Circadian Medicine Flashcards
When does Cough and Dyspnea occur?
Early hours of the morning (approx. 4am)
Time of day variation of airway conductance
Dirunal variation is evident
- Nadir at 4 am
-Peak at mid noon
What is FEF25-75%?
a test for the small airways examining the flow rate during the middle 50% of the exhaled curve.
What is FEV1%
Forced Expiratory volume in the first second
(testing airways for obstruction)
What is the time of day variation of spirometric parameters
BEST LUNG FUNCTION ABOUT MIDDAY
Each Spirometry test exhibits a nadir around 4-5am and acrophase at mid-noon
Where is the lung clock located?
In the Clara Cells
What is the best time for steroid drugs?
3pm
Because it doesnt cause supression of the adrenal glands
What is the best time for beta-agonists?
6PM
Allows for protection for the whole night
What is the diurnal variation for CVD events?
Peaks in the early morning
Is there Diurnal variation in BP?
Yes
Decreases during sleep
Surges during the morning
Why does BP have a diurnal variation?
Relates to gravity
Blood pressure increases upon waking as the effects of standing up causes the increase in BP
Dippers VS Non-Dippers
Dippers
- Nocturnal Dip in BP by 10-20% of the daytime level in normal and hypertensives
Non-Dippers
- Those who display <10% dip in BP during sleep
- Associated with sleep apnea, nocturia (needing to pee) and hypertension
When is the highest incidence of sudden cardiac death ?
Within the first 3h after awakening (due to the increase in BP after waking)
How does timing of exercise effect BP?
SBP had the greatest decrease after 7am Exercise
DBP greatest decrease after 7am and 7pm
Greater amount of time spent in deep sleep after 7am exercise
Difference between LDL and HDL?
LDL
- Bad Cholesterol –> build up in the arteries and form fatty deposits
- Increased risk for heart diseases and stroke
HDL
- Good Cholesterol –> transports excess cholesterol out of the arteries to the liver
- Lower risk for heart disease and stroke
