Sleep

Question 1

what is sleep

Answer 1

reversible behav. state of perceptual disengagement from and unresponsiveness to the env

Question 2

3 ways sleep is measured

Answer 2

1. EEG
2. EOG
3. Chin EMG

Question 3

4 key neurotransmitters to waking state

Answer 3

1. histamine
2. norepi
3. serotonin
4. ach

Question 4

what shows in EEG, EOG and EMG in waking state

Answer 4

EEG: low voltage, high freq, alpha rhythm
EOG: rapid, blinking
tone: high

Question 5

what shows in EEG, EOG and EMG in sleep N1

Answer 5

EEG:

Question 6

what shows in EEG, EOG and EMG in sleep N2

Answer 6

EEG: vertex K complexes with high voltage negatives
EOG: still
tone: high

Question 7

what shows in EEG, EOG and EMG in sleep N3/4 -slow wave

Answer 7

EEG: slow wave - high voltage, low freq
EOG: still
tone: low
+ GH release, restorative sleep

Question 8

what shows in EEG, EOG and EMG in sleep REM

Answer 8

EEG: mixed freq, low volt, sawtooth
EOG: rapid
tone: very low
+ irreg. resp, dreaming state

Question 9

2 phases of REM sleep

Answer 9

1. tonic - impaired thermoreg, hypotension, bradycardia, increased cerebral blood, ICP, erection
2. phasic - vasoconstricion, increased bP, tachycard, even high cerebreal flow and ICP

Question 10

what generates REM sleep

Answer 10

pons critical

Question 11

% of night in each stage

Answer 11

N1 -5%
N2 - 50
N3 - 20
REM - 25

Question 12

2 key factors in control of sleep

Answer 12

process C - circadian

process S - sleepoiness

Question 13

where is sleep initiated

Answer 13

activity in VLPO - increases in adenosine

Question 14

sleep changes with age

Answer 14

newborn: 18hrs
adol. : 10
adults: 7-9
as age delta sleep goes down

Question 15

3 key sleep measures

Answer 15

1. sleep onset latency - should be under 10min
2. REM latency - should be 90
3. sleep effic. - time asleep/time in bed - should be 90%

Question 16

6 drugs affecting sleep

Answer 16

1. anithistamines -drowsy
2. stimulants
3. caffeine -adenosine antag
4. benzos - reduce slow wave
5. antidepress - reduce REM
6. Alcohol - faster onset, but more arousals

Question 17

what is circadian rhythm

Answer 17

internal pacemaker set to 24hrs

Question 18

where is main control center of circadian rhythm

Answer 18

SCN - has control over slave organs, but they also have indiv. molecular control

Question 19

3 general types of insommnia and causes

Answer 19

1. initiation - rule out restless legs and breathing
2. maintenance- intrinisic sleep problems
3. awakinging - depression or breathing

Question 20

3 examples of insomnia subtypes

Answer 20

1. psychophysiologic - learned behaviors
2. sleep state mispercetion - think they are up all night, but aren’t
3. fatal family insomnia- rare neurodegen. disorder

Question 21

5 behav. treatments for insomnia

Answer 21

1. sleep log
2. sleep hygene
3. stim. control
4. sleep restriction
5. relaxation response

Question 22

what is sleep apnea

Answer 22

disordered breathing causing waking, with sig. morbidity (hypertension, stroke, sleepiness, accidents)

Question 23

clinical aspects of obstructive sleep apnea

Answer 23

1. 17 inch neck circumference
2. obesity
3. excessive daytime sleepiness
4. morning headache
5. nasal disorders
6. position or alcohol
7. neuromuscular disorders

Question 24

diff between apnea and hyponea

Answer 24

apnea - no breathing for 10 minutes

hypopnea - reduced airflow for 10 minutes

Question 25

3 types of apnea

Answer 25

1. obstructive - paradox of muscles 2. central - no effort 3. mixed

Question 26

causes of central sleep apnea (6)

Answer 26

1. heart failure 2. syringopulbia 3. lateral medullary syndrome 4. other brainstem function 5. atlantoaxial subluxation 6. myotonic dystrophy

Question 27

what is restless legs

Answer 27

urge to move accompanied by uncomfortable sensation that are releived with movement

Question 28

relation of RLS to periodic limb movement disorder

Answer 28

90% of RLS have PLMD | 50% of PLMD have RLS

Question 29

causes of RLS (4)

Answer 29

1. central spactiticy or peripheral radiculopathy 2. alcohol 3. pregnancy 4. Fe def.

Question 30

treatment of RLS (3)

Answer 30

1. underlying conditions 2. DOPA agonists before bed 3. sinemet - avoid

Question 31

tetrad of narcolepsy

Answer 31

1. excessive daytime sleepiness 2. cataplexy 3. sleep onset dreaming 4. sleep paralysis

Question 32

3 treatments of narcolepsy

Answer 32

1. strategic napping 2. alerting agents (amphetimies) 3. anticataplectic (antidep, methyphenidate)

Question 33

2 receptors inmportant for narcolepsy

Answer 33

1. orexin | 2. hypocretin

Question 34

2 main classes of parasomnia

Answer 34

1. slow wave arousals - terrors, walking, sex, talking | 2. REM disorders - easy to awaken and report corresponding dreams

Question 35

what is predictive about REM sleep disorders

Answer 35

90% develop parkinsons - can be treated with clonazepam

Question 36

what is sleep related epilepsy

Answer 36

seizure more common in sleep - esp 2 hours after onset

Question 37

3 types of sleep related epilepsy

Answer 37

1. benign epi. of childhood 2. electric status epilepticus during sleep 3. nocturnal paroxysmal dystonia

Question 38

what happens to sleep in depression

Answer 38

loss of REM latency