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Questions and Answers
Which treatment is commonly used for Restless Legs Syndrome (Willis-Ekbom disease)?
What is a characteristic feature of sleep paralysis?
Which stage of sleep is associated with the occurrence of startles during the transition from NREM to REM?
Which treatment is NOT a first-line option for sleep disorders like Restless Legs Syndrome?
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What is the primary method used to measure brain activity during sleep?
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Which of the following is a characteristic feature of obstructive sleep apnea?
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Which type of episodes are NOT associated with cataplexy?
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What is the drug of choice for treating cataplexy?
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Which of the following factors is NOT typically associated with the etiology of obstructive sleep apnea?
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Which of the following is a common clinical feature of obstructive sleep apnea?
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What is a key characteristic of sleep terror disorder?
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Which of the following statements about restless legs syndrome is accurate?
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Which treatment is commonly used for sleepwalking disorder?
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What is a typical feature related to nightmares?
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What population percentage is affected by sleepwalking disorder?
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Which factor is often associated with parasomnias?
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What clinical feature is associated with sleep terror disorder?
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Which treatment is recommended for nightmare disorder?
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Study Notes
Restless Legs Syndrome
- First-line treatments include dopamine agonists (pramipexole and ropinirole) and benzodiazepines.
- Other treatments include muscle relaxants, opioids, and gabapentin/pregabalin.
Sleep Startles
- Occur during the transition from stage 3 NREM to REM sleep.
- The motor center is excited, causing muscles to activate suddenly.
- Characterized by a feeling of falling.
Sleep Paralysis
- A state of awareness where a person is unable to move or speak.
- Triggered by sleep deprivation, psychological stress, or abnormal sleep cycles.
- Experienced by 8% to 50% of people at some point in their lives.
- Occurs during REM sleep.
- Characterized by an imbalance in neural functions regulating sleep, causing overlap of sleep states.
- Can be accompanied by hallucinations.
How to Measure Brain Activity
- An electroencephalogram (EEG) measures brain activity by recording electrical signals from the scalp.
- 24 electrodes are placed on the scalp at standard positions.
- Differences in electrical charges recorded by each electrode are plotted on a graph versus time.
- While individual neuron activity cannot be measured, the activity of neuron groups can be observed.
- Polysomnography (PSG) is used in sleep medicine to measure brain activity.
Circadian Rhythm Sleep Disorders
- Common features include insomnia, excessive daytime sleepiness, irritability, frequent waking during abnormal hours, headaches, and impaired concentration.
Parasomnias
- Include sleepwalking disorder, sleep terror disorder, and nightmare disorder.
Sleepwalking Disorder (Somnambulism)
- Occurs during non-REM sleep, resulting in no memory of the event.
- Affects 2% of adults and 20% of children.
- Etiology is unknown but thought to be genetic.
- Characterized by sitting up, walking, or eating during sleep.
- Patients often have a blank stare and difficulty arousing during episodes.
- Treatment includes education and reassurance, and benzodiazepines (clonazepam).
Sleep Terror Disorder
- Occurs during non-REM sleep, resulting in no memory of the event.
- Affects 7% of adults and 30% of children.
- Associated with sleep deprivation, irregular sleep schedules, and medications like sedatives, hypnotics, lithium, and anticholinergics.
- Etiology is either idiopathic or genetic (inherited in 80% of cases).
- Characterized by recurrent episodes during the first third of the sleep cycle, including sitting up, walking, or eating.
- Patients have a blank stare and difficulty arousing during the episode.
- Treatment includes education and reassurance, and benzodiazepines (clonazepam).
Nightmare Disorder
- Occurs during REM sleep, causing the patient to remember the dream.
- Affects 2% of adults, typically during early adulthood.
- Characterized by recurrent frightening dreams during the second half of the sleep cycle.
- Patients remember the dream after awakening.
- Treatment includes therapy and antidepressants (prazosin and antidepressants).
Narcolepsy
- Characterized by excessive daytime sleepiness, cataplexy, sleep paralysis, and hallucinations.
- More common in males than females.
- Etiology is a decreased ability to regulate sleep-wake cycles due to low levels of orexin, a wakefulness-promoting neuropeptide.
- Caused by lesions to the posterior hypothalamus and midbrain.
- Treatment options include sodium oxybate (drug of choice), antidepressants, stimulants, and modafinil.
Obstructive Sleep Apnea
- A chronic breathing-related disorder characterized by repetitive episodes of breathing cessation or reduced airflow during sleep.
- Affects 1-2% of children, 15% of middle-aged adults, and over 20% of older adults.
- Etiology includes obesity, increased neck circumference, and airway narrowing.
- Clinical features include excessive daytime sleepiness, snoring, frequent awakenings, nonrefreshing sleep or fatigue, morning headaches, and hypertension.
- Treatment options include continuous positive airway pressure (CPAP), weight loss, exercise, and surgery.
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Description
This quiz delves into various sleep disorders such as Restless Legs Syndrome, Sleep Startles, and Sleep Paralysis, alongside methods for measuring brain activity like EEG. Explore the symptoms, causes, and treatments associated with these conditions to enhance your understanding of sleep science.
