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Movement disorders CNS Week3 > Overview of sleep > Flashcards

Overview of sleep Flashcards

1
Q

How do we measure sleep in a sleep lab

A

Polysomogram:
Electro-encephalogram (EEG) (changes in neuronal activity)

Electro-myogram (EMG)(muscles)

electrooculogram (EOG) -eye movement

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2
Q

What does the EEG pick up

A 
Different electrical activity 
-beta 
alpha
theta
delta
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3
Q

What happens to Tau in sleep

A

Tau usually accumulates and forms tangles

In healthy brains it is cleared during sleep

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4
Q

If adolescents don’t have enough sleep what could this lead to

A

Increase chance of catching common cold

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5
Q

If you don’t get enough sleep what is the adverse effects on body

A

Adverse metabolic, CV and inflammatory effects

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6
Q

What genes are unregulated during sleep

A

Those involved in synthesis and maintenance of cell membranes and myelin and immunity

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7
Q

What does sleep deprivation lead to

A

Increased sleep propensity, compensated by subsequent increased sleep intensity and/or duration

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8
Q

What does sleep deprivation do to glucose metabolism

A

Decreased glucose metabolism in prefrontal and parietal cortices

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9
Q

What does sleep deprivation do to tau in blood

A

Increase

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10
Q

May the effects on cognition from sleep deprivation be recognised by the individual

A

No

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11
Q

What is insomnia

A

the perception of insufficient or inadequate sleep for 3 weeks or more

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12
Q

What are the types of insomnia

A

Transient - acute stress, jet lag

Short term: situationl stress (bereavement, conflict at work, pain)

Long term- underlying psychiatric illness, chronic alcohol or drug abuse

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13
Q

What is a good treatment for insomnia for long term change

A

Non-pharmacological treatment

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14
Q

What is progressuve relaxation therapy

A

Provides a means for reducing autonomic activity

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15
Q

How is CbT used for insomnia Pre-sleep

A

Pre-sleep thoughts promote cognitive arousal

CBT provides strategies with:

  • a range of strategies that can prevent or interrupt maladaptive thoughts
  • ->thought blodking and distraction
  • ->Cognitive restructuring (beliefs and attitudes)
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16
Q

When is melatonin secreted

A

Around 9. Peaks around 2am which is where you have the deepest sleep

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17
Q

How does melatonin secretion change during night

A

Changes during night. Decreases as you reach morning.

18
Q

What governs the sleep-wake cycle

A

Suprachiasmatic nucleus within the hypothalamus

19
Q

Function of suprachiasmatic nucleus

A

Encourages production of melatonin to induce tiredness with levels peak between 2-4am

20
Q

How does the suprachiasmatic nucleus induce wakefullness

A

Triggers release of cortisol

21
Q

When is Ach active

Where is it active

A

During wakefulness and REm sleep

Acctive in forebrain and brainstem

22
Q

Where is noradrenaline and norepinephrine produced

What does it do

A

Locus coeruleus

Generates arousal fight/flight response

23
Q

What does hiistamine do in sleep

Where is it activated

A

Promotes wakefulness, reducing REM and NREM

Activated in tuberomammillary nucleus

24
Q

What does 5-HT do

A

Promotes wakefllness and suppresses REM sleep

25
Q

What does dopamine do

A

Exerts potent wake promoting effecrs

26
Q

What is REM sleep behaviour disorder

A

Mostly a disorder of older men

They gain activity during REM cycle of sleep e.g. when fighting in their dreams, they can fight in real life too

27
Q

How do you diagnose REM sleep behaviour disorder

A

Clinical history

Poysomnogram (increased muscle tone in REM sleep)

Must rule out obstructive sleep apnoea

28
Q

Symptoms of erstless legs syndrome

A

uncomfortable feeling in legs and feet (itchy,twitchy, throbbing etc)

Powerful urge to move the legs to reduce uncomfortable feeling

Worsened at night when lying or sitting down

29
Q

Causes of restless legs syndrome

A

Dopamine dysfunction

Genetics

Medications (e.g. antipsychotics, antidepressants, anti-nausea)

Chronic illness

Vitamin and mineral deficiencies

Pregnancy

Sleep deprivation

30
Q

What are the type of hypnotics

A 
Short acting (6h half life)
-Benzodiazepines or related Z-drugs

Antihistamines-H1 receptor antagonists

Sedative antidepressants

Valerian (plant) extracts

melatonin/melatonin receptor (MT1/MT2) agonists

31
Q

What ype of benzodiazepines are best for sleep managemtn

A

Short acting (hypnotics)

32
Q

How long can you use benzidiazepines

A

Only for short term use

33
Q

Advantages of benzodiazepines

A

Lethal dose very high

Small effect on sleep pattern (induces ‘normal’ sleep

Do not induce enzymes

Although tolerance and dependance occurs (therefore only to be administered in crisis and short term use)

34
Q

What is coontraindicated with hypnotics such as temazepam

A

Alcohol

Respiratory depression in combination with alchol

35
Q

Disadvantages with benzodiazepines

A

hang-over effect

Some dependence and withdrawal

Sudden medication stop–? anxiety;insomnia;unsteadiness;seizures

36
Q

How do you control the withdrawal of benzodiazepines

A

take them off the drug slowly

37
Q

Mode of acion of ‘Z’ drugs

A

Bind to benzodiazepine binding site on the GABAa receptor (however they are not benzodiazepines)

38
Q

Advantages of ‘Z’ drughs

A

Short half life

Pharmacokinetics not altered by age

No change in REM
little reported rebound or withdrawal effects

No abuse potential

39
Q

Why are benzodiazepines not recommended fort elderly patients

A

There is a chance for impaired renal or hepatic function

-could have an effect on the pharmacokinetics

40
Q

before mebarking on sleep drugs, how should you manage bad sleep

A

Address sleep hygiene and use CBT

41
Q

What do hypnotics do to sleep

A

Induce sleep but do not alter sleep pattern

42
Q

How should you treat insomnia

A

treat cause

Movement disorders CNS Week3 (11 decks)

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