Exam (elaborations)
CCSH TEST 3 QUESTIONS AND ANSWERS
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CCSH TEST 3 QUESTIONS AND ANSWERS
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Name: Score:98 Multiple choice questions
Term 1 of 98
What are some sedating heterocyclics antidepressants?
Adults should generally get between 7-9 hours of consolidated sleep.
Elavil (amitriptyline). Adapin (doxepin), Tofranil (imipramine)
ambien (zolpidem), ativan (lorazepam), halcion (triazolam), restoril (temazepam), sonata
(zaleplon), xanax (alpraxolam), nebutal (pentobarbital, benadryl (diphenhydramine),
unisom (doxylamine), ethanol (ethyl alcohol).
in a typical night, one may go through 4-5 cycles of sleep.
Term 2 of 98
Sleep and energy balance:
Ghrelin- peptide produced by stomach
appetite suppressing
leptin is a hormone released by adipocytes.
- levels increase in response to acute caloric surplus.
- Circadian fluctuation, peaks during sleep
- Provides information about energy balance to hypothalamic regulatory centers.
- Changes associated with reciprocal changes in hunger.
- slow, consistent change in EEG patterns occur
- Sleep cycles about every 90 minutes by 5 years of age
- REM sleep is 20-25% of total sleep time by 3-5 yrs of age.
- Levels rise progressively during fasting and fall to a nadir within one hour of feeding.
- Inhibited by vagus nerve (parasympathetic)
- Links the gastrointestinal system and the hypothalamic orexigenic pathway.
,Term 3 of 98
NREM is broken into how many stages?
-Increased: sleep latency, awakenings, WASO, restless sleep
- Decreased TST
- May increase or decrease N3
- Clozaril (clozapine) and Zyprena (olanzapine) are some of the most sedating.
- Caffeine, nicotine, theophylline, CNS stimulants (methamphetamines, cocaine)
Modafinil decreases EDS
- Increases: Daytime sedation, insomnia complaint, WASO, PLMS
- Decreases: REM, TST
- Medications: effexor (venlafaxine), Cymbalta (Duloxetine).
3 stages.
-N1 which is light sleep. Usually the first stage of sleep.
- N2 still fairly light sleep and covers the majority of sleep we get during the night.
- N3 Deep Sleep (AKA slow wave sleep)
Term 4 of 98
VARIATIONS IN NORMAL SLEEP:
Medications
- Caffeine, nicotine, theophylline, CNS stimulants (methamphetamines, cocaine)
Modafinil decreases EDS
90 minute cycles include:
- 5-10% of N1
- 40-50% N2
- 20-25% N3 (decreases with age)
- 20-25% REM
Stimulants
-All effect sleep.
- Increase: sleep latency, awakenings, N1 & N2, WASO, insomnia complains.
- Decrease: TST, N3, REM
- Examples: Caffeine, nicotine, theophylline, CNS stimulants (methamphetamines,
cocaine)
Modafinil decreases EDS.
Medications, in particular psychotropic and neurotropic medications, can influence
sleep and wake.
,Term 5 of 98
Sleep and energy balance:
Leptin is released by what?
leptin is a hormone released by adipocytes.
- levels increase in response to acute caloric surplus.
- Circadian fluctuation, peaks during sleep
- Provides information about energy balance to hypothalamic regulatory centers.
- Changes associated with reciprocal changes in hunger.
- Sleep homeostasis- with a longer time awake, the drive for sleep builds up
exponentially, and dissipates over the course of sleep.
- SWS/N3 decreasing over successive NREM sleep cycles reflects process S with higher
N3 after sleep deprivation
appetite suppressing.
- Light is a time giver
- Light is carried by retinohypothalamic tract (RHT) to the Suprachiasmatic nucleus
(SCN).
- Coordinated by the SCN, light inhibits melatonin secretion during the dark cycle.
- Damage to the SCN elimiated the circadian rhythms of many behaviors, including
sleep.
- Light, via the photoreceptor melanopsin, may exert its antidepressant effect through a
modulation of the homeostatic process of sleep.
- One physiological marker: core body temperature. The timing of the "nadir" or
minimum temp is in the early hours of the am around 4 am (high sleep propensity), with a
peak around 6 pm (low sleep propensity).
- The proportion of N3 sleep is greatest in the first sleep cycle and dissipates over the
course of the sleep period.
- The propensity for REM sleep is highest in the early morning
, - There are "forbidden zones" for sleep which are times in the circadian phase when it is
difficult to initiate sleep, such as in the 2-3 hours before the habitual sleep onset.
Term 6 of 98
GH (growth hormone)
- Peaks are associated with SWS/ N3
- Peaks 90 minutes after sleep onset
- Sleep deprivation leads to decreased GH
- Caffeine, nicotine, theophylline, CNS stimulants (methamphetamines, cocaine)
Modafinil decreases EDS
- Less hours needed
- N3 is reduced
-Insomnia complains
- Overall increase in sleep complaints
- Medication effects
during sleep, nocturnal urine volume decreases due to decrease of glomerular filtraton,
alteration of renin release, water re-absorption
Term 7 of 98
Infant 0-3,. Are the cycle changes easy to identify?
Transitions between the cycles can be difficult to identify.
They are produced in the hypothalamus. (Narcolepsy).
The cycle between active (REM) and quite (NREM) is about 45-60 minutes.
Elavil (amitriptyline). Adapin (doxepin), Tofranil (imipramine)
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