Sleep Psychology Chapter 5

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Questions and Answers

What is the typical duration of REM sleep periods at the beginning of the night?

  • 10-20 minutes (correct)
  • 20-30 minutes
  • 30-45 minutes
  • 5-10 minutes

Which of the following is an example of an ultradian rhythm?

  • NREM/REM cycle (correct)
  • Body temperature
  • Menstrual cycle
  • Appetite

What characterizes REM sleep based on neurophysiological measurements?

  • High-amplitude, low-frequency EEG pattern
  • Increased muscle tone
  • Inconsistent muscle activity
  • Greater eye movements and loss of muscle tone (correct)

What is the primary role of an electrooculogram (EOG) in sleep studies?

<p>Measuring eye movements during REM sleep (A)</p> Signup and view all the answers

What percentage of total sleep time is typically REM sleep in adults?

<p>20-25% (D)</p> Signup and view all the answers

Which brain wave pattern is predominantly observed during light sleep (Stage 1)?

<p>Theta waves (B)</p> Signup and view all the answers

What is the primary EEG pattern noticed during REM sleep?

<p>Mixed frequencies (B)</p> Signup and view all the answers

At what frequency range do delta waves occur during sleep?

<p>0.5-4 Hz (D)</p> Signup and view all the answers

Which of the following stages of sleep is primarily associated with the presence of sleep spindles?

<p>Stage 2 (A)</p> Signup and view all the answers

What happens to REM sleep proportion as individuals age, particularly in neonates versus the elderly?

<p>It decreases from 50% to lower proportions (D)</p> Signup and view all the answers

Which type of brain wave activity is prevalent when a person is awake with eyes open and alert?

<p>Beta waves (B)</p> Signup and view all the answers

What is the characteristic feature of Stage 4 sleep?

<p>Predominantly delta waves (B)</p> Signup and view all the answers

Which of the following is true regarding the characteristics of alpha waves?

<p>They are present when eyes are closed and inattentive. (C)</p> Signup and view all the answers

What characterizes a vegetative state?

<p>Awake with sleep-wake cycles but no signs of awareness (D)</p> Signup and view all the answers

Which brain activity measurement is typically very low or non-specific in acute coma?

<p>EEG showing flat or isoelectric patterns (A)</p> Signup and view all the answers

What is the definition of brain death?

<p>Irreversible loss of all cerebral and brainstem activities (A)</p> Signup and view all the answers

What features are associated with brain death?

<p>Loss of pain responses and cranial nerve reflexes (C)</p> Signup and view all the answers

Which process assists in transitioning memories from the hippocampus to more permanent areas in the cortex during sleep?

<p>Memory consolidation (A)</p> Signup and view all the answers

Which mechanism is responsible for a vegetative state?

<p>Damage to the cerebral cortex with retained brainstem functions (D)</p> Signup and view all the answers

What is one of the critical benefits of sleep related to neurotoxic waste removal?

<p>Glymphatic clearance (A)</p> Signup and view all the answers

In the context of neurological responsiveness during acute coma, what is behavioral responsivity?

<p>Any observable reactions in response to external stimuli (C)</p> Signup and view all the answers

What typically happens to cerebral metabolism in a patient diagnosed with brain death?

<p>It shows no glucose metabolism due to cessation of activity (A)</p> Signup and view all the answers

What hormone is primarily secreted during the 'healing and repair' period of sleep, particularly between 10 pm and 2 am?

<p>Growth hormone (D)</p> Signup and view all the answers

Which of the following statements is false regarding acute coma?

<p>Patients may exhibit purposeful behavioral responses (A)</p> Signup and view all the answers

Which of the following is NOT a consequence of sleep deprivation?

<p>Enhanced memory consolidation (B)</p> Signup and view all the answers

What role does sleep have in regulating insulin and carbohydrate metabolism?

<p>Enhancing metabolism (D)</p> Signup and view all the answers

Which physiological benefit of sleep is related to immune system functionality?

<p>Optimized cytokine production (A)</p> Signup and view all the answers

One of the impacts of sleep deprivation includes alterations in neurotransmitter levels. Which area of the brain is particularly affected?

<p>Amygdala (B)</p> Signup and view all the answers

Which process is negatively affected by sleep deprivation, impacting learning and decision-making?

<p>Synaptic pruning (D)</p> Signup and view all the answers

What role do intrinsically photosensitive retinal ganglion cells (ipRGCs) play in the circadian rhythm?

<p>They send signals to the suprachiasmatic nucleus in response to light. (B)</p> Signup and view all the answers

How does the SCN influence melatonin production?

<p>By signaling the pineal gland to produce melatonin as light decreases. (D)</p> Signup and view all the answers

What happens to melatonin levels in the morning?

<p>They decrease to promote wakefulness. (D)</p> Signup and view all the answers

Which neurotransmitter accumulates in the brain to contribute to sleep pressure?

<p>Adenosine (A)</p> Signup and view all the answers

What is the main effect of adenosine accumulation in the brain?

<p>It creates a drive for sleep. (A)</p> Signup and view all the answers

How does the SCN contribute to the synchronization of peripheral clocks in the body?

<p>By regulating circadian rhythms across different tissues. (C)</p> Signup and view all the answers

What is the relationship between light exposure and melatonin release?

<p>Decreased light exposure triggers melatonin release. (B)</p> Signup and view all the answers

Which physiological activities are influenced by the SCN related to the sleep-wake cycle?

<p>Body temperature and metabolism. (C)</p> Signup and view all the answers

Which type of sleep apnea occurs when throat muscles intermittently relax and block the airway during sleep?

<p>Obstructive Sleep Apnea (C)</p> Signup and view all the answers

What neurotransmitter is involved in the regulation of sleep-wake cycles, particularly in narcolepsy?

<p>Orexin (B)</p> Signup and view all the answers

Which diagnostic tool is used to measure orexin levels in the diagnosis of narcolepsy?

<p>Cerebrospinal Fluid Analysis (A)</p> Signup and view all the answers

Cataplexy, characterized by sudden loss of voluntary muscle control, is primarily associated with which type of narcolepsy?

<p>Type 1 Narcolepsy (D)</p> Signup and view all the answers

What is a common risk factor associated with obstructive sleep apnea?

<p>Neck size (B)</p> Signup and view all the answers

Which symptom is characteristic of narcolepsy?

<p>Excessive daytime sleepiness (C)</p> Signup and view all the answers

The phenomenon of sudden sleep paralysis that can occur in narcolepsy is mainly attributed to deficiencies in what?

<p>Orexin levels (D)</p> Signup and view all the answers

Which type of parasomnia involves unwanted events like sleepwalking and night terrors during NREM sleep?

<p>NREM-related parasomnias (D)</p> Signup and view all the answers

What change occurs to the duration of REM sleep as sleep cycles progress throughout the night?

<p>It increases, reaching up to 30-45 minutes. (B)</p> Signup and view all the answers

Which of the following physiological indicators shows a notable decrease during REM sleep?

<p>Muscle activity as measured by EMG (A)</p> Signup and view all the answers

What is the primary use of an electroencephalogram (EEG) in clinical settings related to sleep disorders?

<p>To diagnose and classify sleep disorders like sleep apnea. (A)</p> Signup and view all the answers

Which statement correctly identifies characteristics of the NREM/REM sleep cycle?

<p>The NREM/REM cycle typically has a duration that varies throughout the night. (C)</p> Signup and view all the answers

What is a defining feature of ultradian rhythms, particularly in the context of sleep cycles?

<p>They exhibit cycles that repeat every few hours. (D)</p> Signup and view all the answers

What is the defining characteristic of a vegetative state?

<p>Awake but showing no signs of conscious awareness (C)</p> Signup and view all the answers

In the context of brain death, what typically happens to neuronal activity?

<p>Irreversible end of all brain activity (C)</p> Signup and view all the answers

What distinguishes behavioral responsivity from neurological responsiveness?

<p>Behavioral responsivity is a reaction to external stimuli (A)</p> Signup and view all the answers

Which feature is indicative of a condition leading to brain death?

<p>Loss of spontaneous respiration (C)</p> Signup and view all the answers

What is primarily retained in a vegetative state despite the damage to the cerebral cortex?

<p>Brainstem functions (C)</p> Signup and view all the answers

How is the presence of cranial nerve reflexes affected in a brain death scenario?

<p>All cranial nerve reflexes are absent (A)</p> Signup and view all the answers

What type of brain activity is typically observed in an acute coma?

<p>Generally non-responsive, low brain activity (D)</p> Signup and view all the answers

What is the consequence of total brain anoxia in relation to brain death?

<p>Irreversible damage leading to neuronal death (B)</p> Signup and view all the answers

What is the key feature that differentiates coma from vegetative state?

<p>Ability to respond to painful stimuli (C)</p> Signup and view all the answers

Which characteristic is NOT associated with consciousness?

<p>Absence of perceptual ability (B)</p> Signup and view all the answers

What distinguishes brain death from coma or vegetative state?

<p>Complete and irreversible loss of all brain function (A)</p> Signup and view all the answers

In the context of sleep stages, which of the following measurements is least likely to be used for characterization?

<p>Functional magnetic resonance imaging (fMRI) (D)</p> Signup and view all the answers

Which statement most accurately describes a feature of unconsciousness?

<p>Temporal lack of responses with potential for recovery (A)</p> Signup and view all the answers

What is a primary function of sleep that is critical for cognitive processes?

<p>Facilitating memory consolidation (B)</p> Signup and view all the answers

Which of the following best describes the nature of a vegetative state?

<p>Preserved autonomic functions with no evidence of awareness (C)</p> Signup and view all the answers

What is commonly observed in patients diagnosed with locked-in syndrome?

<p>Complete paralysis except for eye movements (D)</p> Signup and view all the answers

What physiological benefit of sleep primarily aids in tissue repair and muscle recovery?

<p>Cellular regeneration (D)</p> Signup and view all the answers

Which of the following statements is true about neurogenesis during sleep?

<p>It is supported by the secretion of growth factors. (C)</p> Signup and view all the answers

How does sleep deprivation most significantly affect mood?

<p>By altering neurotransmitter levels and neural activation (B)</p> Signup and view all the answers

What is the role of the glymphatic system during sleep?

<p>It removes neurotoxic waste from the brain. (B)</p> Signup and view all the answers

Which of the following factors does NOT contribute to impaired metabolism due to sleep deprivation?

<p>Decreased cortisol levels (D)</p> Signup and view all the answers

What effect does slow-wave sleep have on growth hormone secretion?

<p>It enhances growth hormone secretion during sleep. (C)</p> Signup and view all the answers

In what way does sleep support immune system functionality?

<p>By optimizing T-cell activity (B)</p> Signup and view all the answers

Which cognitive function is most directly impaired by sleep deprivation?

<p>Attention and decision-making (B)</p> Signup and view all the answers

What is the primary diagnostic tool for identifying obstructive sleep apnea?

<p>Polysomnography (D)</p> Signup and view all the answers

Which of the following is a neurotransmitter associated with the regulation of sleep-wake cycles?

<p>Orexin (D)</p> Signup and view all the answers

Which of the following symptoms is not typically associated with narcolepsy?

<p>Frequent snoring (B)</p> Signup and view all the answers

The type of sleep apnea characterized by the brain not sending proper signals to the muscles that control breathing is known as:

<p>Central sleep apnea (C)</p> Signup and view all the answers

What is the main distinguishing feature of Type 1 narcolepsy?

<p>Presence of cataplexy (B)</p> Signup and view all the answers

In the context of sleep disorders, which of the following is a common risk factor for obstructive sleep apnea?

<p>Alcohol use (C)</p> Signup and view all the answers

What sleep disorder is characterized by unwanted experiences occurring while falling asleep, during sleep, or waking up?

<p>Parasomnia (C)</p> Signup and view all the answers

Which of the following is a potential cause of narcolepsy in patients with Type 1?

<p>Genetic predisposition (D)</p> Signup and view all the answers

What is the primary photopigment found in intrinsically photosensitive retinal ganglion cells (ipRGCs)?

<p>Melanopsin (D)</p> Signup and view all the answers

Which hormone is produced by the pineal gland and regulated by the suprachiasmatic nucleus (SCN)?

<p>Melatonin (C)</p> Signup and view all the answers

What happens to adenosine levels in the brain as a person spends more time awake?

<p>They accumulate gradually. (C)</p> Signup and view all the answers

How does the SCN influence the body’s various physiological processes?

<p>By communicating with peripheral clocks. (A)</p> Signup and view all the answers

In which phase of the day do melatonin levels typically rise?

<p>In the evening as light levels decrease. (C)</p> Signup and view all the answers

What role does homeostatic sleep pressure play in the sleep-wake cycle?

<p>It gradually increases with time spent awake to create a drive for sleep. (C)</p> Signup and view all the answers

Which physiological function is NOT influenced by the suprachiasmatic nucleus?

<p>Muscle contraction (B)</p> Signup and view all the answers

What is the relationship between light exposure and the regulation of melatonin?

<p>Light exposure decreases melatonin production. (A)</p> Signup and view all the answers

Flashcards

REM sleep duration

REM sleep periods, initially short (10-20 minutes), lengthen in later sleep cycles (up to 30-45 minutes or more).

REM sleep percentage

Adults experience about 20-25% of total sleep time in REM sleep.

Ultradian rhythm

A biological event that repeats itself at regular intervals.

Electroencephalogram (EEG)

Measures electrical activity in the brain.

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Electrooculogram (EOG)

Measures eye movements, especially important during REM sleep stage.

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Electromyogram (EMG)

Measures skeletal muscle activity. Muscle activity decreases as sleep deepens.

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REM sleep characteristics

REM sleep is marked by increased eye movements, reduced muscle tone, and a specific EEG pattern of low amplitude and high frequency.

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Vegetative State

A state of wakefulness without awareness. Individuals have sleep-wake cycles but no conscious awareness or purposeful activity.

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Brain Death

Irreversible cessation of all cerebral and brainstem activities. The irreversible end of brain activity.

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Neurological Responsiveness

Measurable change in brain activity in response to external stimuli.

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Behavioural Responsivity

Behavioural reaction to external stimuli.

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Acute Coma

A severely reduced state of consciousness, characterized by generally non-responsive behaviour and very low brain activity.

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Brain Activity (EEG/PET/fMRI)

Methods used to measure brain activity, like fMRI or EEG.

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Consciously Aware: No

Individuals in this state demonstrate no signs of conscious awareness.

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Behavioural Responsivity: No

Individuals in this state do not demonstrate typical reactions to stimuli.

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Autonomic Instability

Changes in heart rate (HR) and blood pressure (BP) that are not related to external stimuli.

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EEG Alpha Waves

Regular, rhythmic brain waves associated with a relaxed, awake state with eyes closed.

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EEG Beta Waves

Irregular, faster brain waves associated with alertness and engagement.

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EEG Theta Waves

Brain waves of moderate amplitude and frequency, associated with drowsiness and stage 1 sleep.

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EEG Delta Waves

Slowest brain waves, high amplitude, associated with deep sleep.

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Sleep Stage 1

Light sleep, transitioning from wakefulness to deeper sleep, lasting a few minutes.

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Sleep Stage 2

Sleep stage characterized by spindles and K-complexes in brain waves; eye movements cease.

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Sleep Stages 3 & 4

Deepest stages of sleep, marked by delta waves and extreme difficulty to awaken.

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REM Sleep

Sleep stage characterized by rapid eye movements, brain waves similar to wakefulness, and dreaming.

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Alpha Wave EEG Pattern (MCQ)

The EEG pattern observed when a person is awake, with eyes closed, and not actively thinking.

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ipRGCs

Intrinsically Photosensitive Retinal Ganglion Cells that send light signals to the SCN, regulating the circadian rhythm.

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Melatonin

A hormone produced by the pineal gland that regulates sleep-wake cycles, typically increasing at night.

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SCN

Suprachiasmatic Nucleus, a brain region that regulates the circadian rhythm and influences other bodily functions.

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Circadian Rhythm

The roughly 24-hour internal biological clock regulating various bodily functions.

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Melaninphotopigment

A pigment that responds most strongly to blue light in the retina.

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Sleep-wake cycle

The natural cycle of sleep and wakefulness, regulated by the SCN and other factors.

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Peripheral clocks

Biological clocks found in various tissues and organs, synchronized with the SCN's circadian rhythm.

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Homeostatic Sleep Pressure

The increasing drive to sleep as time awake accumulates.

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Adenosine

Neurotransmitter that contributes to sleep pressure.

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Obstructive Sleep Apnea (OSA)

A sleep disorder where throat muscles relax and block the airway during sleep.

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Central Sleep Apnea (CSA)

A sleep disorder where the brain doesn't send proper signals to breathing muscles.

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Complex Sleep Apnea

A combination of OSA and CSA.

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Narcolepsy

Long-term neurological disorder affecting sleep-wake regulation.

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Cataplexy

Sudden loss of muscle control in narcolepsy, ranging from weakness to collapse.

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Parasomnias

Sleep disorders involving unwanted events during sleep or waking.

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Sleepwalking

Moving around while asleep.

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Sleep terrors

A parasomnia marked by intense fear and screaming.

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Polysomnography

Diagnostic test to monitor sleep stages and functions while asleep.

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CPAP

Continuous positive airway pressure device for sleep apnea.

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Sleep disorder risks

Some health factors that may lead to sleep problems.

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Sleep disorder diagnosis

Finding the cause of a sleep disorder.

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Memory Consolidation

REM and slow-wave sleep help strengthen memory connections, moving memories from temporary storage to long-term storage.

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Glymphatic Clearance

The brain's cleaning system, activated during sleep, removes waste like beta-amyloid, which can protect against neurological diseases.

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Neurogenesis

Formation of new brain cells, primarily in the hippocampus, crucial for memory and learning.

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Sleep Deprivation Cognitive Impairment

Not getting enough sleep disrupts memory and learning processes, affecting attention and decision-making.

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Sleep Deprivation Mood Disturbances

Sleep loss affects neurotransmitters and brain activity linked to emotions, causing emotional instability.

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Sleep Deprivation Physical Health Risks

Lack of sleep disrupts the body's daily rhythm, impacting blood pressure and inflammatory responses.

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Sleep Deprivation Immune System Suppression

Sleep enhances the immune system. Lack of sleep weakens the immune system, making you more prone to illness.

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Sleep Deprivation Impaired Metabolism

Sleep regulates insulin and carbohydrate metabolism. Lack of sleep disrupts these processes.

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Cellular Regeneration

Sleep allows for active protein synthesis, crucial for tissue repair.

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Immune Modulation

Sleep optimizes the production of immune cells (cytokines and T-cells).

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Endocrine Homeostasis

Sleep regulates hormones like insulin, cortisol, and growth hormone.

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Muscle Recovery

Sleep promotes the healing of muscles after exertion.

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Energy Rebalance

Sleep shifts metabolism to recovery processes.

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Glycaemic Control

Sleep enhances the body's ability to regulate blood sugar.

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Cardiovascular Equilibrium

Sleep regulates the nervous system's control of the heart rate and blood pressure.

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Consciousness

State of self-awareness, perception, responsiveness, and acting with judgment

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Unconsciousness

Lack of responsiveness to external stimuli and voluntary actions

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Coma

Profound unconsciousness; inability to sense/respond, lost sleep-wake cycle

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Vegetative State

Wakefulness without awareness; sleep-wake cycle, but no conscious activity

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Brain Death

Irreversible cessation of all cerebral/brainstem activity (end of brain function)

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Vegetative State

A condition of wakefulness without awareness. Individuals have sleep-wake cycles but show no signs of conscious awareness or purposeful activity.

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Brain Death

Irreversible cessation of all cerebral and brainstem activities. The irreversible end of all brain activity.

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Neurological Responsiveness

Measurable change in brain activity in response to external stimuli.

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Behavioural Responsivity

Behavioural reaction to external stimuli.

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Acute Coma

A severely reduced state of consciousness, characterized by generally non-responsive behaviour and very low brain activity.

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Brain Activity (EEG/PET/fMRI)

Methods used to measure brain activity, like fMRI or EEG.

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Consciously Aware: No

Individuals in this state demonstrate no signs of conscious awareness.

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Behavioural Responsivity: No

Individuals in this state do not demonstrate typical reactions to stimuli.

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Minimal to none; mostly autonomic

Refers to the level of purposeful behaviour.

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REM sleep duration

REM sleep periods are initially short (10-20 minutes), becoming longer (up to 30-45 minutes or more) throughout the night.

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REM sleep percentage

In adults, REM sleep typically accounts for 20-25% of total sleep time.

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Ultradian rhythm

A biological rhythm that repeats itself at regular, shorter-than-daily intervals.

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Electroencephalogram (EEG)

A test that measures electrical activity in the brain.

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Electrooculogram (EOG)

Measures eye movements.

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Electromyogram (EMG)

Measures the activity of skeletal muscles.

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REM sleep characteristics

Increased eye movements, reduced muscle tone, and a specific EEG pattern of low amplitude and high frequency.

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NREM sleep

Non-Rapid Eye Movement sleep; encompasses stages 1 - 4 of sleep; characterized by the absence of rapid eye movements.

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ipRGCs

Intrinsically Photosensitive Retinal Ganglion Cells that detect light and send signals to the SCN, regulating the circadian rhythm.

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SCN

The Suprachiasmatic Nucleus, a brain region that controls the circadian rhythm and regulates bodily functions, like melatonin.

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Circadian Rhythm

The internal, roughly 24-hour biological clock that regulates various bodily functions.

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Melatonin

Hormone produced by the pineal gland, regulating sleep-wake cycles; levels increase at night.

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Homeostatic Sleep Pressure

Increasing drive to sleep over time, related to time spent awake.

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Adenosine

Neurotransmitter contributing to sleep pressure as the day progresses.

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Peripheral Clocks

Biological clocks in other tissues and organs, synchronized with the SCN's circadian rhythm.

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Obstructive Sleep Apnea (OSA)

A sleep disorder where throat muscles relax, blocking the airway during sleep.

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Central Sleep Apnea (CSA)

A sleep disorder where the brain doesn't send proper signals to the breathing muscles.

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Complex Sleep Apnea

A combination of OSA and CSA.

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Narcolepsy

A neurological disorder affecting sleep-wake regulation, causing daytime sleepiness and sudden sleep attacks.

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Cataplexy

Sudden loss of muscle control in narcolepsy, ranging from weakness to collapse.

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Parasomnias

Sleep disorders involving unwanted events during sleep or waking.

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Sleepwalking

Moving around while asleep.

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Sleep terrors

A parasomnia marked by intense fear and screaming.

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Polysomnography

Diagnostic test to monitor sleep stages and functions while asleep.

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CPAP

Continuous positive airway pressure device for sleep apnea.

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Obstructive Sleep Apnea Risk Factors

Obesity, male gender, large neck circumference, alcohol/sedative use.

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Sleep Disorder Symptoms

Snoring, gasping during sleep, daytime sleepiness, loss of concentration, memory loss.

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Sleep Disorder Diagnosis

Determining the type and cause of sleep problems through evaluation and tests.

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Modern Sleep Issues

Modern society often disrupts natural sleep patterns due to 24/7 stimulation.

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Sleep Apnea Diagnosis (MCQ)

Obstructive Sleep Apnea (OSA).

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Memory Consolidation

REM and slow-wave sleep strengthen memory connections, moving memories from temporary to long-term storage.

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Glymphatic Clearance

The brain's cleaning system, activated during sleep, removes waste like beta-amyloid.

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Neurogenesis

Formation of new neurons in the brain, primarily in the hippocampus, important for memory and learning.

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Sleep Deprivation Cognitive Impairment

Lack of sleep disrupts memory and learning processes, affecting attention and decision-making.

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Sleep Deprivation Mood Disturbances

Sleep loss affects neurotransmitters and brain regions related to emotions, causing emotional instability.

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Sleep Deprivation Physical Health Risks

Lack of sleep disrupts the body's daily rhythm, impacting blood pressure regulation and inflammatory responses.

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Sleep Deprivation Immune System Suppression

Sleep enhances the immune system. Lack of sleep weakens the immune system, making you more prone to illness.

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Sleep Deprivation Impaired Metabolism

Sleep regulates insulin and carbohydrate metabolism. Lack of sleep disrupts these processes.

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Cellular Regeneration

Sleep allows for active protein synthesis, crucial for tissue repair.

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Immune Modulation

Sleep optimizes the production of immune cells (cytokines and T-cells).

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Endocrine Homeostasis

Sleep regulates hormones like insulin, cortisol, and growth hormone.

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Muscle Recovery

Sleep promotes healing of muscles.

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Energy Rebalance

Sleep shifts metabolism to recovery processes.

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Glycaemic Control

Sleep enhances the body's ability to regulate blood sugar.

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Cardiovascular Equilibrium

Sleep regulates the nervous system's control of the heart rate and blood pressure.

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Study Notes

Course Information

  • Class: Year 2 Semester 1
  • Course: CNS
  • Code: CNS
  • Title: Consciousness, Unconsciousness, Sleep & EEG
  • Lecturer: Dr. Melanie Föcking (RCSI-IE), Dr. Colin Greengrass (RCSI-BH)
  • Date: 08.11.2023

Learning Objectives

  • ALO167: Define consciousness and unconsciousness and describe coma, vegetative state and brain death
  • ALO168: Characterise circadian rhythms, ultradian rhythms and sleep stages
  • ALO169: List neurophysiological measurements to characterise sleep stages
  • ALO170: Recall benefits of sleep
  • ALO171: Describe the regulation of sleep-wakefulness cycle
  • ALO172: List sleep disorders

Defining Consciousness, Unconsciousness, Coma, Vegetative State, and Brain Death

  • ALO 167: Defines consciousness and unconsciousness, and describes coma, vegetative state, and brain death.
  • Images of brain scans depicting healthy control, brain death, and vegetative state are included, showing differences in metabolic activity.

O-PET fMRI

  • Assesses cerebral metabolism in various states of consciousness (healthy individuals, vegetative state, locked-in syndrome, minimally conscious).
  • Colour scale indicates glucose metabolism per 100 g of brain tissue per minute.

Consciousness

  • Definition: A state of self-awareness, perception, ability to respond to stimuli, and ability to act with judgment.
  • Features: Characterised by an individual's awareness of their surroundings, thoughts, feelings, memories, and internal sensations. Encompasses the ability to perceive, communicate, and exhibit purposeful behaviour.

Unconsciousness

  • Definition: A temporary or prolonged state where there's a lack of responsiveness to external stimuli and an absence of voluntary actions.
  • Features: Absence or disruption of consciousness where an individual cannot respond to external stimuli.

Coma

  • Definition: State of profound unconsciousness with inability to sense or respond to external stimuli and loss of sleep-wake cycle.
  • Features: Profound unresponsiveness, inability to move spontaneously, no response to painful stimuli, and inability to be awakened.
  • Mechanism: Often involves injury to both cerebral hemispheres or the reticular activating system in the brainstem.
  • Causes: Intoxication, acute neurological injuries, metabolic disorders, CNS infection, stroke, hypoxia.
  • Duration: Generally, few days to few weeks (2-5 weeks).
  • Some patients progress to a vegetative state or die.
  • Glasgow Coma Scale (GCS) is used for classification of acute traumatic brain injury based on the level of consciousness;
    • Severe (GCS 3-8)
    • Moderate (GCS 9-12)
    • Mild (GCS 13-15)

Sleep

  • Sleep is a state of changed consciousness from which a person can be aroused by stimulation.
  • Alternates with wakefulness in a 24-hour cycle (circadian rhythm).
  • Physiological state.

Vegetative State

  • Condition of wakefulness that lacks awareness.
  • Individuals have sleep-wake cycles but do not show any signs of consciousness or purposeful activity.
  • Mechanism: Damage to the cerebral cortex, but retention of some brainstem functions.

Brain Death

  • Definition: An irreversible cessation of all cerebral and brainstem activities.
  • It is the irreversible end of all brain activity due to the total necrosis of cerebral neurons after the loss of blood flow and oxygenation.
  • Mechanism: Total brain anoxia leading to neuronal death.
  • Features: Loss of pain responses, cranial nerve reflexes (like pupillary response, fixed pupils), loss of spontaneous respiration.

Circadian Rhythms, Ultradian Rhythms, and Sleep Stages

  • ALO168: Characterises circadian rhythms, ultradian rhythms, and sleep stages.
  • Circadian Rhythm: Biological processes that have an endogenous oscillation of about 24 hours.
    • Mechanism: Regulated primarily by the suprachiasmatic nucleus (SCN) of the hypothalamus.
    • Features: Roughly 24-hour cycles regulating physiological processes influenced by the natural environment (e.g., light-dark cycles).
  • Ultradian Rhythm: Biological processes that display an endogenous oscillation several times within 24 hours.
    • Mechanism: Includes hormonal feedback loops, NREM/REM sleep cycle, and hunger cycles.
    • Features: Occurring several times within a 24-hour period.
  • Sleep Stages: distinct patterns of brain waves during sleep.
    • Includes Non-REM (NREM) and REM sleep stages Non-REM has four stages (1-4), with stage 4 being the deepest, including extremely slow brain waves and difficulty waking the person. REM sleep is characterized by rapid eye movements, muscle paralysis, and vivid dreams.
    • EEG waveforms are shown depicting different stages.

Measurements for Sleep Stages

  • ALO169: neurophysiological measurements to characterise sleep stages.
  • EEG, EOG, and EMG measure brain waves, eye movements, and muscle activity respectively to characterize sleep stages.

Benefits of Sleep

  • ALO170: Recall benefits of sleep.
  • Cognitive Benefits: Includes memory consolidation, glymphatic clearance, and neurogenesis.
  • Physiological Benefits: Includes cellular regeneration, immune modulation, endocrine homeostasis, muscle recovery, energy rebalance, and glycaemic control.

Regulation of Sleep-Wakefulness Cycle

  • ALO171: Describes the regulation of sleep-wakefulness cycle.
  • Reticular activating system (RAS): A network of neurons in the brainstem plays a critical role in regulating arousal and wakefulness. Projects to various brain regions, facilitating transitions between different states of consciousness.
  • Neurotransmitters: Acetylcholine, noradrenaline, serotonin, and histamine promote wakefulness and alertness. Orexin promotes arousal and sustains wakefulness.
  • Suprachiasmatic nucleus (SCN): Central regulator of the sleep-wake cycle. Receives input from light-sensitive cells in the retina and controls melatonin production in the pineal gland.

Sleep Disorders

  • ALO172: Lists sleep disorders.
  • Insomnia (difficulty falling or staying asleep).
  • Excessive daytime sleepiness (EDS) .
  • Sleep apnoea (pauses or shallow breathing during sleep).
  • Narcolepsy (periods of excessive daytime sleepiness and sudden, irresistible bouts of sleep).
  • Parasomnias (unwanted events or experiences during sleep, including sleepwalking, sleep terrors, confusional arousals, REM sleep behaviour disorder, recurrent isolated sleep paralysis, nightmare disorder).
  • Restless legs syndrome.

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