Chronobiology 2 and Sleep Disorders Flashcards

1
Q

In the hypothalamus, what structures are the “off switch” and the NREM promoting center?

A

VLPO and MNPO

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2
Q

If GABA/ galanin increases…what is the result on sleep?

A

sleep is favored

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3
Q

Are VLPO and MNPO active all the time?

A

No…they are silent during wakefulness

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4
Q

When do the VLPA and MNPO fire the most?

A

During NREM

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5
Q

When does MNPO firing more prevalent?

A

When drifting to sleep

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6
Q

When does VLPO firing more prevalent?

A

when asleep

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7
Q

What neurotransmitter do the VLPO and MNPO contain?

A

GABA and Galanin

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8
Q

What controls REM sleep?

A

Laterodorsal and Pedunculopontine tegmental (LDT/ PPT) Ach firing

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9
Q

How is atonia during REM developed?

A

Ach stimulates neurons in the medulla that release GALA and glycine

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10
Q

True or False:

Levels of 5HT, NE, and DA do not fluctuate during NREM

A

False…they all fluctuate. This allows for the different stages of NREM

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11
Q

During sleep, when does Ach release peak?

A

During REM

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12
Q

How are 5HT, NE and DA inhibited during REM?

A

They are inhibited by feedback inhibition

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13
Q

What happens to the level of adenosine throughout the day?

A

It increases via metablism (breakdown of ATP)

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14
Q

Is a high level of adenosine associated with sleepiness or wakefulness?

A

Sleepiness

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15
Q

What controls the Circadian clock?

A

Genes and proteins

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16
Q

What are the genes/ proteins involved in the circadian clock?

A

CRY, CLK, BMAL-1, PER 1(-3)

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17
Q

Explain the expression of the circadian clock genes/ proteins…

A

Some fluctuate on a 24 hour basis

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18
Q

Explain the relationship between BMAL-1 and PER 1,2,3…

A

They are in counter phase

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19
Q

True or false:

Light and temperature can effect the gene/ protein expression

A

True

20
Q

What are Zeitgebers? Give examples

A

They are factors that also modify our clock

Exogenous melatonin, caffeine, alcohol, light, food, exercise/ activity, social interaction

21
Q

What is insomnia?

A

Difficulty initiating or maintaining or maintaining sleep, early morning awakening, nonrestorable sleep for 1 month

22
Q

How is insomnia treated?

A

Treat with sleeping pills (to increase GABA) and sleep hygiene

23
Q

What is hypersomnia?

A

Excesive daytime sleepiness or inability to maintain wakefulness

24
Q

How is hypersomnia treated?

A

With stimulants and wafefulness hygiene

25
Q

What is Narcolepsy?

A

Sleep attacks daily for 3 monthseristic

Cataplexy (loss of tone) upon waking and hyponogogic hallucination upon sleeping is charact

26
Q

Can there be an “organic” reason for narcolepsy?

A

Missing/ dysfunctional orexia system

27
Q

How is narcolepsy treated?

A

treat with stimulants

28
Q

What are some breathing related sleep disorders and what are the effects of them?

A

Central or Obstructive Sleep Apnea

Yields insomia and hypersomnia

29
Q

What is the treatment for CSA and OSA?

A

CPAP, Dental devices and surgery

Must avoid sedatives!

30
Q

What is circadian rhythm sleep disorder?

A

A condition that yields insomnia or hypersomnia due to sleep-wake cycle mismatch, shift or synchrony

31
Q

What are the two forms of circadian rhythm sleep disorder?

A

Advances type (usually the elderly) and delayed type (usually shift workers)

32
Q

How are circadian rhythm sleep disorders usually treated?

A

Sleep schedule, benzodiazapines, melatonin, exercise, stimulants or light therapy

33
Q

What is dyssomnia NOS?

A

here are two types…Nocturnal myoclonus (now it is called Periodic limb movement disorder) and restless leg syndrome

34
Q

How are dyssomnia NOS conditions treated?

A

with dopamine (D2) receptor agonisits

35
Q

Describe nightmare disorder:

A

Long firghtening dreams where the individual wake alert and oriented and can remember the dream

36
Q

What stage of sleep does nightmare disorder happen during?

A

Occurs during REM

37
Q

Describe sleep terror disorder:

A

Individual wakes disoriented and is not consolable and has no memory of their dream or the event

38
Q

When do sleep terrors occur?

A

In the 1st 1/3 of the night usually during NREM sleep (stage e and 4)

39
Q

When does sleepwalking occur?

A

In the 1st 1/3 of the night usually during NREM sleep (stage e and 4)

40
Q

Describe sleepwalking:

A

No memory of the event typically. Individual might wake up confused but orients easily

41
Q

What is sleep related bruxism?

A

teeth grinding dureing stage 2 of NREM

42
Q

What is the treatment for sleep related bruxism?

A

Mouth guard/ bite plate

43
Q

What is REM sleep behavior disorder?

A

Loss of atonia during REM, so they act out dreams. Typically occurs in men and it can be violent at times

44
Q

How is REM sleep behavior disorder treated?

A

D2 receptor agonists

45
Q

At what stage of sleep dies sleep talking occur?

A

All stages of sleep

46
Q

What is sleep paralysis?

A

Inability to move just prior to falling asleep or upon awakening