Sleep Disorders

Question 1

Outline the normal sleep cycle

Answer 1

• NON-REM

1. Alpha waves ~~~⇒ Theta waves /\/\/\
   
   • 5%
2. Sleep spindles IIIIII [like Theta but narrower] & K-complexes [random spike up & down]
   
   • Sleep based memory consolidation
   • Suppression of cortical arousal
   • 45%
3. Delta waves [large \/\/\/]
   
   • Hardest to wake up, confusion

REM

• Dreaming
• Lightest sleep
• Occurs every 90 minutes
• Variable BP & HR

Question 2

Outline the dyssomnias

Answer 2

• Insomnia
  
  • Trouble getting to sleep for 1+ month
  • Management
    
    • Sleep routine
    • Exercise
    • Anti-histamines
    • Short course Benzodiazapine
• Narcolepsy
  
  • Recurrent sleep attacks during day
  • Low Orexin that refulates arousal
  • Management
    
    • CNS stimulands - Methylphenidate
• Sleep Apnoea
  
  • Obstructive [obesity obstructive larynx]
  • Central [neurological problem losing inspiratory drive]
  • Stop breathing ⇒ Hypercapnia/ hypoxaemia ⇒ Reflexsive systemic vasoconstriction + sympathetic stimulation [hypertension]]
  • Management
    
    • Lose weight
    • CPAP
    • Surgery
• Obesity hypoventilation syndrome
  
  • Obese people cant breath

Question 3

Outline the parasomnias

Answer 3

• Night Terrors
  
  • non-REM
  • No recollections in the mornings
  • Resolves by 5-6
• Nightmares
  
  • REM
  • Remembers the event, drug use
• Somnambulism
  
  • Sleeping walking..
  • non-REM