Sleep and hypnotics Flashcards

1
Q

What is sleep?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is obtundation?

A

a state of consciousness from which only painful stimuli will return the patient to full consciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Functions of sleep?

A

Restorative, protective adaptation, metabolism/weight homeostasis, memory consolidation and integration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is restored during sleep?

A

cortical recovery and tissue repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why is sleep a protective adaptaiton?

A

protection from nocturnal predators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does an electroencephalogram (EEG) record?

A

The activity of populations of neurons in the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does the frequency of an EEG show?

A

How fast the neurons are firing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does the amplitude of an EEG show?

A

The amount of neurons firing in synchrony

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does an EEG sum show?

A

The summed activity from multiple electrodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does it mean for nerve cells to be synchronised?

A

They are all firing together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the amplitude and frequency characteristics of desynchronised neurons?

A

Fast wavelength, low amplitude

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the amplitude and frequency characteristics of synchronised neurons?

A

Slow wavelength, large amplitude

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Delta rhythms?

A

Slow (4Hz) and large amplitude, deep sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Theta rhythms?

A

SLow (4-7Hz), light sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Alpha rhythms?

A

Fast ish (8-13Hz), conscious relaxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Beta rhythms?

A

fastest (>14Hz), awake and alert

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Gamma oscillations?

A

Memory encoding, recall and attention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Two categories of sleep?

A

Rapid eye movement (REM) and non-rapid eye movement (NREM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

REM characteristics?

A

~20 mins, dreaming

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

NREM characteristics

A

60-90 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What happens to the length of NREM stages as you progress through the night

A

gets shorter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What happens to the length of REM stages as you progress through the night

A

gets longer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Awake rhythms?

A

alpha and beta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How long does stage one NREM sleep last?

A

5 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Type of rhythms in REM sleep?

A

beta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Stage 1 NREM characteristics?

A

5 mins, theta rhythms, starting to fall asleep, nerves begin to become synchronized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Stage 2 NREM characteristics?

A

1-15 mins, spindle and k complex rhythms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Stage 3 NREM characteristics?

A

5-25 mins, no eye/body movements, delta rhythms, restorative sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Stage 4 NREM characteristics?

A

Deep sleep, 20-40 mins, delta rhythms

30
Q

What is the EEG of REM sleep similar to?

A

an active, waking brain

31
Q

When does dreaming occur?

A

REM sleep

32
Q

What is REM sleep referred to as?

A

An active, hallucinating brain in a paralysed body

33
Q

What kind of nerve activity predominates in REM sleep?

A

sympathetic

34
Q

What is increased in REM sleep as a result of sympathetic activity?

A

Heart rate, respiration rate and blood flow to the penis

35
Q

Changes in NREM sleep?

A

muscle tension reduced, temp lowered, energy consumption lowered, more parasympathetic activity

36
Q

What area of the brain is important for control of sleep?

A

Reticular activating system

37
Q

What are thalamo-cortical inputs used for?

A

controlling sleep

38
Q

What happens if you stimulate the reticular activating system in the brainstem?

A

wake up an animal

39
Q

Which brain areas make up the reticular activating system?

A

Locus coeruleus, raphe nuclei, brainstem/forebrain, midbrain

40
Q

What are all the areas that are part of the RAS involved in?

A

Amine NT secretion

41
Q

Increased firing of the RAS neurons is associated with?

A

waking up

42
Q

Decreased firing of the RAS neurons is associated with?

A

falling asleep

43
Q

Amine NT associated with locus coeruleus?

A

noradrenaline

44
Q

Amine NT associated with raphe nuclei?

A

serotonin

45
Q

Amine NT associated with brianstem/forebrain?

A

ACh

46
Q

Amine NT associated with midbrain?

A

histamine

47
Q

What is the activity of the RAS regulated by?

A

Hypothalamus

48
Q

Which neuropeptide is expressed in the hypothalamus that helps regulate the RAS?

A

orexin

49
Q

What does orexin do?

A

Stimulates RAS activity

50
Q

What causes decreased firing of RAS neurons

A

GABA

51
Q

What are “REM on” neurons?

A

cholinergic neurons in the brainstem

52
Q

What are “REM off” neurons?

A

Serotonergic and noradrenergic neurons in the brainstem

53
Q

RAS thalamus cortical interactions of an awake brain?

A

Awake–> RAS activates thalamus–> thalamus generates non-rhythmic activity–> cortex entrained into fast waking activity

54
Q

RAS thalamus cortical interactions of an asleep brain?

A

Asleep–> RAS activity switched off–> thalamus generates rhythmic activity–> coretex entrained into slow sleep rhythms

55
Q

Possible effects of insomnia?

A

Difficulty getting to sleep, difficulty staying asleep or feeling sleepy when having had sleep

56
Q

What do drugs that can help you sleep target?

A

GABA

57
Q

Why is GABA targeted by sleepy drugs?

A

GABA can inhibit the RAS,

58
Q

What is decreased activity of RAS associated with?

A

Falling asleep

59
Q

What kind of modulators of GABAa are benzodiazepines?

A

allosteric

60
Q

Nitrazepam and flurazepam are?

A

Long acting benzodiazepines

61
Q

Loprazelam and temazepam are?

A

Short acting benzodiazepines

62
Q

What differentiates the acting time of benzodiazepines used to treat sleep issues?

A

The metabolism time of them (short acting are metabolized quickly)

63
Q

What are the Z drugs?

A

Zolpidem, zolpiclone, zalpeon

64
Q

Action of z drugs?

A

bind at GABA and enhance endogenous activity of GABA

65
Q

What are orexin antagonists used for?

A

hypnotics

66
Q

Where is melatonin secreted from?

A

pineal gland

67
Q

What does melatonin regulate?

A

circadian rhythms

68
Q

Rising melatonin levels means?

A

Need to go to sleep

69
Q

Narcolepsy?

A

Pathological increase in sleep, sudden onset of sleep and sudden loss of motor control

70
Q

What may cause narcolepsy?

A

Reduced numbers of orexin neurons, loss of RAS activation