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Neurology System > Sleep > Flashcards

Sleep Flashcards

1
Q

What is sleep?

A

State of unconsciousness from which individual can be aroused by normal stimuli, light, touch, sound ect. Cyclical

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2
Q

What is a coma?

A

State of unconsciousness from which individual cannot be aroused and does not responds to stimuli.

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3
Q

Why does sleep occur?

A

Due to active inhibitory processes that originate in the pons

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4
Q

What does destruction of the brainstem at the level of the mid-pons create?

A

A brain that never sleeps

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5
Q

Which part of the hypothalamus is also involved in sleep?

A

Suprachiasmatic nuclei

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6
Q

What does SCN demonstrate?

A

24hr circadian rhythm

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7
Q

What can electrical stimulation of the SCN do?

A

Promote sleep

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8
Q

What can damage to the SCN do?

A

Disrupt the sleep-wake cycle

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9
Q

What does activity in the SCN stimulate the release of?

A

Melatonin from the pineal gland

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10
Q

Where is melatonin released from?

A

The pineal gland

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11
Q

What does melatonin correspond with in humans?

A

Feelings of sleepiness but not immediately

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12
Q

What else does the hypothalamus release to to help wakefulness?

A

Orexin

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13
Q

What do orexin neurons do?

A

Orexin neurons are active during the waking state and stop firing during sleep.

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14
Q

What does defective orexin signalling cause?

A

Narcolepsy; individual will suddenly fall asleep, sometimes even when talking.

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15
Q

Where does evidence suggest that sleeping activity originates?

A

Reticular formation of the brainstem

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16
Q

What is the reticular formation closely associated with?

A

Controlling the state of consciousness

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17
Q

How do you asses the level of consciousness in an awake person?

A

Look at their behaviour, general alertness, speech patterns, speech content, reading, writing and calculating skills. Spell words backwards or count backwards,

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18
Q

How do you record patterns of brain activity?

A

Record patterns of brain activity using ElectroEncepheloGram (EEG). EEG uses electrodes placed on the scalp to record activity of underlying neurons.

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19
Q

What is more informative frequency or amplitude?

A

Frequency

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20
Q

What is frequency?

A

Number of waves per second

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21
Q

What is amplitude of waves?

A

The size of waves

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22
Q

What are the 4 main type of wave patterns seen?

A

Alpha
Beta
Theta
Delta

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23
Q

In the relaxed awake state what is the EEG characterised by?

A

High frequency, high amplitude waves

Alpha waves

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24
Q

In the alert awake state what is the EEG characterised by?

A

Even higher frequency, low amplitude asynchronous waves termed waves.

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25
Q

Why does the alert phase create low amplitude waves?

A

Increase in activity is asynchronous as brain is doing so many things at once, and opposing polarities of the signals cancel each other out and do not get recorded on EEG.

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26
Q

What are theta waves characterised by?

A

Low frequency waves that can vary enormously in amplitude

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27
Q

Who are theta waves common in?

A

Children

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28
Q

Which waves occur during sleep in both adults and children?

A

Theta waves

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29
Q

What are delta waves characterised by?

A

Very low frequency but high amplitude

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30
Q

When do delta waves occur?

A

In Deep sleep

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31
Q

What is stage 1 sleep?

A

Slow wave, non-REM, S-sleep. Slow eye movements. Light sleep. Easily roused. High amplitude, low frequency theta waves.

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32
Q

What is stage 2 sleep?

A

Eye movements stop. Frequency slows further but EEG shows bursts of rapid waves called “sleep spindles” (clusters of rhythmic waves, ~12-14Hz)

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33
Q

What is stage 3 sleep?

A

High amplitude, very slow (2Hz) delta waves interspersed with short episodes of faster waves, spindle activity declines.

34
Q

What is stage 4 sleep?

A

exclusively delta waves.
Very difficult to rouse from stage 3 and 4 sleep. Known as Deep Sleep. Sleep walking/talking occurs during these stages.

35
Q

What is REM sleep?

A

REM sleep is characterised by fast waves, eerily similar to those of the awake state (what gives it a similar pattern to our awake state)

36
Q

What occurs in REM sleep?

A

Rapid Eye Movements

37
Q

What % of sleep in REM?

A

25%

38
Q

As the night progresses what happens to our sleep?

A

We spend less and less time in a deep sleep and more and more time in REM sleep

39
Q

What patterns of waves is REM sleep similar to?

A

The awake state

40
Q

During which phase of sleep do dreams occur?

A

REM

41
Q

If dreams occur in deep sleep are they remembered?

A

Rarely

42
Q

When does deep sleep occur?

A

In the first few hours of sleep

43
Q

Which is the most restful type of sleep?

A

Deep slow wave sleep

44
Q

How long does REM sleep last?

A

5-30 mins every 90 mins or so during normal nights sleep

45
Q

When is REM sleep less frequent?

A

Early in the night

46
Q

When is REM sleep more frequent?

A

Later in the night as rest and recovery are established

47
Q

What happens to HR and RR in REM sleep?

A

It becomes irregular

48
Q

What happens to brain metabolism in REM sleep?

A

It increases

49
Q

Is it easy or difficult to arouse someone from REM sleep?

A

Difficult

50
Q

What do sleep deprived subjects demonstrate without exception?

A
  1. Impairment of cognitive function
  2. Impairment of physical performance
  3. Sluggishness
  4. Irritability
51
Q

Is sleep crucial to maintain life?

A

Yes

52
Q

What does sleep support?

A
  1. Neuronal plasticity
  2. Learning and memory
  3. Cognition
  4. Clearance of waste products from CNS
  5. Conservation of whole body energy (although cerebral O2 consumption may actually increase, esp. during REM sleep)
  6. Immune function (reason sleep increases when ill?)
53
Q

How does sleep change through childhood and adolescence?

A

Total sleep time decreases as we age

54
Q

What happens to REM sleep as we age?

A 
It decreases
80% in 10 week premature infant, 
50% at full term declining to a stable 2
5% in adulthood.
May be absent by 80+ years old
55
Q

What is insomnia?

A

“chronic inability to obtain the necessary amount or quality of sleep to maintain adequate daytime behaviour”,

56
Q

What % of adults does insomnia affect?

A

33%

57
Q

What is chronic primary insomnia?

A

Where there is usually no identifiable psychological or physical cause

58
Q

What is temporary, secondary insomnia?

A

Insomnia in response to pain, bereavement or other crisis, usually short lives

59
Q

How do Benzodiazepines affect REM sleep?

A

Less effect

60
Q

What is the issue with benzodiazepines?

A

There are highly addictive and cause many problems on withdrawal

61
Q

What are nightmares?

A

have a strong visual component and are seen during REM sleep, typically occur quite far in the night sleep

62
Q

What stops nightmares?

A

Wakening

63
Q

Does the indiviual have a clear recollection of nightmares?

A

Yes

64
Q

During which sleep do night terrors occur?

A

Deep sleep and delta sleep

65
Q

Who are night terrors common in?

A

Young children

66
Q

Does the individual recollect a night terror?

A

No

67
Q

What is somnambulism?

A

Sleep walking

68
Q

When do night terrors commonly occur?

A

Early night

69
Q

When does sleep walking exclusively occur?

A

In non-REM sleep

70
Q

Who is sleep walking common in?

A

Children and young adults

71
Q

What do individuals do when sleep walking?

A

Walk with their eyes open, can see and will avoid objects, can carry out reasonably complex task such as prepare food

72
Q

Can sleep walkers recall the incident?

A

No

73
Q

What is narcolepsy?

A

When a patient enters directly into REM sleep with little warning

74
Q

What is narcolepsy thought to be caused by?

A

Dysfunctional orexin release

75
Q

What type of rhythm is sleep part of?

A

Circadian rhythm

76
Q

What is circadian rhythm?

A

Biological systems that work in 24 hours

77
Q

Where is the master clock located?

A

Suprachiasmatic nucleus (SCN) of the hypothalamus, lying just above the optic chiasma

78
Q

What external signals can help the master clock?

A

E.g light and dark outside

79
Q

If the SCN is destroyed what is lost?

A

Circadian rhythm of sleep

80
Q

What is believed to happen when we enter the sleep state?

A

active cells become fatigued and excitatory signals fade. At this point inhibitory, peptide signals from the Sleep Centres in the Reticular Formation likely take over and rapidly dominate the weakening excitatory signals leading to rapid progression into the sleep state.

81
Q

What is believed to happen during waking?

A

The inhibitory cells fatigue and the excitatory cells are reinvigorated (been resting overnight).

Neurology System (35 decks)

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