Brainscape's Knowledge GenomeTM

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


See full index

Block 8 Week 1 > Rothrock: Sleep! > Flashcards

Rothrock: Sleep! Flashcards

1
Q

What is the probable ultimate regulator of sleep?

A

hypothalamus

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

What happens to total sleep time with increasing age?

A

it declines

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

Which hormones decrease with sleep? Which increase?

A

cortisol and TSH; growth hormone and prolactin

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

During sleep, pineal derived (blank) production begins and ceases w/ exposure to sunlight

A

melatonin

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

“a natural repeated unconsciousness” whose reason and purpose are unknown

A

sleep

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

What are the 4 stages of sleep?

A

4 non-REM cycles;

1 REM cycle

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

> drowsiness/slow, roving horizontal eye movements/reduced EEG voltage

A

stage 1 sleep

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

EEG shows “sleep spindles” (bursts of biparietal 12-14 Hz waves), slow “vertex waves”

A

stage 2 sleep

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

EEG shows high amplitude slow waves (delta Hz=EEG synchronized

A

stages 3 & 4

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

EEG nonsynchronized*, shows fast wave; bursts of REMs; minimal tonic muscle activity; conjugate REMs; penile erection

A

stage 5 sleep

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

How many non-rem/REM cycles do you go through in a night? During latter portion of the night, what stage of sleep are you primarily in?

A

4-6;

NREM-REM 2

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

How many minutes are spent on each sleep cycle?

A

60-90 mins/cycle

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

How long does the first REM cycle last after sleep onset?

A

70-100 minutes

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

Most dreaming occurs during (blank)

A

REM sleep

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

Are you easily aroused from REM sleep? From NREM 3 sleep?

A

yes; no

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

Things that happen if we don’t sleep for >60hrs?

A 
sleepiness, fatigue, irritability
difficulty concentrating
impaired skilled motor function 
inattention
impaired judgement
nystagmus, loss of accomodation, bilat hand tremor, ptosis, expressionless face, thick speech, mispronunciations, word substit.

if persists: visual/tactile hallucinations, psychosis, seizure activity

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

More serious consequences of chronic lack of sleep?

A 
hypertension
stroke
myocardial infarction
pulmonary hypertension 
early death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

sleep disturbance for prolonged periods in the absence of any causal psychiatric or medical disorder
“sleep hypochondriacs”

A

primary insomnia

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

What are some non-medical causes of secondary insomnia? Some medical causes?

A

EtOH and drug abuse, psychological;

arthritic pain, GERD, PUD, prostatism/nocturia

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

What is a sleep diary?

A

a real-time assessment of your sleep for 7 consecutive days; include bedtime, awakening, out of bed, naps, use of sedatives and stimulants, and symptoms

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

Two most commonly used systems to assess how much sleeplessness you have

A

Epworth Sleepiness Score

Stanford Sleepiness Score

22
Q

If you have a secondary insomnia, how do you treat it?

A

treat the underlying disorder

23
Q

Is there any good treatment currently for primary insomnia?

A

No! We need good therapy for primary insomnias

24
Q

3 things that you might suggest for a patient with chronic primary insomnia?

A

sleep hygiene
cognitive and behavioral therapy
medications

25
Q

Re-set sleep cycle: no naps; dec non-sleep time in bed; exercise
Re-set circadian rhythm: lights out, quiet time
Avoid caffeine, alcohol, tobacco
Bedroom: quiet, dark, rituals, no clock

A

Sleep hygiene

26
Q

What is the problem with having patients on sleep medications?

A

they may work great, but they are terribly hard to stop using over time

27
Q

What are the two types of sleep apnea?

A

central - caused by CNS

obstructive - problem with the airway

28
Q

What is essential for diagnosis of sleep apneas?

A

polysomnography

29
Q

Two forms of central sleep apnea?

A

primary: Ondine’s curse
secondary: lower brain stem abnormalities

30
Q

posterior pharyngeal muscles collapse and narrow airway
noisy, cyclic snoring> apnea (10 to >30 secs)> breathing resumes/brief arousal
occurs during REM and non-REM sleep

A

obstructive sleep apnea

31
Q

How does obstructive sleep apnea present? What patients typically get OSA?

A

excessive daytime somnolence; overweight, middle-aged men

32
Q

Screening tool for sleep apnea with fairly high sensitivity?

A

STOP-BANG

33
Q

What are 6 components of polysomnography?

A 
EMG - looks at muscle activity
Airflow
EEG
O2 sat
Cardiac rhythm
Leg movements
34
Q

When might you find these symptoms:

Nasal obstruction
Long, thick soft palate
Retrodisplaced mandible
Narrowed oropharynx
Redundant pharyngeal tissues
Large lingual tonsil
Large tongue
Large or floppy epiglottis
Retro-displaced hyoid complex
A

obstructive sleep apnea

35
Q

How to treat central sleep apnea?

A

treat underlying cause

low-flow oxygen

36
Q

Are meds helpful for OSA?

A

Not really

37
Q

Treatment for obstructive sleep apnea?

A

CPAP **mainstay therapy
surgical options, like uvulectomy or mandibular advancement
dental appliances
behavioral means, like weight loss and avoidance of alcohol, sedatives, smoking
non-supine sleep

38
Q

unpleasant sensation ( leg>arms) with irresistible urge to move the affected limb

delays sleep onset and occurs in early stages of sleep

common (prevalence>2%)

symptoms provoked by rest, alleviated (briefly) by moving limb(s)

may persist into daytime

A

restless leg syndrome

39
Q

Things that worsen restless leg syndrome?

A

worsens with fatigue and warm weather

40
Q

Restless leg syndrome is associated with what diseases?

A

iron deficiency anemia** check iron level
hypo/hyperthyroidism
pregnancy
certain drugs (TCAs, anti-histamines)

41
Q

Treatment of restless leg syndrome?

A 
iron supplementation
dopamine agonists
long acting L-dopa
gabapentin
clonazepam
42
Q

If a patient w RLS, what should you check?

A

iron level - look for iron deficiency anemia

43
Q

RLS might be due to decreased (blank)

A

dopamine

44
Q

What is in the narcoleptic tetrad?

A

recurrent attacks of irresistible sleep (“narcolepsy”)
cataplexy (~70%) - loss of muscle tone usu provoked by emotions
sleep paralysis (as you’re falling asleep, you can’t move your limbs)
hallucinations (usu visual)

45
Q

When does narcolepsy usu begin? How long do sleep periods last?

A

ages 15-35;

<15 minutes, 2-6 times a day

46
Q

There is an abnormality in what hypothalamic neuropeptide in narcolepsy? These neurons project to sleep structures

A

hypocretin

47
Q

With narcolepsy, what happens to REM and non-REM sleep?

A

they are reversed - you begin with REM sleep

**sleep latency reduced - just drop into sleep

48
Q

How do you diagnose narcolepsy?

A

overnight polysomnography followed by multiple sleep latency test

49
Q

naps at 2 hour intervals/detect REM activity within 15 minutes of sleep onset

A

multiple sleep latency test

50
Q

How to treat narcolepsy?

A

take short naps!
stimulant drugs, like modafinil
TCAs (antidepressants)

Block 8 Week 1 (12 decks)

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