Sleep Medicine Flashcards
Acetylcholine (ACh) is……. during REM sleep
(associated with erections in men)
while Norepinephrine (NE) is……… during REM sleep
Higher
Lower
Serotonin helps to…… Sleep
Initiate
NE pathway begins in the….. , which regulates REM
sleep
Pons
Dopamine effect on sleeping
• Dopamine produces arousal and wakefulness
Origin of melatonin
Pineal gland
Melatonin production is inhibited by…
activation of
photoreceptors cells in the retina
Melatonin secretion regulates the sleep-wake cycle by
inhibiting the circadian alerting system in the
suprachiasmatic nucleus
Role of orexin in sleep
Orexin triggers wakefulness
deficiency of orexin results in sleep- state
instability, leading to sleep disorders like
Narcolepsy
EEG features in sleep stage 1
alpha dropout, vertex waves
EEG features in sleep stage 2
Spindles, vertex waves, k complexes
EEG features in sleep stage 3
Spindles, k complexes, delta waves, slow rhythm
EEG features in sleep stage 4
K complexes, very slow rhythm, delta activity
EEG features in REM sleep
Low amplitude, EMG flatness, intermittent EOG activity
Benzodiazepines cause limited decrease in…. and
Stage…. sleep.
REM, STAGE 3
Moderate alcohol consumption leads to
……. and increased wakefulness during…….
Early sleep onset, during the second half of the night
Alcohol intoxication leads to…
Decreased REM sleep
Barbiturates.(increase /decrease) REM sleep
Decrease
Major depression (increase /decrease) REM sleep
Increase
Tx of narcolepsy
Modafinil
Disease characterized by recurrent episodes of
hypersomnia and hyperphagia psychiatric and
cognitive disturbance
• Lasts for weeks or months, alternating with
episodes of being normal
Kleine Levin Syndrome
Management of insomnia
Antidepressants (SSRI)
BENZODIAZEPINES
Ramelteon
Z-drugs
Tx of seasonal affective disorder
Bright light, CBT
At which stage of sleep does night terror manifest?
Tx?
Stage 3 sleep
Tx is benzodiazepines
