Sleep Flashcards
What are the stages of the sleep cycle?
- Stages 1-4 of the NREM sleep
- REM sleep
What occurs in NREM sleep?
- it is said to be DEEP sleep
- period of REDUCED HR, cerebral BLOOD FLOW, BP, tidal volumes
- Partial muscle relaxation
How is the EEG pattern for NREM sleep?
- synchronised, RHYTHMIC EEG activity
What occurs in REM sleep?
- increased BRAIN activity (similar to when ONE’s AWAKE)
- increased CEREBRAL blood flow
-impaired THERMAL regulation
-atonic muscles
(except diaphragm and extraocular m)
At what stage does Narrative dreaming occur and why is that convenient?
- during REM
- because its the stage at which MUSCLES in the body are ATONIC; therefore one wouldn’t be able to ACT out in their sleep
Which stage is important?
The 4 NREM stages
- time of deep sleep
- only time where lost sleep is REGAINED
- allows RECOVERY of cortex after a LONG day
When is REM sleep important?
it is important for early brain development- not needed for HIGHLY functioning brain
What changes occur throughout to one’s sleep cycle as you grow older?
- neonates: 50% REM sleep (shorter cycles)
- elderly: REDUCED REM latency (INCREASED awakenings)
What is the role of REM with memory storage?
- REM sleep CONSOLIDATES memory and “deletes” unnecessary memory
What other physiological role does REM sleep hold true, esp. with Elderly people?
- maintains IMMUNOCOMPETENCE (why older people become more become more frail)
What physiological process is NREM involved in?
- PROTEIN synthesis
- cell division and growth
What controls the circadian rhythm?
- appetite, body T*, hormone secretions
- LIGHT entrains the body clock(by using the retinal GANGLION cells)
Does sleep have any physiological role in muscle processing?`
- sleep helps with TISSUE repair; cell division peaks during sleep
- GH increases during NREM sleep
What occurs with lack of sleep?
- PREFRONTAL effects such as one gets IRRITABLE
- have VISUAL ILLUSIONS
- microsleeps and LOSS of concentration
What exact function is impaired in the Prefrontal cortex?
- routine and logical tasks are not affected!
- ALERTNESS is affected
What occurs with sleep deprivation?
- more LETHARGIC
- wgt loss (despite eating more)
- skin ulceration and injury
- ?hypothermia/reduced immunity
Sleep is a deadly killer in ______
RTAs
Most suitable hours of sleep?
7-7.5 hrs
How much is a mid-afternoon nap of 15mins worth?
90mins overnig[ht sleep
What are the 2 types of Parasomnias?
NREM and REM
What are the signs and symptoms of NREM parasomnias?
- non-dreamin
- confusional arousals
- sleep walking, TERRORS
- BRUXISM—grind teeth
- RESTLESS LEGS
What is seen in REM parasomnia? And in whom?
- in latter 1/3 of night
- Nightmares
- sleep paralysis
- at any age; in children with PTSD or ANXIETY disorder.
Which parasomnia precedes Parkinson’s Disease?
REM parasomnias
What occurs in Narcolepsy?
- involuntary solmonence when EATING/TALKING
- HARD TO RESIST
- CATAPLEXY (70% of pts)
- hypnagogic halluncinations
- sleep paralysis
- RBD
When is the age of ONSET for narcolepsy ?
50% of adults have symptoms teenager
What is Narcolepsy a/w?
- REM sleep Behaviour d/o (RBD)
What IVX are done for Narcolepsy?
- sleep test (Overnight Polysomnography)
- Multiple sleep Latency test (4 twenty-five min NAPS schedules 2 hrs apart )——-record EEG, muscle activity and eye movement recorded
How may a LP indicate nARCOLEPSY ?
LOW CSF hypocretin levels (<110pg/ml)
Name examples of REM sleep behaviour d.o.
D.t to LOSS of muscle paralysis during REM sleep (seen usually); person will start to act out!
- kick/ punch/slap in bed whilst still asleep
- shout/ leap out
- act out actions of dreams they clearly RECALL
RBD is often seen in what demographic.
Which 2 conditions often present with RBD?
- in men (<50 y.o)
- PARKINSON’s and MULTIPLE SYSTEM ATROPHY
How to differentiate epilepsy from NREM/ REM sleep behavioural disorder?
- conducting a Polysomnography and EEG montage
- eyes are OPEN during an epileptic seizure accompanied by a post-ictal state of confusion
Name the 3 types of dissociative disorders.
- Dissociative d.o of MOvement
- Dissociative AMNESIA
- Dissociative IDENTITY disorder
What are some symptoms of dissociation?
- amnesia
- depersonalisation
- derealisation
- identity Confusion
- indentity alteration
- loss of FEELINGS
- losing control of BODY movements
What occurs with dissociative amnesia?
- pt does NOT remember things that have happened to them (memory LAPSE)
- related to a traumatic event
How is dissociative disorder different from a psychotic patient?
- Dissociative patients are AWARE
What is obstructive sleep apnea?
- sleep d.o that causes you to stop breathing during sleep
- –random closure of airway > SNORING or CHOKING noises
What may contrubute to obstructive sleep apnea?
- sleeping on your back
- tongue falls back, narrowing the airway
