Sleep Flashcards

1
Q

What is slow wave sleep? Or deep sleep

A

Voluntary muscle paralysis

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2
Q

What happens during slow-wave sleep?

A

During this stage your blood pressure drops and your body begins to self-repair. Blood flows to muscles. Growth hormones are stimulated. It is difficult to wake up during this stage and 95% of your growth occurs

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3
Q

What is REM sleep?

A

Rapid eye movement sleep, it is the stage of sleep where most of your dreams happen

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4
Q

What does your brain activity look like during REM sleep?

A

Brain activity looks very similar to brains activity while you are awake

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5
Q

How much of your total sleep time does REM sleep make up?

A

25%, your first REM cycle of a sleep period is typically the shortest around 10 minutes. Each one that follow lasts up to about an hour (cleaveland clinic)

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6
Q

What is the one muscle that works during REM sleep?

A

Diaphragm, the rest of the muscles have limited movement (hypotonia) decreases muscles movement.

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7
Q

Describe the hours of sleep that you need as you age

A

You have decreased slow wave sleep, increased wakenings, slight decrease in total sleep time

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8
Q

What is the average sleep you need up >65 years?

A

6.5 hours

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9
Q

What is a compound that decreases as you age for sleep?

A

Melatonin

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10
Q

What are the two processes that govern sleep and wakefulness?

A

Homeostatic sleep drive and intrinsic circadian rhythm

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11
Q

What is the homeostatic sleep drive?

A

An increase in pressure with more time we are awake whic makes you want to sleep at the end of the day, which then decreases during sleep.

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12
Q

What is intrinsic circadian rhythm?

A

Clocks, we are alert in the day (with a midafternoon dip)

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13
Q

What is obstructive sleep apnea?

A

Decreases in saturation of haemoglobin (oxygen saturation decreases). The airways are partially or completely blocked. Breathing stops and carbon dioxide will accumulate

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14
Q

What is the ribcage movement like in obstructive sleep apnea?

A

There is a period of activity in the ribcage but has become irregular, as there is no airflow

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15
Q

What is central sleep apnea?

A

Where there is something going on in the brain. There is no effort to breath with a cessation of airflow

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16
Q

What happens to the ribcage in central sleep apnea?

A

The ribcage doesn’t move as it isn’t getting the right signals from the brain - so there is no drive to breathe. The condition is rare

17
Q

What is the pathophysiology for obstructive sleep apnea?

A

Increased surface forces acting on the upper airway. Complete or partial collapse of the upper airway

18
Q

What are the symptoms for obstructive sleep apnea?

A

Snoring, witnessed apneas during sleep, excessive daytime sleepiness

19
Q

What are the anatomic factors that promote the pharyngeal narrowing?

A

Large neck, soft tissue, bone and vessels

20
Q

What are some additional factors that promote obstructive sleep apnea?

A

Alcohol use, smoking and using sedatives and hypnotics

21
Q

What are associated medical disorders with obstructive sleep apnea?

A

Endocrine disorders, neurological disorders, prayer willi syndrome, Down syndrome, congestive heart failure, atrial fibrillation, obesity hypoventilation syndrome (slowik JM et al)

22
Q

What muscles are required to maintain patency?

A

Pharyngeal muscles

23
Q

What are some predisposing factors for OSA?

A

Neck size, calories, jaw shape, tonsils and retrognathia

24
Q

What is AHI?

A

The number of apnea events divided by the number of hours of sleep

25
Q

What is the normal AHI?

A

<5

26
Q

What is considered mild apnea?

A

5<15

27
Q

What is considered moderate sleep apnea?

A

15<30

28
Q

what is considered severe sleep apnea?

A

> 30

29
Q

How can help retrognathia causing obstructive sleep apnea?

A

Extensive teeth removal

30
Q

What is the treatment for obstructive sleep apnea?

A

Weight loss, sleep hygiene (avoidance of sedatives, positional changes), mandibular advancement, nasal continuous positive airway pressure (CPAP)

31
Q

What is CPAP?

A

Forcing the airway open - the collapsed airway is now open

32
Q

What happens as you increase the pressure in CPAP?

A

The airway dilates

33
Q

What can you get back once you have been treated from obstructive sleep apnea?

A

Your driving licence back

34
Q

What are other sleep disorders?

A

Circardian rhythm disorders, insomnia, narcolepsy, REM sleep behaviour disorder

35
Q

What is narcolepsy?

A

Excessive sleepiness due to neurological condition caused by failure of neurotransmission in a tiny subset of brain neurones - some people feel like they can’t move (sleep paralysis)

36
Q

What is a REM sleep behaviour disorder?

A

Progressive, with loss of normal REM Antonia leading to acting out of dreams, change in dream content

37
Q

What is REM sleep behaviour disorder treated with?

A

Clonazepan (or other long acting hypnotics)