Sleep DO Flashcards
Sleep is divided into 2 stages:
nonrapid eye movement (NREM) and rapid eye movement (REM).
________ is a state of sleep characterized by slowing of the EEG rhythms, high muscle tone, absence of eye movements, and thoughtlike mental activity.
The brain is inactive while the
body is active.
NREM
Stages of NREM
Stage 1 Disappearance of alpha wave and appearance of theta wave 5%
Stage 2 k complexes and sleep spindles 45%
Stage 3 Appearance of delta wave 12%
Stage 4 Continuation of delta wave 13%
________ is a stage of sleep characterized by aroused EEG patterns, sexual arousal, saccadic eye movements, generalized muscular atony (except middle-ear and eye muscles), and dreams. The
brain is active and the body is inactive.
REM
EEG findings for REM
Bursts of sawtooth waves 25%
Longest of all the sleep stages
Stage 2
Also called slow wave or delta sleep
Hardest to arouse
Tends to vanish in the elderly
Stages 3 and 4
Easiest to arouse
Lengthens in time as night progresses
Increased during the second half of the night
REM
The time needed before you actually fall asleep. Typically less than 15 minutes
in most individuals
Sleep Latency
The period lasting from the moment you fall asleep to the first REM period.
Lasts approximately 90 minutes in most individuals
REM Latency.
However, several disorders will shorten
REM latency; these disorders include _______ and ______
depression and narcolepsy
Characteristics of Sleep from Infancy to Old Age
- Total sleep time decreases.
- REM percentage decreases.
- Stages 3 and 4 tend to vanish.
Neurotransmitters of Sleep
• ____: Increased during sleep; initiates sleep
• ______: Increased during sleep; linked to REM sleep
• _______ Decreased during sleep; linked to REM sleep
•_____: Increased toward end of sleep; linked to arousal and wakefulness
Serotonin
Acetylcholine
Norepinephrine:
Dopamine
Chemical Effects on Sleep
• Tryptophan:_______
• Dopamine agonists: Produce arousal
• Dopamine antagonists: Decrease arousal, thus produce sleep
• _______: Suppress Stage 4 and, when used chronically, increase sleep latency
Increases total sleep time
Benzodiazepines
Chemical Effects on Sleep
• Alcohol intoxication:_____
• Barbiturate intoxication:____
• Alcohol withdrawal: _____
• Barbiturate withdrawal: ______
• ______: Shortened REM latency, increased REM time, suppression of delta,
multiple awakenings, and early morning awakening
Suppresses REM
Suppresses REM
REM rebound
REM rebound
Major depression
A disorder characterized by excessive daytime sleepiness and abnormalities of
REM sleep for a period of greater than 3 months. REM sleep occurs in less than 10 minutes. Patients feel refreshed upon awakening.
Narcolepsy
MC sx Narcolepsy
Sleep attacks
Narcolepsy
Pathognomonic sign, consisting of a sudden loss of muscle tone which
may have been precipitated by a loud noise or intense emotion. If short episode, the
patient remains awake
Cataplexy
Narcolepsy
Hallucinations that occur as the
patient is going to sleep and is waking up from sleep, respectively.
Hypnagogic and hypnopompic hallucinations
Narcolepsy
Most often occurs during awakening, when the patient is awake but unable to move.
Sleep paralysis
Tx of Narcolepsy
Forced naps at a regular time of day is usually the treatment of choice.
Medical TX of narcolepsy
When medications are given, psychostimulants are preferred.
If cataplexy is present, antidepressants
such as TCAs are preferred.
_____ is also used for narcolepsy–
cataplexy by improving the quality of nighttime sleep.
Gamma-hydroxybutyrate (GHB)
A disorder characterized by the cessation of airflow at the nose or mouth during
sleep.
These apneic episodes usually last longer than 10 seconds each. Characterized by
a loud snore followed by a heavy pause.
Sleep Apnea
