WBR0424
| Author | [[PageAuthor::Rim Halaby, M.D. [1]]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Behavioral Science/Psychiatry |
| Sub Category | SubCategory::Pulmonology |
| Prompt | [[Prompt::A 43 year old male patient is diagnosed with hypertension. His physician recommends he undergoes polysomnography to rule out secondary hypertension caused by obstructive sleep apnea. While analyzing the polysomnogram, the physician notes the beginning of a sleep stage characterized by sleep spindles and K complexes. Which of the following findings is most likely to be present in the patient during this stage of sleep?]] |
| Answer A | AnswerA::Rapid eye movement |
| Answer A Explanation | AnswerAExp::Dreaming, erections, and loss of motor tonicity are usually present during REM sleep. |
| Answer B | AnswerB::Bruxism |
| Answer B Explanation | AnswerBExp::Bruxism is usually seen in stage 2 of sleep, characterized by sleep spindles and K complexes. |
| Answer C | AnswerC::Bedwetting |
| Answer C Explanation | AnswerCExp::Bedwetting, night terrors, and sleep walking are usually present during stage 3 of sleep. |
| Answer D | AnswerD::Night terrors |
| Answer D Explanation | AnswerDExp::Night terrors are usually present during stage 3 of sleep. |
| Answer E | AnswerE::Penile erection |
| Answer E Explanation | AnswerEExp::Penile erections are usually present during REM sleep. |
| Right Answer | RightAnswer::B |
| Explanation | [[Explanation::Sleep bruxism is reported in approximately 8% of the adult population. It is the clenching of teeth that occurs during sleep due to rhythmic masticatory muscle movement (RMMA) with repetitive jaw muscle contractions. Bruxism may be a destructive process that causes tooth destruction, jaw pain, limited movement of the mandible, and headaches. Although bruxism can occur in all stages of sleep, it is most frequently seen in stages 1 and 2 than in slow-wave sleep or in rapid eye movement (REM) sleep.
Sleep spindles and K complexes are characteristic findings of stage 2 of sleep on polysomnography. Educational Objective: Sleep bruxism, or teeth clenching during sleep, usually occurs during stage 2 of sleep. This stage is characterized by sleep spindles and K complexes on polysomnography. References:
Lavigne GJ, Kato T, Kolta A, et al. Neurobiological mechanisms involved in sleep bruxism. Critical Reviews in Oral Biology and Medicine. 2003;14(1):30-46
Macaluso GM, Guerra P, Di Giovanni G, et al. Sleep bruxism in a disorder related to periodic arousals during sleep. Journal of Dental Research. 1998;77(4):565-573 |
| Approved | Approved::No |
| Keyword | WBRKeyword::Bruxism, WBRKeyword::polysomnography, WBRKeyword::stage, WBRKeyword::sleep, WBRKeyword::K, WBRKeyword::complex, WBRKeyword::spindle |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |