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62 Cards in this Set
- Front
- Back
What may insomnia and other sleep disorders be an indication of?
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physical and/or emotional illness
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What brain waves are observed with concentration? From what part of the brain are they primarily detected?
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beta waves in the frontal lobes
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A person is drowsy and closes their eyes, what type of brain wave is present and from what part of the brain are the waves originating?
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Alpha waves occurring in the occipital and parietal lobes.
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Is REM or NREM sleep characterized by fast-wave activity?
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REM
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What frequency do alpha waves occur?
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8-12 cycles per second
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If a person is in NREM what is occurring in terms of muscle tone and brain waves?
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Brain waves are high amplitude, low frequency and muscle tone is increased
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What percentage of the total sleep cycle is in NREM?
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75%
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If a person is in stage 1 of NREM what frequency and brain waves are present?
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Theta waves are present with a frequency of 3-7 cycles per second. Stage 1 occupies 5% of the total NREM
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A person transitions from stage 1 sleep into stage 2. How will the signal recorded on an EEG change and what are the waves called in stage 2?
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Theta waves (3-7 cycles per sec) transition to sleep spindles (12-14 cycles) and K- complexes which are slower higher amplitude waves
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Approximately 45% of Sleep time in young adults occurs mostly in stage______?
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2
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What is bruxism and what stage of sleep does it occur in?
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Teeth grinding that occurs in stage 2
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A person is in the deepest stage of NREM, what stage of sleep are they in and what frequency is measured?
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Stages 3 and 4 have delta waves with a frequency of 1-3
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Do delta waves occur primarily toward the beginning or end of a night of sleep?
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Towards the beginning
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A person is sleep walking and having night terrors. Where are they in the sleep cycle?
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NREM stages 3 or 4, delta waves
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Characterize REM sleep!
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decreased muscle tone and high frequency brain waves known as saw tooth waves
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What is bruxism and what stage of sleep does it occur in?
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Teeth grinding that occurs in stage 2
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A person is in the deepest stage of NREM, what stage of sleep are they in and what frequency is measured?
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Stages 3 and 4 have delta waves with a frequency of 1-3
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Do delta waves occur primarily toward the beginning or end of a night of sleep?
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Towards the beginning
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A person is sleep walking and having night terrors. Where are they in the sleep cycle?
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NREM stages 3 or 4, delta waves
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Characterize REM sleep!
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decreased muscle tone and high frequency brain waves known as saw tooth waves. This stage incudes alpha and beta waves.
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REM occupies how much of total sleep time? Does it occur more at the beginning or end of the sleep cycle?
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25% and occurs towards the end
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Is it harder or easier to wake a person from REM sleep? Is brain activity hi or low?
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It is harder to waken someone from REM sleep but easier for them to wake spontaneously. Brain activity is high and dreaming occurs.
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On average how long does it take someone who has fallen asleep to reach the first REM period? What is this period called?
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It takes 90 minutes to reach and is called REM latency
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Someone with major depressive mood disorder is likely to have increased or decreased REM latency?
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Decreased
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How long do REM periods generally last and how often do they occur?
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They occur every 90 minutes and last 10-40 minutes
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Given that the brain activity in REM sleep is increased do you expect the sympathetic or parasympathetic system to be operating?
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The parasympathetic. The sympathetic system is shut down people have miosis and boners while skeletal muscle is relaxed
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You diagnose a patient as having REM sleep behavior disorder. What occurs in this condition that does not occur in normal REM sleep?
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The muscles are not atonic and therefore people can act out their nightmares and hurt themselves or others
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Define REM rebound
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people deprived of sleep for one night will have longer REM sleep periods the following night of sleep. REM sleep may therefore be important in learning and memory consolidation but no one knows and surely no one cares
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Describe the structure of sleep architecture
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Sleep progresses through the 4 stages of NREM and occur in reverse order back to stage 1. A period of REM sleep then occurs
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On average how many sleep cycles occur and how long does each cycle take?
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5-6 cycles occur with each taking ~90 minutes
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A new born is sleeping for 8-10 hours on average. Is this normal? What part of the average neonate is REM?
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No neonates generally sleep 16 hours per night with 50% being in REM
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What sleep changes are likely to exist in an elderly patient?
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Decreased REM, Decreased total hours, Decreased delta sleep, Increased nighttime awakenings
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What sleep changes are likely to exist in a depressed patient?
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Short sleep latency, Short REM latency, Increased REM early in the cycle while decreased later, Long first REM period, Increased total REM and Decreased delta sleep
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Does depression cause increased REM sleep or is it the other way around?
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Actually both may occur
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Give a few examples of drugs that cause increased REM sleep and decreased REM sleep!
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Increased with Reserpine and antihypertensive drugs. Reduced with heterocyclic antidepressants.
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What effect can REM and NREM restriction have in sleep depressed patients?
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It can improve depressive symptoms
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What is the prognosis for someone with fatal familial insomnia?
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You're dead in 1 to 2 years because prion gene mutations fuck your thalamus which is needed for arousal and consciousness
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What are the stepwise effects of being sleep deprived?
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Initial confusion, then aggression, and then delusional thinking
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Which hormones promote sleep? Which hormone increases total sleep time and delta sleep? Which hormone reduces REM sleep?
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Serotonin and acetylcholine. Serotonin increases sleep time and delta time. Acetylcholine decreases REM sleep
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What will be the result if the dorsal raphe nuclei are damaged?
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This is a major sight of serotonin production thus people with damage here will have decreased sleep time and delta sleep
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Acetylcholine is released from what part of the brain? Decreased ACh is seen what condition?
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It is released from the reticular formation and is decreased in Alzheimers disease
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What is melatonin and what is it proposed to do?
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It is a metabolite of serotonin and that may induce sleep
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Which hormones promote arousal and wakefulness?
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Norepinephrine and dopamine
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Will people with mania and other psychotic illnesses have increased or decreased sleep time?
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decreased because dopamine is generally elevated
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What are the two major sleep disorder categories?
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dyssomias and parasomias
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Name several dysomnia conditions!
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This condition is associated with the timing, quality or amount sleep. Examples include insomina, sleep apnea, narcolepsy, restless leg syndrome and sleep drunkenness
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What is a parasomnia? List examples
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Abnormality in the physiology or behavior associated with sleep. examples include bruxism, nightmare disorder, sleep terror disorder, sleep walking and REM behavior disorder
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A person has been unable to sleep on average 3 nights a week for the past month and has been struggling at work. Does this person have insomnia?
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Fuck yes
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Can insomnia be treated with sedative agents like barbituates and benzodiazapenes?
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No because these like alcohol alter sleep architecture
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If someone is having night terrors or is pissing the bed what drug could you prescribe to alleviate the problem?
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Benzodiazapienes because they reduce delta sleep
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In someone who is not psychotic, i.e. someone not in medical school, what is an appropriate way to treat insomnia?
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avoid caffiene at night and develop a sleep ritual
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Which type of sleep apnea is predominately seen in elderly patients?
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Central sleep apnea where little respiratory effort occurs
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What is the most common type of sleep apnea and in what type of people does it mostly occur in?
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It occurs in fat fuckers predominately men aged 40-60. Repiratory effort is present but air can't move through fat clogged airways.
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If a person has daytime sleepiness that results from airway obstruction what do they have?
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Pickwickian syndrome. Short fat men with no necks that haven't been able to lean over and see their penis for decades
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Describe what occurs in narcolepsy!
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People generally have the same total night time sleep but decreased sleep latency (<2 min) and short REM latency (<10 min), reduced total REM and sleep fragmentation
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Narcolepsy is often misdiagnosed as what?
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Americans are generally lazy and therefore we often resemble narcoleptics
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What age group does narcolepsy generally occur in? Is it genetic or acquired?
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adolescents and young adults. Genetic
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Someone that is narcoleptic falls asleep and begins to hallucinate. What do they have?
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hypnagogic narcolepsy
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Someone that is narcoleptic wakes up and begins to hallucinate. What do they have?
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hypnopompic narcolepsy
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Someone has bout of intense laughter and loses all muscle tone. What do they have?
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Cataplexy. This can result from any strong emotional stimulus
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Someone wakes up and cannot move. What do they have?
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Sleep paralysis. Note the eye muscles are still in tact
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How is narcolepsy treated?
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stimulants such as methylphenidate
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