Chapter 8 ( Sleep And Sleep Disorders ) Flashcards
Characters of NREM ?
Slowing of EEG rhythm
Higher muscle tone
Absence of eye movements
Absence of thought like mental activity
Characters of REM ?
Aroused EEG pattern
Sexual arousal
Saccadic eye movement
Dreaming
Sleep waves associated with stage 1 ?
Theta waves
Sleep waves associated with stage 2 ?
Sleep spindles
K complexes
Sleep waves associated with stage 3 ?
Delta waves
In REM sleep memories are consolidated by ?
Hippocampus
Changes in sleep deprived people ?
1- cortisol level rises 2- blood pressure rises 3- glucose tolerance is reduced 4- greater amygdala activation 5- lower prefrontal cortical activity 6- increased negative mood
Biochemical trigger for REM sleep ?
Ration of ACh and NE
NE pathway which regulates REM sleep begins in ?
The pons
Neurotransmitter that helps to initiate sleep ?
Serotonin
Neurotransmitter higher during REM sleep and is associated with erections in males ?
ACh
Neurotransmitte that is lower during REM sleep ?
NE
Neurotransmitter that regulate arousal , wakefulness and appetite ?
Orexin ( hypocretin )
Action of Melatonin ?
Regulates the sleep-wake cycle by inhibiting the circadian alerting system in the suprachiasmatic nucleus
Melatonin production ?
Converted from serotonin in the Pineal gland under directions from the body’s internal circadian clock
Ttt of seasonal affective disorder ?
By bright environmental light
Which capable of activation of photoreceptors in the retina , a process which suppress human melatonin production —> reverses the winter depressive symptoms of patients with SAD
Benzodiazepines effect on sleep ? What will happen if used chronically then stopped
Limited decrease in REM and stage 4 sleep
Sleep latency will increase
Moderate alcohol consumption effect on sleep ?
Early sleep onset
Increased wakefulness during the second half of the night
Alcohol intoxication effect on sleep ?
Decreases REM
Effect of withdrawal of alcohol or barbiturate on sleep ?
REM rebound ( with nightmares )
Major depression effect on sleep ?
Increases REM
Decreases REM latency ( 45 mins rather than 90 mins )
Decreases stage 3 and 4 sleep
Early morning waling and multiple awakening during the night
Narcolepsy mechanism ? Symptoms ? Ttt ?
Its a REM disorder in which the patient enter REM within 10 mins
Its linked to a deficiency in Hypocretin
1- sleep attacks and excessive day time sleepiness
2- Cataplexy
3- Hypnopompic and Hypnogogic hallucinations
4- sleep paralysis : inability to move or speak while falling asleep or waking up
Ttt : Modafilnil Psychostimulants to treat sleepiness Antidepressants to treat cataplexy Gamma hydroxybutirate ( GHB ) to treat both cataplexy and day time sleepiness
Clinical presentation of sleep apnea ?
High risk of sudden death during sleep
Development of severe nocturnal hypoxemia
Pulmonary and systemic hypertension
Nocturnal cardiac arrhythmias
Bradycardia then tachycardia
Dry mouth , headache , daytime restlessness , loud snoring
Ttt of insomnia ?
Sleep hygiene
Behavioral modification : stimulus control
Zaleplon , Zolpidem , Eszopiclone
Ramelteon ( melatonin receptor agonist )
