Sleep physiology and disorders Flashcards Preview

Neurology > Sleep physiology and disorders > Flashcards

Flashcards in Sleep physiology and disorders Deck (14)
Loading flashcards...
1
Q

What are the two stages of sleep?

A

2 stages of sleep: rapid eye movement sleep and non-rapid eye movement sleep

2
Q

Describe REM sleep

  • what proportion of sleep is this
  • what is this assoc. with
  • what is this particularly good for?
A

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
3
Q

Describe NREM sleep

-how many phases?

A

subdivided into 4 phases – with progressively slower wave forms on EEG

this is more important as the cortex relaxes
4
Q

What are the 3 factors that influence sleep?

A

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
5
Q

What scale can be used to assess sleepiness?

A

epworth scale

6
Q

What are sleep disorders called?

A

parasomnias

7
Q

What is REM sleep behavior disorder?

  • what happens?
  • what is reported by partner?
  • what is the treatment
A

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
8
Q

What is NREM parasomnia?

A

these occur in the first half of sleep and include sleep walking and night terrors

9
Q

What is narcolepsy?

-what is the criteria?

A

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

10
Q

How is narcolepsy diagnosed?

  • what is the most common cause?
  • what is the treatment?
A

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
11
Q

What is the most common cause of excessive daytime somnolencE?

A

Sleep apnoea

12
Q

What are the clinical features of sleep apnoea?

A

Common cause of excessive daytime somnolence

Unrefreshed from waking from sleep 

Morning headaches 

Often snore 

Partial upper airways obstruction becomes further narrowed or obstructed during sleep
13
Q

How can sleep apnoea be diagnosed? what is the treatment?

A

Sleep recordings reveal arousals from sleep

5-20/h mild 

20-40/h moderate 

>40 severe 

trial of continuous positive airway pressure may be necessary 

some patients require surgery to remove excess soft tissue from the upper airways
14
Q

What is idiopathic hypersomnolence? what is the treatment?

A

under-recognised and may affect the young

urges to sleep occur and last for 1-2hrs and are unrefreshing 

treatment – modafinil