What is sleep?
Recurring, reversible state where you lose ability to respond to environment
Are you conscious or unconscious when asleep?
Both
What are the two main types of sleep?
REM sleep
Non-R.E.M. Sleep
When does
a) R.E.M. sleep
b) Non-R.E.M. sleep occur?
a) End of the night, short period
b) Start and most of the night
What happens to the body during non R.E.M. sleep?
Relaxation of muscles
Decreased HR and BP
Reduced respiration
Protein synthesis, cell division and growth
What happens to your
a) muscles
b) blood flow
during R.E.M. sleep?
a) complete relaxation (atonic, to stop you from jumping out of bed)
b) increases
What is the most important type of sleep?
Non-R.E.M. sleep
makes up the majority
What is the homeostatic process of sleep?
If you’re in a ‘sleep debt’, your body will try to sleep
Being awake and being asleep are partly controlled by your body’s ___ rhythm.
Circadian
What stimulus ‘resets’ your body clock?
Light
via ‘non-rod, non-cone cells’
What is the name for a stimulus which acts as a cue for your body’s circadian rhythm?
Zeitgeber
Sleep ___ has profound effects on your behaviour and cognition.
Sleep deprivation
What happens when you sleep?
Growth and repair
Protein synthesis and cell division
What is the only time which the cortex rests?
During sleep
What are some of the effects of sleep deprivation?
Loss of concentration
Visual hallucinations
Irritable behaviour
Which behaviours aren’t affected by sleep deprivation?
Strongly reinforced habits e.g protocols
Does sleep deprivation itself kill people?
Probably
People who are sleep deprived are more likely to die in ___.
accidents
At which times does your circadian rhythm make you the most tired?
2pm
4am
How long should you sleep at night?
7 - 8 hours
How long should you nap for in the afternoon?
15 minutes
equivalent to 90 minutes of overnight sleep
Confusion all arousal / Non R.E.M. parasomnia
Why do patients behave primally during confused arousal?
Primitive brain ‘wakes up’ first
What is a parasomnia?
Abnormal transitions from sleeping to wakefulness
e.g sleepwalking, talking, night terrors, paralysis, bruxism
What is a R.E.M. Parasomnia?
Simple behaviours e.g kicking occurring during the last third of the night
R.E.M. parasomnias are strongly associated with which neurodegenerative disease?
Parkinson’s disease
In which disease do patients frequently fall asleep involuntarily?
Narcolepsy
What is the presentation of narcolepsy?
Daytime sleepiness - impossible to resist
Cataplexy - hypotonia in response to strong emotions
Hallucinations - at sleep onset
Sleep paralysis
REM parasomnias
What are the investigations for narcolepsy?
Overnight polysomnography - EEG strapped to head, sleep waves analysed
Multiple sleep latency test
How does a multiple sleep latency test work?
What does it find in narcolepsy?
Patient timed getting to sleep up to four times
REM sleep occurs much faster than in normal people
Do narcolepsy patients lose consciousness during a cataplectic attack?
No
so it’s terrifying
Narcolepsy is a hugely ____ disease.
disabling
What is insomnia?
Inability to sleep
What is psychophysiological insomnia?
Loss of association between bed and sleep