10 - Sleep Flashcards
How do we decrease the stimulation of the reticular formation in order to sleep?
- Reduce sensory input = go somewhere quiet and comfortable, close eyes
- Reduce cortical input = don’t think
What are the functions of sleep?
- Energy conservation
- Body repair
- Memory consolidation
- Clear extracellular debris from the brain
What happens to the EEG when we close our eyes?
Waves synchronise = α waves
On average how many cycles of REM sleep do we get per night?
6 cycles
What are the name of the EEG waves when we are awake and eyes open? At what other point do these waves occur?
β waves
REM sleep
REM sleep is initiated by which brain structure?
Pons
What is responsible for the loss of muscle tone in REM sleep?
Reticular formation sends descending inhibition of LMNs via the reticulospinal tracts
Define insomnia:
Difficulty initiating/maintaining sleep, or non-restorative sleep for >1month, resulting in daytime fatigue which causes significant distress and impairs life
What are the risk factors for insomnia?
- Stress
- Poor sleeping environment
- Shift work
- Caffeine
- Mental health conditions ie anxiety/depression
- Physical health conditions ie chronic pain
- Drugs
Name some drugs associated with insomnia:
- SSRIs
- Theophylline
- Salbutamol
- Methylphenidate
- ‘diet’ pills
How would you manage a patient with insomnia?
- Advise sleep hygiene/routine and regular exercise
- OTC: sleep-eze, nytol, sedating antihistamines
- If severe/acute exab = short-course benzo or Z-drug
Define narcolepsy:
Chronic neurological condition which disrupts normal sleep pattern, causing excessive sleepiness +/- cataplexy
What is cataplexy?
Sudden physical collapse in response to strong emotion or laughter. Seen only in narcolepsy
What are the risk factors for narcolepsy?
- ^M:F
- HLA allele (FH)
- Head trauma
- Infection
- Change in sleep habits
How would you manage a patient with narcolepsy?
Advise: - Contact DVLA - Sleep hygiene/routine - Regular exercise - Planned daytime naps - Educate family/colleagues Drugs: - Modafinil - Methylphenidate - TCAs/SSRIs for sleep paralysis - Benzo for refractory cases
