[8.42/43] Sleep Flashcards
Describe sleep
naturally periodically recurring state of inactivity, characterised by a loss of consciousness and a lack of response to external stimuli
What does inadequate sleep result in?
Reduction of:
- performance
- concentration
- reaction time
- consolidation of information learning
Increase in:
- memory lapses
- accidents and injuries
- behaviour / mood problems
Describe ECGs in sleep
(this is like not rly impt lol)
lower frequencies of ECG; linked to EEG in slow-wave sleep
- heart beat acting as a neural stimulus which evokes a down-state (slow oscillation of ECG evoked potential) - generally weaker and noisier
split into organ (3) + physiological (4)
Parameters of polysomnography and their use?
sleep study tool;
organ functions:
- EMG (electromyogram) - muscle activity
- EEG (electroencephalogram) - brain activity
- EOG (electrooculogram) - eye movement (distinguishes REM and NREM sleep)
physiological functions:
- breathing monitoring
- video and sound monitoring
- BP
- temperature
gashnod
Which NTs are involved in wakefulness?
- Glutamate
- Ach
- Serotonin
- Histamine
- NA
- Orexins
- Dopamine
3
Which NTs are involved in sleep?
- Gaba
- Adenosine (acting as an inhibitor)
- Melatonin
what happens to thalamic relay during sleep?
thalamo-cortico-thalamic circuit:
during sleep: blocked response: receives signal from external stimuli but thalamus to cortex is blocked
Characteristics of REM sleep
- muscle atonia
- rapid ocular movement (EOG desynchronisation)
describe narcolepsy + its side effects
tendency to fall asleep inappropriately during the daytime, despite having sufficient sleep
s/e:
- cataplexy (sudden brief spells of muscle weakness eg. eyes sagging, head drooping, knees buckling)
- hypnogogic/hypnopompic hallucinations (upon falling asleep or waking)
- sleep paralysis
- disrupted night-time sleeping (insomnia)
what is insomnia?
what are the types of insomnia (3) and what are they classified based on?
inability to initiate, maintain sufficient/proper sleep or waking up too early
types:
1. transient (<4 weeks triggered by excitement or stress)
2. short-term (4 weeks - 6 months)
3. chronic (>6 months)
Treatments: Insomnia
- benzodiazepines
- Z drugs (zolpidem; zaleplon)
- antidepressants
- melatonin therapy
- CBT
Describe hypnopompic / hypnagogic hallucination
- hypnagogia –> from waking to sleep
- hypnopompic –> from dreaming to waking
- experiencing narrative or frightening dreams + auditory hallucinations
Treatments: Narcolepsy
- amphetamine derivatives
- antidepressants
- benzodiazepines
- modafinil (CNS stimulant)
what are parasomnias?
unpleasant / undesirable behavioural phenomena which occur during sleep
- including nightmares,
- night terrors,
- sleep walking
- confusional arousals
causes of night terrors
- genetic factors
- sleep breathing disorder
- acute triggers: alcohol, drugs, PTSD
Treatments: parasomnias
- TCAs (eg. imipramine)
- benzodiazepines (eg. diazepam)
types of parasomnias
incl age-range, causes of each, degree of severity
- REM sleep (arousal): REM sleep behaviour disorder (RBD) - lack of somatic muscle atonia, permitting acting out of dream mentation, often with violent or injurious results
- non-REM sleep (partial arousal): common in childhood (sleepwalking), decrease in freq with increasing age; occurs during first third of sleep cycle
- night terrors: partial waking from sleep with episodes of intense screaming, crying, thrashing or fear
- sleepwalking
- sleep terrors (usually no medication for these but some antidepressants benzodiazepines if these episodes lead to risky effects)
okay there’s alot so just a few can alr
causes of insomnia?
depression, restless leg syndrome, hyperthyroidism, arthritis, chronic pain benign prostatic hypertrophy, headaches, periodic leg movement, sleep breathing disorder, bruxism, cramps
caffeine, nicotine, alcohol, exercise, noise, light, hunger
describe melatonin therapy (and what for)
what: neuro-hormone produced by the pineal gland
for?: therapy for sleep-phase onset delay (insomnia, s/e of narcolepsy)
how take: 30mins before bedtime
describe CBT
- aim of changing a person’s beliefs and attitudes about insomnia
- combined w behavioural intervention (eg stimulus control, sleep restriction, relaxation training)
