Sleep Flashcards
What are the alerting neurotransmitters?
Histamine, serotonin and norepinephrine
What is the role of the ventral lateral pre optic nucleus (VLPO) of the hypothalamus?
Activated –> Releases GABA –> sedates alerting chemicals
What is orexin?
Peptide produced in hypothalamus that promotes wakefulness; suvorexant = orexin blocker
What is the two-process model to explain the sleep-wake cycle?
(1) Homeostatic drive to sleep –> driven by sleep debt (increases with duration of waking)
(2) Circadian rhythms
What is the role of the suprachiasmatic nucleus?
SCN activity promotes arousal during the day via alerting neurotransmitters and allows normal sleep at night
What is the role of melatonin in sleep?
It is produced by the brain at night –> allows our drive to sleep to take over
How would you describe REM Behavior Disorder?
Dreaming without muscle paralysis
What are the non-BZ hypnotics? What is their mechanism of action?
Zolpidem, Zalepon, Eszopiclone; interact with BZ receptor on GABA receptor (most commonly prescribed)
What are a few major classes of medications known to cause insomnia?
Steroids
Anti-depressants
Bronchodilators
Levadopa
Name the sedating anti-depressants
Doxepin (TCA)
Mirtazipine (atypical antidepressant)
Trazadone (atypical antidepressant)
Amytriptyline (TCA)
Why do we generally stay away from prescribing benzodiazapines for insomnia?
Dependence and withdrawal
Anterograde amnesia
What are the 4 characteristics of narcolepsy?
Excessive daytime sleepiness
Sleep paralysis (REM but mind is aroused)
Cataplexy (loss of muscle tone due to strong emotion)
Hypnagogic / hypnapompic hallucinations
