Deck 16: Sleep Disorders

Question 1

During REM sleep, responsiveness to environmental stimuli decreases but muscle tone is retained.

Answer 1

False

Question 2

In general, the bedtime and wake time of older adults are earlier than those of younger adults and napping may increase.

Answer 2

True

Question 3

The normal aging process is not associated with a decreased need for sleep, but it is associated with decreased ability to sleep.

Answer 3

True

Question 4

What medical condition, whether as a cause of awakening or in response to awakening for other reasons, is commonly associated with perceived poor sleep quality in older adults?

A) Nocturia
B) Insomnia
C) Obstructive sleep apnea
D) Restless legs syndrome

Question 5

Levels of what hormone are highest before sleep onset and are produced in response to sunlight exposure?

A) Cortisol
B) Melatonin
C) Dopamine
D) Glutamate

Question 6

An increased level of what neurotransmitter is associated with sleep deprivation and its action is blocked by methylxanthines such as caffeine?

A) Dopamine
B) Adenosine
C) Acetylcholine
D) Norepinephrine

Question 7

What stage of the sleep architecture is commonly referred to as "dreaming" sleep?

A) Stage W
B) Stage N1
C) Stage N3
D) Stage R

Question 8

Sleep efficiency falls approximately what percentage per decade, reflecting less time spent asleep while in bed attempting to sleep?

A) 3%
B) 5%
C) 8%
D) 10%

Question 9

Simple visual inspection revealing a small or recessed mandible, dental malocclusion, a large tongue, or enlarged tonsils may suggest overcrowding of the oropharynx, which may contribute to what medical condition?

A) Nocturia
B) Insomnia
C) Obstructive sleep apnea
D) Central sleep apnea

Question 10

Subjective sleep quality can be assessed using which of the following instruments that is composed of 10 items that assess sleep disturbance and medication use as well as daytime dysfunction?

A) The Epworth Sleepiness Scale (ESS)
B) The Pittsburgh Sleep Quality Index (PSQI)
C) The STOP BANG Screening Questionnaire
D) The Insomnia Severity Index

Question 11

Inadequate cognitive function to perform complex mental and decision-making tasks, as well as the development of delirium, are associated with sleep disturbance and may result in institutionalization.

Question 12

NREM sleep is characterized by dreaming with variable responsiveness to environmental stimuli, voluntary muscle paralysis, and variable autonomic activity.

Question 13

Hypoventilation and hypoxemia disorders may occur in the presence of normal pulmonary mechanical properties and may be precipitated by CNS depressants.

Question 14

The proposed response to periods of extended wakefulness, in concert with circadian response to environmental light stimulation of the retina and suprachiasmatic nucleus, is referred to as which of the following?

A) Sleep drive
B) Sleep pacemaker
C) Sleep architecture
D) Sleep efficiency

Question 15

What neurotransmitter promotes sleep and is the primary inhibitory CNS neurotransmitter?

A) Acetylcholine
B) Norepinephrine
C) Glutamate
D) Gamma-aminobutyric acid (GABA)

Question 16

Although not diagnostic, high scores on what sleep assessment instrument suggest the possible presence of obstructive sleep apnea or narcolepsy?

A) The Epworth Sleepiness Scale (ESS)
B) The Pittsburgh Sleep Quality Index (PSQI)
C) The STOP BANG screening questionnaire
D) The Insomnia Severity Index (ISI)

Question 17

Apnea refers to absence of airflow at the nose or mouth for what period of time or longer, and is classifiable by type?

A) 5 seconds
B) 10 seconds
C) 15 seconds
D) 20 seconds

Question 18

The relative amounts of the different sleep stages composing sleep and timing of sleep cycles is referred to as which of the following?

A) Sleep drive
B) Sleep pacemaker
C) Sleep architecture
D) Sleep efficiency

Question 19

Hypoventilation and hypoxemia disorders often follow a slowly progressive course that can lead to what medical condition?

A) Sleep apnea
B) Atelectasis
C) Pulmonary hypertension
D) Chronic obstructive pulmonary disease

Question 20

Diagnosis of narcolepsy is based on patient-reported symptoms and supported by hypocretin-l levels less than 110 ppg/mL in what bodily fluid?

A) Blood
B) Urine
C) Saliva
D) Cerebrospinal fluid