Flashcards in Sleep physiology and disorders Deck (14):
What are the two stages of sleep?
2 stages of sleep: rapid eye movement sleep and non-rapid eye movement sleep
Describe REM sleep
-what proportion of sleep is this
-what is this assoc. with
-what is this particularly good for?
25% sleeping time
associated with dreaming
skeletal muscles become atonic with exception of eyes and diaphragm
good for brain development – infants have more REM sleep
Describe NREM sleep
-how many phases?
subdivided into 4 phases – with progressively slower wave forms on EEG
this is more important as the cortex relaxes
What are the 3 factors that influence sleep?
homeostatic reflex – the longer you’re awake, the easier it is fall asleep
emotional – if feel nervous can’t sleep
circadian rhythm – body clock: changes with age
What scale can be used to assess sleepiness?
What are sleep disorders called?
What is REM sleep behavior disorder?
-what is reported by partner?
-what is the treatment
acting out dreams
often seen in alpha-synucleinopathies (e.g. MSA)
sleeping partner reports patient kicking and punching in sleep
waking is associated with dream content
treat with benzodiazepine
What is NREM parasomnia?
these occur in the first half of sleep and include sleep walking and night terrors
What is narcolepsy?
-what is the criteria?
This is both a disorder of the ability to sustain wakefulness voluntarily and a disorder of REM sleep.
Needs A and B to be present:
A irresistible urges to fall asleep for 15-30 min: patient awakes refreshed. Sleep at night is often disrupted (excessive daytime somnolence)
B cataplexy: loss of posture (head droops, eyelids droop or falling to the floor) provoked by an emotional response e.g. laughter
(sudden weakness or loss of muscle tone without loss of consciousness)
C sleep paralysis: awakes not able to move – this can be normal
D hallucinations just before dropping off to sleep or upon wakening
E fugue-like states with autonomic obedience – almost a waking prolonged absent-minded daydream state
B/C/D/E – intrusion of REM sleep into transition between wakefulness and sleep
How is narcolepsy diagnosed?
-what is the most common cause?
-what is the treatment?
seems to be dysregulation of REM sleep
diagnosed clinically and with the multiple sleep latency test – abnormal if non-sleep deprived subject sleeps before 8mins (8-10 is borderline) and REM onset
most common causes: sleep deprivation or chronic sleep apnoea
treatment is modafinil/amphetamine for sleep disorder
Tricyclic or SSRI for cataplexy
What is the most common cause of excessive daytime somnolencE?
What are the clinical features of sleep apnoea?
Common cause of excessive daytime somnolence
Unrefreshed from waking from sleep
Partial upper airways obstruction becomes further narrowed or obstructed during sleep
How can sleep apnoea be diagnosed? what is the treatment?
Sleep recordings reveal arousals from sleep
trial of continuous positive airway pressure may be necessary
some patients require surgery to remove excess soft tissue from the upper airways