Sleep Physiology, Hypersomnolence, Parasomnias Flashcards Preview

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Flashcards in Sleep Physiology, Hypersomnolence, Parasomnias Deck (42):
1

what is sleep?

normal, recurring, reversible state where there is loss of ability to respond to external environment

2

what makes sleep not a conscious state?

not fully aware of self and environment

3

what makes sleep not an unconscious state?

can respond when stimulated

4

when do you have more non REM sleep?

start of night (3/4 of sleep for young adults is NREM)

5

what occurs to the body during non REM sleep?

synchronised, rhythmic EEG activity

partial muscle relaxation

reduced cerebral blood flow

6

what is heart rate during non REM sleep?

reduced heart rate

7

do you dream during non REM sleep?

yes - get some non-narrative images

8

when do you have more REM sleep?

end of night

9

what happens to body during REM sleep?

EEG shows fast activity

fMRI shows increased brain activity - similar to awake

atonic muscles (except diaphragm and extraocular muscles)

increased cerebral blood flow
impaired thermal regulation

10

do you dream during REM sleep?

yes - narrative dreaming

11

what type of sleep is more important?

non REM sleep (deep sleep)

12

why is non REM sleep more important?

allows cortex to recover after a busy day

13

what is the main role of REM sleep?

early brain development in children

14

what type of drugs suppress REM sleep?

tricyclics

15

how many hours per day do neonates spend seeping?

what kind of sleep?

16
50% REM sleep, shorter cycles

16

what is the trend of REM sleep during 1st decade?

percentage REM sleep falls

REM latency increases

17

what kind of sleep habits do elderly experience?

increased awakenings

reduced REM latency and total sleep time

daytime napping

18

what are the three critical processes of sleep onset?

homeostatic response - regulated need for sleep

emotional response - brain has to be ready to go to bed

circadian rhythm - body clock

19

do adolescents have an advanced or delayed sleep pattern?

delayed

20

do elderly have advanced or delayed sleep pattern?

advanced

21

how long does normal circadian rhythm last?

25 hours

22

how does light entrain body clock?

using retinal ganglion cells (non-rod and non-cone cells) projecting to suprachiasmatic nucleus

(why dark room = cant get up in morning)

23

can the cortex rest when awake?

no - only during sleep

when awake it stays in "quiet readiness"

24

most effects of sleep deprivation and prefrontal - what are these?

no psychoses but become irritable and suspicious

visual illusions

microsleeps and concentration lapses

25

what time is the two peaks of drowsiness?

what also occurs at this time?

4am and 2pm

peak of number of sleep related crashes

26

about 10% of RTAs attended by police are sleep related (most acutely deprived), in what kind of road is this number doubled?

non-urban roads

27

what is most likely cause of accidental death at work in UK just now?

truck driver falling asleep at wheel

28

what do most studies suggest is an acceptable amount of sleep?

7 - 7.5 hours

29

donald trump thinks he only needs 3 hours sleep a night - why is he wrong about this? (and everything else he does)

he has lost perception of how sleepy they are - homeostatic response is dysfunctioning

30

a mid afternoon nap of 15 minutes is equivalent to how many minutes of overnight sleep?

90 mins

31

what occurs during REM parasomnia?

dreaming, much simpler behaviour, usually latter third of night

32

what disease does REM parasomnias often precede?

parkinsons (about 38% of those with REM parasomnias get parkinsons)

33

what occurs during non-REM sleep parasomnias?

non dreaming
confusional arousals
sleep walking
sleep terrors (crying or screaming)
bruxism
restless legs and PLMS
possible dissociation

34

what is the incidence of narcolepsy in UK?

0.04%

35

where are the two peaks of age of narcolepsy onset?

15 and 36

36

what 5 things characterise narcolepsy?

daytime sleepiness - inappropriate times, during eating / talking

cataplexy - loss of muscle tone, triggered by emotion

hypnagogic hallucinations - hallucinations at sleep onset

sleep paralyses - unable to move on falling sleep or awakening with retained consciousness

RBD

37

what investigations take place in narcolepsy?

overnight polysomnography

multiple sleep latency test

lumbar puncture

38

how is a multiple sleep latency test carried out?

4 twenty five minute naps are scheduled about 2 hours apart

record of EEG, muscle activity and eye movement recorded

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

patients falls asleep faster if they are sleepier

39

what is checked during a lumbar puncture for narcolepsy?

CSF hypocretin levels

low (<110pg/ml or 1/3 of mean control value) = narcolepsy

40

are you able to drive with narcolepsy?

yes but cease driving on diagnosis until control is achieved

permanent exclusion from group 2

41

what is REM sleep behaviour disorder?

paralysis that normally occurs during REM sleep is incomplete or absent, allowing the person to act out dreams dreams

characterized by the acting out of dreams that are vivid, intense, and violent

42

what is example of REM parasomnia?

nightmares
sleep paralysis
REM sleep behaviour disorder