BD Sleep Disorders

Define sleep

a reversible behavioral state characterized by perceptual disengagement from and unresponsiveness to the environment.

How does sleep affect physiological functions

They are altered, including a dominance of parasympathetic drive, lower body temperature, and decreased breathing rate.

What is the role of the parasympathetic nervous system during sleep

Becomes more dominant, contributing to a relaxed state and reduced physiological activity.

How does sleep affect body temperature

It decreases in and is a part of the body's natural circadian rhythm.

What happens to breathing rate during sleep

It decreases during sleep, contributing to a sense of relaxation and calmness.

What are the two main types of sleep that all mammals experience

NREM (Non-Rapid Eye Movement) sleep and REM (Rapid Eye Movement) sleep.

What does Non-Rapid Eye Movement Sleep do

Includes deep sleep stages N1/N2/N3 and is associated with physical restoration.

What does Rapid Eye movement do

Involves active brain function, atonia, and mental restoration

How does REM sleep change with age

All species experience REM sleep early in life, but it tends to decrease with age.

What is the typical range for total sleep requirement in humans

varies among individuals, with the median falling within a range of 7 to 9 hours.

How does age impact sleep patterns

The developmental course of the wake/sleep cycle shifts from infants sleeping/waking throughout the day to sleeping mostly at night throughout childhood and adulthood.

What is the ratio of REM to NREM sleep for infants

50:50 REM/NREM ratio.

What is the ratio of REM to NREM sleep for adults

20-25% of their sleep time.

How does the distribution of NREM and REM sleep change throughout the night

NREM sleep predominates in the first half of sleep and is influenced by prior wakefulness. REM sleep predominates in the latter half of sleep and is linked to the circadian rhythm.

Which sleep predominates in the first half of the sleep cycle

NREM sleep, influenced by prior wakefulness

Which sleep predominates in the second half of the sleep cycle

REM sleep, it is linked to the circadian rhythm.

What are the two main factors that dictate sleep patterns

homeostatic sleep drive and circadian rhythms.

Describe the homeostatic sleep drive

The principle that sleep responses are proportionate to the duration of wakefulness. Longer periods of wakefulness lead to an increased likelihood of falling asleep, staying asleep, and experiencing longer sleep duration.

What is the intrinsic circadian rhythm

A roughly 24-hour cycle that influences various physiological and behavioral processes, including the wake/sleep cycle, hormone levels, temperature, immune response, and many others.

What generates the intrinsic circadian rhythm

Generated by the circadian pacemaker located in the SCN (suprachiasmatic nuclei) of the hypothalamus. This is often referred to as the biological clock inherent to an organism.

What aspects of the body's functions are dictated by circadian rhythms

the wake/sleep cycle, hormone secretion, body temperature, immune response, drug metabolism, renal function, airway function, cardiovascular activity, hematology, and even the behavior of neoplastic cells (cancer cells).

What is entrainment in the context of circadian rhythms

synchronization of circadian rhythms to the external environment through the presentation of stimuli, both photic (related to light) and nonphotic, that signal the time of day.

What would happen to circadian rhythms without entrainment

Circadian rhythms would exhibit "free run," causing them to gradually shift to later bedtimes and wake-up times because the internal cycle is not precisely 24 hours.

Explain the opponent process model of sleep regulation?

The circadian rhythm and the homeostatic sleep drive oppose each other. The SCN (suprachiasmatic nuclei) drive wakefulness through environmental cues, while the homeostatic sleep drive pushes for sleep due to the accumulation of wakefulness.

What is the two-process model of sleep regulation

individuals fall asleep primarily due to the homeostatic sleep drive – feeling tired after being awake for a while. They then stay asleep due to the circadian rhythm cycle, with the lowest point (nadir) typically occurring in the early morning hours.

How does sleep deprivation impact biological rhythms

disrupts biological rhythms and affects the functioning of all organs in the body.

What are the primary determinants of alertness and sleepiness

Circadian rhythms, homeostatic sleep drive, age, and other factors such as drugs and disorders.

How has societal sleep duration changed over the past century, and what are the consequences

Society now gets 20% less sleep than it did a century ago. This sleep deprivation has been associated with many accidents and deaths.

What are the recommended sleep requirements for 4-12 months

12-16 hours(Including naps)

What are the recommended sleep requirements for 1-2 years

11-14 hours (including naps)

What are the recommended sleep requirements for 3-5 years

10-13 hours(including naps)

What are the recommended sleep requirements for 6-12

9-12 hours

What are the recommended sleep requirements for 13-18

8-10 hours

What are the recommended sleep requirements for 18 years and beyond

7+ hours

What are some causes of sleepiness

insufficient sleep due to sleep deprivation, fragmented sleep from disturbances like phone calls, and disruption of circadian rhythms from night shifts or rotating schedules.

Is sleep debt cumulative

Yes. It cannot be erased or reduced by training the body to require less sleep.

What is the consequence of consistently getting less sleep than required

creates a sleep debt that must be paid off over time.

What are the impacts of sleep deprivation on basic capacities and tasks

Typically has little to no effect on basic capacities such as vision, hearing, motor skills, learning, and memory, especially for well-learned tasks or procedures.

How does motivation play a role in performing tasks under sleep deprivation

individuals can still perform short-term tasks if they are motivated to do so. However, they may struggle with intensive tasks and maintaining sustained attention.

What are some potential consequences of sleep deprivation

accidents, negative economic and public health outcomes, reduced work and school performance, and impaired psychosocial functions.

What is an example of insufficient sleep

On call sleep loss/inadequate recovery sleep.

What is an example of Fragmented sleep

Pager/phone calls.

What is an example of Circadian rhythm disruption sleep

Night float/rotating shifts.

What is the Epworth sleepiness scale used for

a subjective questionnaire that assesses an individual's likelihood of dozing off in various situations, providing an indication of their level of sleepiness.

What is polysomnography

comprehensive sleep study that involves monitoring various physiological parameters such as EEG (brain activity), airflow, respiration, and more. It provides detailed information about the different stages of sleep.

What does the multiple sleep latency test (MSLT) measure

measures an individual's tendency to fall asleep during waking hours. It involves taking five 20-minute naps at two-hour intervals and measures the average time it takes to fall asleep and the appearance of REM sleep. A normal result is falling asleep in 10-20 minutes without entering REM sleep.

What is the purpose of the maintenance of wakefulness test (MWT)

assesses an individual's ability to stay awake while seated upright in a dimly lit room. It's designed to measure their ability to maintain wakefulness in a controlled environment.

What is actigraphy used for

involves wearing a device, similar to a fitness tracker, that tracks an individual's sleep patterns over a period of time. It provides information about sleep duration, patterns, and activity levels during sleep.

What is the minimum duration required for a diagnosis of insomnia

must be present for at least one month to meet the diagnostic criteria.

What is insomnia

You have trouble falling asleep, staying asleep, or getting good quality sleep.

What are the primary treatments for insomnia

cognitive behavioral therapy, which may include techniques like stimulus control and sleep restriction. Medications are rarely used for treatment.

How is obstructive sleep apnea diagnosed

polysomnography, a comprehensive sleep study. It is characterized by symptoms such as loud snoring, observed apneas, daytime sleepiness, morning sore throat, headaches, elevated BMI, crowded oropharynx, and hypertension.

How is restless leg syndrome diagnosed

diagnosed clinically, and no specific tests are needed.

What is the acronym used by restless leg syndrome

URGE: U (unpleasant limb sensations with urge to move), R (symptoms precipitated by rest), G (symptoms improve with movement), and E (symptoms worsen in the evening).

What is the U in URGE

Unpleasant limb sensations with urge to move

What is the R in URGE

Symptoms precipitated by rest

What is the G in URGE

Symptoms improve with movement

What is the E in URGE

Symptoms worsen in the evening

What are the primary symptoms of narcolepsy

excessive daytime sleepiness and symptoms resulting from abnormal regulation of REM sleep.

What are symptoms of narcolepsy

Cataplexy (sudden loss of muscle tone), hypnagogic hallucinations (hallucinations while falling asleep), and sleep paralysis (temporary inability to move while falling asleep or waking up)

What is Cataplexy

Sudden loss of muscle tone

What is Hypnagogic halluincations

Hallucinations while falling asleep

What is sleep paralysis

Temporary inability to move while falling asleep or waking up.

What is the most common age of onset for narcolepsy

Adolescence. However, it can also occur in patients who have experienced head trauma.