Parkinson's Parkinson's Sleep and Autonomic Function

Question 1

Which sleep disorder is considered a prodromal marker of Parkinson's disease, sometimes appearing 10–15 years before motor symptoms?

Accepted Answer

REM sleep behavior disorder

Answer

Insomnia

Answer

Restless legs syndrome

Answer

Obstructive sleep apnea

Question 2

What abnormality at the muscle level characterizes REM sleep behavior disorder (RBD)?

Accepted Answer

Loss of normal REM sleep muscle atonia (paralysis)

Answer

Complete muscle paralysis during all sleep stages

Answer

Involuntary muscle cramps during non-REM sleep

Answer

Voluntary muscle control preserved during all sleep

Question 3

Which of the following is the most common sleep complaint reported by Parkinson's disease patients?

Accepted Answer

Frequent nighttime awakenings with difficulty returning to sleep

Answer

Inability to enter REM sleep at all

Answer

Sleeping more than 12 hours per day

Answer

Sudden sleep attacks during meals

Question 4

Excessive daytime sleepiness (EDS) in Parkinson's disease is most strongly associated with which medication class?

Accepted Answer

Dopamine agonists

Answer

MAO-B inhibitors

Answer

Anticholinergics

Answer

COMT inhibitors

Question 5

Sudden, irresistible 'sleep attacks' in Parkinson's disease are most often associated with which specific drug?

Accepted Answer

Pramipexole (a dopamine agonist)

Answer

Levodopa/carbidopa

Answer

Rasagiline

Answer

Amantadine

Question 6

Orthostatic hypotension is clinically defined as a drop in systolic blood pressure of at least how many mmHg within 3 minutes of standing?

Accepted Answer

20 mmHg

Answer

10 mmHg

Answer

15 mmHg

Answer

30 mmHg

Question 7

Degeneration of which brain region is most directly responsible for the loss of REM sleep muscle atonia in Parkinson's-associated RBD?

Accepted Answer

Pontine tegmentum (subcoeruleus nucleus)

Answer

Substantia nigra pars compacta

Answer

Hippocampus

Answer

Thalamus