48. Respiratory Disease/Neuro

Question 1

Why do we sleep?

Answer 1

• Not fully-understood
• All animals sleep: despite dangers
• Animals fully deprived of sleep die (biological necessity)
• Sleep is restorative
  
  • Growth hormone surge during sleep
  • Brain plasticity
  • Flushing metabolic waste from the brain (Xie et al., Science, 2013)
• Necessary for proper functioning
  
  • Lack of sleep is associated with illness and impaired functioning

Question 2

What is sleep linked with?

Answer 2

• Conserving energy
• Enhance survival / adaptation
• Aid learning / memory consolidation
• Restorative / repair of injury
  
  • Brain plasticity (forming skills and memories)
  • may directly affect recovery processes

Question 3

What is neural plasticity?

Answer 3

Neural plasticity is defined as the ability of the nervous system to change its activity in response to intrinsic or extrinsic stimuli by reorganizing its:

• structure
• functions
• connections

Question 4

Sleep is Neuroprotective in the ______ Phase of Stroke and Promotes _________

Answer 4

Sleep is Neuroprotective in the Acute Phase of Stroke and Promotes Neuroplasticity

Question 5

How are sleep disorders related to stroke?

Answer 5

• Sleep disorders, such as insomnia and sleep disordered breathing are frequent after stroke and may affect >50% of patients.
• Sleep disorders after stroke may have detrimental effects during the acute phase of stroke (and evolution of the penumbra).

Question 6

The possible mechanisms linking insufficient or fragmented sleep with worse outcomes include what?

Answer 6

elevated sympathetic activation

intermittent hypoxemia

oxidative stress

inflammatory changes

Question 7

What happens to the penumbra if blood flow isn’t restored?

Answer 7

The penumbra is a region of brain effected by stroke where the cells are in a hibernation state

If blood flow isn’t restored, the penumbra becomes part of the core

Question 8

Sleep Deprivation/Disturbances _________Cerebral Infarct Area

Answer 8

Sleep Deprivation/Disturbances Increases Cerebral Infarct Area

Question 9

Healthy sleep following stroke reduces what?

Answer 9

• reactive astrocytes
• Neurocan
  
  • neurocan acts to inhibit neurite outgrowth

Question 10

What is the function of neurocan?

Answer 10

Neurocan acts to inhibit neurite outgrowth

Question 11

How does sleep deprivation improve sleep outcomes?

Answer 11

SDis Reduce Axonal Sprouting of Neurons in the Cerebral Hemisphere.

Healthy sleep in stroke animals is increased compared to sham

Neurogenesis is increased in stroke mice that have undisturbed sleep

Question 12

What are the characteristics of sleep in people with dementia?

Answer 12

People with dementia show changes in sleep architecture and circadian rhythms, including:

• increased sleep latency and night-time awakenings
• decreased slow-wave sleep
• decreased rapid eye movement sleep
• decreased total sleep time
• increased daytime napping

Question 13

Sleep problems were generally associated with a worse evolution, including what?

Answer 13

• the development of more severe cognitive and neuropsychiatric symptoms
• with a diminished quality of life
• a higher caregiver burden

Question 14

Commonly prescribed medications that may contribute to insomnia in older dementia patients include what?

Answer 14

beta-blockers

bronchodilators

corticosteroids

gastrointestinal drugs (eg, H2 blockers and cimetidine)

cardiovascular drugs

neurologic drugs (eg, selegiline)

Question 15

How does sleep deprivation improve novel object recognition memory in Ts65Dn mice?

Answer 15

Sleep deprivation causes sleep intensification

Question 16

What is a T265Dn mouse?

Answer 16

an animal model of down syndrome, provide a unique method to investigate the mechanisms related to ADlike symptoms in patients with down syndrome - Show a decline cholinergic and cognitive deterioration

Question 17

What are the gold standard biomarkers of Alzheimer’s?

Answer 17

CSF Aβ and tau levels are AD’s gold standard biomarkers

Question 18

How can an EEG be used to detect Alzheimer’s?

Answer 18

AD patients demonstrated a slowing of the awake and REM sleep occipital EEG (from 9.40 Hz to 6.40 Hz)

Question 19

Studies in healthy elderly adults found that both diminished slow wave activity (SWA) and SWA disruption were associated with elevated ________

Answer 19

Studies in healthy elderly adults found that both diminished slow wave activity (SWA) and SWA disruption were associated with elevated CSF Aβ

Question 20

What is obstructive sleep apnoea (OSA)?

Answer 20

Obstructive sleep apnoea (OSA) is defined as a sleeprelated breathing disorder characterized by prolonged pauses in the airflow, attributed to the collapsibility of the upper airways, that interrupt normal ventilation, resulting in disruption of a normal sleep pattern

Question 21

What are some sleep-apnoea induced complcations?

Answer 21

Memory problems and inability to think corectly

Increased insulin resistance

Stroke

Cardiac problems

High blood pressure

Increased traffic and workplace accident

Death

Snoring

Depression

Hormone disruption

Question 22

Many people with neurological conditions have an increased risk of developing OSA. These neurological include what?

Answer 22

Stroke

Parkinson’s disease

Alzheimer’s disease

Multiple sclerosis

ALS

Question 23

Several studies reported the association between OSA and other sleep-related breathing disorders with what?

Answer 23

high blood pressure

stroke

diabetes

heart disease

neurocognitive symptoms and ADHD in children

Question 24

What is the relationship between OSA and ADHD?

Answer 24

attention deficits have been reported in up to 95% of children with OSA, and OSA has been reported in as many as 20% to 30% of children with a full ADHD syndrome.

Question 25

What effect does sleep fragmentation have on ADHD?

Answer 25

Sleep fragmentation as a result of OSA can exacerbate the attention disorder that characterizes ADHD

Question 26

What is the mechanism of action for air pollution contributing to stroke?

Answer 26

The mechanism of action is most likely a direct effect of particulate matter—a mixture of solid particles and liquid droplets found in the air and in gases such as ozone and nitrogen dioxide—on the vascular system, causing oxidative stress and inflammation

Question 27

Recent epidemiological studies and animal models suggest an increased risk of _______with sustained exposure to air pollutants, but the underlying mechanisms are unclear and potential confounding factors such as including lifestyle factors (eg, diet, physical activities) and medical history cannot be excluded.

Answer 27

Recent epidemiological studies and animal models suggest an increased risk of dementia with sustained exposure to air pollutants, but the underlying mechanisms are unclear and potential confounding factors such as including lifestyle factors (eg, diet, physical activities) and medical history cannot be excluded.