Sleep Disorder

Question 1

How can you influence SWS (Slow Wave Sleep)

Answer 1

• not by prolonged sleep - by doing exercise - by more mental activity

Question 2

Polysomnography includes:

Answer 2

• EEG: electroencephalogram - EMG: electromyogram - ECG: electrocardiogram - EOG: electrooculogram

Question 3

Hypnogram: REM und SWS

Answer 3

in total two hours SWS and two hours REM. First half of the sleep more SWS, towards the end more REM phases…

Question 4

Name the 4 stages of the NREM sleep.

Answer 4

– Stage 0: Awake; alpha rhythm

– Stage 1: Transition from wakefulness to sleep; light sleep

– Stage 2: Transition btw delta and REM sleep;
*medium sleep; sleep spindles and K complexes *

– Stage 3: Deeper depth of sleep than stage 2;
~ 20% - 50% of a period consists of delta waves

– Stage 4: Greater delta-wave activity than stage 3
very deep sleep; greater than 50% of a period consists of delta waves

Question 5

When does the first REM episode occur?

Answer 5

60 - 90 min after onset of sleep

Question 6

Stages of sleep

Answer 6

• Upon reaching stage 4 and after about 80 to 100 minutes
of total sleep time, sleep lightens, returns through stages 3
and 2
• REM sleep emerges, characterised by EEG patterns that
resemble beta waves of alert wakefulness
– muscles most relaxed
– rapid eye movements occur
– dreams occur
• Four or five sleep cycles occur in a typical night’s sleep –
approx. 25% in slow-wave, a little more in REM

Question 7

• brain activity
• heart rate
• blood pressure
• blood flow to brain
• respiration
• airway resistance
• body temperature
• sexual arousal

Answer 7

Question 8

DSM-5’s major criteria for a diagnosis of
Insomnia Disorder

Answer 8

• Dissatisfaction with sleep quantity or quality, with one or more of the following symptoms: difficulty initiating sleep, difficulty maintaining sleep, early-morning awakening
• The sleep disturbance causes significant distress or impairment in social, occupational, educational, academic, behavioral, or other important areas of functioning
• The sleep difficulty occurs at least 3 nights per week, is present for at least 3 months, and despite adequate opportunity for sleep
• The insomnia does not co-occur with another sleep disorder
• The insomnia is not explained by coexisting mental disorders or medical conditions

Question 9

Who is most likely to have insomnia?

Answer 9

• Are over 45 years of age
• Are overweight or obese
• Have conditions such as pain, hypertension, cardiovascular disease, upper airway disease, restless legs syndrome and/or periodic limb movement
• Have major depression, anxiety or bipolar disorder
• Are shift workers
• Consume large amounts of caffeinated products, alcohol or
recreational drugs

Question 10

Vicious Circle of Sleep

Answer 10

Question 11

non-restorative sleep algorithm

Answer 11