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Brain and Behavior > Lecture 50: Sleep > Flashcards

Lecture 50: Sleep Flashcards

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1
Q

Stage 1 Sleep EEG and corresponding body state

A

Light sleep, less alpha, theta waves; muscle activity slows, twitching

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2
Q

Stage 2 Sleep EEG and corresponding body state

A

Theta waves, sleep spindles, K complexes; slowed breathing, HR

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3
Q

Stage 3 & 4 Sleep EEG and corresponding body state

A

Delta waves; very limited muscle activity

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4
Q

What stage is the most common? %

A

Stage 2; about 50%

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5
Q

Restorative sleep is which stage?

A

Stages 3 & 4

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6
Q

REM Sleep EEG and corresponding body state

A

Similar to waking state; paralysis, rapid eye movements, dreaming, increased HR, rapid breathing

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7
Q

How much time a night do we spend in REM? (% and # cycles)

A

25%, 5 cycles

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8
Q

Sleep cycle. How long does the pattern take?

A

Awake –> stage 1 –> 2 –> 3 –> 4 –> 3 –> 2 –> REM (like stage 1) –> 2; repeats every 90-120 minutes

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9
Q

Sleep latency

A

Time from lights out to stage 1 (10-20 min)

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10
Q

REM latency

A

Time from sleep onset to first REM (90-100 min)

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11
Q

Sleep efficiency

A

Amount of sleep/total time in bed

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12
Q

For infants, how much time do you spend sleeping?

A

2/3 of the day

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13
Q

As we age, what happens to our sleep cycle?

A

Increased sleep latency, noctural awakenings and stage 1, decreased REM latency, sleep efficiency, and stage 4

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14
Q

What are some key pieces of information for a patient with disordered sleep?

A

Sleep hx, meds, family/psych hx, bed partner hx, physical exam, sleep measurements

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15
Q

Scale for measuring sleepiness and structure

A

Epworth Sleepiness Scale asks likelihood to fall asleep in various situations

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16
Q

What does the multiple sleep latency test assess?

A

Objective daytime sleepiness: sleep/REM latency during day

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17
Q

What suggests narcolepsy

A

REM sleep in 2+ naps

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18
Q

Primary sleep disorders (2)

A

Dyssomnias = too much or too little sleep; Parasomnias = abnormal sleep behaviors

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19
Q

Sleep-related breathing disorders are categorized as…

A

A dyssomnia

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20
Q

Define sleep apnea

A

Repetitive episodes of complete or partial cessation of air flow during sleep that often result in oxygen desaturation and terminate with brief arousals

21
Q

Two types of sleep apnea

A

Central = reduction in respiratory drive; Obstructive = upper airway obstruction

22
Q

Two causes of obstructive sleep apnea

A

Obesity or craniofacial abnormalities (leading to soft tissue collapse of airway)

23
Q

Signs of obstructive sleep apnea (3)

A

Excessive daytime sleepiness, loud/choking snoring, pauses in breathing while sleep

24
Q

Consequences of sleep apnea on all causes of mortality

A

3-6 x fold in all-causes of mortality

25
Q

Cardio consequences of sleep apnea

A

CHF, stroke, hypertension

26
Q

Neurocognitive consequences of sleep apnea

A

Accidents, decreased vigilance, executive functioning

27
Q

Metabolic consequences of sleep apnea

A

Increased insulin resistance

28
Q

Prevalence of sleep apnea (%)

A

15%

29
Q

Main sleep apnea treatments (3)

A

Weight loss, positional therapy, C-pap (positive airway pressure therapy)

30
Q

Central sleep apnea means what? What people get it?

A

No respiratory effort at time of airflow cessation; patients w/ lower brainstem lesions

31
Q

Clinical feature of narcolepsy

A

Frequent attacks of irresistible daytime sleepiness; REM sleep INTRUDING when it’s not supposed to

32
Q

What is the “classic tetrad” of narcolepsy

A

“Classic Tetrad” = daytime sleepiness, cataplexy, sleep paralysis, hypnagogic hallucinations

33
Q

T/F: Narcoleptics get normal amounts of sleep per 24 hours

A

True! Also have normal polysomnogram

34
Q

Hypnagogic hallucinations (def)

A

Vivid hallucinations during transition between wakefulness and sleep

35
Q

Cataplexy (def)

A

Sudden intrusion of REM sleep into wakefulness resulting in emotionally-triggered, transient muscle weakness

36
Q

Narcolepsy can involve what hormone?

A

Orexin (reduced or absent)

37
Q

Narcolepsy diagnosis involves…

A

Clinical assessment, REM latency via polysomnography

38
Q

Pharmacologic narcolepsy treatments (2 categories)

A

Stimulants and cataplexy modifying agents (sodium oxybate, REM-suppressing antidepressants)

39
Q

Board sleep disorders (2)

A

Ondine’s curse (sleep –> stop in breathing); Kleine-Levin syndrome (daytime somnolence and other hypers-)

40
Q

Circadian rhythm disorders (def)

A

Recurrent or persistent misalignment between the desired sleep-wake schedule (external physical or social environment) and the endogenous circadian rhythm-related propensity for sleeping and waking

41
Q

Circadian rhythm disorders are often associated with…

A

Night & early-morning shift schedules

42
Q

Shift work sleep disorder (def)

A

Excessive sleepiness during work hours that are scheduled during the usual sleep period and insomnia when attempting to sleep during the usual wake period

43
Q

Sleep-related movement disorders include which two disorders with brief description

A

Restless leg syndrome (urge to move legs) and periodic limb movements of sleep (partner notes this one)

44
Q

RLS and PLMS are primarily; most important secondary cause? One associated disease

A

Idiopathic; iron deficiency; Parkinson’s disease

45
Q

Non-REM Parasomnias (2) and stage. Amnesia? Confusion? Dreaming? Patients?

A

Sleepwalking and sleep terror disorder; delta sleep (Stage 3 & 4); yes, yes, no, children

46
Q

REM Sleep Parasomnias (2) and stage. Amnesia? Confusion? Dreaming? Patients?

A

Nightmare disorder, REM behavior disorder (REM); no, no, yes, older men

47
Q

Pathophysiology of non-REM parasomnia

A

Brief, incomplete awakening during Stage 3 & 4 sleep

48
Q

What’s behind/presentation of sleep terror

A

Waking from Stage 3 & 4 with gasping, panic, and then return to sleep w/out fully waking

49
Q

Pathophysiology of REM behavior disorder and important association

A

Loss of muscle atonia during REM sleep resulting in acting-out of dreams; early manifestations of neurodegenerative disorders

Brain and Behavior (56 decks)

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