Sleep Disorders

Question 1

what is consciousness and unconsciousness

Answer 1

consciousness= awareness of self and environment

unconsciousness= unaware, even when stimulated

Question 2

what is non REM sleep

Answer 2

'deep sleep'
partial muscle relaxation
reduced cerebral blood flow 
reduced HR, BP and tidal volumes 
slower brain waves

Question 3

what is REM sleep

Answer 3

rapid eye movement sleep
increased brain activity
atonic muscles (profoundly relaxed) except eyes and diaphragm
cerebral blood flow increased impaired thermal regulation

Question 4

what types of dreams do you get in the different types of sleep

Answer 4

REM- narrative dreaming

Non REM- non narrative images

Question 5

when in night do you get the different types of sleep

Answer 5

start of night= Non REM

end of night= REM

Question 6

which type of sleep if more important

Answer 6

for adults deep sleep- allows the cortex to recover (protein synthesis, cell division and growth)

for babies REM sleep is more important for brain development

Question 7

what is REM a substitute for in neonates

Answer 7

wakefulness - dreams allow cortex to develop without outside engagement- they sleep for 16 hrs per day

Question 8

what are the three responses needed for sleep onset

Answer 8

homeostatic response (body needs to be tired and have been awake for long enough) 
emotional (brain has to be ready for bed) 
circadian rhythm (body clock)

Question 9

what is the role of REM sleep

Answer 9

consolidates memory, maintains immunocompetence

Question 10

when are the two circadian sleepiness peaks

Answer 10

4am

2pm

Question 11

what do circadian rhythms control

Answer 11

sleep wake, appetite, body temperature, hormone secretions, alertness

Question 12

how does light affect body clock

Answer 12

retinal ganglion cells (non rod non cone cells) projecting to suprachiasmatic nucleus are very sensitive to a specific bright blue light, this resets body clock

Question 13

how does sleep affect excercise

Answer 13

sleep helps tissue repair
sleep related growth hormone
cell division peaks during sleep

Question 14

when can the cortex rest

Answer 14

only when asleep

Question 15

what are the pre frontal effects of sleep deprivation

Answer 15

irritable and suspicious
visual illusions
microsleeps and concentration lapses
dis inhibited

Question 16

what behaviour is not affected by sleep deprivation

Answer 16

well rehearsed tasks
routine behaviour
logic tasks

Question 17

how much sleep do you need per night

Answer 17

7-8 hrs

Question 18

whats the best way to nap

Answer 18

for 15 mins at 2pm= 90 mins overnight

Question 19

what are parasomnias

Answer 19

sleep disorders

Question 20

what are the types of parasomnias

Answer 20

non rem

rem

Question 21

what are the feature of non rem parasomnias

Answer 21

non dreaming
confusional arousals
sleep walking
sleep terrors and paralysis
bruxism
restless legs and periodic limb movement disorder
can be complex behaviours (don’t confuse with dissociation)

takes brain couple seconds to wake up, bit that wakes up is primitive - fight or flight or sex, so can do these actions without remebering

Question 22

what are the features of REM parasomnias

Answer 22

often precede parkinsons
dreaming
simple behaviour
usually latter third of night

Question 23

what are the peaks of onset of narcolepsy

Answer 23

15 and 36

Question 24

is narcolepsy common

Answer 24

no

Question 25

what is the clinical presentation of nacrolepsy

Answer 25

daytime sleepiness (involuntary somnolence during eating/ talking, may be severe, impossible to resist)
cataplexy (loss of muscle tone, triggered by emotion)
hypnagogic hallucinations (hallucinations occurring at onset of sleep)
sleep paralysis (unable to move upon falling asleep or awakening with retained consciousness)
rem behaviour disorder

Question 26

what is rem sleep disorder

Answer 26

when people act out their dreams

Question 27

what sleep disorder do all patients with parkinsons have

Answer 27

rem sleep behaviour disorder

Question 28

what tests can be done to diagnose nacrolepsy

Answer 28

overnight polysomnography (overnight sleep test) 
multiple sleep latency (sees how fast someone falls asleep: 4 20 min naps 2 hrs apart, record RRG, muscle activity and eye movements) = patients with narcolepsy will fall asleep quickly and immediately go into REM sleep

can also do lumbar puncture, would expect low hypocretin levels in narcolepsy