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Neurology Year 3 > Sleep > Flashcards

Sleep Flashcards

1
Q

What is sleep?

A

A normal recurring reversible state in which you loose the ability to respond to the external environment.
Not fully aware of self but able to respond to stimuli

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2
Q

Non REM sleep

A

More common at the beginning of the night

Some non narrative images

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3
Q

What proportion of sleep for the young in NREM?

A

3/4

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4
Q

What does an EEG show in NREM?

A

Synchronised rhythmic activity

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5
Q

Describe the physiological state found in NREM.

A

Partial muscle relaxation
Reduced cerebral blood flow
Reduced HR BP Tidal volume

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6
Q

What does REM stand for?

A

Rapid Eye Movement

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7
Q

Describe REM sleep.

A

Mostly at the end of the night.

Narrative dreaming

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8
Q

What does an EEG show in REM?

A

Fast activity

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9
Q

Describe the physiological state found in REM.

A

Atonic muscles except diaphragm and extra ocular
Increased cerebral blood flow
Impaired thermal regulation
Increase active shown on brain fMRI

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10
Q

Why is deep sleep essential?

A

Allows the cortex to recover

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11
Q

If you are sleep deprived and finally manage to fall asleep for a short period what form of sleep is prioritised?

A

Deep sleep

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12
Q

What is the function of REM sleep?

A

Mainly plays a roll in brain development

Substitute for stimulation from the external environment

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13
Q

REM sleep is indispensable.

A

False it is likely to be dispensable as Dolphins don’t have an REM cycle and drugs such as Tricyclics suppress it.

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14
Q

Describe the sleep of a neonate.

A

16hrs a day roughly a sleep.

50% is REM in order to provide enough stimulation to the developing brain.

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15
Q

As you get older the proportion of REM sleep you experience …….

A

Decreases

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16
Q

Describe the sleep of an elderly person.

A

Increased awakening during the night
Naps throughout the day
REM is reduced
Overall time asleep is reduced

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17
Q

What three things dictate if you can fall asleep?

A

Homeostatic
Emotional
Circadian rhythm

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18
Q

What is the homeostatic factor in sleep?

A

Longer you are awake the more sleepy you get as you build up a sleep debt.

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19
Q

What is the emotional factor in sleep?

A

Need to be in a state of relaxation ad comfortable enough to sleep.

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20
Q

What is the circadian rhythm?

A

Your internal body clock controlled by the light .

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21
Q

What length cycle does your body clock run?

A

25 hours

22
Q

What is the sleep pattern on an adolescent?

A

Delayed

23
Q

What is the sleep pattern of the elderly?

A

Early

24
Q

What else does your circadian rhythm control?

A

Appetite
Thermoregulation
Hormone regulation
Alertness

25
Q

How does light affect your circadian rhythm?

A

Retinal ganglion cells enervated which project to the suprichiasmatic nucleus

26
Q

What cells make up the retinal ganglion cells involved in the circadian rhythm?

A

Non cone Non rod cells

27
Q

What colour light particularly affects your circadian rhythm?

A

Blue light

28
Q

After 5 days of no sleep why is your endurance in exercise reduced?

A

Sleep has no recorded impact on your physiological state your endurance is reduced due to psychological fatigue.

29
Q

Describe the affect of sleep on your body repairing itself.

A

No affect on muscle recovery

Tissue repair is increased

30
Q

Why is tissue repair increased during sleep?

A

Release of sleep related growth hormone SRgh

31
Q

Which areas of the brain require the most sleep?

A

Cortical regions of the brain controlling complex function

32
Q

When awake can regions of the brain rest whilst not in use?

A

No the cortex stays in a state of quiet readiness

33
Q

What are some of the affects of prolonged sleep deprivation?

A

NO psychcosis

Irritable, Suspicious, Visual illusion, Loss of concentration, Visual illusions, Reduced alertness

34
Q

Which region of the brain is responsible for most the symptoms of sleep deprivation?

A

Prefrontal

35
Q

How does sleep kill?

A

Not directly
Most accidents occur around 4am.
reduced alertness communication and decision making skills.

36
Q

What is an acceptable duration of sleep?

A

7-7.5 hours

37
Q

What is the ideal duration of nap and how much normal sleep is it worth?

A

15 mins is equivalent to 90 mins during the night

38
Q

Describe parasomnia during REM sleep.

A

None of the usually atonia.
Interact with the dreams e.g simple movement kicking etc
Occurs in last 1/3 of the night

39
Q

Describe parasomnia during NREM

A

Complex behaviours

Between waking up and actually being awake

40
Q

What are the main symptoms on narcolepsy?

A 
Daytime sleepiness
Cataplexy
Hypnagogic hallucinations
RBD - REM behaviour disorders
Sleep Paralysis
41
Q

Describe daytime sleepiness associated narcolepsy.

A

Involuntary and irresistible somnolence that can occur during any activity.

42
Q

What is cataplexy?

A

Loss of all muscle tone triggered by severe and sudden emotion
Jaw weakness and collapsing

43
Q

What proportion of narcolepsy patients present with cataplexy?

A

70%

44
Q

Epidemiology of Narcolepsy.

A

M:F 1:1

Onset has two peaks 15y to 36y

45
Q

When do hypnagogic hallucinations occur with narcolepsy?

A

Occurs at the onset of sleep

46
Q

What are hypnogogic hallucinations?

A

Very vivid and lucid dreams

47
Q

What are RBD REM behaviours disorders?

A

Acting out of dream

48
Q

What is the social impact of narcolepsy?

A

Reduced social and academic outlook
Reduced employability
Social embarrassing

49
Q

What investigations should be undertaken for narcolepsy?

A

Overnight polysomnographs
Multiple sleep latency tests
Lumbar puncture

50
Q

What is observed in the multiple sleep latency test?

A

REM sleep is reached much faster

51
Q

What is seen on lumbar puncture in narcolepsy?

A

Increased hypocretin

Neither specific or sensitive

52
Q

If someone with narcolepsy is a driver what must happen?

A

Not allowed to drive until control is achieved

Permanently excluded from a type 2 licence

Neurology Year 3 (29 decks)

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