48. Respiratory Disease/Neuro Flashcards
Why do we sleep?
- 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
What is sleep linked with?
- Conserving energy
- Enhance survival / adaptation
- Aid learning / memory consolidation
- Restorative / repair of injury
- Brain plasticity (forming skills and memories)
- may directly affect recovery processes
What is neural plasticity?
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
Sleep is Neuroprotective in the ______ Phase of Stroke and Promotes _________
Sleep is Neuroprotective in the Acute Phase of Stroke and Promotes Neuroplasticity
How are sleep disorders related to stroke?
- 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).
The possible mechanisms linking insufficient or fragmented sleep with worse outcomes include what?
elevated sympathetic activation
intermittent hypoxemia
oxidative stress
inflammatory changes
What happens to the penumbra if blood flow isn’t restored?
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
Sleep Deprivation/Disturbances _________Cerebral Infarct Area
Sleep Deprivation/Disturbances Increases Cerebral Infarct Area
Healthy sleep following stroke reduces what?
- reactive astrocytes
- Neurocan
- neurocan acts to inhibit neurite outgrowth
What is the function of neurocan?
Neurocan acts to inhibit neurite outgrowth
How does sleep deprivation improve sleep outcomes?
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
What are the characteristics of sleep in people with dementia?
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
Sleep problems were generally associated with a worse evolution, including what?
- the development of more severe cognitive and neuropsychiatric symptoms
- with a diminished quality of life
- a higher caregiver burden
Commonly prescribed medications that may contribute to insomnia in older dementia patients include what?
beta-blockers
bronchodilators
corticosteroids
gastrointestinal drugs (eg, H2 blockers and cimetidine)
cardiovascular drugs
neurologic drugs (eg, selegiline)
How does sleep deprivation improve novel object recognition memory in Ts65Dn mice?
Sleep deprivation causes sleep intensification
What is a T265Dn mouse?
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
What are the gold standard biomarkers of Alzheimer’s?
CSF Aβ and tau levels are AD’s gold standard biomarkers
How can an EEG be used to detect Alzheimer’s?
AD patients demonstrated a slowing of the awake and REM sleep occipital EEG (from 9.40 Hz to 6.40 Hz)
Studies in healthy elderly adults found that both diminished slow wave activity (SWA) and SWA disruption were associated with elevated ________
Studies in healthy elderly adults found that both diminished slow wave activity (SWA) and SWA disruption were associated with elevated CSF Aβ
What is obstructive sleep apnoea (OSA)?
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
What are some sleep-apnoea induced complcations?
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
Many people with neurological conditions have an increased risk of developing OSA. These neurological include what?
Stroke
Parkinson’s disease
Alzheimer’s disease
Multiple sclerosis
ALS
Several studies reported the association between OSA and other sleep-related breathing disorders with what?
high blood pressure
stroke
diabetes
heart disease
neurocognitive symptoms and ADHD in children
What is the relationship between OSA and ADHD?
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.
What effect does sleep fragmentation have on ADHD?
Sleep fragmentation as a result of OSA can exacerbate the attention disorder that characterizes ADHD
What is the mechanism of action for air pollution contributing to stroke?
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
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.
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.
