Sleep Flashcards

1
Q

What is sleep?

A

A normal, recurring, reversible state

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2
Q

When do you enter NREM sleeo?

A

Start of night; 3/4 of sleep for young adults is NREM

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3
Q

What is NREM sleep?

A

Synchronised, rhythmic EEG activity, partial muscle realaxation, reduced cerebral blood flow, reduced HR, BP and tidal volumes

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4
Q

Do you dream in NREM sleep?

A

Yes; non-narrative

Wake up with a strong emotion but can’t quite remember what the dream was aobtu

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5
Q

When do you enter REM sleep?

A

End of night

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6
Q

What is REM sleep?

A
EEG shows fast activitiy, fMRI shows increased brain activity 
Atonic muscles (except diaphragm and extraocular muscles), cerebral blood flow increased, impaired thermal regulation
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7
Q

Do you dream in REM sleep?

A

Yes; narrative dreaming. Muscles paralysed so you don’t act out dreams

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8
Q

Which part of sleep is most important?

A

Deep sleep; only part of lost sleep regained after sleep loss
Allows the cortex to recover after a busy day

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9
Q

What is the function of REM sleep?

A

Early brain development; substitute for wakefullness

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10
Q

Do you sleep less or more as you get older, and what type of sleep do you lose?

A

Less

REM sleep falls, REM latency increases

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11
Q

What are the 3 mechanisms that control sleep?

A

Homeostatic
Emotional
Circadian rhythm

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12
Q

What is the circadian rhythm important for?

A

Sleep-wake
Appetite
Hormone secretion

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13
Q

What biological processes occur during NREM sleep?

A

Protein synthesis

Cell division and growth

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14
Q

What biological processes occur during REM sleep?

A

Consolidates memory
Deletes unnecessary memory files
Maintains immunocompetence

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15
Q

When are the 2 peaks in sleepiness?

A

4am

2pm

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16
Q

How many hours does the normal circadian rhythm last?

A

25 hours

17
Q

What is the impact of light on circadian rhythms?

A

Non-rod and non-cone cells project to suprachiasmatic nucleus to reset the body clock every morning

18
Q

What occurs in sleep deprivation?

A

Irritable and suspicious
Visual illusions
Microsleeps and concentration lapses

19
Q

What can you still do well even in sleep deprivation?

A

Prefrontal;
Old and well rehearsed tasks
Routine behaviour
Logic tasks

20
Q

What tasks are not performed well in acute and chronic sleep deprivation?

A
Understanding complex situations and ignoring irrelevancies
Assessing risks and consequences
Dealing with the unexpected
Tracking events
Updating strategies
Communicating well
Showing lateral thought and innovation
21
Q

How much sleep do we need?

A

7-7.5hrs a night

A mid afternoon nap of 15 mins is equivalent to 90 mins overnight

22
Q

What are the different types of parasomnias?

A
NREM 
Non-dreaming
Confusional arousals
Sleep walking
Sleep terrors and paralysis
Bruxism (teeth grinding) 
Restless legs and PLMS
Complex dissociation
23
Q

When will REM parasomnias manifest?

A

Latter 1/3rd of the night

24
Q

Which condition is very closely associated with REM parasomnias?

A

Parkinson’s disease

25
Q

What is the presentation of narcolepsy?

A
Daytime sleepiness
Cataplexy
Hypnagogic hallucinations
Sleep paralysis
RBD
26
Q

What is cataplexy?

A

Loss of muscle tone triggered by strong emotion

27
Q

What are hypnagogic hallucinations?

A

Hallucinations occurring at sleep onset

28
Q

What is sleep paralysis?

A

Inability to move upon falling asleep or awakening with retained consciousness

29
Q

How is narcolepsy investigated?

A

Overnight polysomnography
MSLT; assess how quickly someone falls asleep and enters REM sleep
LP; CSF hypocretin levels with low levels consistent with narcolepsy

30
Q

What is insomnia?

A

Psychophysiological concept

Alertness around sleep