8-22 SLEEP Flashcards
Sleep is the ____state between _____and _____
Sleep is the INTERMITTENT state between WAKEFULNESS and DEATH
List and describe the 3 states of Being
- Wake
- NREM sleep=Active body/physical restoration/Stages N1, N2, N3
- REM sleep=Active Brain/Mental Restoration
1) All species have _____ sleep in EARLY LIFE that will ___[INC/DEC] with age
2) All mammals have _____sleep
1) All SpeCies have REM Sleep in early life but this DEC as general species age
2) All MAMMALS have NREM/REM Sleep
Sleep depends on ____, _____, ______ and _______
Human Sleep depends on AGE, DRUGS/DISORDERS, COURSE OF WAKE/SLEEP CYCLE AND COURSE OF NREM/REM
What is the NREM:REM sleep ratio FOR INFANTS?
Infants NREM:REM= 50%NREM: 50%REM
What is the NREM:REM sleep ratio FOR ADULTSSS?
ADULTS NREM:REM= 75-80%NREM : 20-25%REM
“WE SPEND MORE TIME IN PHYSICAL/BODY RESTORATION DURING SLEEP!”
NREM sleep occurs mostly in the ___half of sleep and is linked to ________
NREM sleep occurs mostly in the FIRST half of sleep and is linked to PRIOR LEVEL OF WAKEFULLNESS
REM sleep occurs mostly in the ____half of sleep and is linked ______
REM sleep occurs mostly in the SECOND half of sleep and is linked to CIRCADIAN RHYTHM
What happens to a Childs sleeping patterns as it grows up?
Children sleeping[wake/sleep pattern] gradually becomes RESTRICTED TO THE NIGHT as they get older
Describe Normal Sleep in Children [2]
- No Sleep Onset REM Periods (SOREMs) until 3 mo. old
* NREM stages 3-6 months
Describe Normal Sleep in ADULTS [2]
1) Adult sleep is entered through NREM stage first
2) REM cycles every 90-120 minutes
Circadian Rhythm
2)Physiologically where does this come from?
Intrinsically NATURAL RHYTHMS of sleep even w/out environmental cues like the sun. Not exactly but approximately a 24 hour rhythm
2)Comes from the circadian pacemaker in the hypothalamus’ suprachiasmatic nuclei(biological clock)
Entrainment [2]
Stimuli (Zeitgebers) signal the time of day and can shift circadian clocks systemically–> enables Circadian Rhythms to synchronize w/ the environment.
2)Can be either photic or non-photi
In the two-process model of sleep Process S=______ and Process C = ______
Process S= homeoStatic INC in sleep pressure w/INC time awake
**Process C=Circadian nadir occurring early in the morning
What is the Sleep debt “payback” ratio?
For ever 2.5 hours you miss in sleep(debt) you will have to payback 1 hour to make up for it! 2.5:1 ratio
What are some Known effects of Sleep Deprivation
- INC car crashes
- Major industrial accidents (cheronobyl, 3 mile island)
- INC risk of blood-borne pathogen exposure accidents in EM residents (sticking self with needle)
Describe the Epworth Sleepiness Scale
0=no chance of dozing off
1= Slight chance of dozing off
2= Moderate chance of dozing
3=HIGH chance of dozing off
What are the 4 Diagnostic Test used for sleep?
- PSG!/Polysomnography :Scoring & Staging(EEG, EMG, Airflow, Respiratory Effect, EKG)(3 stages Wake vs. NREM vs. REM)
- Multiple Sleep Latency Test [MSLT]
- Maintenance of Wakefulness Test
- Actigraphy
Describe the Multiple Sleep Latency Test
Used to Diagnose sleep disorder=preceded by an all-night in lab PSG the well-cntrolled MSLT uses (5) 20-min naps to test tendency of falling asleep during usual wake hours (i.e. Narcolepsy)
What are the Parameters measured in MSLT?
MSLT (multiple sleep latency test) measures
- average latency[eyes close but not sleep] to sleep onset
- Appearance of REM sleep
What are the NORMS for sleep latency: [4]
latency: Lying in bed w/eyes closed but not yet sleep
* 0-5 min of latency=severe hypersomnia=narcoleptic=pt goes to sleep VERY FAST
- 5-10 min of latency=borderline narcoleptic
- 10-20 min latency=NORMAL :-)
*2 or more naps with REM periods=Abnormal
Describe the “Maintenance of Wakefulness Test”
Will test pt ability to STAY AWAKE–> by requiring them to sit up in dimly lit room and stay awake for 40 minutes. Repeats this 4 times throughout the day.
Describe Actigraphy
Minimally invasive cheap at-home method, worn as a watch and used to capture all types of sleep score information that can be interpreted later!
1) Psychological Insomnia
2) Treatment?
PI=Present for at least 1 month and described as heightened arousal in bed and/or evidenced sleep difficulty
2)TRMNT: Cognitive Stimulus control, Sleep restriction, Rx
