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Neurology > Sleep > Flashcards

Sleep Flashcards

1
Q

what is sleep?

A

a readily reversible state of reduced responsiveness to, and interaction with, the environment

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2
Q

what are the two types of sleep?

A

Non-REM, REM

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3
Q

what is the definition of non-REM sleep?

A

Idling brain in a movable body

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4
Q

what are the features of non-REM sleep?

A

slow, large amplitude

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5
Q

what are the EEG features of non-REM sleep?

A
  • Partial relaxation of muscles
  • Temperature and energy consumption are lowered
  • Increase in parasympathetic
  • Some non-narrative images
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6
Q

what are the 4 types of non-REM sleep?

A

N1, N2, N3, N4

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7
Q

what is the features of N1 sleep?

A

between sleep and wakefulness, brain produces theta waves, hypnagogic hallucinations (hearing and seeing things that aren’t there, repetitive movements. Boat, Tetris effect, falling), only lasts a few mins

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8
Q

what is the features of N2 sleep?

A

harder to awaken, more theta waves, sleep spindles (bursts of rhythmic brain activity – inhibit cognitive processes), K complexes (suppress cortical processes and help with memory processing), lasts 5-15 mins

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9
Q

what is the features of N3 sleep?

A

slow wave sleep, delta waves

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10
Q

what is the features of N4 sleep?

A

large EEG rhythms very difficult to wake up, sleep walking and talking

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11
Q

what is the function of non-REM sleep?

A

protein synthesis, cell division and growth, body repair + restoration

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12
Q

what is the definition of REM sleep?

A

active, hallucinating brain in a paralysed body

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13
Q

what are the features of REM sleep?

A

• Fast, low voltage fluctuations EEG activity, fMRI shows increased brain activity

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14
Q

what are the features of REM sleep?

A

Brain activity similar to wakefulness
Atonic muscles (total paralysis) - except diaphragm and extraocular muscles
Dominant control via sympathetic system
Narrative dreaming

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15
Q

what does parasympathetic stimulation in Non-REM sleep cause?

A

reduced cerebral blood flow, reduced heart rate, blood pressure and tidal volumes

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16
Q

what does sympathetic stimulation in REM sleep cause?

A

Cerebral blood flow increased, impaired thermal regulation, heart rate irregular

17
Q

what is the function of REM sleep?

A

consolidates memory, deletes unnecessary memory files, maintains immunocompetence, conserve energy in high metabolic species

18
Q

what is the order of a sleep cycle?

A

N1 → N2 → N3 → N2 → REM → N1 = Repeat

19
Q

how long is an average sleep cycle?

A

90mins

20
Q

what is the average split of REM to Non-REM?

A

75% NREM 25% REM

21
Q

what neurons are responsible for control of sleep?

A

diffuse modulatory neurotransmitter systems

22
Q

what brain stem modulators enhance REM sleep?

A

acetylcholine

23
Q

what controls the EEG rhythms of the brain?

A

Thalamus

24
Q

what is the pattern of sleep tendency?

A

2 peak

25
Q

how long is the circadian rthythym?

A

25 hours

26
Q

what is the cause of narcolepsy?

A
  • CNS Pathology – trauma, stroke, tumours, infection, cysts, MS
  • Genetics – HLA
  • Sporadic
27
Q

what are the clinical features of narcolepsy?

A 
daytime sleepiness
cataplexy
Hypnagogic hallucinations
Sleep paralysis
RBD
28
Q

how is narcolepsy diagnosed?

A

Overnight polysomnography
Multiple sleep latency test
Lumbar puncture - CSF hypocretin

29
Q

what is the pathophysiology of narcolepsy?

A
  • Cholinergic hypersensitivity
  • Serotonin or noradrenaline pathway-specific dysfunction
  • Dopamine pathway dysfunction
  • CNS histamine deficiency
  • Hypocretin (orexin) pathway dysfunction
30
Q

what is the management of Adults with Narcolepsy?

A

o Sleep hygiene + lifestyle changes (non-pharmacological treatment)
o CNS stimulants alone or in combination – modafinil, armodafinil, methylphenidate, dexamfetamine, sodium oxybate, methamphetamine

31
Q

what is the management of adults with cataplexy?

A

o Avoidance of triggers + sodium oxybate and/or antidepressants
o Monoamine oxidase inhibitors

32
Q

what is the management of Children with narcolepsy?

A

o Sleep hygiene + lifestyle changes

o Modafinil or methylphenidate

33
Q

what is the management of Children with cataplexy?

A

o Avoidance of triggers + antidepressants – fluoxetine, venlafaxine, clomipramine

Neurology (18 decks)

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