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PA20023 > 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

What are the functions of sleep?

A

Restoring - rest, relaxation and repair, adaptation (protection from nocturnal predators), energy conservation and memory consolidation and integration.

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3
Q

What is an EEG?

A

An electroencephalogram -it records the activity of populations of neurones. It reveals synchrony of neuronal activity.

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4
Q

What does frequency in an EEG show?

A

How fast neurones are firing.

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5
Q

What does amplitude power) reflect in an EEG?

A

The number of neurones that are in synchrony.

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6
Q

What are the 5 different frequencies representing brain rhythms and functional states?

A

Delta, theta, alpha, beta and gamma.

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7
Q

What is the delta brain rhythm?

A

Deep, dreamless sleep.

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8
Q

What is the theta brain rhythm?

A

Light sleep - dreaming, mental imagery, meditation and memory.

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9
Q

What is the alpha brain rhythm?

A

Conscious relaxation, mental visualisation.

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10
Q

What is the beta brain rhythm?

A

Awake, alert, concentration, cognition, motor activity and navigation.

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11
Q

What is the gamma brain rhythm?

A

Memory encoding and recall, attention, predictions and cognitive processing.

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12
Q

What is the difference between REM and non-REM?

A

non-REM is a deeper sleep that is not associated with dreaming, whereas REM is less of a deep sleep and is associated with dreams.

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13
Q

What is the pattern of REM and non-REM sleep?

A

There are alternate periods of REM and non-REM, with each cycle having shorter and shallower non-REM periods and longer REM periods.

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14
Q

How long are the cycles of REM?

A

20-40 minutes.

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15
Q

How long are cycles of non-REM?

A

60-90 minutes.

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16
Q

What is the reticular activating system?

A

It is an area responsible for regulating wakefulness and sleep-wake transitions.

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17
Q

What happens if the reticular activating system is lesioned?

A

Coma and sleep.

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18
Q

What happens if the reticular activating system is stimulated?

A

Wakefulness.

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19
Q

What happens if the thalamus is stimulated?

A

The patient will fall asleep.

20
Q

What hormones/neurones contribute to sleep cycles?

A

Orexin neurones, cholingergic, serotonergic, noradrenergic, histamine neurones.

21
Q

What are the interactions between RAS, thalamus and cortex in an awake state?

A

The RAS activates the thalamus and the thalamus generates non-rhythmic activity. The cortex is then entrained into fast waking activity.

22
Q

What are the interactions between RAS, thalamus and cortex in an asleep state?

A

The RAS activity is switched off and the thalamus generates rhythmic activity, and the cortex is entrained into slow sleep rhythms.

23
Q

How does the activity of brainstem neurons change from REM to non-REM sleep?

A

Non-REM sleep has decreased activity, whereas in REM sleep they are completely inactive (raphe nuclei and locus coeruleus).

24
Q

What is transient insomnia?

A

Lack of sleep due to noise, shift work and jetlag.

25
Q

What can cause short term insomnia?

A

Emotional issues, stress and anxiety.

26
Q

What can cause chronic insomnia?

A

Pain, depression, alcohol abuse and breathing disorders.

27
Q

What is fatal familial insomnia?

A

A rare prion disease that causes initially mild insomnia, that can develop severely and lead to physical and mental deterioration.

28
Q

What are hypnotics?

A

Psychoactive drugs that induce sleep.

29
Q

What is the action of hypnotics?

A

They potentiate GABA inhibition by enhancing GABAa receptors.

30
Q

What is the name for common hypnotics?

A

Benzodiazepines.

31
Q

What are the problems with hypnotics?

A

There are problems with tolerance and dependence and rebound insomnia.

32
Q

What are the benefits of non-benzodiazepine hypnotics?

A

They may have subunit specificity, meaning there are potentially less side effects.

33
Q

What are some other potential hypnotics?

A

Orexin antagonists, histamine H1 antagonists, gamma-hydroxybutyrate and melatonin receptor agonists.

34
Q

What is narcolepsy?

A

A pathological increase in sleep. There is a sudden onset of sleep episodes and loss of motor control.

35
Q

What are the treatments for narcolepsy?

A

Stimulant drugs such as modafinil and methylphenidate.

36
Q

What are some examples of long acting benzodiazepines?

A

Nitraxepam, flurazepam.

37
Q

What are some examples of short acting benzodiazepines?

A

Loprazelam, temazepam, flunitrazepam.

38
Q

What are some problems with benzodiazepines?

A

Issues with tolerance and dependence and rebound insomnia.

39
Q

What are some examples of non-benzodiazepine hypnotics?

A

Zolpidem, eszoplicone, zalepion.

40
Q

What are some benefits of non-benzodiazepine hypnotics?

A

They may have less sub-unit specifity and may have less side effects.

41
Q

What are some barbiturate and barbirutate-like hypnotics?

A

Phenobarbitone, methaqualone, meprobamate. They are rarely used now.

42
Q

Give an example of an orexin antagonist.

A

Suvorexant.

43
Q

Give an example of Histamine H1 antagonists.

A

Diphenhydramine, chlorpheniramine.

44
Q

What is an example of a melatonin receptor agonist?

A

Melatonin, ramelton.

45
Q

What is gamma-hydroxybutyrate?

A

A naturally occurring drug that may be a GABAB agonist or metabolised to GABA.

46
Q

What can melatonin receptor agonists be used for?

A

Resetting disturbed circadian rhythms - due to jet lag or shift work patterns.

PA20023 (17 decks)

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