Questions and Answers
Dyssomnia includes both insomnia and hypersomnia as types of sleep difficulties.
True
Persistent sleep difficulties are not significantly associated with adverse physical health outcomes.
False
ICD-10 and DSM-5 classify sleep disorders in the same way.
False
Secondary sleep disorders may be symptoms of psychiatric disorders.
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Kleine-Levin syndrome is classified as a non-psychogenic sleep disorder in ICD-10.
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The DSM-5 recognizes only five categories of sleep disorders.
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Parasomnias are related to behaviors associated with sleep.
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Emotional causes are categorized under 'organic sleep disorders' in ICD-10.
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Narcolepsy can be diagnosed primarily through the Epworth Sleepiness Scale.
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The predominant cause of Breathing-Related Sleep Disorder is hereditary.
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Kleine-Levin Syndrome primarily affects adult women.
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Circadian Rhythm Sleep Disorder can result from irregular work schedules.
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Modafinil is an amphetamine used to treat excessive daytime sleepiness in narcolepsy.
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Antidepressants such as Venlafaxine can help manage symptoms of narcolepsy.
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Sodium oxybate primarily enhances daytime alertness in patients with narcolepsy.
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The prevalence of Breathing-Related Sleep Disorder is about 4% in the female population.
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Video recording is a common method used for assessing sleep disturbances.
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Cognitive therapy is not considered an effective treatment for insomnia.
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Melatonin is classified as a non-pharmacological treatment for insomnia.
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A sleep diary should be maintained for a period of at least one week.
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Short-acting benzodiazepines are not commonly used for treating insomnia.
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It is advisable to use mobile devices in bed to help fall asleep.
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Caffeine-containing drinks should be consumed only in the morning to avoid disturbing sleep.
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Recognizing factors that worsen sleep is an important part of evaluating sleep history.
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Puberty triggers a change towards morning preference in adolescents.
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Night terrors are more common than nightmares in children.
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Sleepwalking disorder typically occurs during deep REM sleep.
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Restless legs syndrome can be mistaken for a psychiatric symptom.
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Excessive daytime sleepiness affects approximately 1 in 200 people.
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Parasomnias only occur in children and cannot affect adults.
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Type 1 narcolepsy is characterized by normal levels of orexin-A in the cerebrospinal fluid.
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Narcolepsy may be triggered by infections or other stimuli, indicating it could have an autoimmune aspect.
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Episodes of sleep paralysis are often accompanied by extreme calm.
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Shift-work sleep disorder is listed as one of the causes of excessive daytime sleepiness.
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The peak frequency for nightmares occurs around ages 5 or 6.
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HLA-DQB1*06:02 genotype increases the risk of narcolepsy by a factor of around 100.
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Clonazepam and donepezil are considered effective treatments for REM sleep behavior disorder.
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Night terror disorder can persist into adulthood without any familial ties.
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Type 2 narcolepsy is always associated with cataplexy.
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Approximately 15-30% of the general population possess the HLA-DQB1*06:02 genotype.
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15% of children aged 5 to 12 will walk in their sleep at least once.
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Obstructive sleep apnoea is not mentioned as a cause of excessive daytime sleepiness.
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The DSM-5 classifies insomnia disorder under breathing-related sleep disorders.
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Excessive sleepiness affects approximately 5% of adults.
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In the ICD-10, narcolepsy is classified as a non-organic sleep disorder.
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Transient insomnia can occur due to stress or jet lag.
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The International Classification of Sleep Disorders (ICSD 3) identifies over 100 types of sleep disorders.
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ICD-10 requires insomnia to be present for at least three nights a week for one month to be diagnosed.
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Restless legs syndrome is included in both DSM-5 and ICD-10 classifications of sleep disorders.
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Sleepwalking is classified as a breathing-related sleep disorder in ICD-10.
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The identification of primary nocturnal enuresis falls under the sleep disorders of organic origin category in ICD-10.
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Only 4% of adults meet the criteria for insomnia in the ICD-10 classification.
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Study Notes
Overview of Sleep Disorders
- Growing awareness of sleep problems' impact on mental and physical health has led to increased specialization in sleep medicine.
- Sleep disorders encompass both dyssomnias (insomnia, hypersomnia) and parasomnias (behaviors associated with sleep).
- Sleep issues can indicate primary sleep disorders, be a symptom of psychiatric conditions, or contribute to psychiatric disorders.
Persistent Sleep Difficulties
- Persistent sleep issues are linked to various negative physical health outcomes.
Classification of Sleep Disorders
- DSM-5 identifies 10 sleep-wake disorders including insomnia disorder, hypersomnolence disorder, and narcolepsy.
- ICD-10 categorizes sleep disorders based on aetiology, including non-organic and organic sleep disorders.
Assessment of Sleep Disturbance
- Key screening questions evaluate sleep quality, daytime sleepiness, and nighttime disturbances.
- A comprehensive sleep history and sleep diary help document sleep patterns and related factors.
- Investigations may include actigraphy, polysomnography, and cerebrospinal fluid analysis.
Treatments for Insomnia
- Cognitive and Behavioral Interventions focus on sleep hygiene, sleep restriction, and relaxation techniques.
- Pharmacological Treatments range from short-acting benzodiazepines to melatonin agonists and low-dose sedative antidepressants.
Principles of Sleep Education (Sleep Hygiene)
- Optimal sleep environment: familiar, dark, and quiet.
- Recommended practices include regular bedtime, limited screentime before sleep, and consistent routines.
- Activities to avoid: late exercise, caffeine, excessive alcohol, and large meals before bed.
Insomnia
- Defined as unsatisfactory sleep quality or quantity with difficulty falling asleep, staying asleep, or waking too early.
- Often secondary to other conditions like depression, anxiety, or physical ailments.
- Diagnosis requires persistent insomnia occurring at least three nights per week for a month (ICD-10) or three months (DSM-5).
Narcolepsy
- A neurological disorder characterized by excessive daytime sleepiness, cataplexy, and hypnagogic hallucinations.
- Type 1 narcolepsy involves reduced orexin-A levels and is linked to specific genetic markers (HLA-DQB1*06:02).
- Treatment includes sleep management, stimulant medications, and occasionally antidepressants.
Breathing-Related Sleep Disorder
- Defined by daytime drowsiness with recurrent apneas, often linked to upper airway obstruction.
- About 4% of males are affected, with management focused on addressing the underlying causes and promoting weight loss.
Kleine-Levin Syndrome
- Rare disorder marked by episodes of excessive sleep, hyperphagia, and hypersexuality.
- Affects primarily adolescent boys, with unknown causes and variable treatment approaches, including stimulants and mood stabilizers.
Circadian Rhythm Sleep Disorder
- Encompasses conditions like jet lag and shift-work disorder, leading to fatigue and sleep disturbances due to irregular sleep patterns.
Hypersomnia and Excessive Daytime Sleepiness
- Commonly underdiagnosed, with prevalence estimates of 3-5%.
- Can result from insufficient sleep, medical disorders, or sedative medication use.
Parasomnias
- Abnormal behaviors accompanying sleep, prevalent in children and increasing with age-related disorders.
- Nightmares: Typically peak during childhood; related to anxiety and stressful experiences.
- Night Terrors: More common in childhood; involve episodes of terror within hours of sleep onset.
- Sleepwalking: Typically occurs in children; characterized by repetitive movements or walking while seemingly asleep.
- REM Sleep Behavior Disorder: Agitation during REM sleep; may precede neurodegenerative diseases.
- Restless Legs Syndrome: Painful condition causing disruptive sleep; prevalent among women and the elderly.
- Sleep Paralysis: Characterized by temporary inability to move during sleep transition, often accompanying fear.
Accidents and Behavioral Effects
- Sleep disorders can increase the risk of accidents and significantly impact social and emotional well-being, especially in adolescents.
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Description
This quiz explores various sleep disorders and their impact on both mental and physical health. It covers classifications such as DSM-5 and ICD-10 while emphasizing the importance of sleep assessments. Test your knowledge on persistent sleep difficulties and their implications for overall health.
