sleep disorders Flashcards
what are the ventral lateral and median preoptic area of the hypothalamus known for?
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
when do the ventral lateral proptic area and median preoptic area of the hypothalamus fire?
during NREM, not during wakefulness
when does the ventral lateral preoptic area fire most
while we are asleep ( it keeps us asleep)
when does the median preoptic area fire most
as one drifts off to sleep ( puts us asleep)
why are we paralyzed during REM?
because GABA and glycine are released by neurons into the spinal neuron tract
and Ach is firing and therefore we become atonic
when do we have high levels of adenosine?
when we are awake (during metabolism)
when do we have low levels of adenosine?
when we are asleep
if someone is sleep deprived what happens to the propensity to sleep?
it is increased
how does caffeine counter sleepiness?
it is an antagonist to adenosine receptors it displaces adenosine therefore we don’t feel as tired
what does lack of light cause the release of?
melatonin from the suprachiasmatic nucleus of the hypothalamus
what controls the circadian clock?
genes and proteins including: CRY, CLOCK, BMAL1, PER1, PER2, PER3 some of which fluctuate on a 24 hour basis
what outside factors modify our clock?
exogenous melatonin, caffeine, alcohol. light, food, excercise/activity,social interaction
what does a build up of adenosine result in?
inhibitory feedback of wakefulness centers and stimulates VLPO sleep center so sleep occurs
how is insomnia defined?
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
how do we treat insomnia?
with sleeping pills or sleep hygiene
what area in particular is not working as well if sleep deprived?
anterior cingulate and prefrontal cortices
what is hypersomnia?
excessive day time sleepiness or inability to maintain wakefulness
how do we treat hypersomnia?
with stimulants or wakefulness hygiene
what is narcolepsy definition?
daily sleep attacks for 3 months
what is cataplexy and when can it result
cataplexy is a drop attack that occurs in narcoleptics : they lose muscle tone as they have an attack
what is hypnopompic and what type of sleep disorder can it occur in?
hallucinations upon awakening occurs in narcolepsy
what is hyponogogic and what type of sleep disorder can it occur in?
hallucinations upon sleeping occurs in narcolepsy
what can cataplexy, hyponogogic, or hypnopompic be triggered by?
can be triggered by emotional stimulus
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?
narcolepsy
how can we treat narcolepsy?
with a stimulant
if someone has a breathing related sleep disorder what shouldn’t they be treated with?
GABA based meds nor should they drink a lot of alcohol, sedatives
muscle atrophy and hypotonia is seen in what type of apnea?
obstructive sleep apnea
what are ppl with sleep apnea treated with?
CPAP,dental devices, and surgery
what is advanced type sleep disorder?
when you fall asleep to early so wake up too early as seen in the elderly
what is delayed type sleep disorder?
when you sleep too late at night and wake up too late in the day.
how do we treat sleep scheduling disorders?
with benzodiazepines, melatonin, excercise, stimulants or light therapy
what is nocturnal myoclonus and how do you treat it?
it is unconcious led movements which are treated with dopamine receptor agonist.
describe restless leg syndrome and how do you treat it?
creepy crawly sensation in legs which results in conscious leg movement which are treated with dopamine receptor agonist.
nightmare disorder is
when you have long scary dreams which you remember. they occur during REM and it goes away on it’s own ( self - limiting)
what is sleep terror disorder?
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
when does sleep walking occur?
1st 1/3 of the night, during NREM ( stage 3 or 4 ), don’t remember it occurred and it is self- limiting
what can sleepwalking be caused by?
sleeping pills
what is sleep related bruxism and how can we treat it?
teeth grinding which occurs in stage 2 and can be treated by giving a mouth guard or biting plate.
what is REM sleep behavior disorder?
loss of atonia during REM and men often act out their dreams violently
how is REM sleep behavior disorder treated?
with D2 agonists
when does sleep talking / Somniloquy ( head rocking back and forth) occur
all stages of sleep , it is self limiting
