Chapter 8: Sleep Disorders Flashcards
What are the 2 distinct stages of sleep?
REM and NREM
Some characteristics of NREM sleep?
- divided into 3 stages
- slowing of the EEG
- higher muscle tone
- absence of eye movements
- absence of thought like mental acuity
“idling brain in a movable body”
Some characteristics of REM sleep?
- aroused EEG pattern
- sexual arousal
- saccadic eye movements
- dreaming
Stage 1 sleep has what types of waves?
theta
Stage 2 sleep has what types of waves?
sleep spindles and K complexes
Stage 3 sleep has what types of waves?
delta
ID the sleep wave.
theta
ID the sleep wave.
sleep spindles
ID the sleep wave.
K complexes
ID the sleep wave.
delta waves
Describe Stage 2 sleep.
longest stage of sleep
Describe stage 3 sleep?
- deepest stage of sleep: delta sleep is restorative
- tends to decrease in older adults
Describe sleep latency stage.
About 5-15 min from time one goes to bed and falls asleep
Describe REM latency.
About 90 min from time one falls asleep to first REM period
Describe characteristics of REM sleep as you sleep.
- first REM period of night is 5-15 min and last is 20 - 40 min
- REM increases as night goes on
- greater amounts in second half of night
- easiest to arouse
- memories are consolidated by hippocampus
NREM is greater the first or second half of the night?
greater amounts in first half of night
What neurotransmitter helps to initiate sleep?
serotonin
What neurotransmitter is higher during REM?
ACh
What neurotransmitter is lower during REM?
NE
How do DA levels affect sleep?
produce arousal and wakefulness; they rise upon waking
Besides DA what is another neurotransmitter that regulates arousal, wakefulness and appetite?
Orexin (hypocretin)
How to remember neurotransmitters that affect sleep?
SAND
Serotonin
ACh
NE
DA
If benzos are used chronically, and then stopped they affect what part of sleep most?
sleep latency is increased
How does moderate alcohol consumption affect wakefulness during sleep?
increases wakefulness during the second half of the night
What sleep stage/s do barbs affect?
decrease REM
How do barbs affect REM when one is going through withdrawal?
REM rebound, including nightmares
4 main symptoms of narcolepsy?
- sleep attacks and excessive daytime sleepiness (most common symptom)
- cataplexy
- hypnopompic and hypnogogic hallucinations (common)
- sleep paralysis: inability to move or speak while falling asleep or waking up from sleep
What is secondary insomnia?
(most common type) caused by medical problems, psychiatric problems, medications, etc
What are some treatments for insomnia?
varies:
- sleep hygiene
- behavior modification: stimulus control
- pharmacotherapy: zaleplon, zolpidem, eszopiclone
- Ramelteon: a melatonin receptor-agonist, works on the sleep wake cycle and has less incidence of dependence
What condition can deficient orexin lead to?
narcolepsy
How can lack of orexin lead to narcolepsy?
orexin triggers wakefulness, while low sleep levels of orexin at night serve to drive sleep…. low levels therefore lead to narcolepsy
What stage of sleep do night terrors occur? And what are major features of those with night terrors?
- stage 3
- common in young boys
- familial
- wake up in middle of night and scream
Treatment for night terrors?
benzodiazepines
Do you remember night terrors?
no
Nightmares happen during which stage of sleep?
REM
Features of nightmares?
common during stressful times
Treatment for nightmares?
antidepressants
Do you/ can you remember nightmares?
yes
What stage of sleep does somnambulism occur in?
stage 3
Treatment for somnambulism?
benzodiazepines
What stage does bruxism commonly occur in?
stage 2
