Sleep and other organ systems

Question 1

Cardiac Decelerations during sleep occur at what sleep stage

Answer 1

REM sleep due to increased vagus nerve activity

Question 2

Circadian Pattern of TSH

Answer 2

Low during the day, increase at night

Question 3

What would you see on PSG if pt has depression and insomnia?

Answer 3

Short REM Latency, increased REM later at night. Early awakening

Question 4

Increase in Progesterone during pregnancy leads to what changes in sleep?

Answer 4

Increase in NREM and fatigue

Question 5

What happens to melatonin production in pregnancy

Answer 5

Increases as trimesters progress

Question 6

Prolactin effect on sleep stages

Answer 6

Increase SWS

Question 7

How does sleep apnea affect urinary frequency

Answer 7

OSA is associated with increase ANP production during sleep. This is due to atrial distension from increased negative thoracic pressure during sleep disordered breathing.

High ANP will increase urine output

Question 8

How does PAP therapy affect cardiovascular health in patients with CSA?
- AHI? EF? O2? 6MWT? Mortality? Hospitalization?
What does it NOT affect

Answer 8

CANCAP trial
- CPAP reduces AHI and basal catecholamines
- CPAP modestly improves EF, nocturnal O2, and 6MWT

CPAP does NOT affect hospitalizations or mortality

Question 9

What are the changes in respiration during sleep
- minute ventilation?
- RR?
- Hypercapnic ventilatory response?
- Hypoxic ventilatory response?

Answer 9

• minute ventilation DECREASES
• RR INCREASES
• Hypercapnic ventilatory response DECREASES
• Hypoxic ventilatory response DECREASES

Question 10

Effect of sleep deprivation on cortisol?

Answer 10

Increase

Question 11

Effect of sleep deprivation on growth hormone?

Answer 11

decrease

Question 12

Effect of sleep deprivation on on prolactin?

Answer 12

decrease

Question 13

Effect of sleep deprivation on on TSH?

Answer 13

increase
Sleep decreases TSH

Question 14

Normal cortisol rhythm
- peak
- nadir
-suppressed by what sleep stage

Answer 14

Peaks 8AM
Nadir Midnight
Suppressed by N3

Question 15

Exogenous administration of cortisol on sleep stages
- rem
- n3

Answer 15

decrease REM
Increase N3 at low dose

Question 16

GH pattern of secretion
- males
- women

Answer 16

Men do one large pulse
- women do multiple pulses

Question 17

T levels during sleep
- increase or decrease
- peak levels?

Answer 17

increase
Peaks 90 minutes prior to first REM period

Question 18

Leptin
- day vs night levels
- effect of sleep deprivation

Answer 18

highest during the night, low during the day
Decreases with sleep deprivation

Question 19

Ghrelin
- effect on sleep stages
- effect of OSA and PAP therapy

Answer 19

Promotes N3
Higher with OSA, decreases with PAP