Sleep and Wakefulness

Question 1

Sleep current definition

Answer 1

Highly organized state generated by the cooperative interplay of many bx and neural components

Question 2

EEG of an awake brain

Answer 2

Low voltage, high frequency, fast activity

Question 3

EEG of an asleep brain

Answer 3

Amplitude higher, but less frequency

Slow, synchronized oscillatory, activity is low

Question 4

EOG is looking at what

Answer 4

eye movements to segment sleep based on the eye movement

Question 5

EMG is looking at what

Answer 5

muscle tone

Question 6

2 main phases of sleep

Answer 6

NREM

REM

Question 7

NREM has how many stages

Answer 7

4

Question 8

Stage 1 NREM

Answer 8

Transition from awake to sleeping

Start to see dec in EEG high freq activity

Question 9

Stage 2 NREM

Answer 9

First true stage of sleep

EEG shows spindle waves and K complexes

Question 10

Stage 2 NREM - spindle waves and K complexes are reflective of what

Answer 10

Oscillations between thalamus and cerebral cortex - reflective of gradual relaxation and hyperpolarization of neurons

Question 11

Stage 2 NREM - what happens

Answer 11

Muscle tone dec
Arousal dec
Respiration dec
Temp dec
Eyes roll back and forth

Question 12

Stage 3 NREM

Answer 12

See greater delta wave oscillations, greater slow wave oscillations - signal inc synchronization of cortical and thalamic activity
Further reduction in arousal

Question 13

Stage 4 NREM

Answer 13

Dominance of slow wave activity

Deepest stage of sleep

Question 14

Sleep cycle consists of

Answer 14

Stage 1-4 NREM
Reverse 4-1
REM

Question 15

What happens as the sleep cycle continues throughout the night

Answer 15

Depth of NREM decreases

Duration in REM increases

Question 16

Sleep in REM - what happens on EEG

Answer 16

It goes back to state of higher frequency activity

Brain is activated

Question 17

Sleep in REM - what happens

Answer 17

Inc head movement
Inc HR and RR
Dreams are longer, visual, emotional, not connected to events of daily life

Question 18

Sleep in REM - what percent of total sleep time

Answer 18

25%

Question 19

Circadian Rhythms - are what

Answer 19

day-night cycle

Question 20

What is responsible for Circadian rhythms

Answer 20

Specific retinal ganglion cells that respond to light
Project to suprachiasmic nucleus in the hypothalamus
Firing frequency of the neurons in the nucleus follow an endogenous circadian rhythm

Question 21

What is the master clock, pacemaker that organizes sleep

Answer 21

Suprachiasmatic nucleus in the hypothalamus

Question 22

Sleep - rhythm within sleep of NREM and REM is controlled by what

Answer 22

Brainstem appears to be critical for switch
REM on cells that fire during REM - cholinergic
REM off cells that maximally fire at offset of REM - serotonergic

Question 23

Sleep - rhythm within sleep of NREM and REM - where are the REM on and off cells located

Answer 23

Pontine and geniculate nuclei of the brainstem

Question 24

Sleep deficit is what

Answer 24

Level of sleepiness

Naturally builds up throughout the day

Question 25

Circadian rhythm is defined as what when it comes to determining sleep drive

Answer 25

Defines alertness peaks and wanes throughout the day

Question 26

Sleep drive is defined as what

Answer 26

the difference beteen sleep deficit (sleepiness) and circadian rhythm (alertness)

Question 27

As you get older what happens

Answer 27

Found that people don't sleep as much

Question 28

Sleep disorders - what percent of people experience significant difficulties with sleep on occasion

Answer 28

more than 50%

Question 29

Statistics for people who suffer from chronic sleep problems

Answer 29

1 in 5 people Disruption of sleep and waking is the most common prevalent health disorder in the US! - most common complaint when people go to see their PCP

Question 30

The most common for of sleep disruption is

Answer 30

insomnia

Question 31

Insomnia description

Answer 31

Can be prolonged/severe or temporary/mild Incidence inc with age More common in F

Question 32

Insomnia is defined as what

Answer 32

Difficulty falling asleep, staying asleep or both | Often associated with depression

Question 33

Meds for insomnia

Answer 33

Benzodiazapines Antihistamines Antidepressants

Question 34

Sleep apnea is what

Answer 34

cessation of breathing during sleep | fragmentation of sleep, decrease in sleep quality, daytime sleepiness!

Question 35

Most common type of sleep apnea

Answer 35

Obstructive sleep apnea - physical obstruction of pharynx/breathing can cease for 10 sec or more

Question 36

Sleep apnea - incidence

Answer 36

increases with age | more common in M

Question 37

Sleep apnea - risk factor for

Answer 37

stroke

Question 38

Narcolepsy - impacts what % of pop

Answer 38

0.04%

Question 39

Narcolepsy description

Answer 39

Sleep and sleep mechanisms invade daytime periods | Sleep at night is fragmented and disrupted

Question 40

Narcolepsy - 5 symptoms

Answer 40

1 Sleep attacks during day 2 cataplexy (sudden mm tone, fall, but conscious) 3 hallucinations during transition from sleep to wake 4 sleep paralysis during transition 5 disturbed nocturnal sleep

Question 41

Meds - narcolepsy

Answer 41

amphetamines/CNS stimulant | antidepressants

Question 42

Exercise and sleep

Answer 42

People who slept better were people who exercised | Correlation but no evidence for causality

Question 43

Exercise can help sleep by

Answer 43

Reducing anxiety, reduce depression, temperature regulation, circadian phase shifting effect, improve RLS

Question 44

Sleep disorders and stroke -

Answer 44

Obstructive sleep apnea Insomnia Habitual snoring

Question 45

Untreated sleep disorders do what to stroke outcome

Answer 45

Lengthen hospital stay, influence stroke outcome and re-occurrence

Question 46

Insomnia in TBI

Answer 46

30-70% of TBI pt report s/s of insomnia | Can lead to exacerbation of s/s

Question 47

Implications of insomnia and TBI

Answer 47

Compromise rehab ability or ability for pt to return to work

Question 48

Sleep disorders in chronic TBI

Answer 48

Hypersomnia - 50% - mostly due to sleep apnea, narcolepsy, and periodic limb movement disorder Insomnia - 25% mostly due to sleep maitenence insomnia and sleep onset insomnia

Question 49

Sleep changes common in acute or chronic TBI

Answer 49

BOTH