Sleep Medicine Flashcards
Most important que for sleep/wake cycles?
sunlight
Where does sunlight queues go after entering the eye?
to the suprachiasmatic nucleus via the optic chiasm (which is involved in the light/dark regulation of pineal gland production of Melatonin)
What is the function of the ventrolateral pre optic (VLPO) nucleus?
storage and production of GABA (controls the state of sleep)
How does GABA affect sleep patterns?
it promotes sleep (so does adenosine- levels rise during waking hours and promote sleepyness)
Which neurotransmitters promote awakeness?
histamine
The lateral hypothalamic area of the brain is the source of what?
orexin/hypocretin
What does orexin/hypocretin do?
Nuclei in the lateral/posterior hypothalamus that produce and use orexin as an excitatory neurotransmitter project diffusely to the much of the forebrain and also heavily innervate brainstem nuclei that facilitate wakefulness
How is orexin affected in narcolepsy?
90% of patients with narcolepsy have significantly decreased or undetectable levels of orexin and a marked reduction in the number of orexin secreting neurons.
T or F. Growth hormone is only secreted during sleep
T. Only during non-REM sleep and most right after falling asleep and then right before waking up
Drivers of sleep/wake patterns?
- circadian rhythm
- light ques
Dimensions of evaluation of sleep disorders
- medication effects
- circadian misalignments
- neurological issues
- sleep medicine issues
T or F. Sleep problems consistently increase with age
T.
Sequalae associated with sleep disorders
- CHF
- A fibrillation
- HTN
- CVD
How many stages of non-REM sleep are there?
3
How many minutes does it usually take to enter REM sleep?
(75 + Age) minutes
Why would you be more vulnerable to sleep apnea during REM sleep?
the muscles that dilate your air passages are paralyzed
What neurotransmitters are active during wakefulness?
- Ach
- Monoamines
- Orexin/Hypocretin
What neurotransmitters are active during non-REM sleep?
- Monoamines (some)
- VLPO (GABA)/MNPO
What neurotransmitters are active during REM sleep?
- Ach
- MCH
- VLPO (GABA)/MNPO
- glycine
What controls non-REM sleep?
GABA
What controls REM sleep?
Ach and PPT (pons)
What part of the brain helps disengage the body from environmental stimuli during sleep?
the thalamus is where all affront sensory nerves pass through to the cortex and it is off during sleep
What is one pathology in which the thalamus is often damaged?
stroke
When is melatonin most produced by the pineal gland?
3 AM (drives sleep)
When is restlessness leg syndrome common?
- pregnant women
- iron deficiency
