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Neuroscience > Sleep and Hypnotics > Flashcards

Sleep and Hypnotics 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

Hierarchy of awakeness

A

Alertness > sedation > hypnosis > obtundation > stupor > coma > death

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3
Q

Obtundation

A

Only painful stimuli will make you conscious again

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4
Q

Sleep is important for…

A

Restoration
Homeostasis
Memory consolidation

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5
Q

Electroencephalogram

A

Used to record brain activity
Activity of populations of neurons measured using amplitudes
Reveals synchrony of neuronal activity
Frequencies = how fast neurons are firing

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6
Q

δ waves

A

Deep dreamless sleep
< 4Hz

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7
Q

θ waves

A

Light sleep, dreaming, mental imagery, mediation, memory
4-7 Hz

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8
Q

α waves

A

Conscious relaxation, mental visualisation
8-13 Hz

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9
Q

β waves

A

Awake, alert, concentration, cognition, motor activity, navigation
> 14Hz

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10
Q

γ waves

A

Memory encoding and recall, attention, predictions, cognitive processing

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11
Q

REM

A

Rapid eye movement
Occurs for about 20 mins at a time
Associated with dreaming
β waves

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12
Q

Non-REM

A

Other 4 stages
Stages last for 60-90 minutes total.
Cycle repeats 4-6 times
Stage 4 and stage 3 are lost throughout the night

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13
Q

Awake

A

α and β waves

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14
Q

Stage 1 sleep

A

θ waves
Transitional, lasts 5 mins
Starting to fall asleep
Nerve cells start to become synchronised

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15
Q

Stage 2 sleep

A

Spindles
K-complexes
5-15 minutes
Deeper sleep

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16
Q

Stage 3 sleep

A

δ waves
5-25 mins
All movements are absent
Restorative sleep

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17
Q

Stage 4 sleep

A

δ waves
20-40 mins
Deep sleep
Large amplitude
Slow waveform

18
Q

Autonomic activity in sleep

A

Sympathetic dominates during REM
Non-REM is a rest period - parasympathetic

19
Q

Important areas for controlling sleep

A

Reticular activating system
Thalamus

20
Q

Reticular activating system

A

A group of nuclei in the brainstem
Brain stem lesions result in coma and sleep
Brain stem stimulation induces wakefulness

21
Q

Thalamus and sleep

A

Thalamic stimulation induces sleep
Thalamus decouples the cortex from the rest of the brain so that it can rest
Thalamo-cortical input controls sleep

22
Q

Mechanism of sleep

A

Ascending RAS (neurotransmitters)
Increased firing of these neurons = awakening
Decreased firing of these neurons = falling asleep

23
Q

Ascending reticular activating system

A
  • Locus coeruleus – noradrenaline
  • Raphe nuclei – serotonin
  • Brainstem/forebrain – acetylcholine
  • Midbrain – histamine
24
Q

Increased firing of RAS = awakening

A
  • Orexin neurons in hypothalamus increases firing of RAS and histamine
  • Thalamus generates non-rhythmic activity
  • Cortex entrained into fast waking activity.
25
Q

Decreased firing of RAS = falling asleep

A

RAS/histamine inhibited by GABA/galanin neurons in the hypothalamus

26
Q

REM-on cells are…

A

Cholinergic
Neurons in brainstem

27
Q

REM-off cells are…

A

Serotoninergic and noradrenergic
Brain stem neurons

28
Q

What drives the change to REM or active sleep?

A

Switching on of acetylcholine

29
Q

Sleep disorders

A

Transient insomnia
Short term insomnia
Chronic insomnia
Fatal familiar insomnia (rare prion disease)

30
Q

Insomnia

A

Difficulty going to sleep
Difficulty staying asleep
Waking up feeling as if you didn’t sleep

31
Q

What are hypnotics

A

Drugs used to induce and maintain sleep
Should be used short term and intermittently
Aims to shorten time to sleep and length of sleep without supressing the cycle.

32
Q

Benzodiazepines as hypnotics

A

Problems with tolerance and dependence, and rebound insomnia
Long and short acting depends on the metabolism of the drug

33
Q

Non-benzodiazepines as hypnotics

A

z drugs
May have sub-unit specificity
Potentially fewer side effects

34
Q

Barbiturates and barbiturate-like hypnotics

A

Rarely used now, now mainly used by vets to put animals down
Not as safe in overdose as benzodiazepines

35
Q

Orexin antagonists as hypnotics

A

Orexin switches on the RAS
So supressing it can be hypnotic

36
Q

Histamine H1antagonists or inverse agonists as hypnotics

A

These are over the counter sleep remedies

37
Q

Gamma hydroxybutyrate as hypnotic

A

Naturally occurring
May be a GABAB-agonist or metabolised to GABA

38
Q

Melatonin receptor agonists as hypnotics

A

May reset disturbed circadian rhythms

39
Q

Narcolepsy

A

Pathological increase in sleep, (opposite to insomnia)
Sudden onset of sleep episodes and loss of motor control (cataplexy)
May involve reduced numbers of orexin neurones – loss of RAS activation

40
Q

Treatment of narcolepsy

A

Stimulant drugs e.g. methylphenidate, modafinil, amphetamine-related
Antidepressants - SSRIs, SNRIs, TCAs
Sodium oxybate – (GHB)
Orexin agonists?

Neuroscience (23 decks)

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