Chronobiology 2 and Sleep Disorders Flashcards
In the hypothalamus, what structures are the “off switch” and the NREM promoting center?
VLPO and MNPO
If GABA/ galanin increases…what is the result on sleep?
sleep is favored
Are VLPO and MNPO active all the time?
No…they are silent during wakefulness
When do the VLPA and MNPO fire the most?
During NREM
When does MNPO firing more prevalent?
When drifting to sleep
When does VLPO firing more prevalent?
when asleep
What neurotransmitter do the VLPO and MNPO contain?
GABA and Galanin
What controls REM sleep?
Laterodorsal and Pedunculopontine tegmental (LDT/ PPT) Ach firing
How is atonia during REM developed?
Ach stimulates neurons in the medulla that release GALA and glycine
True or False:
Levels of 5HT, NE, and DA do not fluctuate during NREM
False…they all fluctuate. This allows for the different stages of NREM
During sleep, when does Ach release peak?
During REM
How are 5HT, NE and DA inhibited during REM?
They are inhibited by feedback inhibition
What happens to the level of adenosine throughout the day?
It increases via metablism (breakdown of ATP)
Is a high level of adenosine associated with sleepiness or wakefulness?
Sleepiness
What controls the Circadian clock?
Genes and proteins
What are the genes/ proteins involved in the circadian clock?
CRY, CLK, BMAL-1, PER 1(-3)
Explain the expression of the circadian clock genes/ proteins…
Some fluctuate on a 24 hour basis
Explain the relationship between BMAL-1 and PER 1,2,3…
They are in counter phase
True or false:
Light and temperature can effect the gene/ protein expression
True
What are Zeitgebers? Give examples
They are factors that also modify our clock
Exogenous melatonin, caffeine, alcohol, light, food, exercise/ activity, social interaction
What is insomnia?
Difficulty initiating or maintaining or maintaining sleep, early morning awakening, nonrestorable sleep for 1 month
How is insomnia treated?
Treat with sleeping pills (to increase GABA) and sleep hygiene
What is hypersomnia?
Excesive daytime sleepiness or inability to maintain wakefulness
How is hypersomnia treated?
With stimulants and wafefulness hygiene
What is Narcolepsy?
Sleep attacks daily for 3 monthseristic
Cataplexy (loss of tone) upon waking and hyponogogic hallucination upon sleeping is charact
Can there be an “organic” reason for narcolepsy?
Missing/ dysfunctional orexia system
How is narcolepsy treated?
treat with stimulants
What are some breathing related sleep disorders and what are the effects of them?
Central or Obstructive Sleep Apnea
Yields insomia and hypersomnia
What is the treatment for CSA and OSA?
CPAP, Dental devices and surgery
Must avoid sedatives!
What is circadian rhythm sleep disorder?
A condition that yields insomnia or hypersomnia due to sleep-wake cycle mismatch, shift or synchrony
What are the two forms of circadian rhythm sleep disorder?
Advances type (usually the elderly) and delayed type (usually shift workers)
How are circadian rhythm sleep disorders usually treated?
Sleep schedule, benzodiazapines, melatonin, exercise, stimulants or light therapy
What is dyssomnia NOS?
here are two types…Nocturnal myoclonus (now it is called Periodic limb movement disorder) and restless leg syndrome
How are dyssomnia NOS conditions treated?
with dopamine (D2) receptor agonisits
Describe nightmare disorder:
Long firghtening dreams where the individual wake alert and oriented and can remember the dream
What stage of sleep does nightmare disorder happen during?
Occurs during REM
Describe sleep terror disorder:
Individual wakes disoriented and is not consolable and has no memory of their dream or the event
When do sleep terrors occur?
In the 1st 1/3 of the night usually during NREM sleep (stage e and 4)
When does sleepwalking occur?
In the 1st 1/3 of the night usually during NREM sleep (stage e and 4)
Describe sleepwalking:
No memory of the event typically. Individual might wake up confused but orients easily
What is sleep related bruxism?
teeth grinding dureing stage 2 of NREM
What is the treatment for sleep related bruxism?
Mouth guard/ bite plate
What is REM sleep behavior disorder?
Loss of atonia during REM, so they act out dreams. Typically occurs in men and it can be violent at times
How is REM sleep behavior disorder treated?
D2 receptor agonists
At what stage of sleep dies sleep talking occur?
All stages of sleep
What is sleep paralysis?
Inability to move just prior to falling asleep or upon awakening
