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Supporting life > sleep > Flashcards

sleep Flashcards

1
Q

which neurons are involved in wakefulness –> sleep

A

GABAergic neurons from vlpo in interior hypothalamus nucleus

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2
Q

which neurons are involved in sleep –> wakefulness

A

orexinergic neurons
cholinergic
monoaminergic

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3
Q

how many cycles or rem/non rem sleep do we go through a night?

A

4-6

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4
Q

how long do cycles last?

A

90-110

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5
Q

what form of sleep is entered first?

A

nrem

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6
Q

what does it indicate if sleep is entered through rem?

A

person is depressed, sleep deprived or has narcolepsy

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7
Q

what form of sleep dominates the first third of the night?

A

slow wave sleep

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8
Q

_______ dominate sthe last third of the night

A

REM

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9
Q

how much of a night is wakefulness?

A

normally less than 5%

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10
Q

what are some features of rem sleep?

A 
irregular heart rate
variable bp
irregular resp rate
depressed response to o2 and co2 changes
absent skeletal muscle tone
increased brain o2 consumption
poikilothermic  - body doesnt adapt to room temp changes
frequent penile tumescence, vaginal engorgement
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11
Q

what are some changes in non rem sleep?

A

decreased response to o2 and co2 changes

reduced brain o2 consumption

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12
Q

what is an intrinsic/primary circadian rhythm sleep disorder?

A

alteration of circadian rhythm

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13
Q

what is an extrinsic/secondary circadian rhythm sleep disorder?

A

misalignment between intrinsic and extrinsic signals

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14
Q

are shift work and jet lag intrinsic or extrinsic sleep problems?

A

extrinsic

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15
Q

name some intrinsic circadian rhythm sleep disorders

A

delayed sleep phase disorder
advanced sleep phase disorder
non-24 hr (blindness)
irregular (dementia)

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16
Q

true or false, in circadian problems, sleep is normal when it is at the desired time?

A

true

17
Q

what group is delayed sleep phase common in?

A

teenagers

males

18
Q

what are some clinical features of dspd?

A

unable to advance sleep onset
insomnia/excessive sleepiness
chronic
history of hypnotic use, alcohol at bed time, psych conditions

19
Q

how can dspd be treated?

A

melatonin (6 hrs before bedtime)
phototherapy
cbt

20
Q

what are some short term consequences of shift work?

A

mood disturbances

GI problems

21
Q

______ production is inhibited by light exposure

A

melatonin

22
Q

what are some long term consequences of shift work?

A

mood disorder, cardiovascular risk, cancer eg breast

23
Q

what are some effects of sleep deprivation?

A 
cognitive impairment
memory loss
hallucinations
adhd symptoms
impaired immunity
type 2 diabetes risk
heart disease
decreased reaction time
tremors
growth supression
obesiy (produce more ghrelin in deprivation)
24
Q

what is a hypnagogic hallucination?

A

occur on going to sleep

25
Q

what is the name of hallucination that occurs on waking?

A

hypnopompic

26
Q

what is a parasomnia?

A

abnormal behaviour occuring in association to sleep

27
Q

when do slow wave or nrem parasomnias occur?

A

first third of night

28
Q

describe nrem/slow wave parasomnias

A 
onset in childhood
confusionsal arousal
sleep walking
night terrors
eating disorder
sexsomnia

family history
exacerbate dby sleep deprivation, stress, alcohol, osa, fever
amnesic

29
Q

how are night terrors treated?

A 
cbt
scheduled awakening
keep room safe
pregablin
clonazepam
only wake if episode lasts >45 mins
30
Q

how can nrem parasomnias be treated?

A

cbt
antidepressants
clonazepam
melatonin

31
Q

when do rem parasomnias occur?

A

second half of night

32
Q

what can occur in a rem parasomnia?

A 
nightmares
sleep paralysis
catathrenia
loss of muscle atonia
agression
33
Q

what groups are likely to get rem sleep behaviour disorder?

A 
male
50-65
lewy body cause?
mild cognitive impairment
antidepressants
34
Q

what condition is rem behaviour disorder a predictor of?

A

parkinsons

35
Q

how can rbd be treated?

A

melatonin has good evidence

Supporting life (10 decks)

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