Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Sleep > Intro > Flashcards

Intro Flashcards

1
Q

What are the components of the two process model of sleep?

A
  1. Circadian rhythm (body clock)
    24 hour cycle, rhythmic, intrinsic, generated from SCN
  2. Homeostatic drive (sleep pressure)
    dependent on previous sleep quality and time awake
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a Zeitberger?

A

An environmental agent/event that provides the stimulus for a biological clock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which hormone causes sleepiness?

A

Melatonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How long does a normal sleep cycle last?

A

Around 90 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the stages of sleep?

A
  1. Stage 1 sleep
  2. Stage 2 sleep
  3. Stage 3 sleep (slow-wave/deep) sleep
  4. REM sleep
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How are sleep studies performed?

A

Polysomnography (+ECG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a hypnogram?

A

A graphical representation of the stages of sleep as a function of time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is stertor?

A

Noisy breathing during sleep, usually caused by obstruction at the level of the oral or nasal cavities or oropharynx or nasopharynx

  • Typically low-pitched
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is stridor?

A

High pitched noise while sleeping, usually associated with obstruction at the level of the larynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where is melatonin produced?

A

The pineal gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a normal Epworth sleepiness scale score?

A

If the patient has an Epworth sleepiness score of 10 then they should consider seeking medical advice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How many apnoea hypopnea events per hour is classed as normal?

A

< 5 events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the equation used for lung function predicted values and the age ranges?

A

GLI - available for over 3 year olds but only up to 80 year olds for the box

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What do you measure with sleep pulse oximetry?

A

ODI (oxygen desaturation index), Total number of dips (<3), time below 90%, Nadir value

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is responsible for circadian rhythm and where is it located?

A

The suprachiasmatic nucleus (SCN) - located near cerebral cortex at the bottom of the brain
- in the anterior hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Are circadian rhythm and homeostatic drive linear?

A

Circadian rhythm - is not (dips at 3pm)
Homeostatic drive is

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where is melatonin produced?

A

Pineal gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How can you determine which stage of sleep patients are in?

A

Polysomnography - each stage has different waveforms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which stage of sleep is deep sleep?

A

Stage 3 (delta sleep) - big delta waves seen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What waves are seen in REM sleep?

A

Low-voltage random, Saw-tooth waves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What polysomnography waves are seen when awake?

A

Low-voltage, random waves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What polysomnography waves are seen when drowsy?

A

Alpha waves - low voltage spikes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What polysomnography waves are seen when in stage 1 sleep?

A

Theta waves - short stubby waves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What polysomnography waves are seen when in stage 2 sleep?

A

Sleep spindles - small spikes
K complexes - massive rare spike

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What polysomnography waves are seen when in stage 3 sleep?

A

Delta waves - large common spikes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

In which sleep stage is there hypotonia of skeletal muscles and only the diaphragm working?

A

REM sleep - ensures we don’t act out our dreams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is a hypnogram?

A

Graphical representation of the stages and cycles of sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How much time each night is spent in stage 1 sleep?

A

Very little (5 - 10 mins or so) = 2 - 5% of night

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What percentage of the night is spent in NREM sleep?

A

70 - 80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How do the length of sleep cycles vary throughout the night?

A

First cycle is shorter 70 - 100 mins
Subsequent cycles are 90 - 120 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How long does a stage 2 sleep cycle last and what percent of total sleep time does it make up?

A

Cycle = 10 - 25 mins
Total = 45 - 55%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are stage 3 sleep also called?

A

Slow-wave sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How long does slow wave sleep cycle last and what percent of total sleep time does it make up?

A

Cycle = 20 - 40 mins
Total = 13 - 25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What happens to BP in sleep?

A

BP can be up to 20% lower - however there are spikes with K complexes, arousals and body movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What happens to blood flow in sleep?

A

NREM - blood flow and metabolism is reduced

REM is similar to wakefulness however flow in certain brain areas is increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is stage 3 sleep dependent on?

A

Adenosine - the reason stage 3 sleep time gets shorter throughout the night

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What happens to length of REM sleep throughout the night?

A

It gets longer - why we dream later throughout the night

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What can a morning headache be indicative of?

A

Carbon dioxide retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the Mallampati score?

A

Grading of soft palate obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What percentage of males and females have OSA? (Switzerland study)

A

50% of men and 23% of females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is the difference between OSA and OSAHS?

A

OSA is a precursor and often not symptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is a normal apnoea hypopnoea index range?

A

< 5 events per hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Is ENT surgery recommended for OSA?

A

No, however tonsillectomy might be

44
Q

What is hypoglossal nerve stimulation?

A

Implanted device connected to nerve under tongue
Causes muscle activation to reduce airway collapsibility
- is effective but not available on the NHS

45
Q

When was CPAP first used?

A

1980

46
Q

In addition to improving sleep quality, what else can CPAP improve?

A

Helps lower daytime sleepiness and blood pressure, vascular function and DCCV in AF patients

47
Q

What is obesity hypoventilation syndrome?

A

Combination of obesity (BMI > 30) and daytime hypercapnia
- other causes of impaired ventilation must be excluded
- increased risk of pulmonary hypertension and heart failure

48
Q

How by what percentage is mortality increased in OHS patients?

A

Mortality rate of 23% compared with 9% in eucapnic obesity group

49
Q

What percentage of patients who have OHS also have OSA?

A

90%

50
Q

What are some presenting symptoms of OHS?

A
  1. Morning headaches
  2. Significantly obese
  3. Daytime sleepiness
  4. May have oedema
  5. May have unexplained polycythemia (blood cancer)
51
Q

What is TS90 and what values are commonly present in OHS patients?

A

Time Spend below O2 saturation of 90%
- OHS patients will often have > 30% of night below 90%

52
Q

What are the two main causes of arterial blood gas changes?

A

Metabolic and respiratory

53
Q

What is a normal venous bicarbonate level?

A

23 mEq/L

54
Q

How does non-invasive ventilation compare with CPAP?

A

NIV provides actual ventilation, whereas CPAP only opens airway
No significant difference in performance

55
Q

When is NIV used over CPAP?

A

If only hypoxia and no cessation in breathing

56
Q

What are the treatments for central sleep apnoea?

A

Treat the underlying cause
- adaptive servo-ventilation (sort of a mix of NIV + CPAP) can also be used - but not with patients with HF

57
Q

What is overlap syndrome?

A

OSA and COPD

58
Q

When are OSA patients reviewed for driving again?

A

4 weeks post-CPAP

59
Q

What comprises the ascending arousal system?

A

The hypothalamus, brainstem and basal forebrain

60
Q

What is the VLPO? And what is its function?

A

The ventrolateral preoptic nuclei - a cluster of neurons in the anterior hypothalamus
- it promotes sleep (along with melatonin + others)

61
Q

When is the VLPO active?

A

During sleep - particularly REM

62
Q

What is orexin/hypocretin?

A

A neuropeptide - responsible for stabilising the flip-flop switch of sleep

63
Q

Which neuropeptide is missing in narcolepsy?

A

Orexin / hypocretin

64
Q

Which neurotransmitters promote REM sleep?

A

Acetyle choline, GABA, dopamine, glycine

65
Q

Which neurotransmitters promote NREM sleep?

A

GABA and galanin

66
Q

Which neurotransmitters promote wakefulness?

A

Dopamine, neuradrenaline, histamine, hypocretin/orexin, acetylcholine, glutamate

67
Q

What is caffeine’s half life?

A

3.5 - 7 hours

68
Q

How does caffeine cause wakefulness?

A

Is an adenosine receptor antagonist
- leads to increased brain dopamine

69
Q

How does nicotine impact caffeine?

A

It reduces half-life by 30 - 50%

70
Q

What is sleep paralysis?

A

Abrupt wakefulness before muscle tone returns, accompanied by dream like hallucinations

71
Q

At what age do your sleep cycles remain the same length for the rest of life?

A

8 years old

72
Q

Are sleep cycles longer or shorter in children?

A

Shorter than adults (50 - 60 mins)

73
Q

How many REM cycles do you have per night?

A

4 - 5

74
Q

What generates circadian rhythm?

A

Retinal ganglion cells which communicate with the SCN to provide the sleep body clock

75
Q

How is circadian rhythm synchronised?

A

Zietbergers (external cues)

76
Q

What is the most important Zietberger?

A

Light

77
Q

How many hours of sleep per day do babies require?

A

14 - 17 hours

78
Q

How many hours of sleep per day do teenagers require?

A

8 - 10 hours

79
Q

At what age does amount of slow wave sleep reduce and what does this signify?

A

Late 20s and may signify the start of brain function decline

80
Q

What is the two-process model of learning during sleep?

A

Hippocampus encodes - repeatedly activated
Neocortex - strengthens and re-organises

81
Q

What sleep activity increases when encoding and learning new information?

A

Increased slow wave activity

82
Q

How does sleep impact synaptic plasticity?

A

There is a 40% downscaling of synaptic networks when we sleep
- erase synapses

83
Q

What is the most common sleep disorder excluding OSA?

A

Insomnia

84
Q

What values of the Epworth sleepiness scale indicate: insomnia, normal, excessive sleepiness?

A

Insomnia = 0 - 2
Normal = 2 - 7
Excessive sleepiness > 10

85
Q

What is the STOP-BANG questionnaire?

A

Used to screen for OSA:
Snoring
Tiredness
Observed events
Pressure (blood pressure)

BMI
Age
Neck size
Gender

86
Q

What factors are associated with central apnoea?

A

HF patients and patients on prescription painkillers (e.g. opioids)

87
Q

What is narcolepsy?

A

A sleep switch problem - prevents person choosing when to sleep

88
Q

What is cataplexy?

A

Sudden muscular weakness, triggered by sudden changes in emotions e.g. laughter, anger, surprise

89
Q

What can cause canine narcolepsy?

A

Orexin / hypocretin 2 receptor defects

90
Q

What is thought to cause human narcolepsy?

A

Autoimmune condition due to loss of hypocretinergic neurons in the hypothalamus

91
Q

What are the criteria for Type 1 narcolepsy?

A

Excessive daytime sleepiness > 3 months on a daily basis
One or both of:
- cataplexy
- CSF hypocretin < 110 pg/ml

92
Q

What are the criteria for Type 2 narcolepsy?

A

Excessive daytime sleepiness > 3 months.
No cataplexy
Normal CSF hypocretin
Not explained by any other disorder

93
Q

What percentage of narcolepsy patients are Type 1 and Type 2?

A

70% Type 1
30% Type 2

94
Q

What are some of the medications for narcolepsy and what are their side effects?

A

Psychostimulants e.g. Solriamfetol, ritalin
- have side effect of increased BP

95
Q

What are NREM parasomnias?

A

Incomplete awakening from NREM sleep
- usually young onset (< 20)
- key is finding out what is interrupting their sleep

96
Q

What is REM sleep behaviour disorder?

A

REM consists of short outbursts e.g. dream enactment
- progressive, neurodegenerative disorder

97
Q

How can you identify REM sleep behaviour disorder on polysomnography?

A

Can see effort or movement in REM sleep

98
Q

What are some medications used to treat REM sleep behaviour disorder?

A

Benzodiazepine (sedative) and melatonin

99
Q

What comorbidities is REM sleep behaviour disorder associated with?

A

Neurodegenerative disorders, particularly Parkinson’s

100
Q

What is the first treatment for restlest legs syndrome?

A

Lifestyle

101
Q

What is the first and subsequent medical treatments for restless legs syndrome?

A

Iron (ferritin) if below 75 then treat
- gabapentin, dopamine agonists

102
Q

What medications can aggravate restless legs?

A

Anti-depressants, anti-histamines

103
Q

Is insomnia disorder more common in males of females?

A

Females

104
Q

Should you go to sleep and wake up at the same time?

A

Don’t have to go to sleep at the same time
But should wake up at the same time

105
Q

Can sleep walking occur in NREM sleep?

A

Yes

106
Q

Can sleep walking occur in REM sleep?

A

No

107
Q

What is homeostatic drive to sleep?

A

Sleep pressure that builds up with time awake

Sleep (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions