Sleep

Question 1

What is sleep?

Answer 1

A normal recurring reversible state in which you loose the ability to respond to the external environment.
Not fully aware of self but able to respond to stimuli

Question 2

Non REM sleep

Answer 2

More common at the beginning of the night

Some non narrative images

Question 3

What proportion of sleep for the young in NREM?

Answer 3

3/4

Question 4

What does an EEG show in NREM?

Answer 4

Synchronised rhythmic activity

Question 5

Describe the physiological state found in NREM.

Answer 5

Partial muscle relaxation
Reduced cerebral blood flow
Reduced HR BP Tidal volume

Question 6

What does REM stand for?

Answer 6

Rapid Eye Movement

Question 7

Describe REM sleep.

Answer 7

Mostly at the end of the night.

Narrative dreaming

Question 8

What does an EEG show in REM?

Answer 8

Fast activity

Question 9

Describe the physiological state found in REM.

Answer 9

Atonic muscles except diaphragm and extra ocular
Increased cerebral blood flow
Impaired thermal regulation
Increase active shown on brain fMRI

Question 10

Why is deep sleep essential?

Answer 10

Allows the cortex to recover

Question 11

If you are sleep deprived and finally manage to fall asleep for a short period what form of sleep is prioritised?

Answer 11

Deep sleep

Question 12

What is the function of REM sleep?

Answer 12

Mainly plays a roll in brain development

Substitute for stimulation from the external environment

Question 13

REM sleep is indispensable.

Answer 13

False it is likely to be dispensable as Dolphins don’t have an REM cycle and drugs such as Tricyclics suppress it.

Question 14

Describe the sleep of a neonate.

Answer 14

16hrs a day roughly a sleep.

50% is REM in order to provide enough stimulation to the developing brain.

Question 15

As you get older the proportion of REM sleep you experience …….

Answer 15

Decreases

Question 16

Describe the sleep of an elderly person.

Answer 16

Increased awakening during the night
Naps throughout the day
REM is reduced
Overall time asleep is reduced

Question 17

What three things dictate if you can fall asleep?

Answer 17

Homeostatic
Emotional
Circadian rhythm

Question 18

What is the homeostatic factor in sleep?

Answer 18

Longer you are awake the more sleepy you get as you build up a sleep debt.

Question 19

What is the emotional factor in sleep?

Answer 19

Need to be in a state of relaxation ad comfortable enough to sleep.

Question 20

What is the circadian rhythm?

Answer 20

Your internal body clock controlled by the light .

Question 21

What length cycle does your body clock run?

Answer 21

25 hours

Question 22

What is the sleep pattern on an adolescent?

Answer 22

Delayed

Question 23

What is the sleep pattern of the elderly?

Answer 23

Early

Question 24

What else does your circadian rhythm control?

Answer 24

Appetite
Thermoregulation
Hormone regulation
Alertness

Question 25

How does light affect your circadian rhythm?

Answer 25

Retinal ganglion cells enervated which project to the suprichiasmatic nucleus

Question 26

What cells make up the retinal ganglion cells involved in the circadian rhythm?

Answer 26

Non cone Non rod cells

Question 27

What colour light particularly affects your circadian rhythm?

Answer 27

Blue light

Question 28

After 5 days of no sleep why is your endurance in exercise reduced?

Answer 28

Sleep has no recorded impact on your physiological state your endurance is reduced due to psychological fatigue.

Question 29

Describe the affect of sleep on your body repairing itself.

Answer 29

No affect on muscle recovery | Tissue repair is increased

Question 30

Why is tissue repair increased during sleep?

Answer 30

Release of sleep related growth hormone SRgh

Question 31

Which areas of the brain require the most sleep?

Answer 31

Cortical regions of the brain controlling complex function

Question 32

When awake can regions of the brain rest whilst not in use?

Answer 32

No the cortex stays in a state of quiet readiness

Question 33

What are some of the affects of prolonged sleep deprivation?

Answer 33

NO psychcosis | Irritable, Suspicious, Visual illusion, Loss of concentration, Visual illusions, Reduced alertness

Question 34

Which region of the brain is responsible for most the symptoms of sleep deprivation?

Answer 34

Prefrontal

Question 35

How does sleep kill?

Answer 35

Not directly Most accidents occur around 4am. reduced alertness communication and decision making skills.

Question 36

What is an acceptable duration of sleep?

Answer 36

7-7.5 hours

Question 37

What is the ideal duration of nap and how much normal sleep is it worth?

Answer 37

15 mins is equivalent to 90 mins during the night

Question 38

Describe parasomnia during REM sleep.

Answer 38

None of the usually atonia. Interact with the dreams e.g simple movement kicking etc Occurs in last 1/3 of the night

Question 39

Describe parasomnia during NREM

Answer 39

Complex behaviours | Between waking up and actually being awake

Question 40

What are the main symptoms on narcolepsy?

Answer 40

``` Daytime sleepiness Cataplexy Hypnagogic hallucinations RBD - REM behaviour disorders Sleep Paralysis ```

Question 41

Describe daytime sleepiness associated narcolepsy.

Answer 41

Involuntary and irresistible somnolence that can occur during any activity.

Question 42

What is cataplexy?

Answer 42

Loss of all muscle tone triggered by severe and sudden emotion Jaw weakness and collapsing

Question 43

What proportion of narcolepsy patients present with cataplexy?

Answer 43

70%

Question 44

Epidemiology of Narcolepsy.

Answer 44

M:F 1:1 | Onset has two peaks 15y to 36y

Question 45

When do hypnagogic hallucinations occur with narcolepsy?

Answer 45

Occurs at the onset of sleep

Question 46

What are hypnogogic hallucinations?

Answer 46

Very vivid and lucid dreams

Question 47

What are RBD REM behaviours disorders?

Answer 47

Acting out of dream

Question 48

What is the social impact of narcolepsy?

Answer 48

Reduced social and academic outlook Reduced employability Social embarrassing

Question 49

What investigations should be undertaken for narcolepsy?

Answer 49

Overnight polysomnographs Multiple sleep latency tests Lumbar puncture

Question 50

What is observed in the multiple sleep latency test?

Answer 50

REM sleep is reached much faster

Question 51

What is seen on lumbar puncture in narcolepsy?

Answer 51

Increased hypocretin | Neither specific or sensitive

Question 52

If someone with narcolepsy is a driver what must happen?

Answer 52

Not allowed to drive until control is achieved | Permanently excluded from a type 2 licence