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37 Cards in this Set
- Front
- Back
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how many cycles of REM/NREM sleep are there in one night?
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4-5
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what percentage of sleep is REM sleep?
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20%
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what type of sleep predominates early in the night?
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Delta
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describe EEG for REM and NREM
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NREM = slow
REM = fast, mixed |
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describe HR during REM and NREM
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NREM = slow
REM = variable |
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describe BP during REM and NREM
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NREM = Low
REM = variable |
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describe respiration during REM and NREM
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NREM = slow
REM = fast |
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describe muscle tone during REM and NREM
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NREM = high
REM = low |
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highly active body in a paralyzed body describes REM or NREM sleep?
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REM
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which muscles are not paralyzed in REM sleep?
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extraocular muscles
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idling brain in moveable body describe REM or NREM sleep?
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NREM
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Describe the levels of norepinephrine, serotonin, and acetylchloine during REM sleep?
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Acetylcholine will be high
Norepinephrine will be low 5HT will be low |
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What NT inhibits REM sleep?
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serotonin
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What type of sleep disorder do these belong to?
-Primary insomnia -Primary hyperomnia -Narcolepsy -Breathing-related sleep disorder -Circadian rhythm sleep disorder |
Dyssomnias
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What sleep disorder type do these conditions fall under?
-Nightmare disorder -Sleep terror disorder - Sleepwalking disorder |
Parasomnias
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what are the most commonly seen sleep disorders seen by primary care?
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breathing related - sleep apnea, periodic limb movements, nocturnal myoclonus
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What does this person most likely suffer from.
Obese mle who comes in because he "nods" off while sitting at his desk at work. Gets plenty of sleep, but never feels rested. History of hypertension and neck circumference is > 43 cm. |
obstructive sleep apnea
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is sleep apnea more common in men or women?
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men
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under the age of 25 what is the prototypical patient?
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male african american
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describe the series of events that occur during sleep apnea?
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1. pharyngeal pathway collapses during sleep due to relaxed muscle tone and negative inspiratory pressure
2. O2 sat drops 3. increased respiratory attempts 4. increased pulmonary blood flow - increased BP 5. Person wakes briefly, catches breath 6. Goes back to sleep |
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people with sleep apnea-hypopnea index (API)are at much greater risk for what?
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hypertension
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what is the best treatment for sleep-apnea?
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nasal Continuous Positive Airway Pressure
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muscle twitches every 20-40 seconds characterizes of the anterior tibialis muscle describes what sleep disorder?
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nocturnal myoclonus (periodic limb movement disorder)
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what is the relationship between PLMD and restless leg syndrome (RLS)?
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80% of people with RLS have PLMD, but only 15% of PLMD people have RLS
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why are benzodiazepines effective in treating restless leg syndrome?
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raise waking threshold keeping the person asleep, but do not stop movements
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besides benzo's what else can be used to treat RLS?
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dopaminergic agents, esp. ropinorole
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what is a very characteristic sleep pattern in people with narcolepsy?
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decreased REM latency (normal being 60-90 min, narcolepsy = < 10 min
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what are the 4 drugs used to treat narcolepsy?
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1. Methylphenidate
2. Amphetamine 3. Pemoline 4. Modafinil |
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what is the likely etiology of narcolepsy?
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decreased inhibition of REM sleep by norepinephrine and serotonin
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drugs that treat narcolepsy act how?
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they are noradrenergic
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people with anxiety will most likely present with which type of insomnia?
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sleep onset - other aspects of sleep cycle are still normal
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describe symptoms of insomnia seen with depression?
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1. mid-night wakenings
2. early-morning wakening 3. reduced REM latency |
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what are the pharmacological treatments for insomnia?
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1. Alprazolam (Xanax)
2. Lorazepam (Ativan) 3. Temazepam (Restoril) 4. Triazolam (Halcion) |
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what does BZ-1 do?
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sleep induction
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what does BZ-2 do?
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anxiolysis, confusion, dependence
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what does BZ-3 do?
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anticonvulsant and muscle relaxant site
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what drugs work on BZ-1?
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1. Zaleplon (Sonata)
2. ZOlpidem (Ambien) 3. Eszopiclone (Lunesta) |
