Sunday, February 8, 2009

78 - NIMS MEDICINE february 2009 paper - 3

3q: all of the following are parasomnias except ?

a. somnambulism
b. bruxism
c. sleep terror
d. nocturnal myoclonus

answer: d . nocturnal myoclonus .

Parasomnias are disorders of partial arousal or disorders that interfere with sleep stage transitions. Parasomnias are often attributed to stress, depression, or other psychological and medical conditions. There are four classifications:

Arousal disorders: are disorders of partial arousal which include: confusional arousals, sleepwalking (aka somnambulism: engaging in activities that are normally associated with wakefulness (such as eating or dressing), which may include walking, without the conscious knowledge of the subject), and sleep terrors (aka Pavor nocturnus or sleep terror disorder: abrupt awakening from sleep with behavior consistent with terror).

Sleep-wake transition disorders: interfere with sleep stage transitions. Common examples include: rhythmic movement disorder, sleep starts, sleeptalking, and nocturnal leg cramps.

Other parasomnias: common sleep disorders such as sleep bruxism (teeth grinding), sleep enuresis (bedwetting), snoring, infant sleep apnea, and sudden infant death syndrome (SIDS), sleep paralysis (conscious paralysis upon waking or falling asleep), partial seizures.

Parasomnias usually associated with REM. These include: nightmares, sleep paralysis, and REM sleep behavior disorder, REM behavior disorder (RBD): acting out violent or dramatic dreams while in REM sleep.

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