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Neuroscience > Sleep Disorders > Flashcards

Sleep Disorders Flashcards

1
Q

How does the Ventrolateral AND Median Preoptic Center act as the “off” switch?

A
  1. It increases GABA and Galanin activity

2. It turns off Histamine based TMN (Tuberomammillary nucleus) wakefulnesss

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2
Q

When does VLPO/MNPO fire?

A

aLL OR NONE FIRING during NREM

It is silent during wakefulness

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3
Q

Differentiate the roles of MNPO and VLPO? Explain as a function of timing of firing

A

MNPO puts you to sleep and VLPO keeps you asleep (MNPO fires mostly as one drifts into sleep while VLPO fires while asleep)

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4
Q

Where does the transmitter fibers of MNPO and VLPO project?

A

To Arousal Centers (like LC, PAG, LDT/PPT, DR, Orexins)

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5
Q

What molecule peaks during REM sleep?

A

Acetylcholine

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6
Q

What molecules does ACh feedback inhibits during ReM sleep?

A

5HT, NE, DA…

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7
Q

During what stage of sleep is desynchronized firing similar to wakefulness observed?

A

REM

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8
Q

How is REM sleep induced atonia achieved?

A

GABA and GLY are released into SC MN tracts by stimulated neurons in the medulla

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9
Q

What molecule increases while awake due to ATP breakdown?

A

Adenosine

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10
Q

What is Adenosine’s relationship to sleep?

A

Adenosine stimulates the VLPO sleep center and yield s inhibitory feedback to wakefulness centers

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11
Q

What governs Adenosine build up?

A

Astrocytes

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12
Q

When do you restore ATP?

A

DURING SLEEP

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13
Q

What pathway does caffeine interfere with to prevent sleep?

A

It interferes with the homeostatic sleep drive by binding to adenosine receptors (Adenosine usually activates neurons that promote sleep )

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14
Q

What stimulates melatonin release from hypothalamus? from what nuclei?

A

Lack of light, suprachiasmic nuclei

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15
Q

What controls the Circadian clock and how?

A
  1. Genes and proteins* cause clock to go faster or slower or be synchronized.
  2. Zeitgebers (exogenous melatonin, caffeine, OH, Light, food, exercsie/activity, social interaction)
  • Cycle flips back and forth because it takes 24 hours to build up enough concentration of the proteins
    examples: CRY, CLK, BMAL, PER
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16
Q

What are 3 common sleeping pills

A

Antihistamine
Blood Pressure Pills
GABA agonists

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17
Q

Going to bed at the same time, getting rid of stimuli such as a clock ina room and cold T is a form of Psychotherapy known as…

A

Sleep Hygiene

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18
Q

What are some key diagnosing factors of Insomnia?

A
  • Patient has difficulty initiating or maintaining sleep
  • Patient wakes up early morning
    Non-restorative sleep for 1 month
  • Next day consequences of being tired upon awakening
  • No organic, psychologic, or substance causes
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19
Q

Sleep Deprivation leads to decrease of brain activity in what lobe? what are the effects?

A

Frontal Cortex has reduced activity (72 hours deprived> 67% less activity)

In addition to prefrontal cortex, decrease is also seen in the Ant. Cingulate Gyrus and Thalamus.

20
Q

What sleep disorder is characterized by excessive daytime sleepiness or inability to maintain wakefulness?

A

Hypersomnia

21
Q

What is the typical prescription for Insomnia?

A

Sleeping Pills and Sleep Hygiene

22
Q

What is the typical prescription for Hypersomnia?

A

Stimulants and wakefulness hygiene

23
Q

Should you block or push up RAS in Hypersomnia? Insomnia?

A

Push up, Block

24
Q

Should you block or promote Orexin and SCN system in Hypersomnia?

A

Promote

25
Q

What are the key clinical manifestation in patients suffering from Narcolepsy?

A
  • Daily Sleep attacks x 3 months (Falling asleep with no warning)
  • Cataplexy (sudden loss of muscle tone) leading to drop attacks (sometimes triggered by huge emotional output)
  • Hallucinations
  • No REM latency (no delay)
  • Sleep Paralysis is common- eyes open, can’t move like a seizure
26
Q

Contrast Hypnopompic and Hynogogic

A

Pompic- upon/right before awakening

Gogic- upon/right before sleeping

27
Q

What is treatment for Narcolepsy?

A

Stimulants and Sleep Hygiene (very effective to sleep for 2 hours every 20 minutes)

28
Q

What are some secondary diseases that result from breathing related sleep disroders?

A

Insomnia and Hypersomnia

29
Q

What are the two types of apnea?

A

Central: Brainstem forgets to signal bereathing
Obstructive: airway atrophy blocks air from passing tissues

Increased age and weight are RF for obstructive apnea

30
Q

What is a typical prescription for breathing related sleep disorders?

A

Avoid sedatives
Take CPAP (mask that keeps airways open)
Wear Dental devices ( mouth guards that keep jaw pushed forward)
Surgery as a last resort to keep open airway via carving out tissues

31
Q

What drugs must you NOT give to apnea patients?

A

GABA , sleeping pills, and ALCOHOL b/c it will cause death as patients will lose breaths in sleep

32
Q

Jet Lag disorder is an example of what sleep disorder?

A

Circadian Rhythm Sleep Disorder (Delayed Type- fall asleep way too late and wake up way to o late)

33
Q

How does Circadian Rhythm Disorder lead to in/hypersomnia?

A

Sleep-wake cycle mismatch, shift , or synchrony

34
Q

In Advanced type, which patients are most common and when do they sleep/wake?

A

elderly patients often go to bed too early and wake up too early

35
Q

What is prescribed to patients of Circadian Rhythm Sleep disorder?

A

Sleep Scheduling,
Benzodiazepines,
Melatonin, exercise(in the morning), stimulants, or light therapy, sleeping pills

36
Q

Patients suffering from Nightmare Disorder/ Dyssomnia have what symptoms

A

Nocturnal Myoclonus- Periodic Limb movement, restless leg syndrome (creeping sensations-conscious movement)

37
Q

The disorder with long, frightening dreams occurs in what population most and often during what stage of sleep?

A

Children, during REM sleep

38
Q

Sleep Terror Disorder/sleepwalking disorder is characterized by what manifestations?

A
  • Awake, disoriented, not consolable
  • No memory
  • 1st 1/3 night
  • NREM 9stage 3/.4
  • SELF LIMITING
39
Q

Sleeping Pills often cause which disorder

A

Sleepwalking

40
Q

When dooes sleep walking mostly occur?

A

during 1st 1/3 of night, NREM (stage 3 or 4)

41
Q

Which sleep disorder is associated with teeth grinding? During what stage of sleep does this occur?

A

Sleep Related Bruxism, Stage 2

42
Q

What sleep disorder is characterized by loss of atonia uring REM?

A

REM sleep behavior disorder

43
Q

Which diseases are treated with Doopamine (D2) receptor agonists?

A

Restless Leg Syndrome and REM Sleep Behavior Disorders

44
Q

Somniloquy normally occurs in which population and durng what stage of sleep?

A

In children, and during all stages of sleep

45
Q

Sleep Paralyisis is characterized by an inabillityto move during which part of the sleep/wake cycle?

A

just prior to fallin g asleep or upon awakening

Neuroscience (8 decks)

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