Podcast
Questions and Answers
What is the typical duration of REM sleep periods at the beginning of the night?
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?
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?
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?
What is the primary role of an electrooculogram (EOG) in sleep studies?
What percentage of total sleep time is typically REM sleep in adults?
What percentage of total sleep time is typically REM sleep in adults?
Which brain wave pattern is predominantly observed during light sleep (Stage 1)?
Which brain wave pattern is predominantly observed during light sleep (Stage 1)?
What is the primary EEG pattern noticed during REM sleep?
What is the primary EEG pattern noticed during REM sleep?
At what frequency range do delta waves occur during sleep?
At what frequency range do delta waves occur during sleep?
Which of the following stages of sleep is primarily associated with the presence of sleep spindles?
Which of the following stages of sleep is primarily associated with the presence of sleep spindles?
What happens to REM sleep proportion as individuals age, particularly in neonates versus the elderly?
What happens to REM sleep proportion as individuals age, particularly in neonates versus the elderly?
Which type of brain wave activity is prevalent when a person is awake with eyes open and alert?
Which type of brain wave activity is prevalent when a person is awake with eyes open and alert?
What is the characteristic feature of Stage 4 sleep?
What is the characteristic feature of Stage 4 sleep?
Which of the following is true regarding the characteristics of alpha waves?
Which of the following is true regarding the characteristics of alpha waves?
What characterizes a vegetative state?
What characterizes a vegetative state?
Which brain activity measurement is typically very low or non-specific in acute coma?
Which brain activity measurement is typically very low or non-specific in acute coma?
What is the definition of brain death?
What is the definition of brain death?
What features are associated with brain death?
What features are associated with brain death?
Which process assists in transitioning memories from the hippocampus to more permanent areas in the cortex during sleep?
Which process assists in transitioning memories from the hippocampus to more permanent areas in the cortex during sleep?
Which mechanism is responsible for a vegetative state?
Which mechanism is responsible for a vegetative state?
What is one of the critical benefits of sleep related to neurotoxic waste removal?
What is one of the critical benefits of sleep related to neurotoxic waste removal?
In the context of neurological responsiveness during acute coma, what is behavioral responsivity?
In the context of neurological responsiveness during acute coma, what is behavioral responsivity?
What typically happens to cerebral metabolism in a patient diagnosed with brain death?
What typically happens to cerebral metabolism in a patient diagnosed with brain death?
What hormone is primarily secreted during the 'healing and repair' period of sleep, particularly between 10 pm and 2 am?
What hormone is primarily secreted during the 'healing and repair' period of sleep, particularly between 10 pm and 2 am?
Which of the following statements is false regarding acute coma?
Which of the following statements is false regarding acute coma?
Which of the following is NOT a consequence of sleep deprivation?
Which of the following is NOT a consequence of sleep deprivation?
What role does sleep have in regulating insulin and carbohydrate metabolism?
What role does sleep have in regulating insulin and carbohydrate metabolism?
Which physiological benefit of sleep is related to immune system functionality?
Which physiological benefit of sleep is related to immune system functionality?
One of the impacts of sleep deprivation includes alterations in neurotransmitter levels. Which area of the brain is particularly affected?
One of the impacts of sleep deprivation includes alterations in neurotransmitter levels. Which area of the brain is particularly affected?
Which process is negatively affected by sleep deprivation, impacting learning and decision-making?
Which process is negatively affected by sleep deprivation, impacting learning and decision-making?
What role do intrinsically photosensitive retinal ganglion cells (ipRGCs) play in the circadian rhythm?
What role do intrinsically photosensitive retinal ganglion cells (ipRGCs) play in the circadian rhythm?
How does the SCN influence melatonin production?
How does the SCN influence melatonin production?
What happens to melatonin levels in the morning?
What happens to melatonin levels in the morning?
Which neurotransmitter accumulates in the brain to contribute to sleep pressure?
Which neurotransmitter accumulates in the brain to contribute to sleep pressure?
What is the main effect of adenosine accumulation in the brain?
What is the main effect of adenosine accumulation in the brain?
How does the SCN contribute to the synchronization of peripheral clocks in the body?
How does the SCN contribute to the synchronization of peripheral clocks in the body?
What is the relationship between light exposure and melatonin release?
What is the relationship between light exposure and melatonin release?
Which physiological activities are influenced by the SCN related to the sleep-wake cycle?
Which physiological activities are influenced by the SCN related to the sleep-wake cycle?
Which type of sleep apnea occurs when throat muscles intermittently relax and block the airway during sleep?
Which type of sleep apnea occurs when throat muscles intermittently relax and block the airway during sleep?
What neurotransmitter is involved in the regulation of sleep-wake cycles, particularly in narcolepsy?
What neurotransmitter is involved in the regulation of sleep-wake cycles, particularly in narcolepsy?
Which diagnostic tool is used to measure orexin levels in the diagnosis of narcolepsy?
Which diagnostic tool is used to measure orexin levels in the diagnosis of narcolepsy?
Cataplexy, characterized by sudden loss of voluntary muscle control, is primarily associated with which type of narcolepsy?
Cataplexy, characterized by sudden loss of voluntary muscle control, is primarily associated with which type of narcolepsy?
What is a common risk factor associated with obstructive sleep apnea?
What is a common risk factor associated with obstructive sleep apnea?
Which symptom is characteristic of narcolepsy?
Which symptom is characteristic of narcolepsy?
The phenomenon of sudden sleep paralysis that can occur in narcolepsy is mainly attributed to deficiencies in what?
The phenomenon of sudden sleep paralysis that can occur in narcolepsy is mainly attributed to deficiencies in what?
Which type of parasomnia involves unwanted events like sleepwalking and night terrors during NREM sleep?
Which type of parasomnia involves unwanted events like sleepwalking and night terrors during NREM sleep?
What change occurs to the duration of REM sleep as sleep cycles progress throughout the night?
What change occurs to the duration of REM sleep as sleep cycles progress throughout the night?
Which of the following physiological indicators shows a notable decrease during REM sleep?
Which of the following physiological indicators shows a notable decrease during REM sleep?
What is the primary use of an electroencephalogram (EEG) in clinical settings related to sleep disorders?
What is the primary use of an electroencephalogram (EEG) in clinical settings related to sleep disorders?
Which statement correctly identifies characteristics of the NREM/REM sleep cycle?
Which statement correctly identifies characteristics of the NREM/REM sleep cycle?
What is a defining feature of ultradian rhythms, particularly in the context of sleep cycles?
What is a defining feature of ultradian rhythms, particularly in the context of sleep cycles?
What is the defining characteristic of a vegetative state?
What is the defining characteristic of a vegetative state?
In the context of brain death, what typically happens to neuronal activity?
In the context of brain death, what typically happens to neuronal activity?
What distinguishes behavioral responsivity from neurological responsiveness?
What distinguishes behavioral responsivity from neurological responsiveness?
Which feature is indicative of a condition leading to brain death?
Which feature is indicative of a condition leading to brain death?
What is primarily retained in a vegetative state despite the damage to the cerebral cortex?
What is primarily retained in a vegetative state despite the damage to the cerebral cortex?
How is the presence of cranial nerve reflexes affected in a brain death scenario?
How is the presence of cranial nerve reflexes affected in a brain death scenario?
What type of brain activity is typically observed in an acute coma?
What type of brain activity is typically observed in an acute coma?
What is the consequence of total brain anoxia in relation to brain death?
What is the consequence of total brain anoxia in relation to brain death?
What is the key feature that differentiates coma from vegetative state?
What is the key feature that differentiates coma from vegetative state?
Which characteristic is NOT associated with consciousness?
Which characteristic is NOT associated with consciousness?
What distinguishes brain death from coma or vegetative state?
What distinguishes brain death from coma or vegetative state?
In the context of sleep stages, which of the following measurements is least likely to be used for characterization?
In the context of sleep stages, which of the following measurements is least likely to be used for characterization?
Which statement most accurately describes a feature of unconsciousness?
Which statement most accurately describes a feature of unconsciousness?
What is a primary function of sleep that is critical for cognitive processes?
What is a primary function of sleep that is critical for cognitive processes?
Which of the following best describes the nature of a vegetative state?
Which of the following best describes the nature of a vegetative state?
What is commonly observed in patients diagnosed with locked-in syndrome?
What is commonly observed in patients diagnosed with locked-in syndrome?
What physiological benefit of sleep primarily aids in tissue repair and muscle recovery?
What physiological benefit of sleep primarily aids in tissue repair and muscle recovery?
Which of the following statements is true about neurogenesis during sleep?
Which of the following statements is true about neurogenesis during sleep?
How does sleep deprivation most significantly affect mood?
How does sleep deprivation most significantly affect mood?
What is the role of the glymphatic system during sleep?
What is the role of the glymphatic system during sleep?
Which of the following factors does NOT contribute to impaired metabolism due to sleep deprivation?
Which of the following factors does NOT contribute to impaired metabolism due to sleep deprivation?
What effect does slow-wave sleep have on growth hormone secretion?
What effect does slow-wave sleep have on growth hormone secretion?
In what way does sleep support immune system functionality?
In what way does sleep support immune system functionality?
Which cognitive function is most directly impaired by sleep deprivation?
Which cognitive function is most directly impaired by sleep deprivation?
What is the primary diagnostic tool for identifying obstructive sleep apnea?
What is the primary diagnostic tool for identifying obstructive sleep apnea?
Which of the following is a neurotransmitter associated with the regulation of sleep-wake cycles?
Which of the following is a neurotransmitter associated with the regulation of sleep-wake cycles?
Which of the following symptoms is not typically associated with narcolepsy?
Which of the following symptoms is not typically associated with narcolepsy?
The type of sleep apnea characterized by the brain not sending proper signals to the muscles that control breathing is known as:
The type of sleep apnea characterized by the brain not sending proper signals to the muscles that control breathing is known as:
What is the main distinguishing feature of Type 1 narcolepsy?
What is the main distinguishing feature of Type 1 narcolepsy?
In the context of sleep disorders, which of the following is a common risk factor for obstructive sleep apnea?
In the context of sleep disorders, which of the following is a common risk factor for obstructive sleep apnea?
What sleep disorder is characterized by unwanted experiences occurring while falling asleep, during sleep, or waking up?
What sleep disorder is characterized by unwanted experiences occurring while falling asleep, during sleep, or waking up?
Which of the following is a potential cause of narcolepsy in patients with Type 1?
Which of the following is a potential cause of narcolepsy in patients with Type 1?
What is the primary photopigment found in intrinsically photosensitive retinal ganglion cells (ipRGCs)?
What is the primary photopigment found in intrinsically photosensitive retinal ganglion cells (ipRGCs)?
Which hormone is produced by the pineal gland and regulated by the suprachiasmatic nucleus (SCN)?
Which hormone is produced by the pineal gland and regulated by the suprachiasmatic nucleus (SCN)?
What happens to adenosine levels in the brain as a person spends more time awake?
What happens to adenosine levels in the brain as a person spends more time awake?
How does the SCN influence the body’s various physiological processes?
How does the SCN influence the body’s various physiological processes?
In which phase of the day do melatonin levels typically rise?
In which phase of the day do melatonin levels typically rise?
What role does homeostatic sleep pressure play in the sleep-wake cycle?
What role does homeostatic sleep pressure play in the sleep-wake cycle?
Which physiological function is NOT influenced by the suprachiasmatic nucleus?
Which physiological function is NOT influenced by the suprachiasmatic nucleus?
What is the relationship between light exposure and the regulation of melatonin?
What is the relationship between light exposure and the regulation of melatonin?
Flashcards
REM sleep duration
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
REM sleep percentage
Adults experience about 20-25% of total sleep time in REM sleep.
Ultradian rhythm
Ultradian rhythm
A biological event that repeats itself at regular intervals.
Electroencephalogram (EEG)
Electroencephalogram (EEG)
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Electrooculogram (EOG)
Electrooculogram (EOG)
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Electromyogram (EMG)
Electromyogram (EMG)
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REM sleep characteristics
REM sleep characteristics
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Vegetative State
Vegetative State
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Brain Death
Brain Death
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Neurological Responsiveness
Neurological Responsiveness
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Behavioural Responsivity
Behavioural Responsivity
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Acute Coma
Acute Coma
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Brain Activity (EEG/PET/fMRI)
Brain Activity (EEG/PET/fMRI)
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Consciously Aware: No
Consciously Aware: No
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Behavioural Responsivity: No
Behavioural Responsivity: No
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Autonomic Instability
Autonomic Instability
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EEG Alpha Waves
EEG Alpha Waves
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EEG Beta Waves
EEG Beta Waves
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EEG Theta Waves
EEG Theta Waves
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EEG Delta Waves
EEG Delta Waves
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Sleep Stage 1
Sleep Stage 1
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Sleep Stage 2
Sleep Stage 2
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Sleep Stages 3 & 4
Sleep Stages 3 & 4
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REM Sleep
REM Sleep
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Alpha Wave EEG Pattern (MCQ)
Alpha Wave EEG Pattern (MCQ)
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ipRGCs
ipRGCs
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Melatonin
Melatonin
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SCN
SCN
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Circadian Rhythm
Circadian Rhythm
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Melaninphotopigment
Melaninphotopigment
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Sleep-wake cycle
Sleep-wake cycle
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Peripheral clocks
Peripheral clocks
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Homeostatic Sleep Pressure
Homeostatic Sleep Pressure
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Adenosine
Adenosine
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Obstructive Sleep Apnea (OSA)
Obstructive Sleep Apnea (OSA)
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Central Sleep Apnea (CSA)
Central Sleep Apnea (CSA)
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Complex Sleep Apnea
Complex Sleep Apnea
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Narcolepsy
Narcolepsy
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Cataplexy
Cataplexy
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Parasomnias
Parasomnias
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Sleepwalking
Sleepwalking
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Sleep terrors
Sleep terrors
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Polysomnography
Polysomnography
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CPAP
CPAP
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Sleep disorder risks
Sleep disorder risks
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Sleep disorder diagnosis
Sleep disorder diagnosis
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Memory Consolidation
Memory Consolidation
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Glymphatic Clearance
Glymphatic Clearance
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Neurogenesis
Neurogenesis
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Sleep Deprivation Cognitive Impairment
Sleep Deprivation Cognitive Impairment
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Sleep Deprivation Mood Disturbances
Sleep Deprivation Mood Disturbances
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Sleep Deprivation Physical Health Risks
Sleep Deprivation Physical Health Risks
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Sleep Deprivation Immune System Suppression
Sleep Deprivation Immune System Suppression
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Sleep Deprivation Impaired Metabolism
Sleep Deprivation Impaired Metabolism
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Cellular Regeneration
Cellular Regeneration
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Immune Modulation
Immune Modulation
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Endocrine Homeostasis
Endocrine Homeostasis
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Muscle Recovery
Muscle Recovery
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Energy Rebalance
Energy Rebalance
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Glycaemic Control
Glycaemic Control
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Cardiovascular Equilibrium
Cardiovascular Equilibrium
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Consciousness
Consciousness
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Unconsciousness
Unconsciousness
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Coma
Coma
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Vegetative State
Vegetative State
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Brain Death
Brain Death
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Vegetative State
Vegetative State
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Brain Death
Brain Death
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Neurological Responsiveness
Neurological Responsiveness
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Behavioural Responsivity
Behavioural Responsivity
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Acute Coma
Acute Coma
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Brain Activity (EEG/PET/fMRI)
Brain Activity (EEG/PET/fMRI)
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Consciously Aware: No
Consciously Aware: No
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Behavioural Responsivity: No
Behavioural Responsivity: No
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Minimal to none; mostly autonomic
Minimal to none; mostly autonomic
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REM sleep duration
REM sleep duration
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REM sleep percentage
REM sleep percentage
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Ultradian rhythm
Ultradian rhythm
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Electroencephalogram (EEG)
Electroencephalogram (EEG)
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Electrooculogram (EOG)
Electrooculogram (EOG)
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Electromyogram (EMG)
Electromyogram (EMG)
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REM sleep characteristics
REM sleep characteristics
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NREM sleep
NREM sleep
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ipRGCs
ipRGCs
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SCN
SCN
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Circadian Rhythm
Circadian Rhythm
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Melatonin
Melatonin
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Homeostatic Sleep Pressure
Homeostatic Sleep Pressure
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Adenosine
Adenosine
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Peripheral Clocks
Peripheral Clocks
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Obstructive Sleep Apnea (OSA)
Obstructive Sleep Apnea (OSA)
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Central Sleep Apnea (CSA)
Central Sleep Apnea (CSA)
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Complex Sleep Apnea
Complex Sleep Apnea
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Narcolepsy
Narcolepsy
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Cataplexy
Cataplexy
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Parasomnias
Parasomnias
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Sleepwalking
Sleepwalking
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Sleep terrors
Sleep terrors
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Polysomnography
Polysomnography
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CPAP
CPAP
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Obstructive Sleep Apnea Risk Factors
Obstructive Sleep Apnea Risk Factors
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Sleep Disorder Symptoms
Sleep Disorder Symptoms
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Sleep Disorder Diagnosis
Sleep Disorder Diagnosis
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Modern Sleep Issues
Modern Sleep Issues
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Sleep Apnea Diagnosis (MCQ)
Sleep Apnea Diagnosis (MCQ)
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Memory Consolidation
Memory Consolidation
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Glymphatic Clearance
Glymphatic Clearance
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Neurogenesis
Neurogenesis
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Sleep Deprivation Cognitive Impairment
Sleep Deprivation Cognitive Impairment
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Sleep Deprivation Mood Disturbances
Sleep Deprivation Mood Disturbances
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Sleep Deprivation Physical Health Risks
Sleep Deprivation Physical Health Risks
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Sleep Deprivation Immune System Suppression
Sleep Deprivation Immune System Suppression
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Sleep Deprivation Impaired Metabolism
Sleep Deprivation Impaired Metabolism
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Cellular Regeneration
Cellular Regeneration
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Immune Modulation
Immune Modulation
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Endocrine Homeostasis
Endocrine Homeostasis
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Muscle Recovery
Muscle Recovery
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Energy Rebalance
Energy Rebalance
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Glycaemic Control
Glycaemic Control
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Cardiovascular Equilibrium
Cardiovascular Equilibrium
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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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