WBR0925

{{WBRQuestion |QuestionAuthor={{TS} |ExamType=USMLE Step 1 |MainCategory=Behavioral Science/Psychiatry |SubCategory=General Principles |MainCategory=Behavioral Science/Psychiatry |SubCategory=General Principles |MainCategory=Behavioral Science/Psychiatry |SubCategory=General Principles |MainCategory=Behavioral Science/Psychiatry |MainCategory=Behavioral Science/Psychiatry |SubCategory=General Principles |MainCategory=Behavioral Science/Psychiatry |SubCategory=General Principles |MainCategory=Behavioral Science/Psychiatry |SubCategory=General Principles |MainCategory=Behavioral Science/Psychiatry |SubCategory=General Principles |MainCategory=Behavioral Science/Psychiatry |MainCategory=Behavioral Science/Psychiatry |SubCategory=General Principles |Prompt=Mother of a 6 year old boy comes to the clinic with her son. She says that her son often wakes up during the night with a scream and cries inconsolably. However, in morning he is fine and doesn’t remember anything about waking up and crying at night. Which of the following characterizes the stage of the sleep during which the above mentioned episodes are most likely to occur? |Explanation=Sleep terror is a type of parasomnia which are most likely to occur during the stages 3 and 4 of NREM sleep, also known as delta sleep and slow wave sleep, characterized by highest amplitude and lowest frequency. Other parasomnias such as bed wetting and sleep walking also occur during delta stage. Most common age group affected by sleep terrors is 4-12 years. Commonly, they are characterized by waking up from the sleep with panic, inconsolable crying, autonomic arousal (tachycardia, sweating and hyperventilation), no memory of the episode and no recall of any nightmare. Reassurance and good sleep hygiene are the only recommendations in most cases. |AnswerA=Theta waves |AnswerAExp=Theta waves occur mostly during stage1 NREM sleep. |AnswerB=Beta waves |AnswerBExp=Beta waves are characteristic of REM sleep and are also found when a person is wide awake and alert. Nightmares occur during REM sleep which may present similarly, but child usually has memory of the dream. |AnswerC=Sleep spindles and K complexes |AnswerCExp=Sleep spindles and K complexes are characteristics of NREM stage 2. Bruxism occurs commonly during this stage. |AnswerD=Delta waves |AnswerDExp=Sleep terrors occur during delta sleep (stage 3 +4 NREM sleep) characterized by delta waves. |AnswerE=Alpha waves |AnswerEExp=Alpha waves are found in EEG when a person is awake with eyes closed. |RightAnswer=D |WBRKeyword=Sleep, sleep terrors |Approved=No }}