Sleep physiology, hyper somnolence, parasomnias Flashcards Preview

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Flashcards in Sleep physiology, hyper somnolence, parasomnias Deck (27)
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1
Q

Describe non-REM sleep

A

More at start of night
Synchronised, rhythmic EEG activity, partial relaxation of muscles, reduced cerebral blood flow
Reduced HR, blood pressure and tidal volumes
Some non-narrative images

2
Q

Describe REM sleep

A

Mostly at end of night
EEG shows fast activity, similar to wakefulness
Atonic muscles (except diaphragm and extra ocular muscles
Cerebral blood flow increased, impaired thermoregulation
Narrative dreaming

3
Q

Which part of sleep is essential?

A

Non-REM

4
Q

What is REM sleep thought to be for?

A

Early brain development- substitute for wakefulness

5
Q

Which drugs suppress REM

A

Tricyclic

6
Q

What is non-REM sleep for?

A

Protein synthesis, cell division and growth

7
Q

What does circadian rhythm regulate?

A

Sleep-wake, appetite, body temperature, hormone secretion, alertness

8
Q

How long is a normal circadian rhythm?

A

25 hours

9
Q

How does light entrain body clock?

A

Uses retinal ganglion cells projecting to suprachiasmatic nucleus. Non-rod, non-cone cell/

10
Q

When does cell division peak?

A

Skin mitosis peaks during sleep, however time of day effect- also increases after meals

11
Q

What are the side effects of sleep deprivation?

A

Irritable and suspicious
Visual illusions
Microsleeps and concentration lapses

12
Q

About __% of RTAs attended by police are sleep related

A

10%

13
Q

What is an appropriate amount of sleep?

A

7-7.5 hours

14
Q

A mid afternoon nap is equivalent to __ minutes of sleep overnight

A

90

15
Q

What are the non- REM parasomnias?

A
Non-dreaming
Confusional arousals
sleep walking
Sleep terrors and paralysis
Bruxism
Restless legs and PMLS
16
Q

When are REM parasomias often seen?

A

Preceding PD

17
Q

Which type of sleep disorders show simpler behaviour?

A

REM parasomnias

18
Q

What are the peaks of onset of narcolepsy?

A

age 15 and 36

19
Q

What is the clinical presentation of narcolepsy?

A

Characterised by;

  • Daytime sleepiness
  • Cataplexy
  • Hynagogic hallucinations
  • Sleep paralysis
  • RBD
20
Q

What is daytime sleepiness?

A

Involuntary somnolence during eating/talking

May be severe, and impossible to resist

21
Q

What is cataplexy?

A

Loss of muscle tone triggered by emotion

22
Q

What are hypnagogic hallucinations?

A

Hallucinations occurring at sleep onset

23
Q

What is sleep paralysis?

A

Unable to move upon falling asleep or awakening with retained consciousness

24
Q

What is RBD

A

Sleep behaviour disorder -present in 7-36% of patients with narcolepsy

25
Q

What are the investogations for narcolepsy?

A

Overnight polysomnography

Multiple sleep latency test

Lumbar puncture

26
Q

What is involved in a multiple sleep latency test?

A

4 twenty five minute maps are scheduled out two hours apart

Record of EEG, muscle activity and eye movement recorded

Measures time from start of a daytime nap to the first signs of sleep (sleep latency)

Faster patient falls asleep the more tired they are

27
Q

What is checked in lumbar puncture for narcolepsy?

A

CSF hypocretin levels, Low levels (less than 110pg/ml or 1/3 of the mean control value) are consistent with narcolepsy