Sleep Flashcards
what is sleep
reversible behav. state of perceptual disengagement from and unresponsiveness to the env
3 ways sleep is measured
- EEG
- EOG
- Chin EMG
4 key neurotransmitters to waking state
- histamine
- norepi
- serotonin
- ach
what shows in EEG, EOG and EMG in waking state
EEG: low voltage, high freq, alpha rhythm
EOG: rapid, blinking
tone: high
what shows in EEG, EOG and EMG in sleep N1
EEG:
what shows in EEG, EOG and EMG in sleep N2
EEG: vertex K complexes with high voltage negatives
EOG: still
tone: high
what shows in EEG, EOG and EMG in sleep N3/4 -slow wave
EEG: slow wave - high voltage, low freq
EOG: still
tone: low
+ GH release, restorative sleep
what shows in EEG, EOG and EMG in sleep REM
EEG: mixed freq, low volt, sawtooth
EOG: rapid
tone: very low
+ irreg. resp, dreaming state
2 phases of REM sleep
- tonic - impaired thermoreg, hypotension, bradycardia, increased cerebral blood, ICP, erection
- phasic - vasoconstricion, increased bP, tachycard, even high cerebreal flow and ICP
what generates REM sleep
pons critical
% of night in each stage
N1 -5%
N2 - 50
N3 - 20
REM - 25
2 key factors in control of sleep
process C - circadian
process S - sleepoiness
where is sleep initiated
activity in VLPO - increases in adenosine
sleep changes with age
newborn: 18hrs
adol. : 10
adults: 7-9
as age delta sleep goes down
3 key sleep measures
- sleep onset latency - should be under 10min
- REM latency - should be 90
- sleep effic. - time asleep/time in bed - should be 90%
6 drugs affecting sleep
- anithistamines -drowsy
- stimulants
- caffeine -adenosine antag
- benzos - reduce slow wave
- antidepress - reduce REM
- Alcohol - faster onset, but more arousals
what is circadian rhythm
internal pacemaker set to 24hrs
where is main control center of circadian rhythm
SCN - has control over slave organs, but they also have indiv. molecular control
3 general types of insommnia and causes
- initiation - rule out restless legs and breathing
- maintenance- intrinisic sleep problems
- awakinging - depression or breathing
3 examples of insomnia subtypes
- psychophysiologic - learned behaviors
- sleep state mispercetion - think they are up all night, but aren’t
- fatal family insomnia- rare neurodegen. disorder
5 behav. treatments for insomnia
- sleep log
- sleep hygene
- stim. control
- sleep restriction
- relaxation response
what is sleep apnea
disordered breathing causing waking, with sig. morbidity (hypertension, stroke, sleepiness, accidents)
clinical aspects of obstructive sleep apnea
- 17 inch neck circumference
- obesity
- excessive daytime sleepiness
- morning headache
- nasal disorders
- position or alcohol
- neuromuscular disorders
diff between apnea and hyponea
apnea - no breathing for 10 minutes
hypopnea - reduced airflow for 10 minutes
3 types of apnea
- obstructive - paradox of muscles
- central - no effort
- mixed
causes of central sleep apnea (6)
- heart failure
- syringopulbia
- lateral medullary syndrome
- other brainstem function
- atlantoaxial subluxation
- myotonic dystrophy
what is restless legs
urge to move accompanied by uncomfortable sensation that are releived with movement
relation of RLS to periodic limb movement disorder
90% of RLS have PLMD
50% of PLMD have RLS
causes of RLS (4)
- central spactiticy or peripheral radiculopathy
- alcohol
- pregnancy
- Fe def.
treatment of RLS (3)
- underlying conditions
- DOPA agonists before bed
- sinemet - avoid
tetrad of narcolepsy
- excessive daytime sleepiness
- cataplexy
- sleep onset dreaming
- sleep paralysis
3 treatments of narcolepsy
- strategic napping
- alerting agents (amphetimies)
- anticataplectic (antidep, methyphenidate)
2 receptors inmportant for narcolepsy
- orexin
2. hypocretin
2 main classes of parasomnia
- slow wave arousals - terrors, walking, sex, talking
2. REM disorders - easy to awaken and report corresponding dreams
what is predictive about REM sleep disorders
90% develop parkinsons - can be treated with clonazepam
what is sleep related epilepsy
seizure more common in sleep - esp 2 hours after onset
3 types of sleep related epilepsy
- benign epi. of childhood
- electric status epilepticus during sleep
- nocturnal paroxysmal dystonia
what happens to sleep in depression
loss of REM latency
