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56 Cards in this Set
- Front
- Back
Non-REM?
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slow of EEG pattern
a lot of Muscle Tone No eye movement |
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What is non-REM?
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brain is inactive
body is active |
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Non-REM STages? 1,2,3,4
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6-8 hours sleeping
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What wave in EEG and distribution % stage 1?
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Tetha Waves
alpha disappears, 5% |
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Steage 2?
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k complexes/sleep spindles
45% |
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What is the longest stage we sleep in?
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Stage 2
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When does delta waves happen?
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Stage 3 and stage 4
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What % of sleep is spent in stage 3?
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12%
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WHat % of sleep is spent in stage 4?
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13%
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What is REM?
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aroused EEG pattern
Penile Erections Saccadic Eye Movements (dreaming) Generalized Muscular ATONY (except middle-ear and eye muscles) |
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How long do we stay in REM?
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25%
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What is the slowest waves in sleep?
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Delta
Ala-Deltas go real slow |
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Anothe name for Stage 3,4 sleep?
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Delta Sleep
Slow wave sleep Deepest Stage Hardest to arouse Dissapear in the elderly |
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What is the easiest to wake up?
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REM
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What two stages do we wake up?
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REM
or Stage 2 |
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If you remember your dream what did you wake up in?
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REM Stage
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What is characteristic of REM throught the night?
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the REM stages are longer as the night progresses
gets longer 1st REM 15-20 Last REM 30-40 minutes |
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Where do you find more rem?
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2nd half of the night
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What is REM Latency?
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From the moment you fall asleep to the 1st REM period
average 90 minutes |
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What are two things that affect REM latency?
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Depression
(shortens 60 min.) Narcolepsy (start REM after 10 min.) |
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What is sleep latency?
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moment you go to bed to the moment you fall asleep
about 10-15 min. |
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People with insomnia what happens to sleep latency?
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Sleep Latency increases
(longer) |
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If you are very tired what happens to sleep latency?
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shortens
immediately fall asleep |
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Total sleep time changes w/ age?
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baby sleeps 14-16 hours of sleep
Adolescents sleeps 8-10 hours Elderly 4-5 hours/day Total sleep time decreases with age |
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What happens to REM in age?
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REM decrease with age
Everything decreases with age |
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What are the neurotransmitters of sleep?
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SAND Mr. Sandman bring us our sleep
Serotonin increase (Initiates Sleep) Acetylcholine increase (Dreaming REM) Norepinephrine increases (REM) Dopamine increase (arousal wakefulness |
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What Neurotransmitter causes induction of sleep?
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Serotonin increase
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What neurotransmitter causes REM dreaming?
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Acetylcholine and Norepinephrine increase
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What neurotransmitter wakes us up/arouses the person from sleep?
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Dopamine increase
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What is precursor of serotonin?
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Tryptophan
(turkey sandwich and milk) induces sleep |
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What does bromocriptine in sleep?
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Dopamine agonist
sleeping less it arouses you wake up sooner |
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What does Haloperidol do to sleep?
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Dopa antagonist
decreases DOPA causes sleep |
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What do benzodiazepines do in sleep? What stage do they block?
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blocks stage 4
increase sleep latency can't give benzos more than 2 weeks |
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What does alcohol intoxication do to sleep?
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supresses REM
sleep deprived |
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What happens w/ barbiturate intoxication and sleep?
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supresses REM
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When you are in withdrawal for barbiturate/alcohol?
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REM Rebound
dream more |
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What happens w/ major depression and REM?
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1st rem starts sooner at 60 min.
also longer 1st REM suppresion of DELTA no 3,4 stages early morning awakening |
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What is narcolepsy?
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Patient that falls asleep suddenly
licence suspended falls asleep when talking to friends |
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When question says he feels refreshed when awakening?
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clue for narcolepsy
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Narcolepsy has 4 things associated with it?
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1) sleep attack
2) cataplexy (pathognomonic) 3) hallucinations hypogogic and hypnopompic 4)Sleep Paralysis (cant' move) G gogic going to sleep P waking uPPP! |
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What is cataplexy?
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sudden loss of muscle tone
vs. syncope (no loss of consciousness) |
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Theory behind cataplexy?
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enter REM
falls to ground What triggers it 1) loud noise 2) stress |
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What is the tx of narcolepsy?
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1)Amphetamine
Psycho-stimulants 2) TCAs REM suppressants 3) Gets forced naps during day |
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How do you repressed cataplexy in narcolepsy?
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TCAs
tricyclics |
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What are the three clues to sleep apnea?
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overweight
pat. snores feels tired all day Wife complains about too mnay |
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What is Sleep Apnea defined as?
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Sensation of breathing for more than 10 seconds
pathologic >5 episodes an hour >30 episodes during the night usually more than 300 episodes |
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What is apnea associated with?
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depression
mood changes daytime sleepiness wife complains of restlessness pat. complains of dry mouth, dry throat in the morning headaches in morning, hypoxemia, Pulm. hypertension |
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What are the 3 types of sleep apnea?
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1) Obstructive
2) Central 3) Mixed |
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What is the MC sleep apnea?
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Obstructive
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What is central sleep apnea?
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muscle atonia in oropharynx: nasal, tongue, or tonsil obstruction
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What is central sleep apnea involved in?
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Lack of respiratory effort
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Tx of sleep apnea?
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sleep w/ a mask
O2 PEEP surgical correction |
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Pat. 70yo man trouble sleeping? 7p.m. wake up at 3:00a.m.
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Tell patient to go to bed later
not insomnia |
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What is the MC prescription of the elderly?
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Benzodiazepines
don't give, makes them more confused |
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What triggers insomnia?
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anxiety
depression nervousness |
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What is stimulus control?
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You only use the bed for sleeping
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