Sleep Flashcards
What waves occur when awake?
Aloha and beta (Unsynchronised)
What waves occur in REM sleep?
Beta
What waves occur in stage 1 sleep?
Theta (intermittent activity)
What waves occur in stage 2 sleep?
Spindles (short bursts) and k complexes
What waves occur in stage 3?
Delta - Unsynchronised
What waves occur in stage 4 sleep?
Delta - synchronised
What physiological changes occur in REM sleep?
HR goes up, neck muscles relax, more variable breathing rate, penile erection
According to Carlson and older text books what does sleep not restore and what does it restore?
Does not restore the body but it does restore the brain.
How do we know the brain is indeed resting during sleep?
Delta activity during slow-wave sleep
What does sleep deprivation cause? (7)
Higher level cognitive function is disrupted, working memory, ST memory, attention (individual may not recognise it). Mood changes, increase sleep propensity, compensated by increase sleep intensity and/or duration, decrease glucose metabolism in prefrontal and parietal areas, increase risky behaviour as sleep duration falls below 5 hours. Perceptual changes. Sleep deprivation is correlated with a reduction in cellular immunity and can cause a reduction in N cells, T cells and monocytes function
What type of memory does sleep benefit?
Declarative and procedural memory
Define insomnia
Perception of insufficient or inadequate sleep for 3 weeks or more.
What are ways people can improve their sleep?
Avoid caffeine, alcohol, nicotine. Turn bedroom into a sleep inducing environment. Establish a soothing pre-sleep routine. Go to sleep when tired. Don't be a night time clock watcher. Use light to your advantage. Consistent schedule. Nap before 5pm or not at all. Eat light evening meal and not too late. Balance fluid intake. Exercise 3 hours before bed time.
What are some of the contributing factors to insomnia?
Reaction to distress, organic cause (endogenous depression), faulty/poor sleep management, chronic distress - pain.
What are the 3 types of insomnia?
Transient - 2/3 days, acute stress, jet lag.
Short Term - 3 weeks, up to 50% of patients in this group have underlying psychiatric illness, also chronic alcohol abuse.
What do the 5 P’s for good sleep stand for?
Psychological - decrease stress
Physiological - increase relaxation.
Pharmacological - decrease caffeine and decrease alcohol.
Psychiatric - diagnosis - treatment for anxiety/depression.
Physical - decrease pain.
What is an EEG a useful diagnostic tool in?
Sleep disorders, epilepsy, coma, brain death.
What is the EEG signal?
Algebraic sum of electrical synaptic/glial events from neural population.
Does REM duration increase or decrease during the sleep period?
Increases
What factors promote sleep?
Interleukin-1 - increases during illness.
Adenosine levels increase in sleep and decrease during wakefulness. Caffeine is an adenosine R antagonist - reduces sleepiness.
What are the features of a good hypnotic?
Indices normal sleep, no hangover on waking up, low risk of overdose, lack of tolerance and dependence.
What is the major short acting hypnotic and what is its half life?
Benzodiazepines, half life of 6 hours. Barbiturates no longer used as a hypnotic.
What other drugs are there and why are they not as popular?
Antihistamines, sedative antidepressants, choral hydrate etc .. All have side effects.
Barbiturates have well found actions in what conditions?
Epilepsy and anaesthesia.
What are the problems with barbiturates?
Reduce REM sleep, tolerance, dependence, hangover, poisoning - respiratory depression.
What are some examples of benzo’s?
Temazepam, midazolam etc
What are drugs that bind to BDZ sub-units of the GABAa receptor with BDZ-like action.
Zoplicone, Zolpidem.
What are some partial agonists of BDZs?
Abercarnil, bretazenil.
What type of receptor is the GABA receptor?
Ionotropic receptor - ligand activated (GABA) chloride channel.
What are this clinical uses of BDZs?
Sedative, induces sleep, decreases anxiety, reduce muscle tone, anticonvulsant.
What activity does an EEG pick up?
Alpha waves (smooth activity 8-12 Hz) Beta waves (irregular activity 13-30 Hz) Theta waves (intermittent activity 5-8 Hz) Sleep spindles (short bursts of 12-14 Hz) K complexes (sudden sharp waveforms) Delta (regular, synchronous activity of 1-4 Hz)
