NR-547 Exam Review Question with 100%
Verified Answers
What are the wakefulness neurotransmitters?
Acetylcholine, Histamine, Norepinephrine, Serotonin, Orexin (Hypocretin), and Dopamine.
What neurotransmitters promote sleep?
GABA and Melatonin.
Stage 1 sleep
Drowsiness; easy to awaken.
Stage 2 sleep
Light sleep; sleep spindles; most sleep occurs here.
Stage 3 sleep
Deep sleep; delta waves; difficult to awaken.
Stage 4 sleep
Deepest sleep; delta waves; sleepwalking and night terrors occur here.
REM sleep characteristics
Rapid eye movements, dreaming, sleep paralysis, occurs ~90 minutes after sleep onset.
Diagnostic criteria for chronic insomnia
Difficulty initiating/maintaining sleep ≥3 nights/week for ≥3 months with daytime
impairment.
What must be ruled out before diagnosing insomnia?
,Inadequate sleep opportunity, substance use, medications, and medical conditions.
First-line treatment for chronic insomnia
Cognitive Behavioral Therapy for Insomnia (CBT-I).
Components of CBT-I
Sleep hygiene, stimulus control, relaxation, sleep scheduling, cognitive restructuring.
Sleep hygiene recommendations
Consistent schedule, cool/dark/quiet room, avoid naps, electronics, and bedtime
caffeine/alcohol.
OTC medication commonly used for insomnia
Diphenhydramine (Benadryl).
Major concern with diphenhydramine
Anticholinergic effects and next-day sedation, especially in older adults.
When should melatonin be taken?
1-2 hours before bedtime.
Melatonin primarily improves what?
Sleep onset.
Ramelteon drug class
Melatonin receptor agonist.
Ramelteon primarily improves
Sleep onset.
, Orexin function
Promotes wakefulness.
Orexin deficiency is associated with
Narcolepsy.
Suvorexant (Belsomra) drug class
Dual orexin receptor antagonist.
Suvorexant primarily improves
Sleep maintenance.
Lemborexant (Dayvigo) treats
Sleep onset and sleep maintenance insomnia.
Common Z-drugs
Zolpidem, Eszopiclone, Zaleplon.
Z-drugs mechanism
Bind GABA-A benzodiazepine receptors producing sedation.
Z-drugs are what controlled substance?
Schedule IV.
Major adverse effects of Z-drugs
Sleepwalking, sleep driving, next-day sedation, rebound insomnia, abuse potential.
Common sedating antidepressants
Trazodone, Mirtazapine, Amitriptyline.
Verified Answers
What are the wakefulness neurotransmitters?
Acetylcholine, Histamine, Norepinephrine, Serotonin, Orexin (Hypocretin), and Dopamine.
What neurotransmitters promote sleep?
GABA and Melatonin.
Stage 1 sleep
Drowsiness; easy to awaken.
Stage 2 sleep
Light sleep; sleep spindles; most sleep occurs here.
Stage 3 sleep
Deep sleep; delta waves; difficult to awaken.
Stage 4 sleep
Deepest sleep; delta waves; sleepwalking and night terrors occur here.
REM sleep characteristics
Rapid eye movements, dreaming, sleep paralysis, occurs ~90 minutes after sleep onset.
Diagnostic criteria for chronic insomnia
Difficulty initiating/maintaining sleep ≥3 nights/week for ≥3 months with daytime
impairment.
What must be ruled out before diagnosing insomnia?
,Inadequate sleep opportunity, substance use, medications, and medical conditions.
First-line treatment for chronic insomnia
Cognitive Behavioral Therapy for Insomnia (CBT-I).
Components of CBT-I
Sleep hygiene, stimulus control, relaxation, sleep scheduling, cognitive restructuring.
Sleep hygiene recommendations
Consistent schedule, cool/dark/quiet room, avoid naps, electronics, and bedtime
caffeine/alcohol.
OTC medication commonly used for insomnia
Diphenhydramine (Benadryl).
Major concern with diphenhydramine
Anticholinergic effects and next-day sedation, especially in older adults.
When should melatonin be taken?
1-2 hours before bedtime.
Melatonin primarily improves what?
Sleep onset.
Ramelteon drug class
Melatonin receptor agonist.
Ramelteon primarily improves
Sleep onset.
, Orexin function
Promotes wakefulness.
Orexin deficiency is associated with
Narcolepsy.
Suvorexant (Belsomra) drug class
Dual orexin receptor antagonist.
Suvorexant primarily improves
Sleep maintenance.
Lemborexant (Dayvigo) treats
Sleep onset and sleep maintenance insomnia.
Common Z-drugs
Zolpidem, Eszopiclone, Zaleplon.
Z-drugs mechanism
Bind GABA-A benzodiazepine receptors producing sedation.
Z-drugs are what controlled substance?
Schedule IV.
Major adverse effects of Z-drugs
Sleepwalking, sleep driving, next-day sedation, rebound insomnia, abuse potential.
Common sedating antidepressants
Trazodone, Mirtazapine, Amitriptyline.
