Lecture 9

Question 1

What is sleep enuresis? (RONDSE)

Answer 1

• recurrent involuntary urination during sleep
• > 5yrs old, at least 2x/week, for at least 3mths
• occurs during first 1/3rd of night, all stages of sleep
• NREM: longer duration, partial arousal
• dream content not causal
• social impact
• embarrassment, frustration, anger

Question 2

What is micturition?

Answer 2

contractions of bladder

Question 3

What are the types of sleep enuresis?

Answer 3

1. primary

2. secondary

Question 4

What is primary sleep enuresis? (NUIHRC)

Answer 4

• never consistently dry for 6mths
• undeveloped nocturnal incontinence
• insufficient toilet training
• high urinary volume
• reduced vasopressin
• chromosome 12/13q malfunction

Question 5

What is secondary sleep enuresis?

Answer 5

• consistently dry for 6mths
• loss of bladder control after development
• found w/ diuretics, OSA, epilepsy, stroke, dementia, spinal cord lesions

Question 6

What is the treatment for sleep enuresis?

Answer 6

• underlying cause: stressful events - parent’s divorce/moving
• daytime bladder awareness & pelvic floor training, avoid fluids at night, alarmed mattress pad/clothing
• medication: imipramine hydrochloride (affects bladder myoneural junction)

Question 7

What are (nocturnal) sleep-related eating disorders (NSRED/SRED)? (STUSNGRT)

Answer 7

• sleepwalking, food preparation, compulsive eating behaviour
• triggered by partial arousal from sleep
• unusual items consumed
• safety concerns: damage to person/home from cutting, using oven/stovetop, toxicity
• no memory for events
• GI, obesity concerns
• rare
• teen-young adults

Question 8

What are symptoms of NSRED/SRED? (NUVSP)

Answer 8

• no appetite for breakfast
• undetermined weight gain
• vomiting
• stool issues
• pain (if ingested unusual substances)

Question 9

What are the causes of NSRED/SRED?

Answer 9

• unknown
• correlated with eating disorders/restricted eating
• other sleep disorder/psychological disorder

Question 10

What is treatment for NSRED/SRED? (BLUAM)

Answer 10

• bells/alarms when leave room
• lock cabinets; remove food from house
• unplug oven/remove knobs
• avoid alcohol, determine if other medications’ side effect
• medication: dopamine agonist, SSRIs

Question 11

What is exploding head syndrome (EHS)? (EP IBGPF)

Answer 11

• “episodic cranial sensory shock”
• parasomnia
• imagined loud indecipherable noises
• bright flashes of light
• groupings of muscle twitch/jerk
• painless, no feeling
• fear-inducing

Question 12

What are the features of EHS?

Answer 12

• duration: seconds
• 1x every few months to several times in 1 night, or over several nights, cluster and return
• any sleep stage, more common at sleep onset/waking
• confused w/ headaches, migraines
• onset early teens, 50’s-60’s more common
• rare

Question 13

What are the causes of EHS?

Answer 13

• other sleep disorders
• medication side effects
• substance abuse
• stress

Question 14

What is the treatment for EHS?

Answer 14

• middle ear exam
• stress reduction
• migraine meds
• reassurance that it’s harmless
• relaxation training