Sleep Disorders

Question 1

What is the purpose of the VLPO (Ventrolateral Preoptic area)

Answer 1

Sleep center

Question 2

How does VLPO affect sleep?

Answer 2

Increased GABA and Galanin activity, and turns off histamine based TMN wakefullness half of the switch

Question 3

What is the function of the MNPO (median preoptic area)

Answer 3

Fires mostly as one drifts into sleep

Question 4

What is the function of the VLPO

Answer 4

Fires while asleep to maintain sleep

Question 5

What controls REM

Answer 5

LDT/PPT (Laterodorsal and Pedunculopontine tegmental nuclei) - Ach Firing

Question 6

How is Atonia achieved?

Answer 6

LDT/PPT stimulate neurons in medulla that release GABA and glycine into spinal motor neuron tracts

Question 7

What do Serotonin, Norepi, Dopamine have in common

Answer 7

all fire to some degree suppressing ACh, allowing process of sleep stages 1-4 t/o night

Question 8

What do somnogens do?

Answer 8

Knock you the fuck out

Question 9

How does caffeine keep you awake

Answer 9

Caffeine displaces adenosine on its receptor, promoting wakefulness

Question 10

What stimulates melatonin release, and from where?

Answer 10

Lack of light via optic nerves signals suprachiasmic nuclei of hypothalamus to release melatonin

Question 11

What genes control the circadian clock?

Answer 11

CRY, CLOCK, BMAL1, PER1/2/3

Question 12

What are Zeitgebers

Answer 12

Exogenous melatonin, caffeine, alcohol, light, food, exercise, social interaction all modify our clock

Question 13

Name sleep drive signals

Answer 13

Adenosine, Clock Genes, GABA, Galantin, Melatonin

Question 14

Name circadian alerting signals

Answer 14

Norepi, Dopamine, Serotonin, Orexin, Histamine

Question 15

Describe Insomnia

Answer 15

Difficulty maintaining or initiating sleep for 1 month, next day consequences, no exteernal etiology, treat with sleeping pills and sleep hygiene

Question 16

Describe Hypersomnia

Answer 16

Excessive daytime sleepiness or inability to maintain wakefullness – next day consequences, no organic psycho or substance etiology, treat with stimulants, treat with wakefulness hygiene (don’t take 3 hour naps, be better at being awake)

Question 17

Describe Narcolepsy

Answer 17

Daily sleep attacks for 3 months with cataplexy/hypnopompic (on waking) or hyponogogic hallucinations in sleeping; no external etiology, almost no REM latency, sleep paralysis is common, treat with stimulants

Question 18

What is Cataplexy

Answer 18

Drop attack from muscle tone loss

Question 19

Should you give people with breathing related sleep disorders GABA, sleeping pills, percocet, xanax or alcohol?

Answer 19

YES. (but actually no, definitely not)

Question 20

What is Advanced Type Circadian Rhythm Sleep Disorder?

Answer 20

Mostly with elderly, fall asleep too early and wake up too early

Question 21

What is Delayed Type Circadian Rhythm Sleep Disorder?

Answer 21

jet lag mostly, fall asleep too late, wake up too late

Question 22

What is Nocturnal Myoclonus

Answer 22

unconscious leg movements now called periodic limb movement disorder (PLM)

Question 23

What is Restless Legs

Answer 23

Creeping sensations, conscious movement occurs, treated with Dopamine Receptor Agonists

Question 24

What is the difference between Sleep terror and night mares?

Answer 24

Sleep terror patients awake disoriented, not consolable, with no memory of the events, happen in first 3rd of the night

Question 25

What is Somnambulism?

Answer 25

Sleepwalking

Question 26

What is Somniloquy?

Answer 26

Sleeptalking

Question 27

What is REM sleep behavior disorder?

Answer 27

loss of atonia during REM where patients act out their dreams, especially men and especially violent dreams. treat with Dopamine Receptor D2 agonists

Question 28

What does hypnopompic mean? hypnogogic?

Answer 28

hypnopompic- upon falling asleep

hypnogogic- upon waking up