Sleep-Wake Disorders: Chapter 8

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Questions and Answers

What is the primary effect of even a few hours of sleep deprivation on the immune system?

  • It enhances immune cell production, leading to overactivity.
  • It causes the immune system to target healthy cells.
  • It decreases immune functioning, making the body more susceptible to illness. (correct)
  • It has no significant impact on immune system function.

Sleep deprivation significantly impacts daily functioning. Which of the following aspects is least likely to be affected by sleep loss?

  • Sense of taste (correct)
  • Mood stability
  • Memory consolidation
  • Energy levels

How does sleep loss generally influence depression in individuals who are not already depressed?

  • It can bring on feelings of depression. (correct)
  • It triggers manic episodes.
  • It consistently alleviates depressive symptoms.
  • It has no impact on mood.

Which of the following is a key characteristic that differentiates dyssomnias from parasomnias?

<p>Dyssomnias primarily involve disturbances in the amount, quality, or timing of sleep, whereas parasomnias involve abnormal events during sleep. (B)</p> Signup and view all the answers

What is the main purpose of polysomnographic (PSG) evaluation in assessing disordered sleep?

<p>To evaluate brain wave activity, eye movements, and muscle movements during sleep. (B)</p> Signup and view all the answers

An actigraph is used to assess disordered sleep. What does this device primarily measure?

<p>Body movement to detect stages of wakefulness and sleep (A)</p> Signup and view all the answers

Which of the following is a key diagnostic criterion for insomnia disorder?

<p>Difficulty initiating or maintaining sleep, or early-morning awakening, occurring at least 3 nights per week for at least 3 months. (A)</p> Signup and view all the answers

What factor would disqualify a diagnosis of insomnia disorder?

<p>The insomnia is better explained by generalized anxiety disorder. (D)</p> Signup and view all the answers

Which of the following is a common characteristic associated with insomnia disorder?

<p>Unrealistic expectations about sleep (D)</p> Signup and view all the answers

Which of the following is a defining feature of hypersomnolence disorder?

<p>Sleeping too much or excessive sleep, despite having an adequate opportunity to sleep. (D)</p> Signup and view all the answers

Which diagnostic criterion is essential for diagnosing hypersomnolence disorder according to DSM-5?

<p>Self-reported excessive sleepiness despite a main sleep period lasting at least 7 hours, with associated symptoms. (A)</p> Signup and view all the answers

Which statement is indicative of hypersomnolence disorder?

<p>&quot;I can sleep through the night, but I still feel sleepy throughout the day.&quot; (A)</p> Signup and view all the answers

What is the principal symptom of narcolepsy?

<p>Recurrent intense need for sleep, irresistible lapses into sleep or napping (D)</p> Signup and view all the answers

Which of the following experiences is most indicative of narcolepsy?

<p>Experiencing a sudden loss of muscle tone triggered by laughter. (C)</p> Signup and view all the answers

According to DSM-5 criteria, how often must episodes of an irrepressible need to sleep occur to meet the criteria for narcolepsy?

<p>At least three times per week over the past 3 months (C)</p> Signup and view all the answers

Which of the following statements about narcolepsy is accurate?

<p>It typically improves over time. (A)</p> Signup and view all the answers

Which of the following best describes obstructive sleep apnea hypopnea?

<p>Airflow stops, but the respiratory system continues to work (A)</p> Signup and view all the answers

Which feature is commonly associated with breathing-related sleep disorders?

<p>Morning headaches (A)</p> Signup and view all the answers

What is the cause of disturbed sleep in circadian rhythm sleep-wake disorder?

<p>Brain's inability to synchronize day and night (A)</p> Signup and view all the answers

Which factor primarily contributes to circadian rhythm sleep-wake disorder, according to DSM-5 criteria?

<p>A persistent or recurrent pattern of sleep disruption due to an alteration of the circadian system. (A)</p> Signup and view all the answers

For insomnia, which of the following is the most appropriate use of benzodiazepines and over-the-counter sleep medications?

<p>Short-term solution to manage acute sleep disturbances. (D)</p> Signup and view all the answers

Which approach is generally considered the most effective for addressing circadian rhythm sleep-wake disorders?

<p>Phase delays by moving bedtime later. (B)</p> Signup and view all the answers

What is the primary focus of cognitive behavioral therapy for insomnia (CBT-I)?

<p>Psychoeducation about sleep, changing beliefs about sleep, extensive monitoring using sleep diary, and practicing better sleep habits. (B)</p> Signup and view all the answers

Which statement accurately describes the nature of parasomnias?

<p>The problem with parasomnias is abnormal events <em>during</em> sleep, or shortly after waking. (D)</p> Signup and view all the answers

Which category of sleep is associated with sleep terrors and sleepwalking?

<p>Non-REM (non-dream) sleep (D)</p> Signup and view all the answers

What is a key feature of non-REM sleep arousal disorders, such as sleep terrors and sleepwalking?

<p>Individual has no memory of the episodes (B)</p> Signup and view all the answers

Which of the following scenarios best describes a sleep terror episode?

<p>A child cannot be easily awakened during the episode, and has little memory of the event the next day. (D)</p> Signup and view all the answers

What is the recommended initial approach for treating sleep terrors in children?

<p>Wait-and-see posture (C)</p> Signup and view all the answers

What is the term for sleep walking?

<p>Somnambulism (C)</p> Signup and view all the answers

Which statement is true regarding sleepwalking disorder?

<p>It more common in children. (C)</p> Signup and view all the answers

What is the key characteristic of nightmare disorder?

<p>Repeated episodes of extended and extremely dysphoric dreams that lead to distress and impairment in daily life (B)</p> Signup and view all the answers

Which DSM-5 criterion is essential for diagnosing nightmare disorder?

<p>Nightmare symptoms are not attributable to substance (B)</p> Signup and view all the answers

During which stage of sleep do nightmares typically occur?

<p>REM sleep (B)</p> Signup and view all the answers

Which intervention would be the least likely to be implemented in a treatment plan for nightmare disorder?

<p>Vitamins (C)</p> Signup and view all the answers

Flashcards

Sleep Deprivation

A decrease in immune function, affecting energy, mood, memory, concentration and attention.

Dyssomnias

Difficulties in the amount, quality, or timing of sleep.

Parasomnias

Abnormal behavioral and physiological events during sleep.

Polysomnographic (PSG) evaluation

Evaluation includes Electroencephalograph (EEG), Electrooculograph (EOG), and Electromyography (EMG).

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Insomnia Disorder

A sleep disorder characterized by difficulty initiating or maintaining sleep, or waking too early.

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Hypersomnolence Disorder

Excessive sleepiness despite adequate sleep, or prolonged sleep episodes.

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Narcolepsy

Recurrent intense need for sleep, irresistible lapses into sleep or napping.

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Cataplexy

Sudden, brief loss of voluntary muscle tone triggered by strong emotions.

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Obstructive Sleep Apnea Hypopnea

Airflow stops, but the respiratory system continues to work.

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Central Sleep Apnea (CSA)

The respiratory system stops working for brief periods.

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Circadian Rhythm Sleep-Wake Disorder

Disturbed sleep leading to distress or functional impairment due to the brain's inability to synchronize day and night.

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Phase Delays

Moving bedtime later, often considered the best approach.

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Medical Treatments for Sleep Disorders

Benzodiazepines, over-the-counter sleep medications; stimulants, and antidepressants.

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Cognitive Behavioral Therapy for Insomnia (CBT-I)

Psychoeducation, changing beliefs, monitoring sleep, and practicing better sleep-related habits.

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Nature of Parasomnias

The problem is not with sleep itself, but abnormal events during sleep or shortly after waking.

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Non-REM Sleep Arousal Disorder

Recurrent episodes of incomplete awakening from sleep, sleep terrors or sleepwalking, and no memory of the episodes.

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Sleep Terrors

Episodes more common in children, where the child cannot be easily awakened and has little memory of the event.

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Sleepwalking Disorder

Occurs during non-REM sleep, usually during the first few hours of deep sleep.

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Nightmare Disorder

Repeated episodes of extended, dysphoric dreams that lead to distress or impairment in daily life.

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Study Notes

Sleep-Wake Disorders

  • Chapter 8 focuses on Eating and Sleep-Wake Disorders

Importance of Sleep

  • A few hours of sleep deprivation impairs immune function
  • Sleep deprivation affects energy, mood, memory, concentration, and attention
  • Sleep loss can cause depression in non-depressed individuals
  • Sleep loss can have antidepressant effects in depressed individuals

Sleep Disorders Overview

  • Dyssomnias involve difficulties in the amount, quality, or timing of sleep
  • Parasomnias are abnormal behavioral and physiological events during sleep

Sleep Assessment

  • Polysomnographic (PSG) evaluation assesses disordered sleep
  • Electroencephalograph (EEG) measures brain wave activity
  • Electrooculograph (EOG) tracks eye movements
  • Electromyography (EMG) records muscle movements
  • A detailed history is taken alongside an assessment of sleep hygiene and sleep efficiency
  • Actigraphs are portable wearable devices that detect different stages of wakefulness/sleep through movement

Insomnia

  • Insomnia is a common sleep disorder
  • Microsleeps can occur
  • Problems initiating/maintaining sleep include: trouble falling asleep, waking during the night, or waking too early
  • 35% of adults report daytime sleepiness
  • Insomnia is only diagnosed as a sleep disorder if it can't be better explained by another condition

Insomnia: Facts and Statistics

  • Insomnia is often associated with medical and/or psychological conditions
  • It affects females twice as often as males
  • Unrealistic expectations about sleep are an associated feature
  • Many believe that a lack of sleep will be more disruptive than it is

Hypersomnolence Disorder

  • Hypersomnolence Disorder involves sleeping too much or excessive sleep
  • Long nights of sleep or frequent napping are manifestations of the disorder
  • Experiencing excessive sleepiness is a problem

Hypersomnolence Disorder: Facts and Statistics

  • Hypersomnolence disorderis often associated with medical and/or psychological conditions
  • Hypersomnia should be the primary complaint to be diagnosed, other conditions shouldn't adequately explain
  • Main associated features include: complaining of sleepiness throughout the day, and being able to sleep through the night

Narcolepsy

  • The principal symptom includes a recurrent intense need for sleep, irresistible lapses into sleep or napping
  • At least one symptom must accompany it: Cataplexy, abnormally fast REM sleep, sleep paralysis, or hypnagogic hallucinations
  • Cataplexy involves a sudden, brief loss of voluntary muscle tone triggered by strong emotions such as laughter
  • Experiencing abnormally fast REM sleep (<15 min) is another accompaniment, as evidenced by polysomnographic measures

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