Sleep + Chronic Pain Flashcards
how does the body clock work?
retinal gangia cells projecting suprachiasmatic nucleus
what does non-REM sleep look like on an EEG?
synchronised and rhythmic
what type of sleep causes decreased in HR, BP and tidal volumes?
Non-REM sleep
what is nacroplexy?
daytime sleepiness - involuntary when eating or talking
what is cataplexy?
loss of muscle tone caused by emotion
what is sleep paralysis?
inability to move upon falling asleep
what investigations should be carried out to look at sleep?
multiple sleep latency test
lumbar puncture
what lumbar puncture result is consistent with Nacroplexy?
decreased levels <110
what is REM sleep?
at the end of the night
increased cerebral function and decreased thermal regulation
what does the EEG show in REM sleep?
fast activity with MRI showing brain almost at wakefulness
why is REM sleep important?
early brain development
when are NSAIDs used in chronic pain?
mainly nociceptive pain
what is the MOA of NSAIDs?
inhibition of cyclo-oxygenase with decreased prostaglandin production
what is the 2 main side effects of NSAIDs?
GI bleeding
renal toxicity
what is opioid analgesia used for?
mainly nociceptive pain
what is the MOA of opioid analgesia?
activates endogenous system
stimulates receptors in the limbic system
decreases ascending pain signal transmission in the spinal cord
What are TCAs used for in relation to chronic pain?
neuropathic pain
complex regional pain
tension headache
what is the MOA of TCAs?
inhibition of neural re-uptake of noradrenaline + serotonin
what are SSRIs used for in relation to chronic pain?
neuropathic pain
What is the MOA of SSRIs?
selectively inhibit re-uptake of Noradrenaline or Serotonin by intensifying descending inhibition
where are anti-convulsatns used for in relation to chronic pain?
neuropathic pain
what is the MOA of Gabapentin?
binds to pre-synaptic Ca2+ channels
what is the MOA of Pregbalin?
Interacts with the N-type Ca2+ channels
what is the MOA of Carbamazapine?
blocks Na+ and Ca2+ channels
what are the SE of anti-convulsants?
sedation
peripheral oedema
dizziness
weight gain
what is neuropathic pain?
inappropriate response caused by a dysfunction in the NS
what is nociceptive pain?
appropriate physiological response to painful stimuli via an intact NS
