Sleep

Question 1

what happens when a person is sleep deprived?

Answer 1

cognition and judgment impaired, mood instability, psychosis can develop in chronic loss of sleep, immune dysfunction, GI complaints

Question 2

sleep architecture and the components of each

Answer 2

non-REM sleep- N1, N2, N3

REM sleep- tonic REM, phasic REM

Question 3

when does non-REM sleep mostly occur?

Answer 3

majority of N3 is in the first 1/3 of the night

Question 4

when does REM sleep mostly occur?

Answer 4

majority occurs in the latter 1/2 of the night

Question 5

percentage of sleep time of each stage of non-REM sleep

Answer 5

stage N1- 5%
stage N2- 50%
stage N3- 10-25% total sleep time

Question 6

what type of sleep is associated with non-REM sleep? what type of waves?

Answer 6

slow wave sleep (SWS): delta sleep, deep sleep

Question 7

percentage of total sleep time spent in REM sleep?

Answer 7

20-25%

Question 8

what happens to sleep as we get older?

Answer 8

spend more time awake, less time in non-REM sleep, spend less time in REM sleep

Question 9

type of waves associated with awake with eyes closed sleep

Answer 9

alpha waves

Question 10

stage 1 non-REM sleep type of wave

Answer 10

theta waves

Question 11

waves associated with stage 2 non-REM sleep

Answer 11

sleep spindles and K complexes

Question 12

characteristics of stage 1 NREM sleep vs stage 2 NREM sleep

Answer 12

stage 1- slow eye movements, myoclonic jerks, easy arousal

stage 2- no eye movement, breathing, HR regular, body temp decrease, more difficult to arouse

Question 13

stage 5 NREM sleep: type of waves, characteristics

Answer 13

delta waves, slow wave sleep, delta sleep, deep sleep, N3

decreased BP, RR, GH release, mostly in first 1/3 of night, confusion upon waking

Question 14

characteristics of REM sleep

Answer 14

dream sleep (can remember dreams), purposeful atonia, cortical is active, autonomic instability, arousable without confusion, dominates 2nd 1/2 of night, nocturnal penile/clitoral tumescence

Question 15

percent of day that infants sleep vs adults

Answer 15

infants 66%

adults 33%

Question 16

regulatory influences on sleep, and which ones influence different types of sleep.

Answer 16

circadian system (suprachiasmatic nucleus of hypothal, 24 hr sleep-wake cycle, REM influenced by this)

homeostatic system (adenosine from use of ATP, SWS influenced by this system)

Question 17

how does light influence melatonin?

Answer 17

light enters retina, goes to suprachiasmatic nucleus, light inhibits release of melatonin from pineal gland, causing arousal

Question 18

teenager circadian system fluke

elderly circadian system fluke

Answer 18

teenagers have phase delay (night owl)

elderly have phase advance (morning lark)

Question 19

compounds/actions that inhibit or slow the homeostatic system of sleep load

Answer 19

caffeine- adenosine receptor antagonist

napping

Question 20

causes of insomnia

Answer 20

low sleep drives, increased arousal

Question 21

treatment of insomnia

Answer 21

cognitive behavioral therapy- sleep restriction, stimulus control, sleep hygiene, relaxation

meds

Question 22

difference between PSG and MSLT and purposes of each

Answer 22

PSG=polysomnogram; pulse ox, respiratory effort, airflow, video, for sleep-related breathing disorders

MSLT= mean sleep latency test; determines daytime sleepiness and tendency to enter REM

Question 23

obstructive sleep apnea causes/effects

Answer 23

sleep disruption, excessive negative intrathoracic pressure generated, hypoxia w/ reperfusion injury, hyper and hypocarbia

Question 24

diagnosis of obstructive sleep apnea is done by

Answer 24

PSG

Question 25

treatment of narcolepsy

Answer 25

stimulant amphetamines, nonstimulant modafinil, sodium oxybate (GHB)

Question 26

NREM parasomnias

Answer 26

sleep terrors, somnoabulism (sleep walking), somniloquy (sleeptalking), bruxism (teeth grinding)

Question 27

REM parasomnias

Answer 27

nightmare disorder, REM behavior disorder

Question 28

difference between sleep terror disorder and nightmare disorder

Answer 28

sleep terror: no dream recall, unresponsive to consolation of fear, sweating, dilated pupils, rapid breathing

nightmare disorder: memory of dreams*, able to rapidly orient upon waking

Question 29

what is REM behavior disorder?

Answer 29

loss of atonia, violent motor activity, vivid dream recall, seen with use to stimulants, TCAs, SSRIs, otherwise associated with Parkinson’s disease, etc.

Question 30

classic sleep findings in depression

Answer 30

early morning wakefulness*, decreased REM latency, decreased SWS, decrease in maintaining sleep, increased REM density.