sleep disorders

Question 1

what chemicals control wakefulness

Answer 1

NE, serotonin, dopamine, histamine, ACh, Hypocretin (orexin)

Question 2

what chemical induces NREM sleep

Answer 2

GABA

Question 3

stages of sleep and their eeg waves

Answer 3

Awake eyes open (beta [high frequency, low amp]), awake eyes close (alpha), N1 (theta), N2 (sleep spindles and K complexes), N3 (slow wave, delta), REM (beta)

Question 4

general features of sleep cycle throughout the night

Answer 4

90 min cycles, Longer REM periods as night goes on.

Question 5

pathway from eye to tell about sunlight

Answer 5

Melanopsin containing retinal ganglion cells via retinohypothalamic tract to SCN. Via superior cervical ganglion to pineal gland. Melatonin to receptors on SCN

Question 6

Role of VLPO

Answer 6

induce sleep by releasing GABA and inhibiting cholinergic and aminergic regions (but not completely turning them off)

Question 7

REM-on neurons

Answer 7

held in tonic inhibition by aminergics. When aminergics fall silent throughout the night REM sleep is initiated. Also produce the atonia of REM.

Question 8

During which state do we see sleepwalking, night terrors, bedwetting? Atonia? Erections?

Answer 8

N3; REM, REm

Question 9

what is the principle neuromodulator during REM? what neruomodulator reduces it?

Answer 9

ACh. NE

Question 10

Features of REM sleep

Answer 10

pulse and respiration increased and variable, extraocular eye movements due to paramedian pontine reticular formation. It’s like sex: ^ pulse, penile/clitoral tumescence, decrease frequency with age

Question 11

features of sleep of depressed patients

Answer 11

Decreased slow wave sleep and REM latency. Increased REM early in cycle and total REM. Repeated nighttime awakenings and early morning awakening

Question 12

four criteria of restless legs syndrome

Answer 12

urge to move legs, worsens with times of rest. relieved with movement. worse in evening than day

Question 13

most common causes of secondary RLS

Answer 13

iron deficiency anemia, drug induced

Question 14

cause of narcolepsy

Answer 14

loss of hypocretin secreting neurons

Question 15

Characteristics of narcolepsy

Answer 15

daytime sleepiness. Hypnagogic or hypnopompic hallucinations. Sleep cycle starts with REM. Cataplexy (atonia following emotional stimulus).

Question 16

Sleep terror disorder: occurs during what stage? different from nightmares?

Answer 16

Slow wave sleep. No memory of arousal. Nightmares in REM sleep you remember the scary dream

Question 17

treatment of narcolepsy

Answer 17

daytime stimulants (amphetamines and modafinil) and nighttime sodium oxybate (GHB)

Question 18

REM behavior disorder

Answer 18

enactment of dreams (hitting, defending, etc)

Question 19

tx for advanced sleep phase disorder

Answer 19

sleep schedule planning; timed light exposure (~17 hours after waking), melotonin

Question 20

tx for delayed sleep phase disorder

Answer 20

planned sleep schedules; time light exposure (just after core body temp hits minimum); melatonin about 10 hrs after waking. No hypnotics

Question 21

tx for Non 24 hr sleep wake disorder

Answer 21

Blind: melatonin 1 hr before bedtime. Sighted: melatonin, sleep schedules, light exposure on awakening

Question 22

short term insomnia is due to___. Chronic is due to___

Answer 22

illness, stress; excessive time in bed, napping, conditioning