10
Parasomnias
MELINDA TRIMBLE and CONSTANCE SHIVERS-SMITH
NOTE: This chapter corresponds to Chapter 13 in Fundamentals of Sleep Technology, 2nd edition.
1. Confusional arousals most commonly arise during:
A. The last third of the night
B. Sleep onset
C. Stage N3 sleep
D. The last or next to last REM episode
2. An NREM parasomnia associated with atypical sexual manifestations is:
A. Enuresis
B. Freudian dream expression
C. REM behavior disorder
D. Sexsomnia
3. A variety of medications have been implicated in causing or worsening parasomnias, especially when the medications are mixed with:
A. Grapefruit juice
B. Alcohol
C. Caffeinated beverages
D. Cognitive–behavioral therapy
4. Episodes of sleepwalking in 6-year-old children are most often treated with:
A. Temazepam
B. Pad and bell devices
C. Low-dose clonidine
D. Observation and protection from harm
5. REM sleep behavior disorder is characterized by:
A. Violent outbursts during sleep
B. Recurrent nightmares
C. Loud screaming followed by a rapid return to sleep
D. Dream enactment
6. Patients experiencing a sudden, loud, imagined noise or explosion occurring during the transition from waking to sleep are said to have:
A. Exploding head syndrome
B. Hypnic jerks
C. Jactatio capitus nocturnus
D. Scanners syndrome
7. If performed in the evaluation of a parasomnia, polysomnography must include:
A. Temporal EEG leads
B. Arm and trunk EMG leads
C. Video recording
D. Full seizure montage
CLINICAL VIGNETTES
QUESTIONS 8 TO 10
The parents of a 4-year-old boy bring him to the sleep clinic after witnessing awakenings with screaming occurring once or twice a week. During these episodes, which usually happen within the first 2 to 3 hours of sleep, the boy shows signs of fear, sits up in the bed, and breathes rapidly. During these events, he is inconsolable. In the morning after these episodes, he has no recall of the awakening. His behavior is normal during the day, and he does not seem to be sleepy. Physical examination is unremarkable.
8. What is the most likely diagnosis for these events?
9. What is the most common treatment for this diagnosis?
