Sleep and EEG
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Questions and Answers

Which stage of sleep is sometimes called desynchronized sleep?

  • Stage 2
  • REM sleep (correct)
  • Deep sleep
  • Stage 1

    • How long does REM sleep typically last?

  • 1-5 minutes
  • 5-30 minutes (correct)
  • 60-90 minutes
  • 30-60 minutes

    • What happens to the duration of REM sleep as a person becomes more rested?

  • It stays the same
  • It decreases
  • It becomes unpredictable
  • It increases (correct)

    • What happens to the body during REM sleep?

    <p>The body becomes paralyzed</p> Signup and view all the answers

    How many times does a person typically cycle through REM sleep during a night?

    <p>4-5 times</p> Signup and view all the answers

    What happens to brain metabolism during REM sleep?

    <p>It increases</p> Signup and view all the answers

    What are the two main processes that regulate sleep?

    <p>Circadian rhythms and sleep drive</p> Signup and view all the answers

    What is sleep drive?

    <p>The need for sleep</p> Signup and view all the answers

    What effect does napping for more than 30 minutes during the day have on sleep drive at night?

    <p>It decreases sleep drive</p> Signup and view all the answers

    During which stage of sleep do alpha waves interspersed with theta waves occur?

    <p>Stage 1</p> Signup and view all the answers

    Which brain waves are present during deep sleep and have the lowest frequency?

    <p>Delta waves</p> Signup and view all the answers

    What is the characteristic of REM sleep?

    <p>Loss of muscle tone</p> Signup and view all the answers

    Which waves are present when mental activity is 'on' and the eyes are closed?

    <p>Alpha waves</p> Signup and view all the answers

    Which waves are present with eyes open and mental activity is 'on'?

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

    Which waves have lower frequencies than alpha or beta waves and are found in light sleep?

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

    What are the alternating excitatory and inhibitory synaptic potentials that can be detected by electrodes called?

    <p>EEG waves</p> Signup and view all the answers

    How many stages of slow wave sleep are there?

    <p>4</p> Signup and view all the answers

    Which stage of sleep is largely characterized by delta waves and can transition to REM sleep after 90 minutes?

    <p>Stage 4</p> Signup and view all the answers

    Which neurotransmitter is involved in promoting arousal and wakefulness?

    <p>Orexin</p> Signup and view all the answers

    What can destruction of orexin nuclei within the hypothalamus lead to?

    <p>Narcolepsy</p> Signup and view all the answers

    In addition to promoting arousal and wakefulness, orexin is also involved in which processes?

    <p>Feeding, reward and thermogenesis</p> Signup and view all the answers

    What is the experience of having problems falling asleep, maintaining sleep, or suffering from early morning awakening called?

    <p>Insomnia</p> Signup and view all the answers

    Insomnia can be classified as which of the following?

    <p>Acute, intermittent, or chronic</p> Signup and view all the answers

    What are some factors associated with insomnia?

    <p>Advancing age and poor health</p> Signup and view all the answers

    Which conditions can lead to insomnia?

    <p>Depression, anxiety, and chronic pain</p> Signup and view all the answers

    What is the first step in treating insomnia if there is a medical condition present?

    <p>Addressing the underlying medical condition</p> Signup and view all the answers

    What happens to our ability to obtain REM sleep as we age?

    <p>It decreases</p> Signup and view all the answers

    What are the two main factors that dictate sleep?

    <p>Sleep drive and circadian rhythm</p> Signup and view all the answers

    Which structure is considered the central clock in circadian rhythms?

    <p>Suprachiasmatic nuclei (SCN)</p> Signup and view all the answers

    Where can peripheral clocks be found?

    <p>Visceral organs</p> Signup and view all the answers

    What can disruption of the circadian rhythm lead to?

    <p>Sleep disorders</p> Signup and view all the answers

    Which neurotransmitter within the brain stem helps to induce sleep?

    <p>Serotonin</p> Signup and view all the answers

    Which area of the brain is responsible for sleep onset and decrease of sensory stimuli?

    <p>Reticular inhibitory area</p> Signup and view all the answers

    Which peptides accumulate in the CSF when animals are kept awake for several days?

    <p>Delta sleep-inducing peptide</p> Signup and view all the answers

    Which region of the diencephalon, including the rostral hypothalamus, is involved in sleep regulation?

    <p>Suprachiasmatic nuclei (SCN)</p> Signup and view all the answers

    What can lesions in the SCN promote?

    <p>Wakefulness</p> Signup and view all the answers

    What can drugs that block serotonin formation or lesions within the Raphe nuclei lead to?

    <p>High state of wakefulness</p> Signup and view all the answers

    What can sedative-hypnotics, such as zolpidem (Ambien®), do to brain activity?

    <p>Slow brain activity and promote sleep onset</p> Signup and view all the answers

    Which of the following is a potential side effect of sedative-hypnotics?

    <p>Cognitive impairment</p> Signup and view all the answers

    What is the recommended duration of use for sedative-hypnotics, such as benzodiazepines?

    <p>1 month</p> Signup and view all the answers

    What happens when sedative-hypnotics are abruptly discontinued?

    <p>Development of tolerance</p> Signup and view all the answers

    What should be considered when using sedative-hypnotics in combination with other substances?

    <p>Synergy with CNS depressants</p> Signup and view all the answers

    What is the recommended dosing strategy for sedative-hypnotics?

    <p>Use the lowest effective dose</p> Signup and view all the answers

    Which of the following is NOT a nonpharmacological approach to treating insomnia?

    <p>Sleep deprivation</p> Signup and view all the answers

    Which of the following statements about insomnia diagnosis is true?

    <p>A sleep diary can be helpful in screening for insomnia</p> Signup and view all the answers

    Which of the following conditions might warrant checking ferritin levels in a patient with insomnia?

    <p>Restless leg syndrome</p> Signup and view all the answers

    Which of the following is NOT a recommended item to improve sleep hygiene?

    <p>Regular exercise before bedtime</p> Signup and view all the answers

    Which of the following is a potential adverse effect of benzodiazepines used for insomnia treatment?

    <p>Daytime sleepiness</p> Signup and view all the answers

    Which of the following conditions is sleep restriction NOT recommended for?

    <p>All of the above</p> Signup and view all the answers

    Which of the following neurotransmitters is involved in promoting arousal and wakefulness?

    <p>Norepinephrine</p> Signup and view all the answers

    During which stage of sleep do alpha waves with high frequency bursts called sleep spindles and large, slow potentials called K complexes occur?

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

    Which waves are largely present during Stage 4 of slow wave sleep?

    <p>Delta waves</p> Signup and view all the answers

    After how long can Stage 4 of slow wave sleep transition to REM sleep?

    <p>90 minutes</p> Signup and view all the answers

    Which hormone increases at night and decreases during the day?

    <p>Melatonin</p> Signup and view all the answers

    What happens to sleep drive as you go through your day?

    <p>It increases</p> Signup and view all the answers

    What are microsleep episodes?

    <p>Brief moments of sleep</p> Signup and view all the answers

    What effect can napping for more than 30 minutes during the day have on sleep drive at night?

    <p>It decreases sleep drive</p> Signup and view all the answers

    Which peptides can induce sleep when injected into the cerebral ventricles?

    <p>Delta sleep-inducing peptide</p> Signup and view all the answers

    Where is Orexin produced?

    <p>In the hypothalamus</p> Signup and view all the answers

    When do these peptides accumulate in the CSF?

    <p>When animals are kept awake for several days</p> Signup and view all the answers

    Which neurotransmitter is thought to promote REM sleep?

    <p>Acetylcholine</p> Signup and view all the answers

    What is thought to increase NREM sleep?

    <p>Increases in GABA neurotransmission</p> Signup and view all the answers

    Which sleep stage is thought to be on the opposite extreme of wakefulness?

    <p>REM sleep</p> Signup and view all the answers

    Which of the following is a short-term treatment for insomnia?

    <p>Both A and B</p> Signup and view all the answers

    What adverse effects can be associated with zaleplon (Sonata®)?

    <p>Memory loss and confusion</p> Signup and view all the answers

    Which factor can delay the absorption of zaleplon (Sonata®)?

    <p>High-fat meals</p> Signup and view all the answers

    In which patients is zaleplon (Sonata®) contraindicated?

    <p>Patients with a history of sleepwalking</p> Signup and view all the answers

    Which of the following is a potential adverse effect of zolpidem (Ambien®, Intermezzo®)?

    <p>Hypersensitivity reactions</p> Signup and view all the answers

    Which enzyme is primarily responsible for metabolizing zolpidem (Ambien®, Intermezzo®)?

    <p>CYP3A4</p> Signup and view all the answers

    Which enzyme is responsible for the metabolism of Eszopiclone (Lunesta®)?

    <p>Both A and C</p> Signup and view all the answers

    Which of the following is NOT an adverse effect of Eszopiclone (Lunesta®)?

    <p>Muscle pain</p> Signup and view all the answers

    Which of the following is a potential side effect of Non-BZA agonists?

    <p>Behavior changes</p> Signup and view all the answers

    When should Non-BZA agonists be used?

    <p>Before bedtime</p> Signup and view all the answers

    Which Non-BZA agonist has the longest duration of action?

    <p>Eszopiclone</p> Signup and view all the answers

    Which medication is not recommended for chronic use in the elderly?

    <p>Eszopiclone (Lunesta®)</p> Signup and view all the answers

    What is the longer duration of action for Eszopiclone (Lunesta®)?

    <p>6 hours</p> Signup and view all the answers

    Which receptors does ramelteon (Rozerem®) agonize within the SCN of the hypothalamus?

    <p>Melatonin-1 and melatonin-2 receptors</p> Signup and view all the answers

    What is the most common adverse effect of ramelteon (Rozerem®)?

    <p>Dizziness</p> Signup and view all the answers

    Which of the following is NOT a pharmacotherapeutic use of ramelteon (Rozerem®)?

    <p>Improvement of sleep hygiene</p> Signup and view all the answers

    What is the pharmacokinetic characteristic of ramelteon (Rozerem®)?

    <p>All of the above</p> Signup and view all the answers

    Which receptor(s) does suvorexant inhibit?

    <p>Both OX1R and OX2R</p> Signup and view all the answers

    What is the half-life of suvorexant?

    <p>12 hours</p> Signup and view all the answers

    Which enzymes are involved in the metabolism of suvorexant?

    <p>CYP3A and CYP2C19</p> Signup and view all the answers

    What adverse effect could suvorexant potentially cause related to sleep?

    <p>Cataplexy</p> Signup and view all the answers

    In which patients should suvorexant be used with caution?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is a pharmacotherapeutic use of anti-histamines?

    <p>All of the above</p> Signup and view all the answers

    What is the main pharmacodynamic effect of anti-histamines?

    <p>Inhibition of H1 receptors in the tuberomammillary nucleus</p> Signup and view all the answers

    Which age group is contraindicated from using anti-histamines?

    <p>Children less than 6 years of age</p> Signup and view all the answers

    What are the adverse effects of anti-histamines?

    <p>Impaired urination and cognition in elderly patients</p> Signup and view all the answers

    Which of the following is NOT a pharmacodynamic effect of doxepin?

    <p>All of the above</p> Signup and view all the answers

    Which of the following adverse effects can be associated with doxepin?

    <p>All of the above</p> Signup and view all the answers

    What is the recommended caution when taking doxepin with other medications?

    <p>Avoid taking it with MAOIs</p> Signup and view all the answers

    How does a high-fat diet affect the bioavailability of doxepin?

    <p>Increases bioavailability</p> Signup and view all the answers

    Which neurotransmitters promote wakefulness within the RAS?

    <p>Serotonin and norepinephrine</p> Signup and view all the answers

    What are Z-drugs?

    <p>Non-BZD agonists</p> Signup and view all the answers

    What is the possible mechanism of action of Valerian?

    <p>Unknown, may contain a GABA-like compound or inhibit the breakdown of GABA</p> Signup and view all the answers

    Which of the following is an adverse effect of Valerian?

    <p>All of the above</p> Signup and view all the answers

    What should be avoided when taking Valerian?

    <p>Other CNS depressants, such as alcohol</p> Signup and view all the answers

    Which sleep stage is characterized by delta waves and can transition to REM sleep after 90 minutes?

    <p>Non-REM sleep</p> Signup and view all the answers

    Which of the following is a possible method for increasing Non-REM sleep?

    <p>Increasing GABA transmission</p> Signup and view all the answers

    Which of the following is a potential alternative drug therapy for insomnia?

    <p>Non-BZD agents</p> Signup and view all the answers

    Study Notes

    Sleep Stages

    • REM sleep is sometimes called desynchronized sleep.
    • REM sleep typically lasts around 90-120 minutes.
    • The duration of REM sleep increases as a person becomes more rested.
    • During REM sleep, the body is paralyzed, and brain activity increases.

    Sleep Regulation

    • The two main processes that regulate sleep are sleep drive and the circadian rhythm.
    • Sleep drive is the accumulation of the need for sleep over time.
    • Napping for more than 30 minutes during the day can decrease sleep drive at night.
    • The suprachiasmatic nucleus (SCN) is considered the central clock in circadian rhythms.
    • Peripheral clocks can be found in other parts of the body.

    Brain Waves

    • Alpha waves are present when mental activity is 'on' and the eyes are closed.
    • Beta waves are present when mental activity is 'on' and the eyes are open.
    • Theta waves are present during light sleep and have lower frequencies than alpha or beta waves.
    • Delta waves are present during deep sleep and have the lowest frequency.
    • Alpha waves with high frequency bursts called sleep spindles and large, slow potentials called K complexes occur during Stage 2 of sleep.

    Neurotransmitters

    • Orexin is involved in promoting arousal and wakefulness, as well as regulating other processes.
    • Destruction of orexin nuclei within the hypothalamus can lead to narcolepsy.
    • Serotonin is involved in sleep regulation and can promote sleep.
    • GABA is involved in promoting sleep and relaxation.

    Insomnia

    • Insomnia is the experience of having problems falling asleep, maintaining sleep, or suffering from early morning awakening.
    • Insomnia can be classified as acute or chronic.
    • Factors associated with insomnia include stress, anxiety, and certain medical conditions.
    • Conditions that can lead to insomnia include sleep apnea, restless leg syndrome, and chronic pain.

    Treatment of Insomnia

    • The first step in treating insomnia is to address any underlying medical conditions.
    • Sedative-hypnotics, such as zolpidem (Ambien), can help induce sleep.
    • Non-pharmacological approaches to treating insomnia include sleep restriction, stimulus control, and cognitive behavioral therapy.
    • Sedative-hypnotics should be used for a short duration and at the lowest effective dose.
    • The sleep-wake cycle is regulated by the hypothalamus.
    • The region of the diencephalon, including the rostral hypothalamus, is involved in sleep regulation.
    • Lesions in the SCN can promote sleep disorders.
    • Microsleep episodes are short periods of sleep during the day.
    • The hormone melatonin increases at night and decreases during the day.
    • Peptides that can induce sleep when injected into the cerebral ventricles include galanin and adenosine.

    Medications

    • Zolpidem (Ambien) is a sedative-hypnotic that can help induce sleep.
    • Zaleplon (Sonata) is a sedative-hypnotic that can help induce sleep, but can have adverse effects such as dizziness and nausea.
    • Eszopiclone (Lunesta) is a sedative-hypnotic that can help induce sleep, but can have adverse effects such as dizziness and nausea.
    • Ramelteon (Rozerem) is a sedative-hypnotic that can help regulate the sleep-wake cycle.
    • Suvorexant is a sedative-hypnotic that can help induce sleep by inhibiting the orexin receptor.
    • Anti-histamines can be used to treat insomnia, but can have adverse effects such as drowsiness and dry mouth.
    • Doxepin is a sedative-hypnotic that can help induce sleep, but can have adverse effects such as dizziness and nausea.
    • Valerian is a herbal supplement that can help promote sleep, but can have adverse effects such as dizziness and nausea.

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    Test your knowledge of brain waves with this EEG quiz! Learn about alpha, beta, theta, and delta waves and their significance in different states of consciousness.

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