Sleep Disorders Flashcards
What is the purpose of the VLPO (Ventrolateral Preoptic area)
Sleep center
How does VLPO affect sleep?
Increased GABA and Galanin activity, and turns off histamine based TMN wakefullness half of the switch
What is the function of the MNPO (median preoptic area)
Fires mostly as one drifts into sleep
What is the function of the VLPO
Fires while asleep to maintain sleep
What controls REM
LDT/PPT (Laterodorsal and Pedunculopontine tegmental nuclei) - Ach Firing
How is Atonia achieved?
LDT/PPT stimulate neurons in medulla that release GABA and glycine into spinal motor neuron tracts
What do Serotonin, Norepi, Dopamine have in common
all fire to some degree suppressing ACh, allowing process of sleep stages 1-4 t/o night
What do somnogens do?
Knock you the fuck out
How does caffeine keep you awake
Caffeine displaces adenosine on its receptor, promoting wakefulness
What stimulates melatonin release, and from where?
Lack of light via optic nerves signals suprachiasmic nuclei of hypothalamus to release melatonin
What genes control the circadian clock?
CRY, CLOCK, BMAL1, PER1/2/3
What are Zeitgebers
Exogenous melatonin, caffeine, alcohol, light, food, exercise, social interaction all modify our clock
Name sleep drive signals
Adenosine, Clock Genes, GABA, Galantin, Melatonin
Name circadian alerting signals
Norepi, Dopamine, Serotonin, Orexin, Histamine
Describe Insomnia
Difficulty maintaining or initiating sleep for 1 month, next day consequences, no exteernal etiology, treat with sleeping pills and sleep hygiene
Describe Hypersomnia
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)
Describe Narcolepsy
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
What is Cataplexy
Drop attack from muscle tone loss
Should you give people with breathing related sleep disorders GABA, sleeping pills, percocet, xanax or alcohol?
YES. (but actually no, definitely not)
What is Advanced Type Circadian Rhythm Sleep Disorder?
Mostly with elderly, fall asleep too early and wake up too early
What is Delayed Type Circadian Rhythm Sleep Disorder?
jet lag mostly, fall asleep too late, wake up too late
What is Nocturnal Myoclonus
unconscious leg movements now called periodic limb movement disorder (PLM)
What is Restless Legs
Creeping sensations, conscious movement occurs, treated with Dopamine Receptor Agonists
What is the difference between Sleep terror and night mares?
Sleep terror patients awake disoriented, not consolable, with no memory of the events, happen in first 3rd of the night
What is Somnambulism?
Sleepwalking
What is Somniloquy?
Sleeptalking
What is REM sleep behavior disorder?
loss of atonia during REM where patients act out their dreams, especially men and especially violent dreams. treat with Dopamine Receptor D2 agonists
What does hypnopompic mean? hypnogogic?
hypnopompic- upon falling asleep
hypnogogic- upon waking up
