Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SLEE5101 > Module 3 - Measurement of Sleep > Flashcards

Module 3 - Measurement of Sleep Flashcards

1
Q

What did von Economo discover and when?

A

1916: found that encephalitis in flu epidemic led to profound sleepiness or wakefulness due to specific hypothalamus damage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When did thinking about the unconscious, not just free will, come into discussion?

A

early 1920s due to Freud

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What did Bremer discover and when?

A
  1. Used EEG to define physiology of sleep. Found slow waves.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Who described the stages of NREM sleep using EEG?

A

Loomis in late 1930s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What did Loomis discover?

A

The stages of NREM sleep using EEG in late 1930s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Who discovered the physiology of sleep and when?

A

Bremer in 1928

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When was the Reticular Activating System discovered?

A

1949 by Magoun

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What did Magoun discover and when?

A

The Reticular Activating System as a key area for arousal and consciousness in cats in 1949 by Magoun.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Who discovered REM sleep and when?

A

1953 by Aserinsky and Kleitman. Sleep is active

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What did Aserinsky and Kleitman discover and when?

A

REM sleep, sleep is active. In 1953.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What did Demet discover?

A

In 1954, defined the human sleep cycle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When was the human sleep cycle defined?

A

1954 by Demet.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Who identified the neurophysiology of sleep?

A

Jouvet in 1960s.

Identified different paralysis patterns in NREM and REM sleep.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What did Jouvet discover?

A

The neurophysiology of atonia in sleep in the 1960s.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What did Wurtman discover?

A

The inhibitory control of melatonin with light in 1963.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When was the relationship between melatonin and light established?

A

1963 by Wurtman

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When did polysomnography become a thing?

A

1972 along with all-night tests becoming routine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When was the neurochemistry of sleep being established in the literature?

A

1970s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

In which decade did computers help advance the understanding of sleep?

A

1990s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When were Hcrt1 & 2 peptides discovered?

A

1998

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

In which decade was the genome and cell biology of sleep important in the literature?

A

2000s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When were cellular time keepers in the body discovered?

A

2010

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the general decade-by-decade timeline of sleep medicine?

A

1930-40s: brain is important: EEG + encephalitis + RAS
1950s: sleep cycles
1960s: neurophysiology of sleep + melatonin
1970s: neurochemistry + OSA
1980s: sleep is a clinical speciality (CPAP)
1990s: computers support sleep
2000s: genome and cell biology
2010: cellular time clocks

24
Q

When was sleep apnea discovered?

A

1965 by Gastant in one group and Jung and Kuhlo.

25
Q

When did sleep become a clinical speciality?

A

1980s

26
Q

When was CPAP discovered?

A

1981 by Sullivan

27
Q

When was narcolepsy first described?

A

1880 by Gelineau

28
Q

When was the CNS first described?

A

1875 by Caton

29
Q

List the components of a PSG

A

EEG
EOG
EMG (chin + leg)
airflow
ECG
Respiratory Effort
tCO2
pulse oximetry
body position sensory

30
Q

What is the difference between AC and DC channels?

A

AC: alternating - current changes polarity and direction
DC: direct - one polarity, slower speed

31
Q

What are common PSG recordings in an AC channel?

A

EEG, EOG, EMG

32
Q

What are common PSG recordings in a DC channel?

A

SaO2, Airflow, effort, TcCO2

33
Q

What filters are used on AC channels?

A

Low, high and notch

34
Q

What filters are used on DC channels?

A

Only high frequency

35
Q

What are common errors on AC and DC channels?

A

AC: under sampling
DC: prone to over sampling

36
Q

What frequencies do low, frequency and notch filters filter out?

A

Low: filters slow waves, < 0.5 ,3 ,5
High: fliters fast waves, > 10, 35, 70Hz
Notch: 50Hz

37
Q

What is an issue with using Notch filters

A

Some seizures occur at 50Hz

38
Q

What is the difference between I-IV sleep studies?

A

I: attended, PSG. 4-6 EEG, EOG, EMG, ECG, O2, flow, body position, respiratory effort, video, audio, maybe CO2
II: unattended, PSG, 2 EEG, 1-2EOG, EMG chin, maybe leg. ECG, sPO2, flow, effort, body position [less EEG, reduced EOG, no video, audio, tcCo2]
III: unattended, polygraph, sPO2, flow, effort
IV: unattended, 1-2 channels, Spo2 or actimetry

39
Q

Which amplifier is respiratory effort measured on?

A

AC or DC, but need LFF < 0.1Hz

40
Q

What is aliasing?

A

Misidentification of a signal frequency which introduces distortion or error

41
Q

What is Nyquist Theorem?

A

Sample rate of analogue to digital must be at least 2x the value of the highest frequency you capture.

E.g. EEG expected 0.3-35Hz, therefore LOWEST sampling is 70Hz. Typically use 256 or 516Hz

42
Q

When do we calibrate on a PSG?

A

Regularly required. Biocalibration at the start of every study (blink, eyes closed, move eyes, girt teeth, wiggle fingers, breathe and snore).

DC filters like oximetry (0v=0% and 1v=100%) and TcCO@ with known CO2 calibration.

43
Q

How do you score arousals?

A

In both adults and children:

  • NREM: abrupt shifts in EEG frequency for ≥ 3 seconds with ≥ 10 seconds of sleep prior.
  • REM: same as above PLUS increase in chin EMG for ≥ 1 second.

Every wake must have an arousal scored.
Beware of mixing up spindles and arousal.
Marking the beginning is important, not the end.

44
Q

What are some things to consider about scoring arousals?

A

Every wake must have an arousal scored.
Beware of mixing up spindles and arousal.
Marking the beginning is important, not the end.

45
Q

How do you score a wake period?

A

> 50% of an epoch contains either or both:

  • Alpha in O-leads (10% don’t and another 10% low)
  • Blinks, REMs or reading eye movements
    OR
  • A patient is disconnected from equipment
46
Q

How do you set up for a PSG?

A
  1. Set up display how you like it
  2. Familiarise yourself with patients EEG (N3, REM, N2, N1 and review biological checks)
  3. Allocate sleep stages and mark arousal in 30s epochs
  4. Score respiratory events and leg movements on longer episodes (2,3,5 minutes)
  5. Generate report and check details
47
Q

How do you score sleep onset?

A

Difficult to define as different systems can fall asleep at different times.
EEG can show changes (reduced alpha) but a persons response can differ
Hypnic myoclonia can occur (fall -> startle)

48
Q

How do you score Stage N1 sleep?

A

> 50% epoch has no alpha, replaced by LaMF (do not have to be continuous)

OR, if they don’t produce alpha, N1 until the first sign of:
- EEG 4-7Hz slows down by >1Hz from wake
- vertex sharp waves
- slow eye movements

Keep scoring N1 until evidence otherwise

49
Q

What do you score arousals after N2 or REM sleep?

A

N1

50
Q

What do you score arousals after N3 sleep?

A

N2

51
Q

How do you score stage N2 sleep?

A

First half of epoch or last half of previous epoch has K-Complex or spindle

Continue to score N2 until wake, arousal, body movement, N3 or REM

52
Q

How do you score stage N3 sleep and in which leads do you expect to use?

A

When 20% (6 sec) of the page contains slow waves (0.5-2Hz) which are >75mV as measured by F3 or F4 leads.

CANNOT include:
- Pathological slow waves from encephalopathy or epilepform activity
- Slow waves produced by artefacts (commonly sweat)

Note: if no F-leads, if C or O leads are >75mV you can be sure F-leads would be

53
Q

How do you score REM sleep?

A

All of the following are present:
- LaMF with no spindles or K-complexes
- Low chin EMG for >50% epoch
- REMs at any point in epoch -> so you can go back and score REM once you see them

If the epoch before the above does NOT have REMs, score REM if there is:
- LaMF with no spindles or K-Complexes
- Low chin EMG
- No intervening arousal
- No slow eye movements or wake

May have sawtooth waves

54
Q

When should you use infant or child sleep scoring?

A

Infant: 0-2 months (37-48w)
Child: 2+ months

55
Q

What are child and infant sleep stages?

A

Child: same as adults but also NREM
Infant: Wake/NREM/REM/Transitional

56
Q

How do you determine sleep stages in children?

A

WAKE
- Posterior dominant rhythm is early alpha
- 3.5-4.5Hz (3-4m), 5-6Hz (5-6m), 7.5-9.5Hz (3y)
- Score when >50% epoch has age appropriate range, otherwise same as adult

N1
- PDR replaced by LaMF for >50% epoch or presence of hypnagogic hypersynchrony (v big waves) or high amplitude rhythmic 3-5Hz

N2, N3. REM is the same as adults

57
Q

What are hypnagogic hyper synchrony?

A

Very big waves common in children

SLEE5101 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions