Sleep

Question 1

Non REM: Stages 1-4

Answer 1

• Respiratory pattern is regular
• Heart rate and BP are lower than during relaxed wakefulness
• Activity in the brainstem are lower than during relaxed wakefulness
• Cerebral blood flow and cerebral glucose utilization are lower than during relaxed wakefulness
• Unfocused thought with occasional short dreams

Question 2

REM (Rapid eye movement)

Answer 2

• EEG waves as active as when we are awake

- Muscle tone decreased

Question 3

obstructive sleep apnea

Answer 3

• repetitive upper airway narrowing/collapse
• Loud snoring
• Pauses in your breathing
• Gasp/choke/snort arousals
• Sweating, palpitations/heart racing
• Frequent unexplained awakenings
• Morning headaches and/or dry mouth
• “Non-restorative sleep”
• Needing naps or easily dozing off regardless of the amount of sleep at night
• What causes OSA?1) Weight 2) Neck circumference (≥17 inches) 3) Upper airway anatomy

Question 4

Central sleep apnea

Answer 4

• absence of respiratory effort and airflow lasting more than 10 seconds.
• Thought that heart failure is the most common reason for central sleep apnea . -About 10% of patients with sleep disordered breathing have central apnea other 90% have OSA or sleep apnea hypopnea syndrome.

Question 5

Restless Leg Syndrome

Answer 5

1) Urge to move the legs, usually accompanied or caused by an unpleasant sensation in the limbs
2) Precipitated by rest or inactivity
3) Relieved by movement (i.e. stretching or walking)
4) Worse in the evening and at night

Question 6

Narcolepsy

Answer 6

-Patients usually present between age 15 and 30 yrs old. Incidence similar in both genders.
-Delay in diagnosis is common, with average of fifteen years from symptoms to diagnosis.
-Narcolepsy is a clinical diagnosis based on the symptoms and exclusion of other conditions that may account for them.
Tetrad of narcolepsy
-Excessive daytime somnolence (required for diagnosis)
-Cataplexy reversible bilateral muscle weakness of voluntary muscles when they have extreme emotion
-Hypnagogic or hypnopompic hallucinations when falling asleep or waking up
-Sleep paralysis - know youre awake but cant move body
-Only 10-15% patients have all symptoms.
-triggers for narcolepsy; head trauma, infections severe psychological trauma and disrupted sleep schedules preceding symptoms of narcolepsy