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Year 2 LCRS > Neurology 16 - Sleep > Flashcards

Neurology 16 - Sleep Flashcards

1
Q

Which stages are non-REM/slow wave?

A
  • Stages 1 to 4

- From drowsiness, through light sleep to deep sleep

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2
Q

Describe the EEG rhythm in non-rem sleep

A

Slows gradually from theta when awake (4-8Hz) to delta (0.5-4Hz)

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3
Q

Describe the muscle tone and eye movements in non-rem sleep

A
  • General muscle tone decreases gradually

- Relatively few eye movements

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4
Q

What happens in REM sleep?

A
  • EEG speeds up to Beta (13-30Hz)
  • Low general muscle tone
  • Rapid eye movements
  • Dreams are most prominant and most easily recalled
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5
Q

What is active during dreams?

A
  • Limbic system

- Frontal cortex is less active

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6
Q

What are sleep cycles?

A
  • Passage through the 5 stages of sleep
  • Several sleep cycles in an average nights sleep
  • Lasts around 90 mins
  • Heart rate and respiration rate change in synchrony (increases during REM)
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7
Q

List the main pathways involved in the sleep wake cycle

A
  • Reticular activating system (maintains arousal)
  • Hypothalamic nuclei (control activity of the RAS)
  • Caudal pontine reticular formation
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8
Q

What is the reticular activating system made of?

A
  • Nuclei in the brainstem
  • Raphe nuclei, nucleus coeruleus and colinergic nuclei
  • Projects upwards directly or indirectly via the thalamus to all areas of the cerebral cortex
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9
Q

List the components of the hypothalamic nuclei. What is their role in the sleep wake cycle?

A
  • Lateral hypothalamus promotes wakefulness (orexin/hypocretin)
  • Ventrolateral preoptic nucleus promotes sleep (anterior hypothalamus)
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10
Q

What is the function of the caudal pontine reticular formation?

A
  • Active during REM sleep
  • Suppresses general muscle tone
  • Activates rapid eye movements
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11
Q

Describe the process of circadian control

A
  • Special cells in the retina detect decrease in light level, and activate the suprachiasmatic nucleus of the hypothalamus
  • Suprachiasmatic nucleus modulates sleep-wake circuits and stimulates the pineal gland to secrete melotonin
  • Melotonin syncronises physiological processes with day length
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12
Q

List the evidence that sleep is necessary

A
  • Highly conserved during evolution (most/all animals sleep)
  • Sleep deprivation has detremental effects on life
  • Regulated very accurately
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13
Q

List the possible functions of sleep

A
  • Restoration and recovery
  • Energy conservation (10% drop in BMR)
  • Predator avoidance
  • Memory consolidation
  • Effects on brain function
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14
Q

List the sleep disorders

A
  • Insomnia (too little sleep)
  • Narcolepsy (too much sleep)
  • Hypersomnia (excessive daytime sleepiness)
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15
Q

What is the prevalence of insomnia?

A
  • 20-50% of the general population
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16
Q

List the causes of insomnia

A
  • Most cases are transient (stress/emotional disturbance)
  • Some cases have a physiological cause (sleep aponea or chronic pain)
  • Some cases are due to brain dysfunction (depression, fatal familial insomnia)
17
Q

How is insomnia treated?

A
  • Hypnotics, which enhance GABAergic circuits
  • Sleep hygiene
  • Sleep CBT
18
Q

What is the cause of narcolepsy?

A
  • Genetic deficiency in orexin or hypocretin

- Enter REM sleep directly and repeatedly throughout the day

19
Q

How is narcolepsy treated?

A
  • Sleep management or stimulants

- Eg. Amphetamine

20
Q

What can shift work (sleeping at the wrong time) lead to?

A

Increased risk of certain conditions

  • Diabetes
  • Obesity
  • Cancer
21
Q

List the behavioural criteria for sleep

A
  • Stereotypic or species-specific posture
  • Minimal movement
  • Reduced responsiveness to external stimuli
  • Reversible with stimulation (unlike coma, anaethesia or death)
22
Q

How is sleep monitored?

A
  • EEG (brain)
  • Electrooculogramm (eyes)
  • EMC (muscle)
23
Q

List the stages of sleep

A
  • Awake (EEG, EOG and EMG are active)
  • Stage 1 & 2 are non-REM (lowest EEG, EOG and EMG activity)
  • Stage 3&4 (non-REM - large slow changes in EEG)
  • Stage 5 (REM - highest EOG, EEG rapid activity like in the awake stage)
24
Q

How does EEG change during sleep?

A
  • Becomes slower to stage 5

- Speeds up in REM sleep to be similar to that when awake

25
Q

List the effects of sleep deprivation

A
  • Psychiatric and neurological (sleepiness, irritability, stress, depression, hallucinations)
  • Neurological (accidents, impaired attention and memory, neurodegeneration)
  • Somatic (glucose intolerance, reduced leptin/increased appetite, impaired immunity, increased risk of CVD and cancer)
26
Q

What does the body do after sleep loss?

A
  • Reduced latency to sleep onset
  • Increase slow wave sleep
  • Increase of REM sleep (after selective REM sleep deprivation)
27
Q

List the functions of dreams

A
  • Safety valve for antisocial emotions
  • Memory consolidation
  • Disposal of unwanted memories
28
Q

List the steps taken in sleep hygiene

A
  • Fixed bedtimes
  • Relaxing bedtime routine
  • Go to bed when you feel tired
  • No napping
  • Avoid caffeine, nicotine and alochol late at night
  • Avoiding a heavy meal late at night
  • No phones before bed
29
Q

List the causes of hypersomnia

A
  • Obstructive sleep apnoea
  • Nocturnal pain
  • Medication
  • Anxiety
  • Environmental factors
  • Acid reflux
  • Narcolepsy
  • Idiopathic hypersomnolence
  • Post-traumatic brain injury
30
Q

What is narcolepsy?

A
  • Falling asleep repeatedly during the day, with disturbed sleep at night
  • Cataplexy (sudden, brief loss of muscle tone triggered by strong emotions)
  • Dysfunction of control of REM sleep

Year 2 LCRS (128 decks)

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