Sleep Flashcards
Narcolepsy
- irresistible attacks of refreshing daytime sleep that occur at least 3 times per week for 3 months or more
- associated with low levels of CSF hypocretin (orexin)
- sudden loss of muscle tone (cataplexy)
- increased intrusion of REM sleep into transition between sleep and wakefulness causing hypnopompic (while awakening) and hyponogogic (while falling asleep) and sleep paralysis
Treatment: sodium oxybate (synthetic analog of date rate drug)
Treatments:
Hypersomnolence disorder
excessive sleepiness 3 times per week for three months as demonstrated by prolonged sleep episodes at night that are non-restorative or daily sleep episodes during the day
Treatment: stimulants or provigil
What is used to treat Circadian rhythm sleep wake disorder?
Modafinil
How does depression affect REM?
shortened REM latency
increased percentage of REM sleep
shift in REM distribution from the last half to the first half of the night
over 65
- more REM episodes that are shorter, less total REM sleep
- NREM sleep have decreased amplitude of delta waves
- lower percentage of N3 sleep
- higher percentage of N1 and N2 sleep
- elderly experience increased awakening after sleep onset
sleep terrors
recurrent episodes of awakening and screaming during the first third of the night
- intense fear, autonomic arousal, sweating, tachy, rapid breathing
- no dreams recalled
- small doses of diazepam are often helpful to stop the episodes
sleep in the elderly
decrease in REM and decrease in slow wave sleep
elderly sleep
- gradual decrease in N3 sleep
- increase in N1 sleep
- decreased REM sleep
- sleep efficiency progressively decreases
- progressive advance in sleep/wake times with aging - gradual phase advance in the internal biological clock
sleep walking (somnambulism)
-common age 5-12
-arising out of slow wave sleep (stage 4)-during first one-third of sleep
- medications that may improve condition: imipramine, benzos
night terrors also in stage 4
jk n3
REM in adulthood
25% sleep time
