REM sleep Flashcards
brain activity high or low?
physiological functions?
high brain activity abstract dreams high in general phys actvity Erections in REM But decrease response to CO2, and decrease temp regulation
usual REM latency?
When is st shorter?
90 min
depression
narcolepsy
poikilothermia
inability to regulate body functions
occurs in REM
most REM occurs in which third?
last third
REM % in neonates?
Adults?
50%
25%
EEG pattern?
saw tooth
theta
slow alpha
REM sleep beh DO associated w?
PD,LBD, multiple systems atrophy
(alpha synucleopathie)
yet we do not treat with DA, we treat with clonazepam
Treatment of REM sleep ben DO?
Clonazepam, Ramelteon
Narcolepsy
Pathophysiology
Treatment
Orexin def
Autoimmune
REM intrusion
Sodium oxybate =GHB for narcolepsy with cataplexy
Approved but dangerous
It makes sleep so deep to decrease daytime sleep
Modafinil for sleep attacks
Venlafaxine clomipramine, things that increase NA and DA
Fx of sleep attacks?
Modafinil
Tx of cataplexy
Sodium oxybate ( careful date rape drug) TCA or venlafaxine or SSRI (Clomipramine especially)
Tx of narcolepsy night stuff: hallucinations, )
TCA or venlafaxine or SSRI
so cataplexy, sleep paralysis, hallucinations have the same Tx as cataplexy. they are all REM intrusion phenomena.
PLMD and RLS
iron deficiency in basal ganglia, and DA def
No known increase risk of PD later as far as I understand.
yet, we treat with DA.
give dopaminergic like pramipexole or ropinerole as 1st line.
then gabapentin,
then benzos/opiods
antpsychotics and antidepressants esp mirtazapine can worsen it
wellbutrin is neutral.
associated with anxiety and panic DO
PTSD sleep changes
INCREASED REM latency (cuz they don’t want the nightmares to come)
increased REM
treatment of nightmares in PTSD
prazocin
but also some evidence for trazodone, mirtazapine, AA, gabapentin, topiramate.luvox
