Sleep

Question 1

Narcolepsy

Answer 1

• irresistible attacks of refreshing daytime sleep that occur at least 3 times per week for 3 months or more
• associated with low levels of CSF hypocretin (orexin)
• sudden loss of muscle tone (cataplexy)
• increased intrusion of REM sleep into transition between sleep and wakefulness causing hypnopompic (while awakening) and hyponogogic (while falling asleep) and sleep paralysis
  Treatment: sodium oxybate (synthetic analog of date rate drug)
  Treatments:

Question 2

Hypersomnolence disorder

Answer 2

excessive sleepiness 3 times per week for three months as demonstrated by prolonged sleep episodes at night that are non-restorative or daily sleep episodes during the day
Treatment: stimulants or provigil

Question 3

What is used to treat Circadian rhythm sleep wake disorder?

Answer 3

Modafinil

Question 4

How does depression affect REM?

Answer 4

shortened REM latency
increased percentage of REM sleep
shift in REM distribution from the last half to the first half of the night

Question 5

over 65

Answer 5

• more REM episodes that are shorter, less total REM sleep
• NREM sleep have decreased amplitude of delta waves
• lower percentage of N3 sleep
• higher percentage of N1 and N2 sleep
• elderly experience increased awakening after sleep onset

Question 6

sleep terrors

Answer 6

recurrent episodes of awakening and screaming during the first third of the night
- intense fear, autonomic arousal, sweating, tachy, rapid breathing
- no dreams recalled
- small doses of diazepam are often helpful to stop the episodes

Question 7

sleep in the elderly

Answer 7

decrease in REM and decrease in slow wave sleep

Question 8

elderly sleep

Answer 8

• gradual decrease in N3 sleep
• increase in N1 sleep
• decreased REM sleep
• sleep efficiency progressively decreases
• progressive advance in sleep/wake times with aging - gradual phase advance in the internal biological clock

Question 9

sleep walking (somnambulism)

Answer 9

-common age 5-12
-arising out of slow wave sleep (stage 4)-during first one-third of sleep
- medications that may improve condition: imipramine, benzos

night terrors also in stage 4

jk n3

Question 10

REM in adulthood

Answer 10

25% sleep time