Lecture 9 - Sleep Flashcards
Orexin/Hypocretin:
neurons are located where?
dysfunction leads to ______
lateral hypothalamus;
narcolepsy
adenosine:
levels increase during _____;
controls sleep drive;
what is a receptor blocker?
prolonged wakefulness;
caffeine
ie makes u sleepy
____ is the main inhibitory NT in the spinal chord, important for REM related atonia. ____ is the main sleep NT. ____ is important in REM sleep
glycine, GABA;
Ach
leptin: _____ appetite. levels _____ at night
inhibits;
increases
Sleep Stages:
awake, eyes open = ____ waves;
awake, eyes closed = _____ Waves
beta;
alpha
stage N1 = light sleep, _____ Waves;
stage N2 = deeper sleep, when ____ occurs. _____ and _____ on EEG
theta;
bruxism (teeth grinding);
sleep spindles, K complexes
stage 3: deepest non-rem sleep;
name 3 things that occur during this time;
____ waves
sleepwalking, night terrors, bed wetting;
delta
REM sleep:
loss of motor ____;
____ brain O2 use;
increased ____ (a NT)
tone;
increased;
Ach
REM sleep:
_____ movements occur due to activity of _____;
duration of REM sleep ____ through the night
extra-ocular, PPRF;
increases
obstructive sleep apnea (OSA):
due to pharyngeal ______ –> ______
relaxation;
respiratory effort against airway obstruction
OSA:
associated with excess _______ tissue in adults, _____ _____ in kids
parapharyngeal;
adenotonsillar hypertrophy
sleep apnea is defined as repeated _____ lasting greater than ____ during sleep
cessation of breathing;
10 seconds
OSA:
symptoms include loud _____, _____ headaches, day time somnolence
snoring, morning
sleep apnea:
nocturnal ____ causes systemic/pulmonic ______, arrhyrthmias, and sudden death (ie stroke, MI)
hypoxia, hypertension
hypoxia leads to _____ release and increased_____
EPO, erythropoesis
OSA treatment:
CPAP = stands for continuous ____ ___ ____
positive airway pressure
narcolepsy:
due to decreased _____ production in the ______ –> excessive daytime sleepiness
orexin, lateral hypothalamus
narcolepsy:
associated with _____ (just before sleep) or ____ (just before awakening) hallucinations;
sleep episodes start with _____ sleep
hypnagogic, hypnopompic;
REM (i.e. causes sleep paralysis)
narcolepsy:
_____ is loss of muscle tone following strong emotional stimulus;
treat with daytime stimulants and nighttime ______
cataplexy; sodium oxybate (GHB)
____ _____ syndrome is characterized by an intense urge to move the legs with temporary relief from voluntary leg movements
restless leg
sleep walking:
occurs in stage ____. earlier in the night or later?
do patients remember events?
N3;
earlier;
nope
sleepwalking:
usually in what age group?
_____ can be used to treat by decreasing N3/REM sleep
kids ie 4-6;
benzos
nightmares:
occur during ______.
do patients remember?
REM sleep;
yes
sleep terror disorder:
occurs during _____;
do patients remember?
N3;
nope
psychophysiologic insomnia:
characterized by problems with sleep _____;
duration of more than ____
onset;
1 month
_____ ____ ____ syndrome is onset at an early time in the evening and consequently early morning awakening. common in the ____
advanced sleep phase;
elderly
____ ____ _____ syndrome is inability to fall asleep until early morning resulting in desire to awaken in later morning/early afternoon. common in ____
delayed sleep phase;
adolescents
advanced sleep phase syndrome – treat by going to bed 3 hours ____ every 2 days until desired time is reachedc
earlier
delayed sleep phase syndrome – treat by going to bed 3 hours _____ every 2 days until desired
later
