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Brain and Behavior Exam 3 > Lec 46 Sleep Disorders > Flashcards

Lec 46 Sleep Disorders Flashcards

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1
Q

What is the function of sleep?

A
  • physical restoration
  • optimize waking neurocognitive and emotional function
  • learning, emotional processing
  • health + survival
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2
Q

What kind of waves in awake state with eyes open? eyes closed?

A

eyes open = beta (highest freq)

eyes closed = alpha = 8-14 Hz

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3
Q

What are the stages of non-rem sleep? what percent of sleep do they make up?

A

stage 1 = 5% of sleep = light sleep
stage 2 = 45% of sleep - deeper sleep
stage 3/4 = 25% of sleep- deep slow wave sleep

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4
Q

What kind of sleep is stage 1? type of waves?

A

light sleep ~5% of sleep
have theta waves [4-7 Hz]
muscle activity slows; occasional twitches

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5
Q

What is mneumonic for EEG waves of awake/sleep?

A

At night, BATS Drink Blood

  • Beta [awak open eyes]
  • Alpha [awake closed eyes]
  • Theta [1]
  • Sleep spindles + K complex [2]
  • Delta [3/4]
  • Beta [REM]
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6
Q

What kind of sleep is stage 2? type of waves?

A

deeper sleep = ~45% of sleep
theta continues plus have sleep spindles and K complexes
breathing and HR slow

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7
Q

What kind of sleep is stage 3/4? type of waves?

A

deep/slow sleep = ~25% of sleep
delta waves (0.5-2 Hz) = slow wave
limited muscle activity
when sleepwalking, night terrors, bedwetting occur

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8
Q

What stage of sleep has sleep spindles and k complexes?

A

stage 2

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9
Q

What are characteristics of REM sleep?

A
  • makes up ~25% of sleep; 4-6 episodes per night
  • absent motor tone/activity
  • rapid eye movements
  • dreaming
  • increased HR/BP, brain uses more O2
    may serve memory processing function
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10
Q

What is the pattern of sleep cycle?

A

one cycle: 1 –> 2 –> 3 –> 4 –> 3 –> 2 –> REM

repeats ~ 90-120 min
more REM in second half of night

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11
Q

What is sleep latency?

A

the time from lights out to first NREM stage 1

- usually takes 10-20 min

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12
Q

What is REM latency?

A

the time from sleep onset to first REM

- usually takes 90-100 min

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13
Q

What is sleep efficiency?

A

amount of sleep/total time in bed * 100

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14
Q

How much sleep does average adult need?

A

7-9 hrs

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15
Q

How much of day do infants sleep? how much REM?

A

sleep 2/3 of day

50% of sleep in REM

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16
Q

What happens to sleep cycle with aging?

A

increased: sleep latency, noctural awakenings, NREM stage 1
decreased: delta, REM, REM latency, sleep efficiency

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17
Q

What does polysomnography measure?

A
  • EEG to get brain electrical acivity
  • electro-oculography to measure eye movements
  • EMG to measure muscle tone
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18
Q

What is multople sleep latency test?

A
  • to assess objective daytime sleepiness
  • monitor sleep for a night then allow pt to nap 4-5 times at 2 hr intervals during day and see how many times they go into REM

if go straight into REM during nap –> sign of narcolepsy

19
Q

What is a dyssomnia?

A

disorder of too little or too much sleep

20
Q

What is a parasomnia?

A

abnormal behavior or psych even during specific sleep stages or during transition wake to sleep

21
Q

What is definition of sleep apnea?

A

repetitive episodes of complete or partial cessation of air flow during sleep that causes ox desaturation and ends with brief arousals

  • may be due to reduced resp drive [central] or upper airway obstruction [obstructive]
22
Q

What are symptoms of sleep apnea?

A
  • excessive daytime sleepiness
  • snoring, choking, gasping during sleep
    also:
  • impaired conc, memory loss
  • associated with obesity/HTN
23
Q

What causes each of the 2 types of sleep apnea?

A

central: due to decreased resp drive from brainstem lesion
obstructive: due to upper airway obstruction, associated with obesity

24
Q

What are consequences of obstructive sleep apnea?

A
  • increased mortality

- CHF, stroke, HTN

25
Q

How prevalent is obstructive sleep apnea?

A

~15%

26
Q

What are treatments for obstructive sleep apnea?

A
  • weight loss
  • positional therapy
  • postive airway pressure therapy
27
Q

What is narcolepsy?

A

profound excessive daytime sleepiness

tetrad of signs: daytime somnolence, cataplexy, sleep paralysis, hallucination

  • have repeated attacks of irresistible sleep with REM immediate onset
  • cataplexy = REM sleep during wakefulness causes muscle weakness
  • sleep paralysis: paralysis during waking + falling asleep
  • hallucinations
  • often have normal polysomnogram
28
Q

When does narcolepsy normally present?

A
  • teens - early 10s; symptoms worsen for first few years then persist
29
Q

What is pathophysiology of primary narcolepsy? secondary?

A
  • genetic or autoimmune origin
  • destruction of hypothalamic orexin secreting neurons in lateral hypothalamus

secondary: head trauma, MS, craniopharyngioma, tumor in upper brainstem, hypthalamic sarcoid granuloma

30
Q

How do you treat narcolepsy?

A

daytime – stimulants (amphetamines, modafinil)

nighttime – sodium oxybate

31
Q

What is ondine’s curse? cause?

A

primary hypoventilation syndrome

  • total loss of automatic breathing esp. in sleep
  • have apneic periods that lead to awakenings

due to: absent external arcuate nuclei of medulla and depleted neurons in medullary respiratory areas

32
Q

What is kleine levin syndrome?

A
  • repeated episodes of excessive daytime somnolence
  • hypersexuality
  • hyperphagia [eat a lot]
  • episodes last days to wks

etiology unknown

33
Q

What is a circadian rhythm disorder?

A

misalignment between desired sleep-wake scheudle and endogenous circadian-rhythm

34
Q

What are symptoms of shift work sleep disorder?

A
  • excessive sleepiness during work hours scheduled during usual sleep period
  • insomnia when attempting to sleep during usual wake period
  • mood instability
  • associated with insomnia, excessive sleepiness, or both
  • non-specific GI symptoms
  • work related errors, industrial accidents
35
Q

What is restless leg syndrome?

A

spontaneous leg movement/urge to move leg
occurs at rest only
has negative impact on sleep initiation and maintenance

36
Q

What is etiology of restless leg?

A

genetic = dominant inheritance

secondary: iron deficiency, renal disease, diabetes, MS, parkinsons

37
Q

When does sleepwalking disorder occur?

A

non-rem sleep stage 3-4

38
Q

when does sleep terror occur?

A

non-rem stage 3-4

39
Q

what does nightmare disorder occur?

A

REM sleep

40
Q

for non-rem sleep disorder: What is timing? amnesia? confusion? dreaming? demographics? autonomic activity?

A
  • occurs in first 2 hours of night
  • amnesia occurs
  • confusion follows
  • occurs in children
  • variable autonomic activity
41
Q

for rem sleep disorder: What is timing? amnesia? confusion? dreaming? demographics? autonomic activity?

A
  • occurs anytime
  • no amnesia = vivid dream recall
  • no confusion
  • occurs in older men
  • high autonomic activity

acting out dreams, unresponsive to environment

42
Q

What is cause of non-rem sleep disorders?

A

disorders of arousal –> sudden brief but incomplete arousal

genetic component to it
its relatively benign

43
Q

What causes REM sleep disorders?

A

idiopathic

can be early manifestation of neurodegeneration [PD]

Brain and Behavior Exam 3 (32 decks)

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