Sleep disorders and seizures Flashcards
What is the relationship between glutamate and GABA?
Glutamate is an excitatory NT– stimulates neuronal activity (CNS activation)
GABA is the primary inhibitory NT– stimulates neuronal inhibition (enhance GABA=CNS depression)
seizure activity can occur when there is an imbalance between these glutamate and GABA (too much glutamate or not enough GABA)
What is the limbic system?
a group of structures located deep within the brain responsible for emotional expression, learning and memory
-interacts with the hypothalamus, cortex and brainstem to operate our “emotional life”
How is the limbic system involved with stress?
the amygdala (part of the limbic system) plays an important role in our emotional response to stress– when we’re stressed the amygdala is activated (ex. fear and anxiety)
-fight or flight response
-people with PTSD have increased amygdala response
-people with social anxiety disorder (SAD) and panic disorder also respond more strongly in their amygdala
Define Anxiety disorders
anxiety disorders include pathological levels of anxiety that interfere with functioning and include:
-generalized anxiety disorder
-OCD
-specific phobias
-social anxiety disorder
-panic disorder
-post-traumatic stress disorder
Define sleep hygiene
a person’s bedtime routine and habits (like using screens in bed) that may interfere with sleep
What is actigraphy?
pt wears a monitor to measure motor activity during waking and sleep hours
What is polysomnography?
sleep study using oximetry, recording eye movement, muscle tension, respiration, ECG and brain waves (EEG) to test for sleep apnea
What are some complications of untreated obstructive sleep apnea (OSA)?
-hypertension
-right-sided heart failure form pulmonary hypertension
-cardiac dysrhythmias
What are some non-pharmacological sleep strategies for insomnia?
-reduce caffeine intake before bed
-avoid eating right before bed
-avoid awakening pt for nonessential tasks
-avoid afternoon naps
-decrease noise, dim lights, set appropriate room temp
-evaluate ongoing need for medications that may interfere with sleep
What is a seizure?
a sudden transient disruption in brain electrical activity caused by too much neuronal excitation
-too much glutamate or not enough GABA
-can be focal or global
-not all types are associated with loss of consciousness
What are the 3 broad categories of seizure?
1) partial (focal) seizures involves a limited portion of one brain hemisphere– loss of consciousness is not common
2) generalized (global) seizures involved both brain hemispheres– tonic-clonic seizures are a type of generalized seizures and are associated with convulsions and loss of consciousness
3) special seizure syndromes such as febrile seizure and status epilepticus
What is the acronym for seizure triggers?
STOP SEIZURE
What does the acronym STOP SEIZURE stand for?
Stress
Trauma
Overexertion
Period, pregnancy
Sleep loss
Electrolyte and metabolic issues
Illness
visualiZation disturbances, sounds or smells
Undermedicated
Recreational drugs
ETOH
What are the two categories of seizures?
-based on cause
1) provoked seizures are secondary to some other disorder (ex. prolonged fever in children, brain injury and infection, and alcohol withdrawal)
2) unprovoked seizures are those for which there are no identifiable cause
the term epilepsy is used if the seizure (regardless of type) is recurrent
Define Status Epilepticus
a seizure event lasting for more than 5 minutes– a medical emergency because it can cause significant brain injury and even death
