How is sleep affected in the elderly?
Reduced REM and reduced Delta (Deep) Sleep
- increased awakenings - reduced efficiency
What stage of sleep is the majority of night?
Stage 2 – Sleep Spindles + K-Complexes
Where would you find theta waves?
Stage 1 Sleep
How does alcohol and benzodiazepines affect sleep efficiency and types of sleep?
Reduced REM and Delta Sleep
When is the most amount of Delta Sleep?
- Younger
- Beginning half of the night of sleep
How does sleep different from regular adult and depressed adult?
Depressed Adult
- Takes longer to fall asleep - increased latency
- More REM (Less REM Latency)
- Less Delta
- Decreased Sleep Efficiency
What neurotransmitter is important for REM sleep?
ACh
What is the different between Dyssomnia and Parasomnias?
Dyssomnias – problems in timing, quality, and amount
Parasomnias – abnormal physiologic behavior associated with sleep.
What is the difference between Night Terrors and Nightmares?
Nightmare – During REM – cause awakenings and can remember the nightmare
Night Terror – Screaming in Fear, mostly children, during Stage 3/4, no memory, unable to be awakened
When does sleep walking generally occur?
Delta Sleep
- First Half of the Night
What is REM Sleep disorder usually associated with?
- No paralysis during REM Sleep
- Parkinson Disease / Lewy Body Dementia
How is REM sleep different in depressed individuals?
Short REM Latency (takes less time to get into REM)
Increased REM in the sleep cycle
Increased Total REM
Reduced Delta Sleep Overall (since more REM)
What is most commonly associated with obstructive sleep apnea?
- Daytime Sleepiness
- Obesity
- Respiratory Acidosis (increased pCO2)
- Pulmonary Hypertension
What are the two types of sleep apnea?
- Central Sleep Apnea = Elderly
- Obstructive Sleep Apnea = Obesity, Men, 40-60
If a patient has been diagnosed with daytime sleep attacks and is diagnosed with Narcolepsy, what might be the effect on sleep?
- Very decreased sleep latency and REM latency
- Fragmented REM Sleep
- Less REM sleep
What kind of symptoms do Narcolepsy patients typically experience?
- Hallucinations when falling asleep or waking up
- Sudden Sleep Attacks – Cataplexy
- Sleep paralysis when waking up
What is the best way to treat Narcolepsy without medications for stimulation?
Schedule Naps during the day to increase total REM sleep and reduce number of sleep attacks
If you are watching an EEG and see “Saw Tooth” waves, what might be the stage of sleep?
REM
What are characteristics of REM sleep?
- Penile/Clitoris stimulation
- Paralysis of skeletal muscles
- Increased BP
- Increased Brain Oxygen use
- Increased Pulse
What stage of sleep would Bruxism be present during?
Stage 2
Without light simulation, such as in blind people, what is their natural circadian rhythm to become?
- Delayed Sleep Cycle
- - 25 hours
A 13 year old experiences periods of excessive sleepiness during the day that is not relieved with increased sleep or naps and has bouts of binge eating during these periods of sleepiness. What is the most likely cause?
Klein-Levin Syndrome
What is associated with hypocretin deficiency?
Necrolepsy
Who would be susceptible to advanced sleep phase?
- Depressed Individuals
-
Depression / Bipolar Disorders63
-
Defense Mechanisms22
-
Sleep Disorders32
-
Somatic Disorders29
-
Anxiety and Sleep Pharm41
-
Pyschosis Drugs53
-
Eating Disorders22
-
Personality Disorders28
-
Substance Abuse45
-
Traumatic Brain Injuries17
-
Neurodevelopmental Disorders34
-
PTSD12
-
Sexual Assault and Domestic Abuse26
-
Schizophrenia and Bipolar17
