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Question 1 of 25
1. Question
Sleep-related problems affect _______ Americans of all ages.
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Question 2 of 25
2. Question
The main categories of sleep disorders include _______.
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Question 3 of 25
3. Question
A growing number of “clock genes” have been identified since 1996 that play a critical role in mammalian circadian timing. In addition, there is clear evidence that _______ nuclear tissues have genes and can demonstrate circadian rhythms.
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Question 4 of 25
4. Question
_______ has been identified as a risk factor for the onset of subsequent depression, anxiety, and substance use disorders.
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Question 5 of 25
5. Question
There have also been several public health education initiatives, including an effort to establish lifelong healthy sleep habits in school-age children begun in 2001 with _______, the “Star Sleeper” as the “spokescat” for healthy sleep.
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Question 6 of 25
6. Question
It is generally recognized that the sleep/wakefulness rhythm is not driven directly by the circadian clock, but rather emerges from an interaction of the circadian clock located within the suprachiasmatic nucleus (SCN), and a distinct _______ in which the drive or need for sleep depends upon the prior amount of wakefulness and sleep.
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Question 7 of 25
7. Question
Sleep disorders may arise from dysfunction at several levels within these two timing systems. Alterations in the circadian _______ within the SCN, changes in the sleep homeostat, and alterations in the coupling between the two timing systems may each be causal in sleep disturbances.
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Question 8 of 25
8. Question
Discovery that chronic partial sleep loss for _______ can lead to metabolic and endocrine changes that are precursors for specific disease states (e.g., obesity and diabetes) and are also relevant to aging:
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Question 9 of 25
9. Question
Sleep time is defended by an accumulation of _______, the need for more sleep that results from sleep restriction. Recent study findings in animals and humans suggest that a complete and sustained loss of sleep can, in rare and extreme cases, result in death. It is likely that an understanding of the effects of sleep loss will reveal basic principles of brain function relevant to a broad spectrum of neurological and behavioral disorders. Sleep is known to strongly affect the activity of most brain neurons.
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Question 10 of 25
10. Question
Research has delineated the molecular basis of Narcolepsy and circadian rhythm disorders (Section V). Genes responsible for these disorders have been positionally cloned and found to code for specific proteins, some of which are receptors for other small molecules that could be targets for chemically synthesized drugs. These might be effective for sleep/wake pharmacology. Indeed, the clinical utility of drugs such as modafinil and gammahydroxybutyrate (GHB) for Narcolepsy, and selective dopamine receptor agonists for treatment of RLS, has been demonstrated. In addition, while short-term pharmacologic treatment for Insomnia has been demonstrated to be efficacious, most Insomnia is_______.
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Question 11 of 25
11. Question
_______ and sleep scheduling will constitute at least part of any comprehensive strategy to maintain alertness and performance during extended continuous operations. Cell phones, beepers, and other communication devices can put some workers in a perpetual “oncall” status in which sleep might be interrupted by need for rapid decisions and/or other dutyrelated tasks. Studies of sleep inertia (and sleep inertia countermeasures), therefore, will be of increasing relevance and importance. Finally, the physiological effects of acute and chronic sleep loss in vital organ systems other than the brain have only just begun to be explored
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Question 12 of 25
12. Question
studies have begun to explore selected relationships between chronic partial sleep deprivation and sleep disruption related to primary sleep disorders, mood and performance deficits in children and adolescents, and academic failure. Studies of sleep in children with primary behavior and learning problems have further supported an association between sleep restriction and performance impairments. Evidence indicates that children experience significant daytime sleepiness as a result of disturbed or inadequate sleep, and most studies suggest _______ between sleep disturbance and behavioral problems.
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Question 13 of 25
13. Question
Eight genes that significantly contribute to the generation of circadian periodicity have been isolated in mammals. Recently, studies in humans have shown, for the first time, a correspondence between human and animal _______. Most strikingly, a mutation in the gene HPER2, a gene known to be involved in the regulation of circadian rhythmicity in mammals, was demonstrated to cause Familial Advanced Sleep Phase Syndrome (FASPS) in a human family. Additionally a polymorphism in CLOCK, another gene involved in the generation of circadian rhythmicity, was found to influence morningness-eveningness tendencies in humans. These studies are likely to be extended, with the discovery of other human mutations and polymorphisms affecting circadian regulation.
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Question 14 of 25
14. Question
Functional neuroimaging techniques (primarily_____) reveal that NREM sleep is associated with deactivation of centrencephalic regions (brainstem, thalamus, basal ganglia) and multimodal association cortices (e.g., prefrontal and superior temporal/inferior parietal regions). REM sleep is characterized by reactivation of all centrencephalic regions deactivated during NREM sleep except the multimodal association areas. Thus, deactivation of the multimodal association areas has been shown to be a defining characteristic of sleep.
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Question 15 of 25
15. Question
_____ studies during sleep-deprived wakefulness reveal regional cerebral deactivations that are especially prominent in prefrontal and inferior parietal/superior temporal cortices, and in the thalamus. These patterns are similar to that found during NREM sleep, but the deactivations are of lesser magnitude than during NREM sleep). This pattern is consistent with, and helps explain, the nature of cognitive performance deficits that occur during sleep loss.
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- MRI
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Question 16 of 25
16. Question
Scans taken at 5 vs. _____ minutes after awakening suggest that re-emergence of conscious awareness upon awakening occurs as a function of centrencephalic reactivation, and reestablishment of a specific pattern of functional interconnectivity between brain regions. These data also suggest that restoration of alertness (e.g., dissipation of sleep inertia effects) occurs as a function of reactivation and reestablishment of functional interconnectivity patterns involving prefrontal cortices. These findings could constitute an important first step toward specification of the physiological basis of post-sleep waking cognitive capability.
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Question 17 of 25
17. Question
Excessive daytime sleepiness is a major public health problem associated with interference with daily activities including _______. Optimum daytime performance with minimal sleepiness in adolescents and young adults appears to require at least eight to nine hours of sleep at night with few interruptions. A majority of adolescents and adults, however, report habitual sleep durations of fewer than seven hours per night during the week and fewer than eight hours of sleep each night on weekends.
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Question 18 of 25
18. Question
The relationship between sleep (quantity and quality) and estimates of morbidity and mortality _______. Data from epidemiological studies suggest that a habitual short sleep duration (less than six hours sleep per night) or long sleep duration (more than nine hours sleep per night) is associated with increased mortality. A recent epidemiological report found that self-reported sleep duration averaging either less or more than seven hours of sleep daily was associated with higher mortality. It is not clear how sleep duration increases risk. Moreover, although such epidemiological studies have used very large convenience samples, they have relied on retrospective self-report, the least accurate index of sleep.
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Question 19 of 25
19. Question
Sleep architecture is unaffected by menstrual cycle phase. But body temperature is elevated and circadian rhythm amplitude is reduced during sleep, however, in the high progesterone phase (luteal) of the menstrual cycle, but the underlying mechanism is not known. Compared to men, women have a blunted drop in body temperature and an earlier nadir of the_______.
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Question 20 of 25
20. Question
Women _______ have reduced slow wave sleep and REM latency. Body temperature throughout the menstrual cycle is similar to that of normal cycling women in the luteal phase.
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Question 21 of 25
21. Question
Many medical disorders can impair sleep quality and can, in turn, be adversely affected by poor sleep. Common examples include
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Question 22 of 25
22. Question
Sleep is a powerful _______ of epilepsy, with some epilepsy syndromes occurring exclusively or predominantly during sleep. These include benign childhood epilepsy with centrotemporal spikes, autosomal dominant nocturnal frontal lobe epilepsy, and continuous spike-wave activity during sleep. Sleep deprivation has also been described as a risk factor for epileptic seizures, although alcohol use and work-related stress are confounding factors.
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Question 23 of 25
23. Question
Restless Legs Syndrome (RLS) is a sensorimotor disorder characterized by periodic irresistible urges to move the legs, usually associated with unpleasant and uncomfortable sensations in the legs. These symptoms occur during wakefulness, but are exacerbated or engendered by rest/inactivity and partially relieved by movement. The _______ pattern of symptoms likely reflects modulation by the circadian system. RLS is reported to profoundly disturb sleep, yet the extent of nocturnal sleep disturbance and of daytime sleepiness has not been established.
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Question 24 of 25
24. Question
Narcolepsy is a disabling neurological disorder characterized by sleepiness and symptoms of abnormal REM sleep. It is most commonly diagnosed with the following tests:
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Question 25 of 25
25. Question
Risk factors for drowsy driving crashes include:
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