lecture 11-12 Flashcards
insomnia
unsatifactoyr sleep, string cormodbility with psych disorder
narcolepsy
chronic daytime sleepiness
RAS reticular activating system
diffuse nerual network, projection from midbrain and pons, to cortex, modulates signals that reach cortex, cruical for behavioral arousal and conciousness
sleep/wake switch
on= awake, wakefulness
off= tired,sleeping
what does a hypocretin neruon do?
stablizies wakefulness in the LAT
suprachiasmatic nucleus
bodys internal clokc and is actiavted by melaotonin, lighta nd activity to promte either sleep or wakefulness
excessive daytime sleepiness
switch is off during the daytime
insomnia
switch on at night
disturabnaces in cricadium rythem
phase delayed= switch turned on too late
phase advanced= turned on too early
circadian wake drive
result on input to the suprachiasmatic nucleus, spike in the morning and decrease through the day
homestatic sleep drive
inc longer one is awak and dec with sleep
what happens as the day starts to end, circadium wake drive starts to diminish
the homestatic inc, the VLPO triggered to release GABA in the tubermammilarry nucleus (tmn)
treatments of insomnia
benzos
z-drugs
melatongeric hyponotics
antihistmaines/histamines
treatment for narcolepsy
Modafinil is a novel wake-promting agent that is chemically distnct from CNS stimulants
enhances GLU and inhits GABA
adverse effects of Modafinil
headche, flushing, dry mouth, sick, confused thoughts, anixety, depression
Z-drugs MOA
bind to GABAa receptors that does not a cause high degree of tolerance, dependence or withdraw, inc zolpidem
what is Ramelteon and the MOA
melatonin agonist, targeted MT1 and MT2 receptor agonist Ramelton does not have affinity for GABA receptors, which negates potential for abuse
unlike z does not effect motor skills or balance
what is agomelatine
is a dual-action antidepressants with affinity melatonin MT1/MT2 RECEPTORS
non-selective(5-HT antagonist) , improves depression and sleep
anthistamine MOA
1st gen antihistamines are non-selective H1 antagonists
makes people tired
histamine
regulates wakefulness
MOA: sythezied from histidine and packaged into vesicular monoamine transporter 2 (VMAT2)
once in synaptic cleft histamine excites neurons via the H1 receptor or can inhbit histamergenic and other enurons vis the H3 receptor
where is histamine produced
produced by cells in the tubermammillary nucleus (TMN)
Doxepin
antihistamine
demonstrates blocking a wake-promoting
specfic to H1 antagonist
benzo vs CBT with sleep
reliability reduced with psycholgical interventions, shown CBT works better overtime
what are better benzos or z drugs, meltonergic hypontics, antishitimines or behavior
benzos are effective, yet have adverse side effects
z-drugs are not as effective
MH effective for initation, w/o adverse side effects
antihsitomines (except H1 antagonists) are effective in maintence rather than initation
bheavior: more durable effects
