Sleep Flashcards
When does non REM sleep tend to occur?
Towards the end of the night
What age group have mainly non-REM sleep?
Teenagers (3/4 of their sleep is non rem)
What physiological changes occur during non-REM sleep?
Partial muscle relaxation
Reduced cerebral blood flow
Reduced HR, blood pressure and tidal volume
Does REM sleep have narrative or non narrative images?
Narrative
What type of images are seen in non-REM sleep?
Non narrative
What physiological changes occur in REM sleep?
Increased cerebral blood flow
Impaired thermal regulation
Atonic muscles
In non- REM sleep what is seen on an EEG?
Synchronised rhythmic EEG activity
In REM sleep what is seen on an EEG?
Fast activity and increased brain wakefulness
What muscles are not atonic during REM sleep?`
Diaphragm
Extra-ocular muscles
What is the purpose of REM sleep?
Early brain development
Maintains immunocompetence
Consolidates memories and potentially deletes unnecessary memory files
What animals do not have a REM cycle?
Dolphins
What medication suppresses REM sleep?
Tricyclics
Deep sleep allows for what part of the brain to recover?
The cortex
What age group has roughly 50% REM sleep?
Neonates
What is the typical sleeping pattern of elderly patients?
Increased awakenings
Reduced REM latency
Reduced total sleep time
Daytime napping
What does non-REM sleep allow for?
Protein synthesis
Cell division and growth
What cells are responsible for using light to train the body clock?
Retinal ganglionic cells
non rod and non cone cells
Where do the retinal ganglionic cells transmit to?
Suprachiasmatic nucleus
If you have been sleep deprived, how much sleep can be made up?
1/3rd
All non-REM
What process peaks during sleep?
Cell division
Lack of sleep affects which region of the brain most?
Prefrontal cortex
What are some of the prefrontal effects of sleep deprivation?
Irritable and suspicious
Visual illusions
Microsleeps and lapses n concentration
An afternoon nap of ____ minutes is equivalent to ____ minutes overnight?
15 mins = 90 mins
Give some symptoms of non-REM parasomnias:
Confusion arousals Sleep walking Sleep terrors / paralysis Bruxism Restless legs and PLMS
What are the common characteristics of Narcolepsy?
- Daytime sleepiness
- involuntary - Cataplexy (loss of muscle tone)
- Hypnagogic hallucinations
- Sleep paralysis
- RBD
What investigations can be done for Narcolepsy?
Actigraphy and sleep diary
Overnight polysomnography
Multiple sleep latency test
How is a multiple sleep latency test carried out?
4 twenty five min naps scheduled 2 hours apart
Record of EEG, muscle activity and eye movement
Measures time from start of a daytime nap to the first signs of sleep
Why might you do a lumbar puncture in a patient with potential Narcolepsy?
CSF hypocretin levels which are low (< 110pg/ml) are consistent with narcolepsy
How is Narcolepsy managed?
Sleep hygiene, lifestyle changes and CNS stimulants
List some examples of CNS stimulants used 1st line in Narcolepsy?
Modafinil
Armodafinil
List some CNS stimulates used 2nd line in Narcolepsy?
Dexamphetamine
Methylphenidate
What scale is used to measure the level of residual sleepiness / monitor patients with Narcolepsy?
Epworth Sleepiness Scale
