Chrono-neuropharmacology 2

Question 1

Shift work and circadian rhythm disruptions

Answer 1

Body temperature; respiratory rate; hormonal production; menstrual cycle; urinary excretion; cell division

Question 2

Shift work and mental health

Answer 2

Stress; anxiety; depression; neuroticism; reduced vigilance; burnout syndrome

Question 3

Shift work and CVDs

Answer 3

40% increased risk for: angina pectoris; hypertension; myocardial infarction

Question 4

Shift work and reproduction

Answer 4

Spontaneous abortion; low birth weight; prematurity

Question 5

Shift work on the brain

Answer 5

Sleep loss; REM sleep reduction; stage 2 sleep reduction; fatigue; reduce brain volume

Question 6

Shift work and GI disorders

Answer 6

Dyspepsia; heartburn; abdominal pains; flatulence

Question 7

Shift work and cancer

Answer 7

Increases risk of breast cancer and colorectal cancer

Question 8

Overnight shift work carcinogen ranking

Answer 8

2A (1,2A,2B,3,4)- probably carcinogenic

Question 9

Nurse studies on extended period of rotating nightwork

Answer 9

1979: 36% increased risk of breast cancer, 35% colorectal cancer and 43% endometrial cancer
1989: 79% increased risk of breast cancer

Question 10

Why is sleep necessary?

Answer 10

Basic homeostatic need; important for learning, memory, growth and repair; sleep deprivation associated with cognitive impairment, performance impairment and immune system impairment

Question 11

Awake

Answer 11

Beta waves

Question 12

Drowsy, relaxed (usually closed eyes)

Answer 12

Alpha waves

Question 13

Stage 1 sleep

Answer 13

Theta waves

Question 14

Stage 2 sleep

Answer 14

Sleep spindles, K complexes

Question 15

Stage 3 sleep and stage 4 sleep

Answer 15

Delta waves

Question 16

REM sleep

Answer 16

Fast, random waves

Question 17

Sleep cycle architecture

Answer 17

diagram

Question 18

Sleep cycle outline

Answer 18

70-90 minute cycles of REM, NREM, NREM SWS

Question 19

VLPO is important for

Answer 19

SWS

Question 20

Ascending reticular system

Answer 20

… triggers waking

Question 21

Circadian regulation of sleep

Answer 21

diagram

Question 22

Lesion of the DMH…

Answer 22

…attenuate or eliminate circadian rhythms of sleep-wake

Question 23

Opponent process model

Answer 23

Homeostatic sleep drive (closing sleep gate); circadian drive for arousal (creating sleep gate)

Question 24

Lesion on the SCN…

Answer 24

…allows homeostatic drive to takeover (removes circadian)–> short bouts of sleep as pressure builds up, complete loss of rhythmicity

Question 25

Sleep is... (wrt. disease)

Answer 25

...indicative of many disorders and altered in many diesease

Question 26

Sleep and circadian disorders

Answer 26

table

Question 27

Per3 VNTR

Answer 27

Per3(4/4) evening preference and delayed sleep phase syndrome Per3(5/5): extreme morning preference (increased evening sleep drive, higher deep sleep, early arousal); v poor cognitive performance if sleep deprived (~10% UK pop)

Question 28

Familial advanced phase sleep syndrome (FASPS)

Answer 28

Early chronotype, associated w Per2(S662G) and CK1δ (T44A and H46R) All these MTs accelerate degradation of PER thus speed up the clock

Question 29

Delayed sleep phase syndrome

Answer 29

Sleep onset insomnia, inability to wake up at a conventional time Extreme late chronotype Mis-sense mutation (V647G) in Per3 increases risk of developing DSPS. Mutation in CK1ε (S408N) gene decreases risk of developing DSPS.

Question 30

Sleep and MDD

Answer 30

90% of patients w MDD report sleep disturbances; persistent insomnia increases the risk of relapse into major depressive episode; sleep disruption most reported symptom preceding manic/depressive episode in BD; TCAs also sedatives + strong hypnotic; management of sleep has therapeutic benefit

Question 31

Sleep and schizophrenia

Answer 31

Unstable circadian rhythms; sleep disturbances; fragmented rest-activity patterns; improving sleep quality often improves negative symptoms

Question 32

Sleep and ageing

Answer 32

Decreases in light exposure, photoreception, circadian oscillator amplitude; change in chronotype; increase in concomitant diseases --> increased likelihood of sleep disorders

Question 33

Why does AD affect sleep?

Answer 33

Degeneration of AChergic Ns in basal forebrain; SCN degeneration in MODELS has been observed; melatonin levels decreased and rhythm lost; circadian NAdergic reg of pineal by SCN affected in (pre)clinical patients