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CMED 311 > WEEK 3: Sleep Physiology and Disorders [Salonga] > Flashcards

WEEK 3: Sleep Physiology and Disorders [Salonga] Flashcards

1
Q

is a state in which the person is aware of and

responds to sensory input from the environment

A

wakefulness

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2
Q

a state of behavioral quiescence accompanied by
an elevated arousal threshold and a species-specific sleep
posture (recumbent sleep posture, closed eyes, diminished
responsiveness to external stimuli and decrease in or
absence of movements)

A

Sleep

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3
Q

Sleep is an active process, irreversible state of responsiveness to the stimuli of the outside world. T or F

A

F. sleep reversible state of unresponsiveness

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4
Q

give 5 functions of sleep?

A
  • Memory consolidation
  • Energy conservation
  • Body growth
  • Regulation of immune function
  • Protective behavioral adaptation
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5
Q

2 classifications in the nomenclature in the stages of sleep?

A

R&K and AASM

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6
Q

stages of sleep in R&K

A

wake (Stage W)
NREM (Stages 1 to 4)
REM (stage REM)

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7
Q

stages of sleep in AASM?

A

Wake: Stage W
NREM: Stage N1, N2, N3 (N3+N4)
REM: Stage R

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8
Q

NREM and REM occur in alternating cycles, each lasting approx __________ witha total of _________ cycles

A

90 - 100 mins; 4-5 cycles

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9
Q

in healthy adults, NREM sleep accounts for how many percent of sleep time?

A

75-90%

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10
Q

REM sleep accounts for how many % of sleep time?

A

10 - 25 %

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11
Q

in NREM, how many percent is accounted for each sleep time per stage?

A

Stage 1: 3 -5%
Stage 2: 50 - 60%
Stage 3 and 4: 10 - 20%

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12
Q

newborn sleeps approximately how many hours?

A

16-20 hrs

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13
Q

how many hrs of sleep in childhood?

A

10 hrs

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14
Q

In the full-term newborn, sleep cycles last approximately___________ alternating through a ______ hour
inter-feeding period).

A

60
minutes (50% NREM, 50% REM;

3-4 h

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15
Q

2 basic process in the regulation of sleep and wakefulness?

A 
Process C (Circadian Process)
Process S (Sleep homeostasis)
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16
Q

There are two circadian peaks in wakefulness: one is during _________, and another is during ___________

Sleep propensity is least during these peaks of
circadian rhythms of arousal

A

one
occurring (early evening) and a second peak (late
morning).

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17
Q

greatest sleep propensity is during periods of?

A

between 3 to 5 am and early-mid afternoon between 3 to 5 pm

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18
Q

is characterized by an increase in sleep pressure
following sleep deprivation that is related to the duration
of prior wakefulness followed by a decline in sleep need
as sleep accumulates.

A

Sleep Homeostasis

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19
Q

refers to the short-lived reduction
of alertness that occurs immediately following awakening
from sleep and disappears within 2 to 4 hours.

A

Sleep Inertia (process W)

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20
Q

2 mechanisms in the control of daily rhythm of sleep and arousal?

A

Suprachiasmatic nucleus of the hypothalamus (body clock)

Pineal Gland’s secretion of melatonin

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21
Q

this sets the suprachiasmatic clock?

A

Light

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22
Q

tiny endocrine gland situated at the

center of the brain

A

Pineal Gland

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23
Q

major pineal hormone?

A

Melatonin

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24
Q

melatonin is derived from?

A

Tryptophan

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25
Q

light supresses/increases melatonin secretion?

A

supresses

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26
Q

2 major RF ascending pathways projections into the brain?

A

Dorsal pathway and ventral pathway

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27
Q

Trace the dorsal pathway?

A

Dorsal pathway
→ thalamus
→ cerebral cortex
(thalamocortical system)

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28
Q

Trace the ventral pathway?

A

Ventral pathway → subthalamus and posterior
hypothalamus → basal forebrain and septum → cerebral
cortex

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29
Q

Descending RAS function?

A

connects to the cerebellum and to
nerves responsible for the various senses; helps maintain our posture and
balance in wake state

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30
Q 
Most wake circuits originate
in the \_\_\_\_\_\_\_\_ which
stimulate the thalamus,
hypothalamus (Hyp) and
basal forebrain. These
projections also inhibit sleep
centers
A

Brain stem arousal

nuclei (BAN),

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31
Q

Centers for NREM sleep?

A

Forebrain (anterior hypothalamus-preoptic region,
including ventrolateral preoptic area [VLPO] and basal
forebrain)

32
Q

neurotransmitters of NREM sleep?

A

serotonin and GABA; others are adenosine and norepinephrine.

33
Q

control centers for REM sleep?

A

Pons (pedunculopontine tegmental nuclei and the
laterodorsal tegmental nuclei)
Brainstem reticular formation, especially oral pontine reticular formation,
other brainstem (lower medullary) and spinal cord
neurons

34
Q

Neurotransmitters for REM sleep?

A

Ach!!! others include GABA and glycine

35
Q

circadian pacemaker?

A

Suprachiasmatic nucleus

36
Q

Hypothalamus control of sleep, pls trace?

A

SCN > Supraventricular zone, Dorsomedial nucleus > Paraventricular nucleus, lateral Hypothalamus, VLPO (ventrolateral preoptic nucleus)

37
Q 
The PVN is stimulated
by the SCN, in a
circadian fashion, to
produce
\_\_\_\_\_\_\_\_\_\_
A

corticotrophin releasing
factor
(CRF) which acts on pituitary gland, which in turn produces ACTH > adrenal glands will then release cortisol

38
Q

______is one of the factors involved in the sleep/wake cycle
through a feedback system whereby it can then influence
activity in the hypothalamus.

A

Cortisol

39
Q 
is considered
an underlying
cause of
insomnia and
may be
related to
dysfunction of
the HPA axis.
A

Hyperarousal

40
Q

there is thought to be reduced basal

ACTH secretion and a reduction of central CRF. hyper/hypoarousal?

A

Hypoarousal

41
Q

hypoarousal will lead to? hyperarousal will lead to?

A

sleep

hallucinations

42
Q

Body temperature is ______in the early morning,
rising throughout the morning and then staying fairly steady
until it begins to ________ in the late evening.

A

also at its lowest ;

decline again

43
Q

The human sleep–wake cycle is closely age linked: pls enumerate

A

newborn baby sleeps from 16 to 20 h a day
o child: 10 to 12 h.
o total sleep time drops to 9 to 10 h by mid-adolescence
and to about 7 to 7.5 h during young adulthood
o gradual decline to about 6.5 h develops in late adult life

44
Q 
Relaxed wakefulness (W) with the eyes closed is
accompanied in the electroencephalogram (EEG) by\_\_\_\_\_\_\_\_\_\_\_\_
A

posterior alpha waves of 9 to 11 Hz (cycles per second) and

intermixed low-voltage fast activity of mixed frequency

45
Q

With drowsiness, as the first stage of sleep sets in, the
eyelids begin to droop, the eyes may rove slowly from
side to side, and the pupils become smaller, the muscles
relax and the EEG pattern changes to one of
progressively lower voltage and mixed frequency with a
loss of alpha waves; this is associated with slow, rolling
eye movements: what stage of sleep?

A

N1 stage

46
Q

there is the appearance of 0.5- to 2-s bursts of biparietal
12- to 14-Hz waves (sleep spindles) and intermittent highamplitude,
central-parietal sharp slow-wave complexes
(vertex waves) on EEG. what stage of sleep?

A

N2

47
Q

represents slow-wave sleep with predominant theta
rhythms
o The first three stages are the NREM sleep.

A

N3 stage 3 of sleep

48
Q

deep slow wave sleep with a preponderance of delta
frequency activity. Vertex waves and sleep spindles are
no longer evident.

A

REM sleep

49
Q

is associated with further reduction in muscle
tone except in the extraocular muscles and with bursts of
rapid eye movement thus the term rapid eye movement

A

REM sleep

50
Q

In the first portion of a typical night’s sleep, the normal young
and middle-aged adult passes successively through stages
N1, N2, N3, and R (REM) sleep. t or F?

A

T

51
Q

T or F? The first REM period may be brief; the

later cycles have less stage N3 sleep or none at all.

A

T

52
Q

In the latter portion of a night’s sleep, the cycles consist
essentially of two alternating stages—REM sleep and stage
N2 (spindle– K-complex) sleep. T or F?

A

T

53
Q

What stage of sleep is this EEG characteristic: posterior reactive alpha rhythm

A

W - awake

54
Q

What stage of sleep is this EEG characteristic: diffuse theta and loss of alpha

A

Drowsy - stage 1

55
Q

What stage of sleep is this EEG characteristic: diffuse theta

A

REM - predominance of dreaming

56
Q

What stage of sleep is this EEG characteristic: Sleep spindles and K complexes?

A

Stage 2 - light sleep

57
Q

What stage of sleep is this EEG characteristic: hihg voltage theta and delta activity

A

stage 3 and 4 (N3) - deep sleep

58
Q

Much of the night’s complex visual dreaming has been found to occur in the__________, with the qualifications noted below, and dreams are recalled most consistently if the subject is awakened during this time.

A

REM period

59
Q

Subjects are easily aroused from REM sleep, but arousing a person during stage N3 is more difficult T or F?

A

T

60
Q

uncontrollable random sleep attacks

A

Narcolepsy

61
Q

temporary cessation of breathing while sleeping usually involving loud snoring

A

Sleep apnea

62
Q

Circadian Rhythm sleep disorder: symptoms include varying degrees of difficulty in initiating or maintain sleep, daytime fatigue, decrements in daytime alertness and performance. resolves without treatment after 2 to 7 days

A

jet lag type

63
Q

Circadian Rhythm sleep disorder: late appearance of sleep (around 2 am) but normal total sleep time and architecture which lead to sleep onset insomnia and difficulty awakening at desired time

A

Delayed sleep phase type

64
Q

Circadian Rhythm sleep disorder: Symptoms of insomnia or excessive sleepiness, adaptation takes 1 to 2 weeks

A

shift work type

65
Q

Disorder that produces complaints of insomnia or excessive sleepiness
▪ Intrinsic sleep disorders
▪ Extrinsic sleep disorders
▪ Circadian Rhythm Sleep Disorders

A

Dyssomnias

66
Q 
Disorders that intrude into or occur during sleep but do not result in insomnia or excessive sleepiness:
Arousal Disorders
▪ Sleep-wake transition disorders
▪ REM related Parasomnias
▪ Other Parasomnias
A

Parasomnias

67
Q

Happens during partial arousal from stage 4 sleep
o Usually begins with piercing scream
 It usually occurs soon after falling asleep, during stage 3 or 4 sleep

A

Sleep terror

68
Q

o occurs during any sleep stage

o Is more frequent among children

A

Somniloquy

69
Q

These are disorders occurring during deep sleep

A 
o 1. Sleep walking (somnambulism)
o 2. Sleep terrors or night terrors (pavor nocturnus)
o 3. Sleep-related enuresis
o 4. Bruxism
o 5. Sleep-taking (somniloquy)
70
Q

sleep disorder associated with HLA DR2

A

narcolepsy

71
Q

aka ekbom sndrome?

A

restless leg syndrme

72
Q

episodic hypersomnolence aka?

A

Kleine levin syndrome

73
Q

REM sleep disorders?

A

Narcolepsy
Nightmare
REM behavior disorder
chronic paroxysmal hemicrania

74
Q

Initial step in sleep disorders treatments

A

lifestyle changes that include a healthy diet, regular exercise and good habits

75
Q

pharmacological mx:

A

Dieatary supplements: melatonin and L tryptophan

short acting benzodiazepines

z drugs: zolpedium

low dse antridepressants

CMED 311 (47 decks)

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