greater than 15 apneas
symptomatic: less than 15 apneas

Question 18

EEG moniters

Answer 18

sleep stages

Question 19

EOG electrooculography monitros

Answer 19

horizontal and vertical eye movements

onset of REM

Question 20

EMG electromyogrpahy monitors

Answer 20

atonia during REM
limb movements
effort during respiratory events

Question 21

Polysomnography monitors what

Answer 21

airflow

others: ecg, pulse oximetry

Question 22

what are risk factors for central sleep apnea

Answer 22

age greater 65
men
heart failure 
stroke
long-acting opioid use

Question 23

clinical findings for central sleep apnea

Answer 23

daytime sleepiness

Question 24

how do you diagnose central sleep apnea

Answer 24

polysomnography

Question 25

treatment for central sleep apnea

Answer 25

positive airway pressure | treat underlying disorder

Question 26

Narcolepsy

Answer 26

disorder of sleep-wake control

Question 27

etiology of narcolespry

Answer 27

loss of orexin A and B signaling from hypothalamus | genetic factors

Question 28

role of Orexin A and B

Answer 28

stabilize wakefulness | prevent inappropriate transitions to REM or NREM sleep

Question 29

what genetic factor is present in patients with Narcolepsy

Answer 29

DQB1 0602 haplotype

Question 30

clinical feature of narcolepsy

Answer 30

daytime sleepiness: fall asleep throughout day with little warning sleep paralysis: occur without falling asleep cataplexy ( strong emotion/laughter) hallucinations: occurs while falling asleep

Question 31

when do narcolepsy patients enter REM sleep, normal person

Answer 31

n: within 20 min normal: 90 mins

Question 32

what diagnostic tool is sued for Narcolepsy

Answer 32

polysomnography | multiple sleep latency test (MSLT)

Question 33

what is multiple sleep latency test (MSLT)

Answer 33

subjects monitered while trying to fall asleep sleep latency measured if less then 8 min--> narcolepsy normal is 10-15 minutes must occur at least 2 times

Question 34

Restless leg syndrome

Answer 34

spontaneous, continous leg movements | unpleasant paresthesias

Question 35

what relieve restless leg syndrome

Answer 35

movement

Question 36

what is related to secondary RLS associations

Answer 36

iron deficiency | end stage renal disease

Question 37

what is periodic limb movement of sleep

Answer 37

sudden jerking leg movements

Question 38

what is the difference between diagnosis of primary and secondary restless leg syndrome

Answer 38

primary: normal neurologic exam secondary: abnormal neurologic exam polysomnography not necessary

Question 39

clinical feature of shift work disorder

Answer 39

difficulty sleeping past noon

Question 40

traveling east to west is easier for who

Answer 40

individuals with sleep-wake cycle longer than 24 hours