Sleep Disorders

Question 1

What type of sleep is narcolepsy a disorder of?

Answer 1

REM

Question 2

In what condition do you get a sudden decrease in voluntary muscle tone occuring with sudden emotion such as laughter?

Answer 2

Cataplexy

Question 3

What is the main symptom of narcolespy?

Answer 3

Excessive daytime tiredness

Question 4

In which condition do you get uncontrollable urges to sleep at inappropriate times such as eating a meal or talking?

Answer 4

Narcolepsy

Question 5

How are narcolepsy and cataplexy related?

Answer 5

Cataplexy is a specific symptom of narcolepsy although narcolepsy can occur without cataplexy

Question 6

In what condition do you feel awake but are unable to move?

Answer 6

Sleep paralysis

Question 7

What is the most common reason for sleep paralysis?

Answer 7

Sleep deprivation

Question 8

What treatments are available for narcolepsy?

Answer 8

Modafinil
Dexamphetamine sulphate
Methylyphenidate
Antidepressents (SSRIs) 
Planned naps throughout the day

Question 9

What treatments are available for cataplexy?

Answer 9

Sodium Oxybutate
Clomipramine hydrochloride
SSRI
Amphetamines

Question 10

How do you confirm a diagnosis of narcolepsy?

Answer 10

Multiple sleep latency test

Question 11

You do a LP and take a sample of CSF from someone with narcolepsy/ What are you likely to see?

Answer 11

Low hypocretin

Question 12

What part of the brain is thought to be associated with circadian rhythm, particularly sleep - wakefullness cycle?

Answer 12

Suprachiasmatic nucleus (sita just above the optic chiasm)

Question 13

Is REM or non REM sleep more important?

Answer 13

Non REM

Question 14

In mild sleep deprivation what part of the brain is affected most?

Answer 14

Prefrontal cortex

Question 15

What are the symptoms of sleep deprivation (besides tiredness)

Answer 15

Becoming irritable and suspicious
Visual Illusions
Microsleeps and concentration lapses

Question 16

Give three things that are not affected by the prefrontal cortex

Answer 16

Well rehearsed tasks
Routine behaviour
Logic tasks

Question 17

What sleep disorder is being described here:

1. Sleep walking
2. Sleep terrors
3. Sleep paralysis

Answer 17

Non REM parasomnia

Question 18

In what neurological condition do you see disorders of REM sleep?

Answer 18

Parkinsons disease

Question 19

What is the name given to a sleep disorder in which you act out very vivid dreams whilst you sleep?

Answer 19

REM parasomnia

Question 20

When do REM parasomnias usually occur?

Answer 20

Latter third of the night

Question 21

Why do you get parasomnias?

Answer 21

Part of the brain is awake and part is asleep

Question 22

What is usually the underlying cause of parasomnias?

Answer 22

Sleep deprivation

Stress

Question 23

What is narcolepsy?

Answer 23

Chronic neurological condition involving the loss of the brains ability to regulate sleep wake cycles. People with the conditions get excessive daytime sleepiness

Question 24

What is cataplexy?

Answer 24

a medical condition in which strong emotion or laughter causes a person to suffer sudden physical collapse though remaining conscious
Present in 70% of patients with narcolepsy

Question 25

What are the symptoms seen in narcolepsy?

Answer 25

Daytime sleepiness
Cataplexy
Hypnagogic hallucinations
Sleep paralysis
REM behaviour disorder

Question 26

What investigations would you do in someone who has a sleep disorder?

Answer 26

Overnight polysomnography

Multiple sleep latency test

Question 27

Describe the multiple sleep latency test

Answer 27

4 x 25 minute naps are scheduled throughout the day
During these naps there is recording of EEG, muscle activity and eye movement
Measures how fast the patient falls asleep and therefore assesses their degree of daytime sommolence.

Question 28

What substance, found in CSF might be low in narcolepsy?

Answer 28

Hypocretin

Question 29

What three investigations would you do for suspected narcolepsy?

Answer 29

1. Multiple sleep latency test
2. Hypocretin level - low in narcolepsy
3. Overnight polysomnography