1. Lori Davis, Manager Respiratory Diagnostic & Evaluation Services & Biomedical Engineering West Park Healthcare Centre Lori Davis reports no conflict of interest

2. How Bad are YOUR sleep Habits? A. I watch Letterman every night and am at work by 7 a.m. B. I have a glass of wine every night before bed (to help me relax) C. I can sleep without a bed partner, but I can’t sleep without my phone D. I follow every sleep hygiene rule and am rested and refreshed every day.

3. Learning Objectives To gain general knowledge about sleep and sleep disorders. To facilitate discussion about the above topics and encourage audience participation using the automated audience response system.

4. Which mammal sleeps the longest each day? A. Brown bat B. Giraffe C. Lion D. Cow

5. Which statement is false? A. Total sleep time is approximately 18 hours/day at birth, declining to 13 hours at age 1. B. Stage 3 (slow wave sleep) comprises about 50% of the total sleep time in toddlers and young children. C. The amount of sleep required for optimal alertness in adolescents is about 9 hours. D. REM sleep, as a percentage of total sleep time, is reduced in healthy old age.

6. Normal total sleep time for most adults aged 20-60 is: A. 6 hours B. 8 hours C. 5 hours D. 9 hours

7. What percentage of people in Portugal stay up past midnight, the highest percentage of any country? A. 75% B. 60% C. 85% D. 95%

8. Anything less than 5 minutes to fall asleep at night means; A. The book you are reading is really boring B. You are sleep deprived C. You are very efficient with your time D. You need to take a sleeping pill

9. Which of the following disasters have NOT been attributed to human error in which sleep deprivation played a role? A. Exxon Valdez oil spill off Alaska B. Walkerton, Ontario contaminated water tragedy C. The Challenger Space Shuttle disaster D. Chernobyl nuclear accident

10. Circadian rhythms are slightly longer than 24 hours and influence our body temperature, sleep, wakefulness and hormonal changes.

11. The circadian “clock” is located in the suprachiasmatic nucleus of the brain and is synchronized by environmental time cues, the strongest being: A. Noise B. Light C. Hunger

12. True or False Adolescents and older individuals prefer to go to bed later and wake up later in the morning? A) True B) False

13. Which statement is False? A. Obstructive sleep apnea is a periodic reduction or stoppage in breathing as a result of a narrowed or obstructed pharyngeal airway B. 25% of middle aged men and 9% of middle aged women have OSA C. Everyone who snores has OSA and everyone who has OSA snores D. OSA can increase the risk of heart disease and stroke

14. Which of the following does not contribute to OSA? A. Tracheostomy tube B. Large tongue C. Receding jaw D. Large tonsils E. Excess fatty tissue in the neck

15. Which of the following polysomnograms show an obstructive apnea?

16. A.A.

17. B.B.

18. C.C.

19. Which of the previous polysomnograms show an obstructive apnea? A. B. C.

20. The most effective treatment of OSA is: A. Weight loss B. Sleeping on side C. CPAP D. Dental appliance E. Medications to relieve stuffiness

21. Which of the following is NOT a possible consequence of OSA? A. Stroke B. Hypertension C. Divorce D. Heart attack E. Narcolepsy F. Depression G. Diabetes

22. Restless Legs Syndrome is a movement disorder that is described by patients in the following way: A. Worms crawl under my skin if I don’t keep moving my legs. B. My legs decide they want to run and I have to follow C. After I get in bed, a gremlin grabs my legs and leads me around like a puppet D. All of the above

23. Clinical symptoms (RLS) include U– urge to move legs R– rest induced G– gets better with activity E– evening or night worsening

24. Which statement is True? A. Men are 2-3x more likely to have RLS than women B. Symptoms most commonly start in the teens or earlier C. The sensation usually comes on at night and can interfere with sleep D. There are no genetic factors implicated in the cause of RLS

25. RLS is related to a deficiency of ______ in the brain A. Iron B. Dopamine C. Cerebrospinal fluid D. Gray matter

26. Secondary RLS is often seen in which of the following disorders? A. End-stage renal disease B. Pregnancy C. Iron deficiency D. All of the above

27. Periodic Limb Movements The National Sleep Foundation estimates that 35% or more of people aged 65 years and older experience period limb movements. Which one of the following epochs of sleep study data is an example of PLMs?

28. A.A.

29. B.B.

30. C.C.

31. Periodic Limb Movements Which one of the previous epochs of sleep study data is an example of PLMs? A. B. C.

32. PLM Causing Arousals

33. Which of the following statements is False? A. Stress, anxiety and depression are the most common causes of insomnia B. Insomnia is a condition that involves problems falling asleep or staying asleep C. Insomnia can only be treated with medications D. Chronic insomnia may increase the risk of developing depression

34. True or False Sleep medications for the treatment of insomnia should only be used for a short period of time as they lose their efficacy and there is a risk of dependency when used nightly for prolonged periods of time. A) True B) False

35. Which 2 statements are False 1. Narcolepsy is a neurochemical disorder related to Hypocretin (orcxin) deficiency 2. Onset of symptoms is usually in early childhood 3. Patients are typically diagnosed within 2 years of the onset of symptoms 4. Narcolepsy is characterized by excessive daytime sleepiness with recurrent and uncontrollable sleep attacks during the day. A. 1 & 2 B. 3 & 4 C. 2 & 3 D. 1 & 4

36. Which characteristic, featured below, is only see in narcolepsy? A. Cataplexy B. Sleep paralysis C. Hypnogogic/hypnopompic hallucinations D. Excessive daytime sleepiness with sleep attacks

37. What sleep disorder plagues this Twilight Star? A. Restless Legs Syndrome B. Insomnia C. Obstructive Sleep Apnea D. Narcolepsy

38. Which sleep disorder do these celebrities have in common? A. Restless Legs Syndrome B. Insomnia C. Obstructive Sleep Apnea D. Narcolepsy

39. Which sleep disorder do these entertainers have in common? A. Restless Legs Syndrome B. Insomnia C. Obstructive Sleep Apnea D. Narcolepsy

40. And what’s up with this late night talk show host? A. Restless Legs Syndrome B. Insomnia C. Obstructive Sleep Apnea D. Narcolepsy

41. What did I learn from this workshop? A. Absolutely nothing – I was sleeping. B. A little bit – I’m going to bed earlier tonight. C. A lot – I’m coming back in my next life as a brown bat.