Psyc20006 Biological Psychology (Melbourne Uni) Lecture 18

Front 1

Two main categories sleep disorders. 1.d.............. 2.p....................

Back 1

1.dysomnia 2.parasomnia

Front 2

1.dysomnia:

Back 2

Primary Insomnia, Primary, Hypersomnia, Narcolepsy, Breathing-related, sleep disorder, Circadian rhythm sleep disorder

Front 3

2.parasomnia:

Back 3

Nightmare disorder, Sleep terror, disorder, Sleepwalking

Front 4

Sleep apnea

Back 4

Apnea- cessation of airflow. Hypopnea- reduction of air flow. a sleep disorder characterized by abnormal pauses in breathing or instances of abnormally low breathing, during sleep. Each pause in breathing, called an apnea, can last from a few seconds to minutes, and may occur 5 to 30 times or more an hour.[1] Similarly, each abnormally low breathing event is called a hypopnea. Sleep apnea is diagnosed with an three forms of sleep apnea: central (CSA), obstructive (OSA), and complex or mixed sleep apnea (i.e., a combination of central and obstructive) constituting 0.4%, 84% and 15% of cases respectively.[2] In CSA, breathing is interrupted by a lack of respiratory effort;overnight sleep test called a polysomnogram, or "sleep study".

Front 5

Obstructive sleep apnea (OSA), definition- risk factors:

Back 5

in OSA, breathing is interrupted by a physical block to airflow despite respiratory effort, and snoring is common. obesity (esp around the neck), systemic hypertension - high blood pressure, narrowing of pharynx.

Front 6

Obstructive sleep apnea (OSA), symptoms:

Back 6

chronic, loud snoring,gasping, choking, excessive day time sleepiness, disruption of normal sleep architecture, personality change & cognitive differences.

Front 7

Obstructive sleep apnea (OSA), consequences:

Back 7

intermittent hypoxemia (decreased oxygen in blood), disruption of normal sleep pattern, depression, irritability, cardiovascular problems, sexual dysfunction, learning & men difficulties

Front 8

Obstructive sleep apnea (OSA), treatment: -behavioural, - nasal crap, oral dental devices, - surgery.

Back 8

-exercise, avoidance of alcohol & sees b4 bed, don't lay on back, - non-invasive, fast working BUT participants poor compliance. - useful in mild cases. - invasive NOT uniformly effective + high risk

Front 9

Narcolepsy, definition:

Back 9

Narcolepsy is a sleep disorder that causes excessive sleepiness and frequent daytime sleep attacks.

Front 10

Narcolepsy, 4 classic features.

Back 10

1.EXCESSIVE DAYTIME SLEEPINESS 2.CATAPLEXY HYPNAGOGIC 3.HALLUCINATIONS 4.SLEEP PARALYSIS

Front 11

Narcolepsy prevalence:

Back 11

0.02-0.18%- Israel - 0.002% -Japan - 0.18%

Front 12

Narcolepsy symptoms:

Back 12

Symptoms represent REM sleep components intruding into wake
cataplexy - REM sleep atonia
sleep paralysis - REM sleep atonia hallucinations - intrusion of dreams REM appears at sleep onset (and in MSLT)
REM-on cells in pontine reticular activating system (RAS) fire selectively during REM sleep periods In narcolepsy, monoamine-dependent inhibition of REM-on cells may be defective

Front 13

Narcolepsy diagnosis:

Back 13

abnormal immune function ~ HLA sub typing PSG (short SOL, short REM latency, increased wake) MSLT (rapid sleep onset, REM onset)

Front 14

Narcolepsy treatment:

Back 14

EDS - CNS stimulants(modafinil) CATAPLEXY - anticataplectics (clomipramine, fluoxetine) Planned naps to control sleepiness, reduce drug use

Front 15

REM Sleep Behavioural Disorder: The disorder consists of .................. behaviour during
REM sleep. It is due to a failure of ................ inhibition during
REM

Back 15

motor, motor

Front 16

Disorders Specific to Children

Back 16

• Sudden Infant Death Syndrome • Attention Deficit Disorder • Disorders of Arousal from Sleep

Front 17

Disorders Shared With Adults, But Which May Have a Different Expression in Children:

Back 17

Obstructive Sleep Apnea Syndrome • Periodic Leg Movements
• Narcolepsy • Circadian Rhythm Sleep Disorders • Childhood Sleeplessness

Front 18

Approximately........% of children will suffer from a sleep disorder.

Back 18

25

Front 19

Arousal Disorders:

Back 19

- Calm Sleep Walking- Agitated Sleep Walking- Confusional Arousals- Sleep Terrors (Pavor Nocturnus)

Front 20

General Features of Arousal Disorders:

Back 20

General Features of Arousal Disorders • Occur in association with an arousal from SWS • Mental confusion and disorientation• Automatic behaviour • Relative non reactivity to external stimuli • Poor response to efforts to provoke behavioural wakefulness• Retrograde amnesia for the event• Only fragmentary or no recall of dream mentation

Front 21

Arousal disorders- treatment: Arousal disorders occurring in young children
(~ < .....) are typically a natural feature of sleep. and should NOT be .............

Back 21

8, treated

Front 22

Delayed Sleep Phase Syndrome

Back 22

a circadian rhythm sleep disorder, a chronic disorder of the timing of sleep, peak period of alertness, the core body temperature rhythm, hormonal and other daily rhythms, compared to the general population and relative to societal requirements. People with DSPD generally fall asleep some hours after midnight and have difficulty waking up in the morning. LATE but CONSISTENT sleep time. Common in adolescents.

Front 23

As we have seen synaptic density, and thus brain metabolism,............. in infancy and ........... over adolescence.
Thus, homeostatic drive peaks in infancy and falls over adolescence and this is reflected in changes in the levels of .............. activity or SWA

Back 23

peaks, falls, Delta

Front 24

Puberty is associated with a delay in the c.................. o.....................

Back 24

circadian oscillator

Front 25

In adolescence the oscillator shifts from a bedtime around 10pm to .....................
Thus, the best time to ............... is delayed

Back 25

11-11:30pm, wake-up