Sleep Flashcards

1
Q

what is sleep

A

reversible behav. state of perceptual disengagement from and unresponsiveness to the env

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2
Q

3 ways sleep is measured

A
  1. EEG
  2. EOG
  3. Chin EMG
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3
Q

4 key neurotransmitters to waking state

A
  1. histamine
  2. norepi
  3. serotonin
  4. ach
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4
Q

what shows in EEG, EOG and EMG in waking state

A

EEG: low voltage, high freq, alpha rhythm
EOG: rapid, blinking
tone: high

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5
Q

what shows in EEG, EOG and EMG in sleep N1

A

EEG:

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6
Q

what shows in EEG, EOG and EMG in sleep N2

A

EEG: vertex K complexes with high voltage negatives
EOG: still
tone: high

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7
Q

what shows in EEG, EOG and EMG in sleep N3/4 -slow wave

A

EEG: slow wave - high voltage, low freq
EOG: still
tone: low
+ GH release, restorative sleep

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8
Q

what shows in EEG, EOG and EMG in sleep REM

A

EEG: mixed freq, low volt, sawtooth
EOG: rapid
tone: very low
+ irreg. resp, dreaming state

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9
Q

2 phases of REM sleep

A
  1. tonic - impaired thermoreg, hypotension, bradycardia, increased cerebral blood, ICP, erection
  2. phasic - vasoconstricion, increased bP, tachycard, even high cerebreal flow and ICP
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10
Q

what generates REM sleep

A

pons critical

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11
Q

% of night in each stage

A

N1 -5%
N2 - 50
N3 - 20
REM - 25

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12
Q

2 key factors in control of sleep

A

process C - circadian

process S - sleepoiness

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13
Q

where is sleep initiated

A

activity in VLPO - increases in adenosine

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14
Q

sleep changes with age

A

newborn: 18hrs
adol. : 10
adults: 7-9
as age delta sleep goes down

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15
Q

3 key sleep measures

A
  1. sleep onset latency - should be under 10min
  2. REM latency - should be 90
  3. sleep effic. - time asleep/time in bed - should be 90%
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16
Q

6 drugs affecting sleep

A
  1. anithistamines -drowsy
  2. stimulants
  3. caffeine -adenosine antag
  4. benzos - reduce slow wave
  5. antidepress - reduce REM
  6. Alcohol - faster onset, but more arousals
17
Q

what is circadian rhythm

A

internal pacemaker set to 24hrs

18
Q

where is main control center of circadian rhythm

A

SCN - has control over slave organs, but they also have indiv. molecular control

19
Q

3 general types of insommnia and causes

A
  1. initiation - rule out restless legs and breathing
  2. maintenance- intrinisic sleep problems
  3. awakinging - depression or breathing
20
Q

3 examples of insomnia subtypes

A
  1. psychophysiologic - learned behaviors
  2. sleep state mispercetion - think they are up all night, but aren’t
  3. fatal family insomnia- rare neurodegen. disorder
21
Q

5 behav. treatments for insomnia

A
  1. sleep log
  2. sleep hygene
  3. stim. control
  4. sleep restriction
  5. relaxation response
22
Q

what is sleep apnea

A

disordered breathing causing waking, with sig. morbidity (hypertension, stroke, sleepiness, accidents)

23
Q

clinical aspects of obstructive sleep apnea

A
  1. 17 inch neck circumference
  2. obesity
  3. excessive daytime sleepiness
  4. morning headache
  5. nasal disorders
  6. position or alcohol
  7. neuromuscular disorders
24
Q

diff between apnea and hyponea

A

apnea - no breathing for 10 minutes

hypopnea - reduced airflow for 10 minutes

25
3 types of apnea
1. obstructive - paradox of muscles 2. central - no effort 3. mixed
26
causes of central sleep apnea (6)
1. heart failure 2. syringopulbia 3. lateral medullary syndrome 4. other brainstem function 5. atlantoaxial subluxation 6. myotonic dystrophy
27
what is restless legs
urge to move accompanied by uncomfortable sensation that are releived with movement
28
relation of RLS to periodic limb movement disorder
90% of RLS have PLMD | 50% of PLMD have RLS
29
causes of RLS (4)
1. central spactiticy or peripheral radiculopathy 2. alcohol 3. pregnancy 4. Fe def.
30
treatment of RLS (3)
1. underlying conditions 2. DOPA agonists before bed 3. sinemet - avoid
31
tetrad of narcolepsy
1. excessive daytime sleepiness 2. cataplexy 3. sleep onset dreaming 4. sleep paralysis
32
3 treatments of narcolepsy
1. strategic napping 2. alerting agents (amphetimies) 3. anticataplectic (antidep, methyphenidate)
33
2 receptors inmportant for narcolepsy
1. orexin | 2. hypocretin
34
2 main classes of parasomnia
1. slow wave arousals - terrors, walking, sex, talking | 2. REM disorders - easy to awaken and report corresponding dreams
35
what is predictive about REM sleep disorders
90% develop parkinsons - can be treated with clonazepam
36
what is sleep related epilepsy
seizure more common in sleep - esp 2 hours after onset
37
3 types of sleep related epilepsy
1. benign epi. of childhood 2. electric status epilepticus during sleep 3. nocturnal paroxysmal dystonia
38
what happens to sleep in depression
loss of REM latency