Match each clinical presentation to the most accurate sleep-wake disorder diagnosis.
- Narcolepsy Type 1A 22-year-old woman with excessive daytime sleepiness and sudden, brief episodes of bilateral facial and limb weakness triggered by hearing a joke.
- REM Sleep Behavior DisorderA 65-year-old man who frequently punches and yells during sleep, often waking up to vividly recall defending himself from attackers.
- Non-REM Sleep Arousal DisorderA 5-year-old boy who abruptly sits up in bed screaming with tachycardia, is unarousable by his parents, and has no memory of the event the next day.
- Delayed Sleep-Wake Phase DisorderA 19-year-old college student who consistently cannot fall asleep before 3:00 AM, struggles with morning classes, but sleeps restfully for 8 hours on weekends.
Answer
Narcolepsy Type 1 matches with the young woman experiencing cataplexy; REM Sleep Behavior Disorder matches with the older man enacting vivid dreams; Non-REM Sleep Arousal Disorder matches with the young child having sleep terrors with amnesia; and Delayed Sleep-Wake Phase Disorder matches with the college student exhibiting a shifted sleep schedule.
Each clinical vignette provides pathognomonic features for specific sleep-wake disorders. Narcolepsy type 1 is defined by cataplexy and sleepiness. REM sleep behavior disorder is characterized by dream enactment due to absent REM atonia. Non-REM sleep arousal disorder (sleep terrors) presents with profound autonomic arousal and amnesia for the episode. Delayed sleep-wake phase disorder involves a shifted but otherwise normal circadian sleep pattern.
Step-by-Step Solution
Key Concept
Clinical differentiation of major sleep-wake disorders based on symptomatology, sleep cycle stage, and patient demographics.