Lecture 9 - Sleep

Question 1

Orexin/Hypocretin:
neurons are located where?
dysfunction leads to ______

Answer 1

lateral hypothalamus;

narcolepsy

Question 2

adenosine:
levels increase during _____;
controls sleep drive;
what is a receptor blocker?

Answer 2

prolonged wakefulness;
caffeine

ie makes u sleepy

Question 3

____ is the main inhibitory NT in the spinal chord, important for REM related atonia. ____ is the main sleep NT. ____ is important in REM sleep

Answer 3

glycine, GABA;

Ach

Question 4

leptin: _____ appetite. levels _____ at night

Answer 4

inhibits;

increases

Question 5

Sleep Stages:
awake, eyes open = ____ waves;
awake, eyes closed = _____ Waves

Answer 5

beta;

alpha

Question 6

stage N1 = light sleep, _____ Waves;

stage N2 = deeper sleep, when ____ occurs. _____ and _____ on EEG

Answer 6

theta;
bruxism (teeth grinding);
sleep spindles, K complexes

Question 7

stage 3: deepest non-rem sleep;
name 3 things that occur during this time;
____ waves

Answer 7

sleepwalking, night terrors, bed wetting;

delta

Question 8

REM sleep:
loss of motor ____;
____ brain O2 use;
increased ____ (a NT)

Answer 8

tone;
increased;
Ach

Question 9

REM sleep:
_____ movements occur due to activity of _____;
duration of REM sleep ____ through the night

Answer 9

extra-ocular, PPRF;

increases

Question 10

obstructive sleep apnea (OSA):

due to pharyngeal ______ –> ______

Answer 10

relaxation;

respiratory effort against airway obstruction

Question 11

OSA:

associated with excess _______ tissue in adults, _____ _____ in kids

Answer 11

parapharyngeal;

adenotonsillar hypertrophy

Question 12

sleep apnea is defined as repeated _____ lasting greater than ____ during sleep

Answer 12

cessation of breathing;

10 seconds

Question 13

OSA:

symptoms include loud _____, _____ headaches, day time somnolence

Answer 13

snoring, morning

Question 14

sleep apnea:

nocturnal ____ causes systemic/pulmonic ______, arrhyrthmias, and sudden death (ie stroke, MI)

Answer 14

hypoxia, hypertension

Question 15

hypoxia leads to _____ release and increased_____

Answer 15

EPO, erythropoesis

Question 16

OSA treatment:

CPAP = stands for continuous ____ ___ ____

Answer 16

positive airway pressure

Question 17

narcolepsy:

due to decreased _____ production in the ______ –> excessive daytime sleepiness

Answer 17

orexin, lateral hypothalamus

Question 18

narcolepsy:
associated with _____ (just before sleep) or ____ (just before awakening) hallucinations;
sleep episodes start with _____ sleep

Answer 18

hypnagogic, hypnopompic;

REM (i.e. causes sleep paralysis)

Question 19

narcolepsy:
_____ is loss of muscle tone following strong emotional stimulus;
treat with daytime stimulants and nighttime ______

Answer 19

cataplexy;
sodium oxybate (GHB)

Question 20

____ _____ syndrome is characterized by an intense urge to move the legs with temporary relief from voluntary leg movements

Answer 20

restless leg

Question 21

sleep walking:
occurs in stage ____. earlier in the night or later?
do patients remember events?

Answer 21

N3;
earlier;
nope

Question 22

sleepwalking:
usually in what age group?
_____ can be used to treat by decreasing N3/REM sleep

Answer 22

kids ie 4-6;

benzos

Question 23

nightmares:
occur during ______.
do patients remember?

Answer 23

REM sleep;

yes

Question 24

sleep terror disorder:
occurs during _____;
do patients remember?

Answer 24

N3;

nope

Question 25

psychophysiologic insomnia:
characterized by problems with sleep _____;
duration of more than ____

Answer 25

onset;

1 month

Question 26

_____ ____ ____ syndrome is onset at an early time in the evening and consequently early morning awakening. common in the ____

Answer 26

advanced sleep phase;

elderly

Question 27

____ ____ _____ syndrome is inability to fall asleep until early morning resulting in desire to awaken in later morning/early afternoon. common in ____

Answer 27

delayed sleep phase;

adolescents

Question 28

advanced sleep phase syndrome – treat by going to bed 3 hours ____ every 2 days until desired time is reachedc

Answer 28

earlier

Question 29

delayed sleep phase syndrome – treat by going to bed 3 hours _____ every 2 days until desired

Answer 29

later