Sleep Disorders Flashcards
origin and expression of circadian rhythms
hypothalamic nuclei
- suprachiasmatic
- subparaventricular
- dorsomedial
diencephalic control of sleep onset
hypothalamic nuclei
- ventrolateral preoptic
- lateral
- tuberomamillary
basal forebrain
Pontine control of the REM-NREM cycle
Mesopontine nuclei
- laterodorsl tegmental
- pedunculopontine
- dorsal raphe
- locus coerleus
how many sleep cycles does the average adult have and how long do they last
5-6 sleep cycles
each lasts ~90minutes
what stage of sleep do most adults spend most time in
Stage 2
it is also most common to wake from
about how many sleep cycles do infants have and what accounts for half of the sleep time?
6-9 sleep cycles
half time is in REM
how does sleep correlate with age
sleep decreases with age
what are some functions of sleep
restoration
detox
preservation of energy
which stage of sleep vanishes in the elderly
REM, then Stage 3
That’s why they tend not to feel as rested
Describe Stage 0 sleep
period of wakefulness with eyes closed
Alpha waves (which decrease as drowsiness increases)
Describe Stage 1 Sleep
sleep onset stage
provides brief transition from wakefulness to sleep
mainly Beta waves and slo theta waves
~5% of total sleep
Describe Stage 2 sleep
dominated by Theta waves with K spindle complexes
teeth grinding (bruxism) occurs here
majority of sleep time (45-55%)
easiest to wake from
Describe Stage 3 Sleep
slow wave/ deep sleep
high voltage Delta waves
increased muscle tone
absent eye movements
15-20% of total sleep time
activities occurring during stage 3 sleep
sleep walking
eneuresis
night terrors
Describe REM sleep
cardiac and respiratory rate fluctuations
penile and clitoral engorgement
20-25%of total sleep time
desynchronized sleep
rapid conjugate eye movements
reduced muscle tone
what pathologic event occurs during REM sleep
Narcolepsy
what stage does dreaming occur
REM
treatment of Narcolepsy
Modafinil (weakly)
what happens during REM deprivation
interferes with performance and learning of complicated tasks
decreased attention to details
which substances are seen in deep sleep
ACH: more towards deep sleep (highest in REM)
Serotonin: more towards deep sleep
Less Norepi is seel during deep sleep
what triggers REM
ratio of ACh and Norepi
Things that could decrease REM
Benzodiazepines
High EtOH
Major Depressive Disorder (increased REM, but decreased latency)
what could happen with high EtOH during REM sleep
REM rebound
night mares
Describe REM sleep behavior disorder
dream enacting behaviors
content of action-filled or violent dreams of being attacked or trying to escape from a threatening situation
vocalizations are often loud, emotion-filled, and profane
Describe Narcolepsy
recurrent episodes of an irrepressible need to sleep
must have occurred at least 3x/ week over the past 3 months
Describe nightmare disorder
repeated extended, extremely dysphoric, and well-remembered dreams that usually involve efforts to avoid threats to survival, security, or physical integrity.
Typically occurring during the second half of sleep
Describe NREM Sleep Arousal Disorder
sleepwalking and sleep terrors—represent variations of the simultaneous admixture of elements of both wakefulness and NREM sleep, thereby resulting in the appearance of complex motor behavior without conscious awareness
usually amnesia after waking
Describe RLS
sensorimotor, neurological sleep disorder characterized by a desire to move the legs, usually associated with uncomfortable sensations typically described as creeping, crawling, tingling, burning, or itching
worse at rest and at night
Describe Insomnia Disorder
difficulty initiating or maintaining sleep, or early morning awakening with an inability to return to sleep
occurs at least 3 nights a week for 3 months
how is insomnia typically treated
- CBT
- Benzos, Z drugs
Describe hypersomnolence disorder
excessive sleepiness occurs at least 3 times a week for 3 months, as evidenced by prolonged sleep episodes, daytime sleep episodes, or difficulty being fully awake after abrupt awakening;
treatment for hypersomnolence disorder
stimulant agents: methylphenidate/ Adderall
Stimulant Antidepressants: Fluoxetine
Describe Circadian Rhythm Sleep-Wake Disorder
persistent or recurring patterns of sleep disruption that result from an altered sleep-wake schedule, or occur when the sleep-wake cycle is not correctly synchronized with a person’s daily schedule
Describe Obstructive Sleep Apnea Hypopnea
breathing repeatedly stops and starts during sleep
at least 5 episodes per hour of sleep
most common category of breathing-related sleep disorders
cannot breathe normally because of upper airway obstruction.
Describe central sleep apnea
repeated episodes of apneas and hypopneas during sleep caused by variability in respiratory effort.
These occur because the brain fails to send proper signals to the muscles that control breathing
Describe Sleep related hypoventilation
frequent episodes of shallow breathing lasting longer than 10 seconds during sleep
result of a decreased response to high carbon dioxide during sleep
Signs of Sleep deprivation
increased cortisol
increased blood pressure
inflammation
amygdala activation
transient psychotic symptoms
confusion
agitation
