Sleep

Question 1

NT in waking state

Answer 1

histamine, NorE, seotonin, Ach

-low alpha waves, eye movement rapid/blinking, high muscle tone

Question 2

N1 stage

Answer 2

EEG: lower. alpha and theta, vertex wves
EOG: slow roving eye movment
EMG: high tone, starting to drop
-lgiht sleep, fragmented

Question 3

N2 stage

Answer 3

EEG: vertex K, high voltage, spindles
EOG: still eyes
EMG: high tone

Question 4

N3 stage

Answer 4

EEG: slow wave, delta, high voltage, low f
EOG: still
EMG: low

• reduce BP, HR, RR
• release GH
• homeostatic

Question 5

REM

Answer 5

EEG: mixed, low V, sawtooth
EOG: REM
EMG: very low so don’t act out dreams

• irregular breathing, HR, dreaming, cholinergic states
• pons
• act out dream…Tx: benzos

Question 6

Sleep cycle

Answer 6

90 min cycles
N1 - 5%
N2 50%
N3 20%
REM 5%

Question 7

COntrollers of sleep

Answer 7

• sleepiness and circadian systems
• OREXIN/HYPOCRETIN - posterior thalamus. sleepiness
• onset - anterior hypothalamus
• IL1 peptide induce sleep
• adenosine - sleepiness
• melatonin - sleepiness

drugs:
-antihistamine > sleepy
-benzos > sleepy but reduce slow wave
-antidep > sleepy but reduce REM
SSRI > roving eye in light sleep
alcohol > sleepy but fragmented

stimulants - caffeine is a adenosine antag

Question 8

Insomnia

Answer 8

-increased arousal
-determine if initation, maintenance, awakening issue
Tx:-benzos but not long term

Question 9

Sleep apnea

Answer 9

• breating in sleep > sleep disruption and excesive sleepiness
• accident risk
• Tx: cpap, lifestyle, dental devices, surgery

Question 10

Restless Leg Syndrome

Answer 10

• urge to move, uncomfortable feeling
• worse iwth rest
• relieved with movement
• worse at night

Causes; neuropathies, alcohol, pregnancy, iron deff, ferritin

Tx: underlying, dopaminergic agonists, Sinemet, clonazepm, opioids

Question 11

Narcolepsy

Answer 11

• excessive dytime sleepiness
• cataplexy - motor tone loss iwth stimulus
• hypnaogogic hallucination - dream immedi
• sleep paralysis

Cause: autoimmune, linked to H1N1
Tx; napping, alert agents (modafinil, methlphenidate, amphetamine-like)
-anticataplectic - TCA, SSRI, methylphenidate, GHB, sodium oxybate

Question 12

Slow Wave sleep arousals

Answer 12

• wake up but don’t know

- night terrors, confusional, sexsomnia, sleep walking

Question 13

Sleep related epilepsy

Answer 13

• seizures in sleep

- usually in slow wave

Question 14

Depression nd sleep

Answer 14

-shorter REM