sleep disorders

Question 1

what are the ventral lateral and median preoptic area of the hypothalamus known for?

Answer 1

the VPLO is a sleep center,

they are both involved in making you sleep because they increases GABA and Galanin activity which is inhibitory to arousal centers

and they both turn off the histamine based TMN wakefulness

Question 2

when do the ventral lateral proptic area and median preoptic area of the hypothalamus fire?

Answer 2

during NREM, not during wakefulness

Question 3

when does the ventral lateral preoptic area fire most

Answer 3

while we are asleep ( it keeps us asleep)

Question 4

when does the median preoptic area fire most

Answer 4

as one drifts off to sleep ( puts us asleep)

Question 5

why are we paralyzed during REM?

Answer 5

because GABA and glycine are released by neurons into the spinal neuron tract

and Ach is firing and therefore we become atonic

Question 6

when do we have high levels of adenosine?

Answer 6

when we are awake (during metabolism)

Question 7

when do we have low levels of adenosine?

Answer 7

when we are asleep

Question 8

if someone is sleep deprived what happens to the propensity to sleep?

Answer 8

it is increased

Question 9

how does caffeine counter sleepiness?

Answer 9

it is an antagonist to adenosine receptors it displaces adenosine therefore we don’t feel as tired

Question 10

what does lack of light cause the release of?

Answer 10

melatonin from the suprachiasmatic nucleus of the hypothalamus

Question 11

what controls the circadian clock?

Answer 11

genes and proteins including: CRY, CLOCK, BMAL1, PER1, PER2, PER3 some of which fluctuate on a 24 hour basis

Question 12

what outside factors modify our clock?

Answer 12

exogenous melatonin, caffeine, alcohol. light, food, excercise/activity,social interaction

Question 13

what does a build up of adenosine result in?

Answer 13

inhibitory feedback of wakefulness centers and stimulates VLPO sleep center so sleep occurs

Question 14

how is insomnia defined?

Answer 14

difficulty initiating or maintaing sleep , early morning awakening , non-restorative sleep for a month that isn’t due to a pathology, pyschological problem or drinking alcohol or coffee

Question 15

how do we treat insomnia?

Answer 15

with sleeping pills or sleep hygiene

Question 16

what area in particular is not working as well if sleep deprived?

Answer 16

anterior cingulate and prefrontal cortices

Question 17

what is hypersomnia?

Answer 17

excessive day time sleepiness or inability to maintain wakefulness

Question 18

how do we treat hypersomnia?

Answer 18

with stimulants or wakefulness hygiene

Question 19

what is narcolepsy definition?

Answer 19

daily sleep attacks for 3 months

Question 20

what is cataplexy and when can it result

Answer 20

cataplexy is a drop attack that occurs in narcoleptics : they lose muscle tone as they have an attack

Question 21

what is hypnopompic and what type of sleep disorder can it occur in?

Answer 21

hallucinations upon awakening occurs in narcolepsy

Question 22

what is hyponogogic and what type of sleep disorder can it occur in?

Answer 22

hallucinations upon sleeping occurs in narcolepsy

Question 23

what can cataplexy, hyponogogic, or hypnopompic be triggered by?

Answer 23

can be triggered by emotional stimulus

Question 24

there is almost no REM latency ( the period of time in the sleep period from sleep onset to the first appearance of REM sleep.) in what sleep disorder?

Answer 24

narcolepsy

Question 25

how can we treat narcolepsy?

Answer 25

with a stimulant

Question 26

if someone has a breathing related sleep disorder what shouldn’t they be treated with?

Answer 26

GABA based meds nor should they drink a lot of alcohol, sedatives

Question 27

muscle atrophy and hypotonia is seen in what type of apnea?

Answer 27

obstructive sleep apnea

Question 28

what are ppl with sleep apnea treated with?

Answer 28

CPAP,dental devices, and surgery

Question 29

what is advanced type sleep disorder?

Answer 29

when you fall asleep to early so wake up too early as seen in the elderly

Question 30

what is delayed type sleep disorder?

Answer 30

when you sleep too late at night and wake up too late in the day.

Question 31

how do we treat sleep scheduling disorders?

Answer 31

with benzodiazepines, melatonin, excercise, stimulants or light therapy

Question 32

what is nocturnal myoclonus and how do you treat it?

Answer 32

it is unconcious led movements which are treated with dopamine receptor agonist.

Question 33

describe restless leg syndrome and how do you treat it?

Answer 33

creepy crawly sensation in legs which results in conscious leg movement which are treated with dopamine receptor agonist.

Question 34

nightmare disorder is

Answer 34

when you have long scary dreams which you remember. they occur during REM and it goes away on it’s own ( self - limiting)

Question 35

what is sleep terror disorder?

Answer 35

not awake but screaming, yelling in sleep, doesn’t occur during REM and you don’t remember it you are in deep sleep ( NREM) and it occurs in the 1st 1/3 of the night and this is self-limiting

Question 36

when does sleep walking occur?

Answer 36

1st 1/3 of the night, during NREM ( stage 3 or 4 ), don’t remember it occurred and it is self- limiting

Question 37

what can sleepwalking be caused by?

Answer 37

sleeping pills

Question 38

what is sleep related bruxism and how can we treat it?

Answer 38

teeth grinding which occurs in stage 2 and can be treated by giving a mouth guard or biting plate.

Question 39

what is REM sleep behavior disorder?

Answer 39

loss of atonia during REM and men often act out their dreams violently

Question 40

how is REM sleep behavior disorder treated?

Answer 40

with D2 agonists

Question 41

when does sleep talking / Somniloquy ( head rocking back and forth) occur

Answer 41

all stages of sleep , it is self limiting