SM_87b: Circadian Rhythms and Sleep Flashcards
Relaxed wakefulness has ___
Relaxed wakefulness has alpha waves
Stage N1 of sleep has ____
Stage N1 of sleep has theta waves
Stage N2 of sleep has ____ and ____
Stage N2 of sleep has sleep spindles and K complexes
Stage N3 of sleep has ____
Stage N3 of sleep has delta waves
____, ____, and ____ are active neurotransmitters during wakefulness
ACh, monoamines (DA, NE, serotoni), and orexin/hypocretin are active neurotransmitters during wakefulness
___ has higher firing rate and ___ has slower firing rate during NREM sleep
VLPO/MNPO has higher firing rate and monoamines (DA, NE, serotonin) has slower firing rate during NREM sleep
____, ____, and ____ have increased firing rate during REM
ACh, MCH, and VLPO/MNPO have increased firing rate during REM
Flip-flop switch involves activation of ____ for wakefulness and ____ for sleep
Flip-flop switch involves activation of locus coeruleus / tuberomamillary nucleus / raphe for wakefulness and venterolateral preoptic nucleus (VLPO)/eVLPO for sleep
Two process model of sleep regulation posits that the interaction of ____ and ____ generate timing of sleep / waking
Two process model of sleep regulation posits that the interaction of sleep/wake dependent homeostatic Process S and circadian Process C generate timing of sleep / waking
____ regulates circadian rhythms
Suprachiasmatic nucleus regulates circadian rhythms
Rate-limiting step in molecular clock is ____
Rate-limiting step in molecular clock is phosphorylation of PER/CRY by CK1ε/δ
Describe the molecular clock
Molecular clock
- CLOCK and BMAL1 are transcribed and exit the nucleus.
- They dimerize, then re-enter the nucleus to upregulate PER and CRY.
- PER and CRY exit the nucleus and dimerize
- PER and CRY are phosphorylated by CK1ε/δ (this is the rate limiting step)
- PER and CRY re-enter the nucleus to inhibit their own transcription.
This whole process takes ~24 hours
Melatonin levels are highest at ____
Melatonin levels are highest at night
Melatonin is measured in the ____, ____, and ____
Melatonin is measured in the urine, saliva, and plasma
Advanced sleep wake disorder involves ____ and ____
Advanced sleep wake disorder involves advance in phase of major sleep period in relation to desired sleep / wake time and normal sleep quality and duration
____ is the broken step in most patients with advanced sleep wake phase disorder
Phosphorylation of PER and CRY is the broken step in most patients with advanced sleep wake phase disorder
Advanced sleep wake phase disorder is treated with ____, ____, and ____
Advanced sleep wake phase disorder is treated with planned sleep schedules, timed evening light exposure, and timed morning melatonin administration
Irregular sleep wake disorder is a chronic complaint of ____, ____, or both but total sleep time per 24 period is essential normal
Irregular sleep wake disorder is a chronic complaint of insomnia, excessive sleepiness, or both but total sleep time per 24 period is essential normal
Irregular sleep wake disorder is usually seen in ____ and ____
Irregular sleep wake disorder is usually seen in developmentally delayed children and adults with dementia
(due to poor sleep hygeine or neurological impairment)
Irregular sleep wake disorder is treated with ____, ____, and ____
Irregular sleep wake disorder is treated with mixed modality therapy, timed light exposure, and timed melatonin administration
Delayed sleep wake phase disorder involves ____ and ____
Delayed sleep wake phase disorder involves delay in the phase of major sleep period in relation to the desired sleep / wake time and normal sleep quality / duration
Delayed sleep wake phase disorder is treated with ____, ____, and ____, but NOT ____
Delayed sleep wake phase disorder is treated with planned sleep schedules, timed light exposure, and timed melatonin administration but NOT hypnotics
Non-24 hour sleep wake disorder involves ____
Non-24 hour sleep wake disorder involves complaint of insomnia / excessive sleepiness related to abnormal synchronization between 24 hour light-dark cycle and endogenous circadian rhythm
Non-24 hour sleep wake disorder results in the blind due to ____
Non-24 hour sleep wake disorder results in the blind due to loss of photic input to the SCN through the retino-hypothalamic tract
Non-24 hour sleep wake disorder results in the sighted due to ____
Non-24 hour sleep wake disorder results in the sighted due to multiple factors, including a combination of minimal social cues and a prolonged intrinsic circadian period
Non-24 hour sleep wake phase disorder is treated in the blind via ____
Non-24 hour sleep wake phase disorder is treated in the blind via timed melatonin administration
Non-24 hour sleep wake disorder is treated in the sighted via ____, ____, and ____
Non-24 hour sleep wake disorder is treated in the sighted via timed melatonin administration, strict sleep schedules, and timed light exposure
____ is approved medication for treatment of non-24 hour sleep wake disorder
Tasimelteon is approved medication for treatment of non-24 hour sleep wake disorder
Shift work sleep disorder is ____
Shift work sleep disorder is complaint of insomnia / excessive sleepiness that is temporally associated with a recurring work schedule that overlaps the usual time for sleep
Shift work sleep disorder is treated with ____, ____, and ____
Shift work sleep disorder is treated with light pulses, light exposure on awakening, and specific sleeping times
Jet lag sleep disorder is ____
Jet lag sleep disorder is complaint of insomnia / excessive daytime sleepiness associated with jet travel across at least two time zones
- Associated impairment of daytime function, general malaise, or somatic symptoms such as GI disturbance within 1-2 days after travel
Jet lag sleep disorder is treated with ____ and ____
Jet lag sleep disorder is treated with light exposure and melatonin administration
Light in the biological morning (after core body temperature is minimum) and melatonin at night _____ the circadian clock
Light in the biological morning (after core body temperature is minimum) and melatonin at night advance the circadian clock
Light at night and melatonin in the morning ____ the circadian clock
Light at night and melatonin in the morning delay the circadian clock
