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Neurology > Sleep > Flashcards

Sleep Flashcards

1
Q

What is sleep?

A

Normal, recurring, reversible state

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2
Q

What is lost during sleep?

A

The ability to respond to the external environment

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3
Q

Describe how sleep is both not conscious and not unconscious.

A

Non conscious - not able to respond to self and external environment
Not unconscious - as can respond when stimulated

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4
Q

When does NON-REM sleep occur?

A

At the start of the night

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5
Q

What proportion of sleep for young adults is NON-REM?

A

3/4

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6
Q

What is EEG activity like during NON-REM sleep?

A

Synchronised

Rhythmic

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7
Q

What happens to muscles during NON-REM?

A

They are partially relaxed

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8
Q

What happens to cerebral blood flow during NON-REM sleep?

A

REDUCED

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9
Q

What are dreams like during NON-REM sleep?

A

Some non-narrative images

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10
Q

When does REM sleep occur?

A

At the end of the night

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11
Q

What does an EEG show during REM sleep?

A

FAST activity

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12
Q

What does an MRI during REM sleep show?

A

Increased brain activity

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13
Q

What are the EEG and MRI findings during REM sleep similar to?

A

Wakefulness

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14
Q

What happens to muscles during REM sleep?

A

They become ATONIC, except some

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15
Q

What muscles do not become ATONIC during REM sleep?

A

Respiratory

Extra-ocular

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16
Q

What does REM stand for?

A

Rapid Eye Movement

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17
Q

What happens to thermal regulation during REM sleep?

A

It is impaired

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18
Q

What type of dreaming occurs in REM sleep?

A

Narrative

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19
Q

Deep sleep is _______ sleep

A

ESSENTIAL

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20
Q

What type of sleep is regained after sleep loss?

A

DEEP

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21
Q

Why is deep sleep important?

A

It allows the cortex to recover after a busy day

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22
Q

What is the main importance for REM sleep?

A

For early brain development - substitute stimulation for wakefulness

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23
Q

REM sleep is dispensable

A

TRUE

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24
Q

What term is used to describe REM sleep?

A

Non-wakefullness

Not sleep

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25
Q

What common drugs suppress REM sleep?

A

Tricyclics

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26
Q

Describe the sleeping patterns of neonates.

A

Spend 16 hours per day asleep – 50% REM sleep, have shorter cycles

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27
Q

Describe what happens to REM sleep after the first decade.

A
  • % REM sleep falls.

* REM latency increases

28
Q

Outline what happens to sleep in the elderly.

A
  • Increased awakenings
  • Reduced REM latency
  • Reduced total sleep time and daytime napping
29
Q

What controls sleep?

A

Biology and physiology, NOT psychology

30
Q

What is circadian rhythm important for?

A
  • Appetite
  • Sleep-awake
  • Hormones
31
Q

Children sleep later and waken later

A

FALSE

- sleep earlier and waken earlier

32
Q

Adolescents have a _____ sleep pattern

A

DELAYED

33
Q

Elderly have an ____ sleep pattern

A

ADVANCED

34
Q

Give examples of human processes controlled by circadian rhythm.

A
  • Sleep-awake
  • Appetite
  • Body temp
  • Hormone secretions
  • Alertness
35
Q

How long does normal circadian rhythm last?

A

25 hours

36
Q

What entrains the body clock?

A

LIGHT

37
Q

Describe how light controls the body clock.

A

RETINAL GANGLION CELLS, projecting to SUPRACHIASMATIC NUCLEUS

38
Q

What is NON-REM sleep important for?

A
  • Cell division and growth

* Protein synthesis

39
Q

What is REM sleep important for?

A
  • Consolidation of memories
  • Deletion of unnecessary memory files
  • Maintenance of immunocompetence
40
Q

Species with high metabolic rates have longer sleep times. What does this suggest?

A

Importance in conserving energy

41
Q

Sleep is related to ___ hormone release

A

GROWTH

42
Q

Sleep helps with?

A

Tissue repair

43
Q

What happens to cell division during sleep?

A

PEAKS

  • skin mitosis peaks during sleep
  • however, time of day effect, increases after meals
44
Q

Describe the cortex and rest.

A

The cortex can only rest when fully asleep

Until, it is in ‘quiet readiness’

45
Q

What is the relationship between cortices and sleep?

A

More complex cortices need more sleep

46
Q

Most effects of sleep deprivation affect what part of the cortex?

A

PRE-FRONTAL

47
Q

What are the problems associated with lack of sleep and the pre-frontal cortex?

A
  • become irritable and suspicious, but no ‘psychoses.’
  • visual illusions.
  • microsleeps and concentration lapses.
48
Q

What does sleep deprivation, affecting pre-frontal function NOT affect?

A
  • routine
  • old, well rehearsed tasks
  • logic tasks
49
Q

What does sleep deprivation affecting the pre-frontal lobe do?

A

Impairs alterness

50
Q

How much sleep do we need a night?

A

7/7.5 hours

51
Q

What is a 15 minute nap equivalent to?

A

90 minutes during the night

52
Q

What is a parasomnia?

A

A disorder characterized by abnormal or unusual behaviour of the nervous system during sleep

53
Q

Describe NON-REM parasomnias.

A
  • Non-dreaming.
  • Confusional arousals.
  • Sleep walking.
  • Sleep terrors and paralysis.
  • Bruxism. (grinding teeth)
  • Restless legs + PLMS (periodic limb movements of sleep).
  • Often complex behaviours – possible dissociation
54
Q

What is bruxism?

A

Grinding teeth

55
Q

90% of patients with what condition have REM parasomnias?

A

Parksinson’s

56
Q

Describe REM parasomnias.

A
  • Dreaming.

* Much simpler behavior (than NREM).

57
Q

At what part of the night do REM parasomnias usually occur?

A

Later 1/3rd of the night

58
Q

What is Narcolepsy?

A

A condition characterized by an extreme tendency to fall asleep whenever in relaxing surroundings

59
Q

At what ages does narcolepsy peak?

A

15 and 36

60
Q

Often patients with REM sleep problems have narcolepsy

A

TRUE

61
Q

Describe the clinical presentation of Narcolepsy.

A
  • Daytime sleepiness
  • Cataplexy
  • Hypnagogic Hallucinations
  • Sleep paralysis
62
Q

What is cataplexy?

A

Loss of muscle tone triggered by emotion

63
Q

What are Hypnagogic Hallucinations?

A

Hallucinations occurring at sleep onset

64
Q

What Ix’s should be done for suspected Narcolepsy?

A
  • Overnight polysomnography
  • Multiple sleep latency test
  • LP (not routine anymore)
65
Q

Describe the multiple sleep latency test.

A

4 x 25 minute naps are scheduled about two hours apart
Record of EEG, muscle activity and eye movement recorded
Measures time from the start of a daytime nap to the first signs of sleep (sleep latency)
Faster patient falls asleep faster if they are sleepier

66
Q

Describe the LP findings that show Narcolepsy.

A

Low hypocretin levels (<110pg/ml or 1/3rd of the mean control value)

Neurology (42 decks)

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