sleep

Question 1

which neurons are involved in wakefulness –> sleep

Answer 1

GABAergic neurons from vlpo in interior hypothalamus nucleus

Question 2

which neurons are involved in sleep –> wakefulness

Answer 2

orexinergic neurons
cholinergic
monoaminergic

Question 3

how many cycles or rem/non rem sleep do we go through a night?

Answer 3

4-6

Question 4

how long do cycles last?

Answer 4

90-110

Question 5

what form of sleep is entered first?

Answer 5

nrem

Question 6

what does it indicate if sleep is entered through rem?

Answer 6

person is depressed, sleep deprived or has narcolepsy

Question 7

what form of sleep dominates the first third of the night?

Answer 7

slow wave sleep

Question 8

_______ dominate sthe last third of the night

Answer 8

REM

Question 9

how much of a night is wakefulness?

Answer 9

normally less than 5%

Question 10

what are some features of rem sleep?

Answer 10

irregular heart rate
variable bp
irregular resp rate
depressed response to o2 and co2 changes
absent skeletal muscle tone
increased brain o2 consumption
poikilothermic  - body doesnt adapt to room temp changes
frequent penile tumescence, vaginal engorgement

Question 11

what are some changes in non rem sleep?

Answer 11

decreased response to o2 and co2 changes

reduced brain o2 consumption

Question 12

what is an intrinsic/primary circadian rhythm sleep disorder?

Answer 12

alteration of circadian rhythm

Question 13

what is an extrinsic/secondary circadian rhythm sleep disorder?

Answer 13

misalignment between intrinsic and extrinsic signals

Question 14

are shift work and jet lag intrinsic or extrinsic sleep problems?

Answer 14

extrinsic

Question 15

name some intrinsic circadian rhythm sleep disorders

Answer 15

delayed sleep phase disorder
advanced sleep phase disorder
non-24 hr (blindness)
irregular (dementia)

Question 16

true or false, in circadian problems, sleep is normal when it is at the desired time?

Answer 16

true

Question 17

what group is delayed sleep phase common in?

Answer 17

teenagers

males

Question 18

what are some clinical features of dspd?

Answer 18

unable to advance sleep onset
insomnia/excessive sleepiness
chronic
history of hypnotic use, alcohol at bed time, psych conditions

Question 19

how can dspd be treated?

Answer 19

melatonin (6 hrs before bedtime)
phototherapy
cbt

Question 20

what are some short term consequences of shift work?

Answer 20

mood disturbances

GI problems

Question 21

______ production is inhibited by light exposure

Answer 21

melatonin

Question 22

what are some long term consequences of shift work?

Answer 22

mood disorder, cardiovascular risk, cancer eg breast

Question 23

what are some effects of sleep deprivation?

Answer 23

cognitive impairment
memory loss
hallucinations
adhd symptoms
impaired immunity
type 2 diabetes risk
heart disease
decreased reaction time
tremors
growth supression
obesiy (produce more ghrelin in deprivation)

Question 24

what is a hypnagogic hallucination?

Answer 24

occur on going to sleep

Question 25

what is the name of hallucination that occurs on waking?

Answer 25

hypnopompic

Question 26

what is a parasomnia?

Answer 26

abnormal behaviour occuring in association to sleep

Question 27

when do slow wave or nrem parasomnias occur?

Answer 27

first third of night

Question 28

describe nrem/slow wave parasomnias

Answer 28

``` onset in childhood confusionsal arousal sleep walking night terrors eating disorder sexsomnia ``` family history exacerbate dby sleep deprivation, stress, alcohol, osa, fever amnesic

Question 29

how are night terrors treated?

Answer 29

``` cbt scheduled awakening keep room safe pregablin clonazepam only wake if episode lasts >45 mins ```

Question 30

how can nrem parasomnias be treated?

Answer 30

cbt antidepressants clonazepam melatonin

Question 31

when do rem parasomnias occur?

Answer 31

second half of night

Question 32

what can occur in a rem parasomnia?

Answer 32

``` nightmares sleep paralysis catathrenia loss of muscle atonia agression ```

Question 33

what groups are likely to get rem sleep behaviour disorder?

Answer 33

``` male 50-65 lewy body cause? mild cognitive impairment antidepressants ```

Question 34

what condition is rem behaviour disorder a predictor of?

Answer 34

parkinsons

Question 35

how can rbd be treated?

Answer 35

melatonin has good evidence