Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
112 Cards in this Set
- Front
- Back
|
What causes REM sleep debt?
|
sleep deprivation
|
|
|
what happens if you are in REM sleep debt and you go to sleep?
|
you'll have more REM sleep
|
|
|
What is REM?
|
rapid eye movement
|
|
|
What is unihemispheric sleep?
|
Sleeping but on only one half of the brain.
|
|
|
Function of unihemispheric sleep:
|
Protection - to remain alert against predators, or stay swimming if you're a fish.
|
|
|
What is the normal length of the REM cycle in humans?
In birds? |
Humans - 90-110 min
Birds - 2.5 min |
|
|
How many people in the US suffer moderate to severe sleepiness?
|
63 million - 1/5 of americans
|
|
|
What percent report interference w/ daily activities?
|
60%
|
|
|
What percent report nodding off while driving?
|
37%
|
|
|
What is the normal sleep requirement for:
-adults -infants -children -teens |
Adults = 8.5 hrs
Infants = 14-16 hrs Children = 10 hrs Teens = 10 hrs |
|
|
What is the average amt sleep that adults in US get?
|
6.8 hrs
|
|
|
2 Functions of sleep:
|
-Survival
-Restoration |
|
|
What 4 things are decreased by inadequete sleep?
|
1. Alertness
2. physical performance 3. Neuropsycho performance 4. Overall health |
|
|
Specific functions of NREM sleep: (3)
|
-Growth/tissue repair
-Immune system enhancement -Restoration of cerebral energy stores |
|
|
Specific functions of REM sleep (4):
|
1. Processing of information
2. Unlearning irrelevent info 3. Memory consolidation 4. Facilitation of learning and memory |
|
|
Normal healthy young adult:
-Sleep times -Total sleep time (TST) -Sleep efficiency -WASO (wake after sleep onset) |
Times: 11pm - 7am
TST = 7-8 hrs Sleep effic = >95% WASO = <5% |
|
|
What is pathological sleepiness?
|
Falling asleep in less than 5 minutes after you go to bed
|
|
|
What is significant sleepiness?
|
Falling asleep in 6-15 min after going to bed
|
|
|
How long should it take to fall asleep when you go to bed?
|
15 min
|
|
|
Stages of Sleep:
|
-NREM
-REM |
|
|
Stages of NREM sleep; what percentage is each?
|
1 - 2-8%
2 - 45-55% 3/4 - 13-23% |
|
|
What do we call the mixed Stage of 3/4?
|
-Delta stage
or -SWS - slow wave sleep |
|
|
When does NREM predominate?
|
During the first half of the night
|
|
|
When does REM predominate?
|
During the last half of the night
|
|
|
What are the 2 types of REM sleep?
|
-phasic - rapid eye movement
-Tonic - no eye movement |
|
|
What is the ratio of time spent in REM vs NREM sleep at night?
|
20:80
|
|
|
How much total time is spent in REM sleep?
|
90-110 min
|
|
|
How many REM cycles per nite?
|
4-5
|
|
|
What type of sleep do you wake up out of normally?
|
REM
|
|
|
When do you dream?
|
REM
|
|
|
What is the deep restful type of sleep?
|
NREM
|
|
|
What type of sleep do children have lots of? How many REM cycles typically?
|
Stage 4
-typ 4 cycles of REM |
|
|
How do elderly sleep patterns differ from young adults and children?
|
Most time is spent in stage 2; little to no time in stage 3/4
-Wakenings much more freq |
|
|
How is the normal sleep:wake cycle different from the normal day?
|
It is a little longer; so we're always fighting against the calender...?
|
|
|
4 Regulators of the human sleep-wake behavior:
|
-Circadian rythms
-Homeostatic processes -Ultradian regulation -Environmental cues |
|
|
Ultradian means:
|
less than 24 hrs
|
|
|
How does the 2process model describe sleep regulation?
|
Process S = homeostatic process
Process C = circadian component |
|
|
How does the homeostatic process regulate sleep?
|
The longer the organism is awake, the greater propensity they have to sleep.
|
|
|
How does the circadian component regulate sleep?
|
By its oscillations that affect the propensity for sleep/wake
|
|
|
What is the theory represented by the Reciprocal Interation model?
|
The ultradian cycle of NREM and REM sleep is due to reciprocal interactions of REM facilitory and inhibitory neurons
|
|
|
4 important locations in the brain for regulating NREM sleep:
What does VLPO do? |
-VLPO (thalamus) - TELLS YOU TO GO TO SLEEP - NREM; releases ACh which turns off all REM signals.
-Locus ceruleus (breathing) -Suprach. nucleus -Raphe |
|
|
Where are REM ON CELLS located?
|
Pedunculopontine nucleus
|
|
|
Where are REM OFF CELLS located?
|
Raphe
|
|
|
What protein factor promotes both wake and sleep?
|
Serotonin
|
|
|
What is an important sleep promoting factor? What inhibits it, how?
|
Adenosine
-Caffeine inhibits it by competing for its receptors. |
|
|
What happens to heartrate during sleep?
|
decreases
|
|
|
In what phases of sleep does HR decrease?
|
Both NREM and REM
|
|
|
What happens to reduce HR in NREM sleep?
|
Tonic increase in PNS causes bradycardia
|
|
|
What happens to reduce HR in REM sleep?
|
STill the tonic increase in PNS
Also decrease in SNS |
|
|
How much does HR tend to decrease during sleep?
|
10-15 bpm
|
|
|
In which sleep phase does HR vary more?
|
REM
|
|
|
What do we call the cardiac oscillations during REM?
|
Tachybrady phenomona
|
|
|
What happens to cardiac output during sleep?
|
Falls progressively - most during the last sleep cycle, especially during REM.
|
|
|
What accompanies the falling CO during the last sleep cycle?
|
Oxygen saturation - reaches its lowest low.
|
|
|
consequence of lower CO / O2 sat in cardiopulm patients:
|
most likely to die during early morning hours.
|
|
|
How does Bloodflow change during NREM sleep?
|
-Skin, muscle, splanchnic bloodflow changes little
-Cerebral flow decr by 5-25% |
|
|
How does Bloodflow change during REM sleep?
|
-Splanchnic/Renal bloodflow increases (rest/repose)DILATE
-Muscle/Skin bflow decreases via Vasoconstriction |
|
|
What happens to cerebral bloodflow during REM sleep?
|
Increases by up to 40% of the normal waking levels
|
|
|
What does Bloodflow show about NREM vs. REM sleep?
|
NREM shows resting brain activity, reduced ativity; where REM shows active brain, increased activity.
|
|
|
How does systemic blood pressure change during sleep?
|
NREM - falls 5-15%
REM - fluctuates |
|
|
How does Pulmonary bp change during sleep?
|
It increases form 18/8 to 23/12
|
|
|
When during sleep is
-PNS predominant? -SNS changed? |
-PNS predomint in both NREM/REM
-SNS is inhibited during REM |
|
|
Why do BP and HR fluctuate during REM?
|
Because of phasic vagal inhibition and sympathetic activation
|
|
|
What happens to TPR during NREM vs REM?
|
NREM: decreases slightly
REM: decreases more |
|
|
What controls respiration during wakefullness?
|
a)metabolic/ANS system
b)behavioral/voluntary system |
|
|
What controls respiration during NREM sleep?
|
Metabolic ANS system (blood gas levels)
|
|
|
What controls respiration during REM sleep?
|
Behavioral - not blood gases; become less sensitive to them.
|
|
|
How do respirations change during NREM sleep?
|
Minute ventilations become decreased due to a decrease in tidal volume.
|
|
|
What is the respiratory pattern like in NREM sleep?
|
Stable and rythmic.
|
|
|
How do respirations change during REM sleep?
|
Same as in NREM; become decreased.
|
|
|
What is the respiratory pattern like in REM sleep?
|
Unstable and irregular - especially in the phasic component.
|
|
|
How do bloodgas levels change during sleep?
-CO2 -O2 (arterial) -O2sat -Alveolar O2 |
CO2 increases 2-7 mmHg
All O2 levels decrease |
|
|
What is a normal partial press of CO2 and what would it be during sleep?
|
Norm: 40
Sleep: 42-47 |
|
|
What is a normal partial press of arterial O2 and what would it be during sleep?
|
Norm: 90
Sleep: 80-87 |
|
|
How much do O2 sat levels drop during sleep?
|
1-2%; a drop in 4% would be pathological!
|
|
|
What does hypercapnia do normally, when not sleeping?
|
Stimulates an arousal
|
|
|
What happens to the hypercapnic arousal stimulus during sleep?
|
It becomes stronger than the hypoxemia arousal stimulus.
|
|
|
How much does CO2 have to increase to stimulate an arousal?
|
8-15 mm Hg.
|
|
|
How much does O2 sat have to decrease to stimulate an arousal?
|
75%
|
|
|
How many times do CO2 levels increase enough to cause an arousal during the normal sleeping?
|
<5X per hour
|
|
|
What do we call the pattern of increasing CO2 levels until they stimulate an arousal?
|
Cheyne-Stokes breathing
|
|
|
Summary; how is the hypoxic ventilatory response changed in NREM sleep? in REM?
|
NREM: decreased
REM: further decreased |
|
|
2 factors that contribute to the decreased hypoxic ventilatory response during sleep:
|
-Increased upper airway resistance
-Decreased chemosensitivity |
|
|
What happens to the Hypercapnic Ventilatory response in NREM and REM sleep?
|
NREM: decreased
REM: further decreased |
|
|
2 factors that contribute to the decreased hypercapnic ventilatory response during sleep:
|
-Increase in upper airway resistance
-Decreased # of functional medullary respiratory neurons |
|
|
Why do CO2 AND O2 ventilations decrease during sleep?
|
-Metabolism slows at sleep onset
-Ventilation is proportional to metabolism |
|
|
When does metabolism speed back up?
|
at 5am
|
|
|
Why is the Partial press of CO2 increased during sleep?
|
Because of the alveolar hypoventilation caused by decreased minute ventilations (decreased tidal volume).
|
|
|
How do the pupils change during
-NREM and REM sleep -REM sleep |
NREM/REM: PNS increases to cause constriction
PHASIC REM: central inhibition of PNS outflow causes dilation |
|
|
What happens to body temp at onset of sleep?
|
It falls 1-2 degrees C
|
|
|
When is the lowest body temp seen?
|
in 3rd nrem/rem cycle
|
|
|
What happens to thermoregulation during REM sleep?
|
It is inoperative
|
|
|
So what is the difference of body regulation between NREM and REM sleep?
|
NREM: see sweating/panting (shivering)
REM: no sweat/panting |
|
|
What happens to the limb muscles during sleep?
-NREM -REM |
NREM: slightly decreased tone
REM: mrkldy relaxed - atonia |
|
|
What changes in the upper airway muscles occur during sleep?
|
Upper airway: resistance increases
Lower airway: dilator muscles reduce to reduce resistance. |
|
|
What happens to Gastric Acid secretions during sleep?
|
They peak between 10pm and 2am
|
|
|
What happens to gastric motility during sleep?
|
Mostly inhibition of motor functions.
|
|
|
What 2 changes in esophageal function take place during sleep?
|
-Swallowing suppressed
-Saliva output decreased |
|
|
How is intestinal motility affected by sleep?
|
-Migrating motor complex recurs every 90 min in stomach and small intestine, but at its lowest velocity relative to other times of the day.
|
|
|
What does the periodicity of the MMC correlate with?
|
The NREM/REM cycle
|
|
|
What important hormones are released during sleep?
|
ACTH,
Aldosterone Growth hormone Gonadotropic hormone Prolactin TSH Melatonin |
|
|
When do plasma concentrations of GH peak? How long does it stay?
|
-90 min after sleep onset
-circulates 1-3 hrs during SWS |
|
|
What does ACTH induce?
|
Cortisol release
|
|
|
When does Cortesol peak and at its lowest?
|
Lowest: in early part of sleep
Peak: between 4-8 AM |
|
|
When is prolactin highest and when does it begin to rise?
|
Begins to incr 60-90 min after sleep onset
-Highest during sleep from 5AM-7 |
|
|
When do Gonadotropic hormones increase?
|
During prepuberty and puberty - during sleep
|
|
|
3 hormones with no relationship to sleep:
|
FSH
LH ADH |
|
|
What is the relationship of TSH with sleep?
|
SLEEP INHIBITS IT!
Highest just before bedtime, lowest during day |
|
|
When does aldosterone peak?
|
Just before bedtime
|
|
|
When does melatonin begin to rise and peak?
|
-Begins to rise in evening
-Peaks betwen 3-5AM. |
|
|
What suppresses melatonin levels?
|
Bright light
|
|
|
What might be the function of sleep?
|
Energy conseration
|
