Clinical Perspective of Sleep Cycle & Sleep Disorders Flashcards
What is the most common psychiatric disorder to present as insomnia?
Major Depressive Disorder
What disorder is characterized by an overwhelming desire to sleep with sleep attacks?
Narcolepsy
This sleep disorder is characterized by difficulty falling asleep, staying asleep, or waking early.
Insomnia Disorder
What is the pathophysiology of narcolepsy?
Deficiency of orexin
What are the stages of the sleep cycle?
N1, N2, N3, REM
These waves generally signify active thinking and concentration.
Beta waves
These neurotransmitters play an important role in wakefulness and the suppression of sleep.
Orexin, norepinephrine, acetylcholine, dopamine, serotonin, histamine
Acetylcholine levels are lowest during which stage of sleep?
N3
This sleep disorder is characterized by repeated interruptions in normal respiration.
Sleep apnea
K-complexes and sleep spindles characterize what stage of sleep?
N2
Night terrors and sleepwalking occur during this stage of sleep.
N3
What are the types of sleep apnea?
Obstructive and central sleep apnea
From where is melatonin secreted?
Pineal gland
What drug is taken at night to prevent daytime sleep attacks associated with narcolepsy?
Sodium oxybate
These neurotransmitters play an important role in the promotion of sleep.
GABA, melatonin
These are visual images that occur upon waking.
Hypnopompic hallucinations
What brain waves predominate during wakefulness?
Alpha & beta waves
What is the difference between a sleep terror and a nightmare?
Sleep terrors occur during N3 sleep and are associated with sudden arousal, intense fear, and no recollection of the terror.
Nightmares occur during REM sleep and are remembered upon waking.
What waves are present during N2 sleep?
K-complexes and sleep spindles
What medications may be used for insomnia disorder?
Ramelteon, Suvorexant, anti-histamines
These drugs are used to manage daytime sleepiness associated with narcolepsy.
Modafinil, amphetamines
What structure is responsible for dictating the circadian rhythm?
Suprachiasmatic Nucleus
What are the general types of sleep?
REM & non-REM sleep
What physiologic changes occur during REM sleep?
Erections, increased HR & BP, loss of motor tone (except extraocular and respiratory muscles), increased brain O2 usage
What is the difference between orexin and hypocretin?
Nothing, they are different names for the same molecule
These are visual images that occur upon going to sleep.
Hypnagogic hallucinations
What criteria are required for a diagnosis of hypersomnolence disorder?
Sleep lasting 9+ hours that is not restorative, multiple episodes of sleep during the day, or difficulty with arousal upon awakening
3 episodes/week for 3 months
What is a common cause of obstructive sleep apnea in children?
Adenotonsillar hypertrophy
This test is generally required to diagnose a sleep disorder.
Polysomnography
How long must symptoms occur for a diagnosis of insomnia?
At least 3 nights/week for 3 months
Most sleep is spent in this stage.
N2
What is the first treatment for insomnia disorder?
Sleep hygiene - engaging in behaviors that promote restful sleep
What are the major risk factors for obstructive sleep apnea?
Obesity, male, older age
What waves are present during N1 sleep?
Theta waves
What waves are present during REM sleep?
“Sawtooth” waves
These disorders are characterized by a misalignment between desired and actual sleep patterns.
Circadian Rhythm Sleep-Wake Disorders
True/False. Benzodiazepines promote sleep onset, but result in less sleep.
True - less REM sleep
What waves are present during N3 sleep?
Delta waves
What histamine receptor is implicated in wakefulness?
H1
From where is orexin secreted?
Lateral hypothalamus
What is the first-line treatment for sleep apnea?
Positive Airway Pressure
What are the stages of non-REM sleep?
Light sleep - N1, N2
Deep sleep - N3
Sleep is essential for what brain function?
Memory - synaptic growth and pruning
