Chronobiology 2 and Sleep Disorders

Question 1

In the hypothalamus, what structures are the “off switch” and the NREM promoting center?

Answer 1

VLPO and MNPO

Question 2

If GABA/ galanin increases…what is the result on sleep?

Answer 2

sleep is favored

Question 3

Are VLPO and MNPO active all the time?

Answer 3

No…they are silent during wakefulness

Question 4

When do the VLPA and MNPO fire the most?

Answer 4

During NREM

Question 5

When does MNPO firing more prevalent?

Answer 5

When drifting to sleep

Question 6

When does VLPO firing more prevalent?

Answer 6

when asleep

Question 7

What neurotransmitter do the VLPO and MNPO contain?

Answer 7

GABA and Galanin

Question 8

What controls REM sleep?

Answer 8

Laterodorsal and Pedunculopontine tegmental (LDT/ PPT) Ach firing

Question 9

How is atonia during REM developed?

Answer 9

Ach stimulates neurons in the medulla that release GALA and glycine

Question 10

True or False:

Levels of 5HT, NE, and DA do not fluctuate during NREM

Answer 10

False…they all fluctuate. This allows for the different stages of NREM

Question 11

During sleep, when does Ach release peak?

Answer 11

During REM

Question 12

How are 5HT, NE and DA inhibited during REM?

Answer 12

They are inhibited by feedback inhibition

Question 13

What happens to the level of adenosine throughout the day?

Answer 13

It increases via metablism (breakdown of ATP)

Question 14

Is a high level of adenosine associated with sleepiness or wakefulness?

Answer 14

Sleepiness

Question 15

What controls the Circadian clock?

Answer 15

Genes and proteins

Question 16

What are the genes/ proteins involved in the circadian clock?

Answer 16

CRY, CLK, BMAL-1, PER 1(-3)

Question 17

Explain the expression of the circadian clock genes/ proteins…

Answer 17

Some fluctuate on a 24 hour basis

Question 18

Explain the relationship between BMAL-1 and PER 1,2,3…

Answer 18

They are in counter phase

Question 19

True or false:

Light and temperature can effect the gene/ protein expression

Answer 19

True

Question 20

What are Zeitgebers? Give examples

Answer 20

They are factors that also modify our clock

Exogenous melatonin, caffeine, alcohol, light, food, exercise/ activity, social interaction

Question 21

What is insomnia?

Answer 21

Difficulty initiating or maintaining or maintaining sleep, early morning awakening, nonrestorable sleep for 1 month

Question 22

How is insomnia treated?

Answer 22

Treat with sleeping pills (to increase GABA) and sleep hygiene

Question 23

What is hypersomnia?

Answer 23

Excesive daytime sleepiness or inability to maintain wakefulness

Question 24

How is hypersomnia treated?

Answer 24

With stimulants and wafefulness hygiene

Question 25

What is Narcolepsy?

Answer 25

Sleep attacks daily for 3 monthseristic Cataplexy (loss of tone) upon waking and hyponogogic hallucination upon sleeping is charact

Question 26

Can there be an "organic" reason for narcolepsy?

Answer 26

Missing/ dysfunctional orexia system

Question 27

How is narcolepsy treated?

Answer 27

treat with stimulants

Question 28

What are some breathing related sleep disorders and what are the effects of them?

Answer 28

Central or Obstructive Sleep Apnea Yields insomia and hypersomnia

Question 29

What is the treatment for CSA and OSA?

Answer 29

CPAP, Dental devices and surgery Must avoid sedatives!

Question 30

What is circadian rhythm sleep disorder?

Answer 30

A condition that yields insomnia or hypersomnia due to sleep-wake cycle mismatch, shift or synchrony

Question 31

What are the two forms of circadian rhythm sleep disorder?

Answer 31

Advances type (usually the elderly) and delayed type (usually shift workers)

Question 32

How are circadian rhythm sleep disorders usually treated?

Answer 32

Sleep schedule, benzodiazapines, melatonin, exercise, stimulants or light therapy

Question 33

What is dyssomnia NOS?

Answer 33

here are two types...Nocturnal myoclonus (now it is called Periodic limb movement disorder) and restless leg syndrome

Question 34

How are dyssomnia NOS conditions treated?

Answer 34

with dopamine (D2) receptor agonisits

Question 35

Describe nightmare disorder:

Answer 35

Long firghtening dreams where the individual wake alert and oriented and can remember the dream

Question 36

What stage of sleep does nightmare disorder happen during?

Answer 36

Occurs during REM

Question 37

Describe sleep terror disorder:

Answer 37

Individual wakes disoriented and is not consolable and has no memory of their dream or the event

Question 38

When do sleep terrors occur?

Answer 38

In the 1st 1/3 of the night usually during NREM sleep (stage e and 4)

Question 39

When does sleepwalking occur?

Answer 39

In the 1st 1/3 of the night usually during NREM sleep (stage e and 4)

Question 40

Describe sleepwalking:

Answer 40

No memory of the event typically. Individual might wake up confused but orients easily

Question 41

What is sleep related bruxism?

Answer 41

teeth grinding dureing stage 2 of NREM

Question 42

What is the treatment for sleep related bruxism?

Answer 42

Mouth guard/ bite plate

Question 43

What is REM sleep behavior disorder?

Answer 43

Loss of atonia during REM, so they act out dreams. Typically occurs in men and it can be violent at times

Question 44

How is REM sleep behavior disorder treated?

Answer 44

D2 receptor agonists

Question 45

At what stage of sleep dies sleep talking occur?

Answer 45

All stages of sleep

Question 46

What is sleep paralysis?

Answer 46

Inability to move just prior to falling asleep or upon awakening