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Neuropsychiatric Disorders > Sleep > Flashcards

Sleep Flashcards

1
Q

Which animals show unihemispheric and asymmetric non-REM sleep?

A

Marine animals and birds

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2
Q

What has been observed in humans when sleeping in a novel environment for the first time?

A

Interhemispheric asymmetry - the dominant hemisphere does not appear to fall asleep as deeply, showing increased vigilance in response to deviant stimuli

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3
Q

Where does interhemispheric asymmetry occur in the brain?

A

The default-mode network

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4
Q

Sleep is…..

A

✨dangerous
✨omnipresent
✨universal
✨irresistible
✨strictly regulated
✨serious consequences

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5
Q

How many hours sleep are recommended for adults?

A

7-9 hours

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6
Q

What happens to REM sleep as we get older?

A

It decreases

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7
Q

Why is REM hypothesised to be greatest in the first 2 years of life?

A

REM is when the brain is most active during sleep, during which new connections can be made

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8
Q

What is post-REM important for?

A

Cognition

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9
Q

What did Yetishi et al find in their study of sleep patterns around the world?

A

People in preindustrial societies can function on less sleep BUT this is likely because they engage in less demanding cognitive tasks

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10
Q

When do we need more sleep?

A

▪️As babies/children
▪️When under stress
▪️When engaging in complex cognitive tasks

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11
Q

What two EEG sleep patterns are seen in mammels and birds across evolution?

A

REM and non-REM

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12
Q

What happens to the body in extreme sleep deprivation?

A

▪️Metabolic overdrive
▪️Food intake increased 80% and body weight decreases 20%
▪️Increased levels of plasma noradrenaline, T3, and T4
▪️Sepsis
▪️Thermoregulatory and metabolic imbalance
▪️Death

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13
Q

What is fatal familial insomnia?

A

An autosomal dominant inherited prion disease that causes increasing insomnia before death

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14
Q

What are the first symptoms of FFI and how long do these last?

A

Increasing insomnia, resulting in anxiety, paranoia, and phobias for approximately 4 months

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15
Q

What is the second stage of FFI?

A

Hallucinations and panic attacks for approximately 5 months

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16
Q

What is the third stage of FFI?

A

Catatonia, complete inability to sleep and rapid weight loss for approximately 3 months

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17
Q

What is the final stage of FFI?

A

Dementia, during which they become unresponsive or mute, following by death. This usually occurs over 6 months.

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18
Q

What are the Roiter family known for?

A

The majority of research into fatal familial insomnia

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19
Q

What is the main neurological finding in those with FFI?

A

Decreasing activity in the thalamus (hypometabolism)

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20
Q

Where and when does neurodegeneration begin in FFI?

A

In the thalamus, approximately 13-21 months before clinical presentation

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21
Q

What are the main stages of the sleep cycle?

A

▪️N1 (stage 1)
▪️N2 (stage 2)
▪️N3 (stage 3&4)
▪️REM

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22
Q

How long is each sleep cycle?

A

80-100 minutes

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23
Q

How many sleep cycles do people usually have in a night?

A

4-6

24
Q

What percentage of sleep is non-REM sleep in adults?

A

75-80%

25
Q

What percentage of sleep is REM sleep in adults?

A

20-25%

26
Q

What happens in the first stage of sleep (N1) and how long does this last?

A

The body falls asleep and starts to relax. This usually takes 5-10 minutes (3-8% of sleep)

27
Q

What happens during N2 and how much of sleep is this?

A

Stable light sleep - brain activity, heart rate and breathing slows, body temperature drops, and the brain produces sleep spindles. This stage is very important for cognition.

It is approximately 45-55% of sleep

28
Q

What happens during N3 and what proportion of sleep is it?

A

Deep restorative sleep aka slow wave sleep - body and tissue is restored, increased delta brain waves.

It is approximately 15-20% of sleeo

29
Q

What is REM sleep and what happens during it?

A

Dreaming sleep

▪️Brain activity increases again
▪️Learning and memory consolidation
▪️Muscle atonia (low muscle tone)

30
Q

What are the main brain regions involved in sleep?

A

The thalamus and a complex set of nuclei in the brainstem

31
Q

What state is the brain in during waking?

A

A catabolic state:

▪️Breaking down or losing tissue
▪️Sympathotpnic
▪️Type 2 humoral immune responses

32
Q

Are hallucinations in DLB and narcolepsy intrusions of REM into wakefulness?

A

Maybe!

33
Q

What state is the brain in during NREM sleep?

A

An anabolic state:

▪️Building and preparing tissue - plasticity?
▪️Parasympathetotonic
▪️Pulsed release of GH, insulin, prolactin, and neuroprotective factors
▪️Unrequired synapses and compounds?

34
Q

How does blood flow change in REM sleep compared to waking?

A

▪️Increased flow towards the brain stem, limbic forebrain, and parietal operculum related to increased hallucinatory experience
▪️Decreased blood flow to dorsolateral prefrontal cortex related to decreased thinking

35
Q

Activity in which areas decrease during REM sleep?

A

Frontal and parietal areas, particularly the DLPFC (associated with decreased thinking and lack of sense of entity)

36
Q

Which type of memory is predominantly activated during REM sleep and why?

A

Emotional memories - enables us to reply them without emotion, aiding the reduction of associated emotional charge

37
Q

What state is the brain in during REM sleep?

A

An antihomeostatic state - muscle atonia, decreased sleep drive

Very important not to go into REM too early on extreme expeditions!

38
Q

What happens to metabolism during slow wave sleep?

A

It drops by 40%

39
Q

Atrophy in the medial PFC is associated with _________________ disruption in sleep, which leads to impaired ___________________

A

▪️Slow wave activity
▪️Memory consolidation

40
Q

What is hypothesised to happen to astrocytes during sleep and why?

A

They tuck in, decreasing contact with neurons and synapses, due to decreased noradrenaline

41
Q

Which stage of sleep is thought to be most influential in the development of neuropsychiatric disorder?

A

Non-REM

42
Q

What is the SHY hypothesis?

A

The synaptic homeostasis hypothesis - it claims that sleep, particularly slow wave, is needed to reestablish synaptic homeostasis which is challenged by neuroplasticity (a systematic bias towards net increase of synaptic strength)

43
Q

What is obstructive sleep apnoea (OSA)?

A

A sleep related breathing disorder where the walls of the throat relax and narrow during sleep, interrupting normal breathing (repeatedly stops and starts)

44
Q

How does OSA affect cognition?

A

OSA in adults is associated with cognitive deficits, particularly in working memory, attention, and executive function

45
Q

Does CPAP therapy improve OSA-related cognitive deficits?

A

Yes!

46
Q

Why does OSA affect cognition?

A

Intermittent hypoxia may affect brain structure and function, possibly due to interrupted production and clearance of metabolic products and toxins in the brain

47
Q

What does iRBD stand for?

A

Idiopathic Rapid Eye Movement Sleep Behaviour Disorder

48
Q

What is iRBD?

A

A parasomnia characterised by dream-enacting and motor behaviours due to the loss of muscle atonia during REM sleep

49
Q

IRBD is prodromal to what category of neurodegenerative disorders?

A

Alpha-synucleinopathies such as Parkinson’s disease, dementia with Lewy bodies, or multiple system atrophy

50
Q

Why might use of antidepressants be associated with worse iRBD?

A

▪️Unmasking of alpha-synucleinopathy process through the serotonergic system?
▪️High prevalence of depression in the prodromal stages of PD?

51
Q

What themes are common in iRBD dreams and behaviours?

A

▪️Aggression
▪️Animals
▪️Learned behaviours in accordance with cultural and social norms

52
Q

What sleep disorder is associated with sleepwalking?

A

Non-REM parasomnia

53
Q

How do you distinguish REM parasomnia from NREM parasomnia?

A

▪️Patients don’t tend to move around, sticking to dreamscape coordinates
▪️Video telemetry
▪️Occurs later on in sleep
▪️More frequently in older adults

54
Q

What is GBA mutation associated with?

A

High likelihood of developing alpha-synucleinopathy (parkinsonism), with high degree of cognitive impairment and sleep disturbance

55
Q

How does REM change through the night?

A

It increases in length, from ~10 minutes in the first cycle to ~30 minutes

56
Q

What are the two main processes needed for sleep?

A
  1. Homeostatic (toxins accumulate as a biproduct of metabolism that induce sleep once at a certain level)
  2. Circadian
57
Q

What kind of dysfunction can commonly occur with narcolepsy and why?

A

Metabolic as they are both regulated by the thalamus

Neuropsychiatric Disorders (30 decks)

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