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Anatomy involved in sleep: Locus coeruleus
For arousal (NEPI)
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Anatomy involved in sleep: Raphe and Pineal gland
5HT and Melatonin for sleep onset
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Anatomy involved in sleep: Hypothalamus
hypocretin for circadian cycle
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Anatomy involved in sleep: posterior hypothalamus
waking the body
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Anatomy involved in sleep: diffuse thalamic system (DTS)
spreading arousal to all areas of the brain
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Yerkes-Dodson Law
performance peaks with a moderate amount tension/arousal/anxiety
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Sleep disturbances are extremely common and are often ________ of medical or psychological issues
symptoms
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What does sleep require to maintain?
energy
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How much sleep is enough: newborns
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How much sleep is enough: preschoolers
11-12 hours per day
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How much sleep is enough: elementary schoolers
at least 10 hours
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How much sleep is enough: teens
9-10 hours with a 3 hours shift forward
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How much sleep is enough: adults
7-8 hours
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How much sleep is enough: geriatric adults
7-8 with fragmentation throughout the day
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Normal sleep parameters: total sleep time
6-13 hours of uninterrupted sleep
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Normal sleep parameters: sleep onset latency (SOL)
longer than 30 minutes to fall asleep >3 days a week
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Normal sleep parameters: NREM vs REM
- NREM: 3 stages proportional to physical activity during the day
- REM: proportional to mental activity
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What type of brain waves are created during the 3 stages of NREM sleep?
- N1: alpha
- N2: theta
- N3: delta/slow wave
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Which type of brain waves are created during REM sleep?
Alpha, and REM sleep tends to get longer throughout the sleep cycle
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What phasic phenomena are associated with the N2 cycle?
- sleep spindles and K complexes
- seem to reflect inhibitory activity and the brain's attempt to keep itself asleep in response external or internal provocation
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what phasic phenomena are associated with REM sleep?
- PGO spikes and saw-toothes waves
- reflect information processing patterns probably involved in re-organizing brain pathways
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what are the two types of napping?
- replacement: thought to be ok because it makes up for lost sleep
- appetitive: not good because it interferes with the diurnal rhythm
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what are the characteristics of NREM?
- physical restoration
- muscle growth
- endocrine rejuvenation
- vascular growth
- glymphatic cleaning
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what are the characteristics of REM?
- brain restoration
- synaptogenesis with protein synthesis
- glial repair and neural healing
- vascularization
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Primary sleep problems: Narcolepsy
- sleep attacks
- cataplexy
- sleep onset REM
- hyponagogic hallucinations
- sleep paralysis and excessive daytime sleepiness
- largely genetic and often triggered by strong emotions
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Primary sleep problems: Kleine-Levin Syndrome
- Hypersomnia >11 hours
- often with a feeling of unreality or confusion
- excessive eating
- hypersexuality
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Primary sleep problems: sleep apneas
- obstructive: blocked airflow
- central: reduced respiratory effort (incubus attack)
- mixed: Alveolar hypoventilation (increased c02)
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What are the treatments for sleep apnea?
- oral devices that keep the chin forward
- losing weight
- exercise
- avoid alcohol
- surgical intervention
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Primary sleep problems: REM-Behavior disorder
- acting out dreams while asleep
- Ambien can induce this
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Primary sleep problems: Restless Leg Syndrome
sensation of crawling or irritability in the legs relieved with movement, but only in the evening
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Primary sleep problems: Nocturnal myoiclonus
- involuntary kicking or agitated movement of the legs
- not the same as RLS
- can be seizure-related, kidney, anemia, thyroid, or parkinson's related
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Primary sleep problems: Circadian Rhythm Disorder
onset of sleepiness is out of sync with light/dark cycle
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What is the infernal trinity?
- insomnia - depression - pain
- if a person has one, they will probably have the other two eventually
- if they already have 2, the third is a certainty
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What is the difference between parasomnias and primary sleep problems?
Parasomnias are typically stage N3 disorders, sleep problems tend to be REM stage disorders
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Parasomnias: somnambulation
sleep walking
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Parasomnias: somniloquy
sleep talking
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Parasomnias: Enuresis
bed wetting
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Parasomnias: Pavor Nocturnis
sleep terrors
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what type of insomnia is associated with anxiety disorders?
sleep onset insomnia
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what type of insomnia is associated with depression?
early morning waking insomnia
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what type of insomnia is associated with ruminative disorders?
sleep maintenance insomnia
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the size of an action potential is ______ and determined by ________
- fixed
- the diameter of the axon
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Direct electrical synapses are called what?
ephapsis
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chemical synapses are called what?
neurotransmitter based
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What are the basic neurotransmitters?
- Acetycholine - ACh
- Norepinephrine - NEPI: energy
- Dopamine - DA: pleasure
- Serotonin - 5HT: purpose
- Gamma amino butyric acid - GABA
- Glutamate - GLU
- Glycine - GLY
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most medications work on the _______ _________ neuron
pre-synaptic
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what determines the intensity/importance of an action potential?
frequency (not size) of the received message
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