L1 Hx of sleep medicine Flashcards

1
Q

1 sleep disorder

A

sleep deprivation

NOT diagnosible

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2
Q

Leading Theories of Why We Sleep

A
  1. Restoration and recovery
  2. Energy conservation
  3. Predator avoidance
  4. Memory consolidation

REMP

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3
Q

Restoration and recovery

A

Restores biological processes degraded in wakefulness

Increase in growth hormones

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4
Q

Energy conservation

A

Metabolism drops 5-10%
Endothermy  internal regulation of temperature
Sleep needed to offset high energy cost
Hypothalamus regulates body temp

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5
Q

Predator avoidance

A

Lying still is less likely to attract a predator
Most predators are active at night
Tonic (as in muscle tone) immobility reflex  aka animal hypnosis or death feigning – last line of defense against an attacking predator
Total immobilization so animal appears dead - predators not interested in dead prey
Similar to REM sleep when body is almost paralyzed
Reflexes are suppressed
Body temp drops

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6
Q

Memory consolidation

A

Idea that memories are consolidated best during REM sleep:
Brain cells grow and make neuronal/synaptic connections
Can increase in strength
“Neurons that fire together wire together”
Fine tune binocular vision system
Unimportant memories disappear
Harmless discharge of strong emotions

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7
Q

Activation synthesis theory

A

Part of memory consolidation theory

dreams occur bc neurons are firing and brain is trying to make sense of it

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8
Q

Who was Robert MacNish and what did he believe?

A

1834
Author, Philosophy of sleep
Sleep = passive, inactive state of the brain
Sleep occurs bc of lack of stimuli at night/reduced sensory input
Wakefulness occurs bc bombardment of stim from environ
No distinction b/w sleep, paralysis, stupor, intox, hypnosis, etc.

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9
Q

Hypnotoxin theory

A
19th century
fatigue products (toxins and the like) accumulate through the day, finally causing sleep, during which they are gradually eliminated
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10
Q

Who is Nathaniel Kleitman

A

1928, Founder of sleep medicine
FInds those who are sleep deprived are impaired
People who stayed awake all night will be more impaired at night than next day (no support hypnotoxin theory)
Greatest impairment after 60 hours
Sleep a passive process / the absence of wakefulness

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11
Q

Richard Caton was the first to use…

A

1875
Physiologist who is experimenting with animals
Put electrodes on animals, can measure brain waves / electrical activity
EEG – electroencephalogram
Used paper to record activity

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12
Q

Hans Berger found..

A

Recorded electrical activity in the human brain

Sleep could be measured quantitatively

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13
Q

What did Davis and Harvey do/find?

A

Describe major elements of sleeping brainwave patterns
Take brief samples of brain activity while people sleep
Sleep characterized by high amplitude slow waves
Can happen from ½ per sec to 4 per sec
Wakefulness by low amplitude fast waves (alpha)
14 per second
Evidence for sleep being a passive process

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14
Q

Reticular Activating System

A

1949
Thought to be endogenous mechanism in brain
Area which stimulates alertness and makes you stay awake
Lesions in the RAS gives delta sleep (very slow like a coma)

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15
Q

Edouard Gelineau discovered?

A
1880
Discovered Narcolepsy
Narke - stupor, unconscious
Lepsis - seizure/overtaken
Triggered by strong emotion
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16
Q

Richard Henenberg discovered?

A

1916, Cataplexy - collapse of muscles

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17
Q

Charles Dickens wrote about what?

A

1836
Obstructive Sleep Apnea
“Posthumous Papers of the Pickwood Club” -Joe
Obesity, hypoventilation syndrome

18
Q

Freud on dreams

A

“The royal road to the unconscious”
Book – “The Interpretation of Dreams”
Theory of dreams inspired much interest in sleep
Dreams were repressed urges
Too threatening to come about during the day
Ego goes to sleep at night
Id is building up steam during the day – can be released symbolically at night
Needed a medical degree to practice psychoanalysis

19
Q

Chronobiology means…

A

Study of biological rhythms

Definite 24 hour period of life

20
Q

John Jacques de’Ortous deMairan - what did he discover?

A

Heliotropic plant – plant that is attracted to the sun
Plant that is open during the day and closed at night … continues to open and close despite having no exposure to the sun = on an endogenous cycle / internal chronobiology

21
Q

Circadian rhythms - meaning of the word

A

“About a day”
Circa = about
Dia = day

22
Q

Kleitman and infants - what was he interested in and what did he find?

A

interested in cycles of activity and inactivity
Hypothesized that their hunger is adaptive and recurring, therefore making their waking times unusual and sporadic
First to notice the fluttering of the eyelids – notices rapid movement right when child sleeps … slowing of the movement … then seems to disappear with deeper sleep

23
Q

What movement produces the greatest neocortical activation - more so than any other movement?

A

Eye movement

superior colliculus activates before eye movement

24
Q

Eugene Aserinsky - who and what did he do?

A

Kleitman’s student
Looking for a way to find when eye movement begins
Were measuring 5 minutes epochs (intervals)
Device that measures eye movement – EOG (electrooculogram)
Found that when adults fall asleep, it was gradual and into delta waves and stages (will have rapid periods), whereas infants go into sudden onset REM sleep periods (SOREMPS) – like narcolepsy
Basic cycle of sleep identifies at this time due to EOG and EEG

25
Q

Aserinsky and Kleitman unsuccessful initially because…

A

Not enough paper

Needed to nap in between

26
Q

Aserinsky and Kleitman made which huge discovery and how did they go about it?

A

Began to wake people up during eye movement and not … found dreams mostly during the eye movement
**Identifying 2 types of sleep

27
Q

When was the first article published on theory of dual REM sleep? And what happened to it?

A

1953

Squashed bc went against scientific theory of RAS

28
Q

Dementhe and Kleitman - what did they do?

A
1957
continuous EEG recordings
126 nights
33 subjects
described and quantified occurrence of REM
29
Q

Stage 1

A

4-5%
light sleep
muscle activity slows down
occasional muscle twitching

30
Q

Stage 2

A

45-55%
breathing pattern and heart rate slow
slight decrease in body temp

31
Q

Stage 3

A

4-6 percent
deep sleep begins
brain begins to generate slow delta waves

32
Q

Stage 4

A
12-15%
very deep sleep
rhythmic breathing
limited muscle activity
delta waves
33
Q

Stage 5

A
REM
20-25%
brainwaves speed up, almost indistinguishable from when awake
dreaming occurs
muscles relax
heart rate increases
breathing rapid and shallow
34
Q

EMG

A

electromyography

measures muscle movement

35
Q

EEG

A

electroencephalography

measures brain waves (electrical activity in the brain)

36
Q

EOG

A

electrooculography
measures eye movement
(occipital)

37
Q

why are we paralyzed by sleep?

A

bc of the PONS

part of the brain that shuts down the impulse to the spinal cord

38
Q

What did Michel Jouvet discover?

A

Suppression of muscle activity

39
Q

Dementhe discovered..

A

Complete suppression of reflexes during REM

40
Q

Types of movement disorders

A
  1. Restless leg syndrome
  2. Sleep paralysis
  3. Periodic limb movement disorder

RESTLESS
PARALYSIS
LIMB MOVEMENT

41
Q

Duration of interval from one eye movement period to the next..

A

90-100 minutes

42
Q

What did the regular occurrence of REM indicate?

A

That dreams did not occur b/c of sleep disturbances