1: Sleep - physiology, hypersomnolence, parasomnias Flashcards Preview

Neurology Week 4 2018/19 > 1: Sleep - physiology, hypersomnolence, parasomnias > Flashcards

Flashcards in 1: Sleep - physiology, hypersomnolence, parasomnias Deck (34)
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1
Q

What is sleep?

A

Recurring, reversible state where you lose ability to respond to environment

2
Q

Are you conscious or unconscious when asleep?

A

Both

3
Q

What are the two main types of sleep?

A

REM sleep

Non-R.E.M. Sleep

4
Q

When does

a) R.E.M. sleep
b) Non-R.E.M. sleep occur?

A

a) End of the night, short period
b) Start and most of the night

5
Q

What happens to the body during non R.E.M. sleep?

A

Relaxation of muscles

Decreased HR and BP

Reduced respiration

Protein synthesis, cell division and growth

6
Q

What happens to your

a) muscles
b) blood flow

during R.E.M. sleep?

A

a) complete relaxation (atonic, to stop you from jumping out of bed)
b) increases

7
Q

What is the most important type of sleep?

A

Non-R.E.M. sleep

makes up the majority

8
Q

What is the homeostatic process of sleep?

A

If you’re in a ‘sleep debt’, your body will try to sleep

9
Q

Being awake and being asleep are partly controlled by your body’s ___ rhythm.

A

Circadian

10
Q

What stimulus ‘resets’ your body clock?

A

Light

via ‘non-rod, non-cone cells’

11
Q

What is the name for a stimulus which acts as a cue for your body’s circadian rhythm?

A

Zeitgeber

12
Q

Sleep ___ has profound effects on your behaviour and cognition.

A

Sleep deprivation

13
Q

What happens when you sleep?

A

Growth and repair

Protein synthesis and cell division

14
Q

What is the only time which the cortex rests?

A

During sleep

15
Q

What are some of the effects of sleep deprivation?

A

Loss of concentration

Visual hallucinations

Irritable behaviour

16
Q

Which behaviours aren’t affected by sleep deprivation?

A

Strongly reinforced habits e.g protocols

17
Q

Does sleep deprivation itself kill people?

A

Probably

18
Q

People who are sleep deprived are more likely to die in ___.

A

accidents

19
Q

At which times does your circadian rhythm make you the most tired?

A

2pm

4am

20
Q

How long should you sleep at night?

A

7 - 8 hours

21
Q

How long should you nap for in the afternoon?

A

15 minutes

equivalent to 90 minutes of overnight sleep

22
Q

Confusion all arousal / Non R.E.M. parasomnia

A
23
Q

Why do patients behave primally during confused arousal?

A

Primitive brain ‘wakes up’ first

24
Q

What is a parasomnia?

A

Abnormal transitions from sleeping to wakefulness

e.g sleepwalking, talking, night terrors, paralysis, bruxism

25
Q

What is a R.E.M. Parasomnia?

A

Simple behaviours e.g kicking occurring during the last third of the night

26
Q

R.E.M. parasomnias are strongly associated with which neurodegenerative disease?

A

Parkinson’s disease

27
Q

In which disease do patients frequently fall asleep involuntarily?

A

Narcolepsy

28
Q

What is the presentation of narcolepsy?

A

Daytime sleepiness - impossible to resist

Cataplexy - hypotonia in response to strong emotions

Hallucinations - at sleep onset

Sleep paralysis

REM parasomnias

29
Q

What are the investigations for narcolepsy?

A

Overnight polysomnography - EEG strapped to head, sleep waves analysed

Multiple sleep latency test

30
Q

How does a multiple sleep latency test work?

What does it find in narcolepsy?

A

Patient timed getting to sleep up to four times

REM sleep occurs much faster than in normal people

31
Q

Do narcolepsy patients lose consciousness during a cataplectic attack?

A

No

so it’s terrifying

32
Q

Narcolepsy is a hugely ____ disease.

A

disabling

33
Q

What is insomnia?

A

Inability to sleep

34
Q

What is psychophysiological insomnia?

A

Loss of association between bed and sleep