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NSB Lectures > Physiology of Sleep > Flashcards

Physiology of Sleep Flashcards

1
Q

What is - a natural periodic state of rest for the mind and body - in which eyes usually close and consciousness is completely or partially lost, so there is a decrease in bodily movement and responsiveness to external stimuli?

A

Sleep

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2
Q

How much of our lives is spent sleeping?

A

Approx 1/3

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3
Q

Are sleeping patterns uniform for everyone?

A

No - some people need more sleep, some less.

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4
Q

How does old age impact on sleep?

A

Sleep can become fragmented in old age - thought to attribute to various ailments as we get older.

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5
Q

How can a lack of sleep impact on a person?

A

Can lead to significant impact on physiological as well as psychological well being - inc. affecting memory, temper, language and sense of time.

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6
Q

How can we measure sleep?

A

Questionnaires

Physiological measurements - e.g. EEG, using biomarkers

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7
Q

What is wrong with the questionnaire approach to assessing sleep?

A

Subject to interpretation by P, increased levels of error due to bias

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8
Q

Why are physiological methods better for measuring sleep quality?

A

They are free from base and have reproducible results.

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9
Q

Which method involves recording a gross average of electrical potentials of cells and fibres in the brain area close to an electrode?

A

EEG

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10
Q

Which method involves recording a gross average of electrical potentials of cells and fibres in the brain area close to an electrode?

A

EEG

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11
Q

What does EEG stand for?

A

Electroencephalography

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12
Q

How does an EEG work?

A

Neurones generate electric potentials in the brain - some positive, some negative. The electrode on the scalp works out the sum total of charge in that area and reports it on a graph = brain waves

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13
Q

How many neurons are usually detected by one electrode?

A

About 10,000

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14
Q

What happens to the brain when there is no stimulus?

A

The neurons form a rhythmic pattern = synchronous rhythm on the EEG

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15
Q

What are the basic requirements for signal detect?

A

Neurons must be active in synchrony to generate large enough electrical field to be detected from the scalp

Neurons must be aligned in parallel orientation - so they summate rather than cancel out

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16
Q

What does amplitude of the EEG signal depend on?

A

Number of active cells, total amount of excitation & timing of activity

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17
Q

How does an awake brain appear on EEG

A

Irregular rhythm, high frequency but low amplitude waves

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18
Q

How does an asleep brain appear on EEG?

A

Regular rhythm, with low frequency and high amplitude waves

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19
Q

Why do brain waves appear even when neurons are not being stimulated?

A

Thalamic cells = voltage-gated ion channels - self-discharge at rhythmic intervals even in the absence of external input.

Thalamic pacemaker neurons become synchronised via cellular and chemical communication. = Regular pattern on EEG

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20
Q

Which ions passthrough thalamic pacemaker neurons?

A

Na, K & Ca

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21
Q

What are the functions of brain rhythms when asleep?

A

We dont know

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22
Q

How does increased, synchronised activity appear on EEG?

A

As larger amplitude waves

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23
Q

What physiological responses occur when we are asleep?

A

Decreased in HR, RR & brain activity

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24
Q

What behavioural changes occur when we are asleep?

A

Lack of gross movement

Rapid Eye movement cycles

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25
Q

How many sleep cycles do we experience during the night?

A

6-7

26
Q

What are the stages of sleep?

A

Awake
Stage 1 - NREM
Stage 2 - NREM
Stages 3-4 NREM
REM

26
Q

What are the stages of sleep?

A

Awake
Stage 1 - NREM
Stage 2 - NREM
Stages 3-4 NREM
REM

27
Q

Name the stages of sleep on this EEG

A
28
Q

How many stages of non-rem sleep are there?

A

4

29
Q

What identifies Stage 1 NREM (N1)?

A

Irregular, jagged, low-voltage waves.

Brain activity is high - but starts to decline

30
Q

What identifies Stage 2 NREM (N2?)

A

Sleep Spindle and K-complex presence

31
Q

What is the sleep spindle?

A

A frequency of 12-14 Hz burst for at least 500ms.

32
Q

What is the sleep spindle?

What is it generated by?

A

A frequency of 12-14 Hz burst for at least 500ms

Generated by oscillating interactions between the thalamus and the cortex

33
Q

How can you identify the K-complex? What is it caused by?

A

Is a sharp high-amplitude positive wave followed by a smaller slow negative wave.

Occurs randomly and in response to auditory stimuli. Brain is responsive to the stimuli and monitors but doesn’t necessarily wake up from it

34
Q

How can you identify stages 3 & 4 of NREM sleep?

A

Have δ waves = slow, large amplitude, regular waves

35
Q

What are stages 3&4 of NREM sleep known as?

A

Slow-wave sleep (SWS)

36
Q

At which stage of sleep can sleepwalking, nightmares and bed wetting occur?

A

Stages 3&4 NREM

37
Q

How does REM sleep appear on EEG?

A

Irregular, low voltage fast waves (similar to Stage 1).

38
Q

What happens during REM sleep?

A

Increased brain activity - may be because of dreaming

39
Q

Which sleep cycle is most important to awake rested?

A

REM

40
Q

How many stages of REM sleep do you get a night?

A

5-6

41
Q

Which stage is the brain most active and the body the least active in?

A

REM sleep

42
Q

What happens when you transition from NREM to REM sleep?

A

You awake slightly before entering REM sleep

43
Q

What physiological changes occur during REM sleep?

A

Postural muscles become more relaxed

HR, RR & BP are more variable than other stages

Increased blood supply to reproductive organs

44
Q

How long does the entire sleep cycle last?

A

90-120 mins

45
Q

Humans cycle from Stage 1 to REM during the first cycle of sleep. What happens in subsequent cycles?

A

Subsequent cycles start from stage 2 to REM every 90-110 mins

46
Q

Which drugs are best for inducing sleep?

A

Benzodiazepines

47
Q

How do benzodiazepines work?

A

Are GABA A modulators - modulate the Cl channel - allowing it to stay open longer - thus hyper polarising the cell = induction of sleep.

48
Q

How do benzodiazepines affect the sleep cycle?

A

Increase N1 & N2 but decrease N3&4 and REM sleep

49
Q

What is a big problem with benzodiazepines?

A

Dependance

50
Q

What are the limitations of the EEG?

A

No sensitive enough to pick up individual APs

Cannot distinguish between excitation, modulatory or inhibitory activity

Limited anatomical specificity

51
Q

Which scan is best for anatomical specificity of brain waves?

What is its drawback?

A

fMRI best

Very expensive

52
Q

Which hormones are involved in circadian rhythm?

A

Cortisol (day) and Melatonin (night)

53
Q

How does the circadian clock work?

A

Is present in the brain - receives information from light and regulates production of melatonin and cortisol, controlling sleep cycle. Also sets the peripheral clocks.

54
Q

What things are controlled by the peripheral circadian clocks?

A

Excretion, digestion, urination - synchronise internal organs

55
Q

Name 2 types of NREM parasomnias

A

Sleepwalking
Night Terrors

56
Q

Name one type of REM parasomnias

A

Sleep Behavioural Disorder

57
Q

What is a sleep-related disorder called?

A

Parasomnia

58
Q

What disorder is this?

P gets out of bed whilst still asleep, exhibits limited awareness and responsiveness to surroundings

A

Sleep walking (NREM)

59
Q

What disorder is this?

P often screams in sleep - most are not responsive to outside stimuli and have no recollection of the source for their terror upon waking.

A

Night Terrors (NREM)

60
Q

What disorder is this?

A

Unusual vocalisations or movements during REM sleep,

NSB Lectures (48 decks)

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