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Flashcards in Sleep DIsorders Deck (22):
1

"Attenuation of the posterior dominant background rhythm" is the buzz phrase for which stage of sleep?

N1

2

What are the buzz word characteristics for N2?

sleep spindles and K complexes

3

What's the buzz phrase for N3?

background consisting of more than 20% in delta frequency (0.5 to 2 Hz range)

4

What stage of sleep is suppressed by benzos?

N2

5

What stage of sleep is suppressed by antidepressants and alcohol?

REM

6

What percentage of time is spent in REM sleep for adults?

20-25%

7

What part of the brain controls circadian rhythms?

suprachiasmatic nucleus of the hypothalamus (with inputs from the pineal gland via melatonin)

8

What can be seen in someone with restless leg syndrome while they're asleep?

periodic limb movements of sleep - repetitive involuntary movements of the lower extremity that last 2-3 seconds and then are followed by a slow recovery of the normal leg position

9

What should lab evaluation of RLS include?

ferritin and iron levels because many patients with RLS have iron deficiency

10

What are the treatments of choice for RLS?

dopamine agonists - ropinirole and pramipexole preferred over levodopa

11

What does augmentation mean in the setting of RLS?

it's the occurrence of RLS symptoms earlier in the day in response to dopamine agonists

12

What are the four components of narcolepsy?

narcolepsy
cataplexy
sleep paralysis
hypnagogic hallucinations

13

What is the pathophysiology of narcolepsy?

loss of hypocretin-secreting neurons in the hypothalamus

14

What would you see in the CSF in narcolepsy?

a hypocretin level less than 110 pg/mL

15

What's the typical diagnostic test for narcolepsy though?

a multiple sleep latency test that involves several short naps and monitoring of the latency to sleep onset and latency to REM onset.

sleep latency of less than 8 minutes with more than two episodes of REM at sleep onset is diagnostic for narcolepsy

16

What is the agent of choice for treatment of narcolepsy?

modafinil

17

What agents are used to treat the cataplexy component?

TCAs, fluoxetine, venlafaxine and sodium oxybate (a GABA metabolite)

18

Describe a sleep terror. How are they distinguished from nightmares?

rapid awakening from sleep with fearful behavior like screaming, associated with autonomic hyperactivity

a lack of memory for the event distinguishes sleep terrors from nightmares

19

What is the preferred treatment for REM sleep behavior disorder?

clonazepam

20

Nocturnal cramps are painfultightness of the lower extremity muscles ocurring at night. What's the most effective medication for this?

quinine

21

What is the most common sleep disorder?

insomnia

22

What is the first step in treating insomnia?

behavioral changes - sleep hygiene