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Sleep Physiology :sheep::sleeping: (Sleep Latency amount of time…
Sleep Physiology :sheep::sleeping:
not great for getting Q's right on test
important for counseling pts
Stages of sleep
in order to progress you have to get to the previous stage
Awake
N1
Theta waves
*absent alpha waves
N2
K- komplexes
Sleep spindles
N3
delta waves
REM
restful sleep
engages memories
processes the day
EEG = awake brain
EMG = atonia, except eye mvt :eye:
:female_sign:& :male_sign: erections :eggplant:
N1
closer to awake stage (including REM) is easy to wake
N2
N3
deep sleep difficult to arouse
:alarm_clock: causes grogginess, ripped from deep sleep
waking from a dream = not so bad
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Sleep Latency
amount of time sleeping :sleeping: until N1 (falling asleep time)
increased in insomnia
decreased in sleep deprivation (crashing)
influenced by the amount of sleep had, or other diseases
REM Latency
Restful sleep :sheep:
time it takes from N1 to get to REM (normal = 40min)
short naps don't get to REM
Decreased in Narcolepsy
Decreased in sleep deprivation
REM deprivation happens in : OSA (constantly aroused from sleep), EtOH abuse (low sleep latency, but reduces REM, aka shitty sleep)
REM Rebound Phenomenon
amount of REM increases w/ REM deprivation (eg CPAP increases REM, EtOH cessation increases REM)
Neurotransmitters: SANDMAN
unpredictable, but these are guidelines
S
erotonin
A
cetylcholine
N
orepinephrine
D
opamine
:arrow_up: = aroused, awake :open_mouth:
GABA
:arrow_up: = decreased sleep latency
= decreased N3
eg EtOH :beer_mugs:, nonspec BZD, BZD1 (zolpidem)
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:arrow_up: = aroused, awake :open_mouth:
eg cocaine use
:arrow_up: = more dreams/vivid
:arrow_up: = more sleep
eg SSRI
Nightmares :see_no_evil:
Night terror :jack_o_lantern:
Path: bad
dreams
in N3
not dreams, active behaviors while asleep
Pt:
has tone
, "awake" / but not really
Parents complain about their child :unamused::unamused::boy::skin-tone-2:
Kid will outgrow it
Tx: Reassurance, its normal
& don't use EtOH or BZD's to treat
Parasomnias:
Sleep walking
out of scope of this lecture
Path: Dreams gone bad
REM stage
Pt: atonia
easy to wake up
will remember dream
happens at any age
Dx: clinical
Tx: none
maybe reduce stressors in life
:warning:Exception is PTSD = SSRI, CBT
:warning:Self Medication w/ BZD & EtOH :beer_mugs:reduces REM and pt's will self medicate. Bad bad bad.