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Flashcards in Sleep Deck (38):
1

what is sleep

reversible behav. state of perceptual disengagement from and unresponsiveness to the env

2

3 ways sleep is measured

1. EEG
2. EOG
3. Chin EMG

3

4 key neurotransmitters to waking state

1. histamine
2. norepi
3. serotonin
4. ach

4

what shows in EEG, EOG and EMG in waking state

EEG: low voltage, high freq, alpha rhythm
EOG: rapid, blinking
tone: high

5

what shows in EEG, EOG and EMG in sleep N1

EEG:

6

what shows in EEG, EOG and EMG in sleep N2

EEG: vertex K complexes with high voltage negatives
EOG: still
tone: high

7

what shows in EEG, EOG and EMG in sleep N3/4 -slow wave

EEG: slow wave - high voltage, low freq
EOG: still
tone: low
+ GH release, restorative sleep

8

what shows in EEG, EOG and EMG in sleep REM

EEG: mixed freq, low volt, sawtooth
EOG: rapid
tone: very low
+ irreg. resp, dreaming state

9

2 phases of REM sleep

1. tonic - impaired thermoreg, hypotension, bradycardia, increased cerebral blood, ICP, erection
2. phasic - vasoconstricion, increased bP, tachycard, even high cerebreal flow and ICP

10

what generates REM sleep

pons critical

11

% of night in each stage

N1 -5%
N2 - 50
N3 - 20
REM - 25

12

2 key factors in control of sleep

process C - circadian
process S - sleepoiness

13

where is sleep initiated

activity in VLPO - increases in adenosine

14

sleep changes with age

newborn: 18hrs
adol. : 10
adults: 7-9
as age delta sleep goes down

15

3 key sleep measures

1. sleep onset latency - should be under 10min
2. REM latency - should be 90
3. sleep effic. - time asleep/time in bed - should be 90%

16

6 drugs affecting sleep

1. anithistamines -drowsy
2. stimulants
3. caffeine -adenosine antag
4. benzos - reduce slow wave
5. antidepress - reduce REM
6. Alcohol - faster onset, but more arousals

17

what is circadian rhythm

internal pacemaker set to 24hrs

18

where is main control center of circadian rhythm

SCN - has control over slave organs, but they also have indiv. molecular control

19

3 general types of insommnia and causes

1. initiation - rule out restless legs and breathing
2. maintenance- intrinisic sleep problems
3. awakinging - depression or breathing

20

3 examples of insomnia subtypes

1. psychophysiologic - learned behaviors
2. sleep state mispercetion - think they are up all night, but aren't
3. fatal family insomnia- rare neurodegen. disorder

21

5 behav. treatments for insomnia

1. sleep log
2. sleep hygene
3. stim. control
4. sleep restriction
5. relaxation response

22

what is sleep apnea

disordered breathing causing waking, with sig. morbidity (hypertension, stroke, sleepiness, accidents)

23

clinical aspects of obstructive sleep apnea

1. 17 inch neck circumference
2. obesity
3. excessive daytime sleepiness
4. morning headache
5. nasal disorders
6. position or alcohol
7. neuromuscular disorders

24

diff between apnea and hyponea

apnea - no breathing for 10 minutes
hypopnea - reduced airflow for 10 minutes

25

3 types of apnea

1. obstructive - paradox of muscles
2. central - no effort
3. mixed

26

causes of central sleep apnea (6)

1. heart failure
2. syringopulbia
3. lateral medullary syndrome
4. other brainstem function
5. atlantoaxial subluxation
6. myotonic dystrophy

27

what is restless legs

urge to move accompanied by uncomfortable sensation that are releived with movement

28

relation of RLS to periodic limb movement disorder

90% of RLS have PLMD
50% of PLMD have RLS

29

causes of RLS (4)

1. central spactiticy or peripheral radiculopathy
2. alcohol
3. pregnancy
4. Fe def.

30

treatment of RLS (3)

1. underlying conditions
2. DOPA agonists before bed
3. sinemet - avoid

31

tetrad of narcolepsy

1. excessive daytime sleepiness
2. cataplexy
3. sleep onset dreaming
4. sleep paralysis

32

3 treatments of narcolepsy

1. strategic napping
2. alerting agents (amphetimies)
3. anticataplectic (antidep, methyphenidate)

33

2 receptors inmportant for narcolepsy

1. orexin
2. hypocretin

34

2 main classes of parasomnia

1. slow wave arousals - terrors, walking, sex, talking
2. REM disorders - easy to awaken and report corresponding dreams

35

what is predictive about REM sleep disorders

90% develop parkinsons - can be treated with clonazepam

36

what is sleep related epilepsy

seizure more common in sleep - esp 2 hours after onset

37

3 types of sleep related epilepsy

1. benign epi. of childhood
2. electric status epilepticus during sleep
3. nocturnal paroxysmal dystonia

38

what happens to sleep in depression

loss of REM latency

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