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sleep medicine 1, 2, 3 Flashcards

1
Q

define what sleep is

A

distinct neurological state when organisms are unaware of its surroundings

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2
Q

what are the two signs to show animals are sleeping

A

dropping abdomen and drooping antennae

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3
Q

what are the three distinct states of brain activity

A
  1. wakefullness
  2. slow wave sleep NREM
  3. REM sleep also called paradoxical
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4
Q

what is the characterisation of slow wave sleep

A

the brain is tuned down and eyes are shut, unaware of our surroundings. the motor system is awake

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5
Q

what distinct stage of sleep do most parasomnias occur in

A

NREM

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6
Q

what happens during REM seep

A

the cortex is same activity as when awake but we are not aware of our surroundings, if you awake during REM you can report dreams.

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7
Q

what stage of sleep are you paralysed

A

REM

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8
Q

why are you paralysed in REM sleep

A

inhibition of the descending alpha motor neurones

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9
Q

what is lucid dreaming

A

halfway between REM and wakefulness

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10
Q

what is sleep paralysis

A

wake up from REM unable to move, paralysis is still present and motor system is not in wakefulness yet

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11
Q

slow-wave sleep has what amplitude

A

high amplitude

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12
Q

what are the four stages of NREM sleep

A
  1. drowsiness
  2. light sleep
  3. deeper sleep
  4. deepest sleep
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13
Q

what stage of NREM sleep is the first proper stage of sleep

A

light sleep (2)

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14
Q

why is NREM sleep low frequency with high amplitude

A

because the cells are synchronised cell firing

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15
Q

why is REM sleep high frequency with low amplitude

A

because the cells are desynchronised cell firing

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16
Q

How can you tell if someone is in REM sleep?

A

rapid eye movements

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17
Q

what is skeletal muscle paralysis caused by

A

inhibition of descending alpha Motor neurones

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18
Q

is sleep voluntary or involuntary

A

voluntary because we decide when to sleep. However, extreme sleep deprivation sleep is then involuntary

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19
Q

what is the 3 process system that makes us sleep

A
  1. homeostatic
  2. circadian
  3. ultradian
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20
Q

what is sleep propensity

A

the pressure to sleep

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21
Q

why do we wake up?

A

due to decrease homeostatic and circadian pressure

22
Q

what prevents the body from recouping from missed sleep

A

body clock

23
Q

how many hours on average do we spend in REM sleep

24
Q

how many hours on average do we spend in light sleep

25
what can sleep disorders be categorised by
1. disorders of initiating and maintaining sleep DIMS 2. disorders of excessive sleepiness DOES 3. parasomnias 4. circadian rhythm disturbances
26
what are the two categories of DIMS
acute or chronic
27
what are examples of DIMS
insomnia, depression, poor sleep hygiene, drug induced, fatal familial insomnia
28
what is fatal familial insomnia
very rare inherited condition, related to mad cow disease. Develops insomnia in teens and then die by mid 20's
29
what are examples of things that cause poor sleep hygiene
phones, tv, electronic distractions
30
what are the examples of primary DOES
narcolepsy, cerebral injury, idiopathic hypersomnolence
31
primary DOES are related too
related to brain disorders
32
what is idiopathic hypersomnolence
naturally sleep people
33
what is narcolepsy
an autoimmune disorder that causes a lack of orexin producing cells. this causes switches from REM to NREM = disrupted sleep
34
what are the four main symptoms of narcolepsy
1. irresistible sleepiness 2. cataplexy 3. hypnagogic hallucinations 4. sleep paralysis
35
what is cataplexy
motor inhibition of REM sleep, the patient is completely awake but there is sudden muscle weakness
36
what are examples of secondary DOES
1. obstructive sleep apnoea 2. central sleep apnoea 3. limb movement disorders
37
obstructive sleep apnoea can cause
hypertension, MI, stroke, diabetes
38
how does a person with obstructive sleep apnoea wake up
person struggles to breath, rising Co2 and lowering O2 causes the person to wake up
39
what is bruxism
a type of parasomnia, teeth grinding
40
what are examples of circadian rhythm disorders
1. delayed sleep phase syndrome 2. advanced sleep phase syndrome 3. non-entrained circadian rhythm
41
all teenagers experience what type of circadian rhythm disorder
delayed sleep phase syndrome
42
what type of circadian rhythm disorder do the elderly experience
advanced sleep phase syndrome
43
what do we look at when assessing sleep
duration, quality, architecture, associated phenomena
44
how can we assess sleep duration
1. sleep dairy 2. actigraphy 3. polysomnography
45
limitations with sleep diaries
moderately objective, sleep often underestimated
46
what is actigraphy
recording of movement when someone is sleeping, prolonged for around 6 weeks movement = wakeful little movement = sedated no movement = sleep
47
what is polysmnography
recording of physiological variables: EEG, EOG, EMG, ECG and body movement
48
how can you record respiratory polysomnography
chest wall movement air flow airway pressures
49
how can you record cardiovascular polysomnography
heart rate, heart variability, blood pressure
50
how to assess wakefulness
questionnaires, multiple sleep latency, multiple wakefulness, vigilance testing
51
what is the Epworth sleepiness scale
likelihood of falling asleep in 8 common situations normal people: 2-10 insomnia : 0-6 narcolepsy: 13-23
52
what are examples of combination tests for assessment of sleep
Berlin sleep apnoea questionnaire Pittsburgh sleep quality index

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