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Sleep Flashcards

1
Q

Uses of EEG

A

. Diagnosis of disease
. Determination of brain death
. Distinguish stages fo sleep

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2
Q

Alpha wave

A

. Rhythmic waves w/ freq. of 8-13 Hz and moderately low voltage
. Characteristic of awake patients resting quietly

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3
Q

Beta waves

A

. Lower voltage at higher frequency (14-50 Hz)
. During activation of cortex in awake patient
. Observed primarily when actively concentrating

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4
Q

Theta waves

A

. Higher voltage w/ freq. of 4-7 Hz
. Mostly recorded in children in parietal and temporal lobes
. Can be seen in adults experiencing frustration and disappointment
. Recorded during stages 2-4 of slow-wave sleep and in bursts during REM

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5
Q

Delta waves

A

. Very slow (less than 4 Hz) high voltage waves
. Recorded in stage 3 slow-wave sleep and stage 4 slow wave sleep
. Also characteristic of coma

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6
Q

Waking state

A

. Alpha when relaxed

. Beta when concentrating (beta replaces alpha)

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7
Q

Types fo sleep

A

Slow-wave sleep

. REM

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8
Q

Stage 1 sleep

A

. Alpha waves disappear and replaced by low voltage mixed freq. waves
. Thoughts become dissociated but subjects easily aroused by low-intensity stimulation
. Transitional stage btw drowsy but awake and light sleep

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9
Q

Stage 2 sleep

A

. Light creep
. Low voltage mixed freq. waves
. Occurrence of sleep spindles (short bursts alpha waves) and K complexes (single large biphasic deflections)

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10
Q

Stage 3 sleep

A

. Deep sleep w/ delta waves w/ freq. less than 2Hz observed 20-50% of time

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11
Q

Stage 4 sleep

A

. Deep sleep w/ delta waves more than 50% of the time

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12
Q

Eye movement in slow wave deep sleep stages

A

. Stage 1: slow rolling movement
. 2-4 motionless
. Other skeletal mm. Are active during stages 1-4

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13
Q

REM sleep

A

. At end of each slaw wave sleep cycle
. Short period where EEG pattern looks similar to wide awake pattern (beta) even through person is dreaming and not awake
. Difficult to arouse person, but a person is more likely to spontaneously wake up in REM that’s other stages
. Rapid eye movements
. Irregular HR and respiration
. Story-like dreaming

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14
Q

New sleep classification system

A

. Stage W: wakefulness
. Stage N1 and N2: light sleep
. Stage N3: (combines stages 3 and 4): deep sleep
. Stage R: active/REM sleep
. Pattern of cycles called sleep architecture

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15
Q

When are stages 3 and 4 more likely to occur opposed to REM

A

. 3 and 4 more likely in first few hrs of sleep
. REM more frequent and period is longer late in sleep period (morning hrs)
. If total sleep time is shortened then REM sleep is disproportionately reduced

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16
Q

Age in relation to sleep cycle

A

. Sleep time dec. w/ age

. Relative percentage of REM vs slow wave dec. from infancy to adulthood

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17
Q

Skeletal mm. Changes during sleep

A

. activity declines during slow wave sleep
. During REM there is tonic inhibition of skeletal m. Except eye mm. And primary mm. Of respiration
. Period twitches and muscular tremors of face and limbs occur in REM when periodic bursts of excitatory activity break through generalized tonic inhibition

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18
Q

Cardiovascular and respiratory system during sleep cycle

A

. Slow wave sleep has steady dec. in bp, HR, and RR
. REM has inc. and large oscillations in bp, HR, and RR
. Very high phasic bps in REM assoc. w/ strokes and heart attacks
. Fatal heart attacks most common from 5-6am when most people are in REM sleep

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19
Q

Growth hormone in children sleep cycle

A

. Secreted exclusively during sleep
. Peaks during early portion of sleep period (non-REM stages 3 and 4)
. In adolescence and puberty it is still mostly at night but there are also peaks throughout the day

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20
Q

Prolactin in sleep

A

. Secretion occurs almost entirely during sleep

. Maximal in morning hours

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21
Q

Cortisol during sleep

A

. Reaches its minimum early in sleep and peaks at end of sleep period

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22
Q

TSH secretion during sleep

A

. Peaks prior to onset of sleep and then declines during sleep

23
Q

Luteinizing hormone during sleep

A

. Drives testosterone production
. Inc. during sleep responsible for meal puberty
. LH secretion in adult males is less related to sleep

24
Q

Follicle stimulating hormone in sleep

A

. Follows similar pattern to LH

. During female puberty it peaks during sleep

25
Body temp during sleep
. As night progresses core Body temp drops reaching minimum during slow wave sleep. In early morning hrs . During REM body temp. Inc. slightly
26
Renal function changes during sleep
. Dec. urine volume | . Inc. osmolality
27
Functions of slow wave sleep
. May serve as time for body rest and metabolic restoration
28
REM sleep functions
. Needed for physical changed necessary for long-term memory and learning
29
Circadian rhythm cycle
8 hr sleep | 16 hr awake
30
Suprachiasmatic nucleus of hypothalamus
. Basic circadian rhythm . Inputs from retina modulate it . Jet lag and sleep problems assoc. W/ working alternating shifts dur to confusion of visual cues . Interacting pos. And neg. feedback loops that regulate gene expression are central to setting basic circadian rhythm
31
Arousal systems in brain
. Cholinergic neurons in upper pons activate thalamic nuclei and adrenergic neurons in upper brainstem to stimulate cerebral cortex . Peptidergic neurons in hypothalamus contain orexins and melanin concentrating hormone to stimulate cerebral cortex and brainstem arousal areas
32
Arousal system in brainstem
. Raphe nuclei . Part of reticular activating system that sets general level of arousal . Amphetamines act here to promote arousal and dec. sleep . Excitatory neurons in reticular activating system are active during working state and lead to arousal and enhanced attention to outside word
33
Sleep systems in hypothalamus
. Inhibitory GABA-containing neurons in preoptic nucleus of hypothalamus inhibit arousal areas of brainstem . Orexin-containing neurons in lat. hypothalamus activate arousal areas . His-containing neurons in post. Hypothalamus project to reticular activating system and promote wakefulness . Drowsiness assoc. w/ anti-histamines due to inhibition of histaminergic neurons
34
REM-promoting areas of brain
. Pontine tegmentum | . Ventrolat. Periaqueductal gray matter
35
Sleep-promoting peptides
. VIP and delta sleep inducing peptide (DSIP) inducing delta waves . DSIP does not initiate sleep but keep sleep/wake cycle in proper order
36
Sleep-inhibiting peptides
Orexins/hypocretins . Released from neurons whose cell bodies are in lat. hypothalamus but axons project throughout brain . Similar to GI hormone secretin . Activate thalamic nuclei and stimulate cerebral cortex and brainstem around areas
37
Cytokines and sleep
.lipopolysaccharide . IL-1 . Interferon-alpha-2 . TNF
38
Cholecystokinin (CCK) and sleep
. Contributes to drowsiness assoc. w/ large meal
39
ADH and sleep
May promote REM sleep
40
Melatonin
. Secreted by pineal gland . Acts on suprachiasmatic nucleus via specific receptors that lead to gene transcription of proteins involved in circadian rhythm . Useful treatment of jet lag and insomnia in elderly but not as general sleeping pill
41
Insomnia
, difficulty falling asleep, awakening frequently, waking up early and not being able to get back to sleep . Waking up feeling unrefreshed . Caused by stress, anxiety, caffeine
42
Disorders of excessive somnolence (DOES)
. Most common is narcolepsy . Chronically sleepy during day . Often have abnormal tendency to progress suddenly from being awake to REM sleep in response to emotional stimulus . Abnormal REM sleep accompanied by cataplexy (loss of mm. Tone/paralysis) . Assoc. w/ loss of hypocretin producing cells in hypothalamus
43
Dysomnias
. Disturbances of normal circadian rhythmicity of sleep | . Jet lag is reduced after a 16 hr fast
44
Parasomnias
. Normally undesirable behaviors that occur exclusively during sleep or are exaggerated by sleep
45
Night terrors
. Certain types of dreams occurring during slow wave sleep characterized by feelings as opposed to specific images . Most common in kids 3-5 . Child will waken abruptly, scream and run about disoriented unable to speak coherently, then go back to sleep after 3-4 minutes
46
Sleepwalking
. Complex motor behaviors while person is in slow wave sleep . Eyes are open and person appears awake
47
REM sleep disorder
. Person acts out dreams during sleep when they are normal paralyzed . Dreams usually frightening and are. Accompanied by violent behavior
48
Pseudoinsomnia (sleep state misperception)
. Person sleeps adequately but dreams about not being asleep . Wake up tired w/ dark eye circles
49
Obstructive sleep apnea
. Physical blockage of airway due to collapse of soft tissue in rear of through . Assoc. w/ obesity and snoring
50
Central sleep apnea
. Rare . Skeletal m. Inhibition during REM extends to inhibition of respiratory mm. . Lead to inc. risk of high bp, stroke, and heart attack . Can be turreted w/ CPAP or surgery . Weight loss can be effective long-term solution
51
Restless leg syndrome and periodic limb movement disorder
. Pins and needles, itchiness, or creeping crawling sensations leading to vigorous movement of legs esp. around bedtime . Awakens sleeper during sleep . PLMD consists of repetitive movement of toe, foot, knee, or hip during sleep that can also lead to awakening . Treatment if severe: dopaminergic agonists, benzos, or opioids
52
Effects of sleep deprivation
. Inc. incidence of hypertension, weight gain, periodontal disease, and suicide . Acute deprivation leads to cognitive decline, mood swings, and depression
53
Sleep promoting pharmacology
. Alcohol due to relaxation . Hypnotics . Anti-histamines . DSIP
54
Sleep inhibiting drugs
. Caffeine . Meds (steroids, opiates can cause sleep apnea, vit. B) . Cocaine: suppresses REM sleep . Newer narcolepsy drugs: stimulants modafinil and armodafinil

Neuroscience (31 decks)

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