Sleep Flashcards
EEG wave when awake and alert
Beta
EEG wave when awake, but eyes closed, relaxed
Alpha
EEG wave during N1 stage of sleep
Theta
EEG wave during Stage N2 sleep
Sleep spindles and K complexes
Stage N3 EEG wave
Delta (lowest frequency, highest amplitude)
EEG wave during REM sleep
Beta
When does bruxism occur
Stage N2; is grinding teeth
What is the deepest non-REM sleep
N3; 25% of sleep time in young adults
longest phase of sleep (most time)
N2
When do slepwalking, night terrors, and bedwetting occur (phase)
N3
When does dreaming occur?
REM
*also boners, loss of motor tone
Extraocular movements during REM due to activity of what
Paramedian pontine reticular formation (PPRF)
Principal NT in REM sleep? What NT reduces REM sleep?
ACh is primary; NE reduces
What two drugs shorten N3 sleep?
- Imiprimine
2. Benzos
What is the cause of cataplexy in narcoleptic pts?
They immediately go into REM sleep, so get muscle paralysis and fall where they stand
What common drug for insomnia should be avoided in the elderly
Antihistamines
What should be done before starting a pt on a TCA for insomnia?
Get EKG; risk of arrhythmias
Which sleep med can be used long-term per FDA
Eszoplicone (lunesta)
Difference between Zolpidem and Ramelteon MOA?
Zolpidem–> acts as benzo receptor, so rebound insomnia when withdrawn
Ramelteon–> works at melatonin receptor (non-addictive); but avoid w/ hepatic insufficiency
1st line tx for narcolepsy
modafinil (stimulant)
3 options for tx of cataplexy in narcoleptics
- Venlafaxine
- Fluoxetine
- Atomoxetine (mild stim.)
*antidepressant work by increasing NE and helping prevent sudden onset of REM sleep and thus cataplexy
