W7_02 Abnormal Sleep

Question 1

what are three subtypes of insomnia?

Answer 1

psychophysiologic;
paradoxical insomnia;
fatal familial insomnia (prion)

Question 2

what’s the mechanism for sleep apnea and morning headaches?

Answer 2

increased CO2 causes vasodilation and increased ICP

Question 3

definition of apnea?

Answer 3

absent airflow for >10 seconds

Question 4

DDx of central sleep apnea?

Answer 4

synringobulbia;
lateral medullary syndrome;
other brainstem issues;
atlantoaxial subluxation;
myotonic dystrophy;

Question 5

how is restless legs syndrome differentiated from a peripheral nerve syndrome?

Answer 5

because of the movement and the circadian rhythm components

Question 6

what aggravates restless syndrome?

Answer 6

begins/worsens with rest?

Question 7

difference of restless leg syndrome and periodic limb movement disorder?

Answer 7

RLS is the sensation and PLMD is the manifestation;
90% of RLS ppl have PLMD
50% of PLMD ppl have RLS

Question 8

what are causes of restless leg syndrome?

Answer 8

CNS (spasticity) or PNS (neuropathy);
alcohol use;
pregnancy;
iron deficiency;
ferritin issues

Question 9

how to treat restless leg syndrome/period limb movement disorder?

Answer 9

iron and folate supplementation;

dopaminergic agonists before bed

Question 10

what is the classic tetrad to diagnose narcolepsy?

Answer 10

1-excessive daytime sleepiness;
2-cataplexy;
3-hypnagogic hallucinations;
4-sleep paralysis

Question 11

what gene is correlated to narcolepsy?

Answer 11

HLA DQB1*0602 (suggests autoimmune issue)

Question 12

what are modafinil, methylphenidate, and other amphetamine-like drugs used for?

Answer 12

narcolepsy treatment

Question 13

anticholinergics, SSRIs, methylphenidate, sodium oxygate/GHB are examples of what kinds of drugs?

Answer 13

anticataplectic, for treatment of narcolepsy (cataplexy)

Question 14

orexin and hypocretin are what?

Answer 14

genes responsible for narcolepsy in dogs and mice

Question 15

where is preprohypocretin synthesized?

Answer 15

lateral/posterior hypothalamus

Question 16

night terrors, confusional arousals, somnambulism, sexsomia, somniloquy are examples of what?

Answer 16

slow wave sleep arousals; usually in first third of sleep

Question 17

what is REM sleep behaviour disorder?

Answer 17

loss of normal descending spinal inhibition in REM sleep; last third of sleep.

Question 18

idiopathic REM sleep behaviour patients go on to develop which disease?

Answer 18

parkinsonism

Question 19

which stage of sleep are epileptiform spikes most localizable?

Answer 19

REM

Question 20

which stage of sleep do most epileptic discharges occur?

Answer 20

NREM

Question 21

how does REM sleep and depression relate?

Answer 21

depression linked with shorter REM latency

Question 22

how long is a sleep cycle?

Answer 22

~90 minutes