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?

The body becomes paralyzed Signup and view all the answers

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

What happens to brain metabolism during REM sleep?

It increases Signup and view all the answers

What are the two main processes that regulate sleep?

Circadian rhythms and sleep drive Signup and view all the answers

What is sleep drive?

The need for sleep Signup and view all the answers

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

It decreases sleep drive Signup and view all the answers

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

Stage 1 Signup and view all the answers

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

Delta waves Signup and view all the answers

What is the characteristic of REM sleep?

Loss of muscle tone Signup and view all the answers

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

Alpha waves Signup and view all the answers

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

Beta waves Signup and view all the answers

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

Theta waves Signup and view all the answers

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

EEG waves Signup and view all the answers

How many stages of slow wave sleep are there?

4 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?

Stage 4 Signup and view all the answers

Which neurotransmitter is involved in promoting arousal and wakefulness?

Orexin Signup and view all the answers

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

Narcolepsy Signup and view all the answers

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

Feeding, reward and thermogenesis Signup and view all the answers

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

Insomnia Signup and view all the answers

Insomnia can be classified as which of the following?

Acute, intermittent, or chronic Signup and view all the answers

What are some factors associated with insomnia?

Advancing age and poor health Signup and view all the answers

Which conditions can lead to insomnia?

Depression, anxiety, and chronic pain Signup and view all the answers

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

Addressing the underlying medical condition Signup and view all the answers

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

It decreases Signup and view all the answers

What are the two main factors that dictate sleep?

Sleep drive and circadian rhythm Signup and view all the answers

Which structure is considered the central clock in circadian rhythms?

Suprachiasmatic nuclei (SCN) Signup and view all the answers

Where can peripheral clocks be found?

Visceral organs Signup and view all the answers

What can disruption of the circadian rhythm lead to?

Sleep disorders Signup and view all the answers

Which neurotransmitter within the brain stem helps to induce sleep?

Serotonin Signup and view all the answers

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

Reticular inhibitory area Signup and view all the answers

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

Delta sleep-inducing peptide Signup and view all the answers

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

Suprachiasmatic nuclei (SCN) Signup and view all the answers

What can lesions in the SCN promote?

Wakefulness Signup and view all the answers

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

High state of wakefulness Signup and view all the answers

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

Slow brain activity and promote sleep onset Signup and view all the answers

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

Cognitive impairment Signup and view all the answers

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

1 month Signup and view all the answers

What happens when sedative-hypnotics are abruptly discontinued?

Development of tolerance Signup and view all the answers

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

Synergy with CNS depressants Signup and view all the answers

What is the recommended dosing strategy for sedative-hypnotics?

Use the lowest effective dose Signup and view all the answers

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

Sleep deprivation Signup and view all the answers

Which of the following statements about insomnia diagnosis is true?

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

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

Restless leg syndrome Signup and view all the answers

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

Regular exercise before bedtime Signup and view all the answers

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

Daytime sleepiness Signup and view all the answers

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

All of the above Signup and view all the answers

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

Norepinephrine 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?

Stage 2 Signup and view all the answers

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

Delta waves Signup and view all the answers

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

90 minutes Signup and view all the answers

Which hormone increases at night and decreases during the day?

Melatonin Signup and view all the answers

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

It increases Signup and view all the answers

What are microsleep episodes?

Brief moments of sleep Signup and view all the answers

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

It decreases sleep drive Signup and view all the answers

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

Delta sleep-inducing peptide Signup and view all the answers

Where is Orexin produced?

In the hypothalamus Signup and view all the answers

When do these peptides accumulate in the CSF?

When animals are kept awake for several days Signup and view all the answers

Which neurotransmitter is thought to promote REM sleep?

Acetylcholine Signup and view all the answers

What is thought to increase NREM sleep?

Increases in GABA neurotransmission Signup and view all the answers

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

REM sleep Signup and view all the answers

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

Both A and B Signup and view all the answers

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

Memory loss and confusion Signup and view all the answers

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

High-fat meals Signup and view all the answers

In which patients is zaleplon (Sonata®) contraindicated?

Patients with a history of sleepwalking Signup and view all the answers

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

Hypersensitivity reactions Signup and view all the answers

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

CYP3A4 Signup and view all the answers

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

Both A and C Signup and view all the answers

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

Muscle pain Signup and view all the answers

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

Behavior changes Signup and view all the answers

When should Non-BZA agonists be used?

Before bedtime Signup and view all the answers

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

Eszopiclone Signup and view all the answers

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

Eszopiclone (Lunesta®) Signup and view all the answers

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

6 hours Signup and view all the answers

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

Melatonin-1 and melatonin-2 receptors Signup and view all the answers

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

Dizziness Signup and view all the answers

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

Improvement of sleep hygiene Signup and view all the answers

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

All of the above Signup and view all the answers

Which receptor(s) does suvorexant inhibit?

Both OX1R and OX2R Signup and view all the answers

What is the half-life of suvorexant?

12 hours Signup and view all the answers

Which enzymes are involved in the metabolism of suvorexant?

CYP3A and CYP2C19 Signup and view all the answers

What adverse effect could suvorexant potentially cause related to sleep?

Cataplexy Signup and view all the answers

In which patients should suvorexant be used with caution?

All of the above Signup and view all the answers

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

All of the above Signup and view all the answers

What is the main pharmacodynamic effect of anti-histamines?

Inhibition of H1 receptors in the tuberomammillary nucleus Signup and view all the answers

Which age group is contraindicated from using anti-histamines?

Children less than 6 years of age Signup and view all the answers

What are the adverse effects of anti-histamines?

Impaired urination and cognition in elderly patients Signup and view all the answers

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

All of the above Signup and view all the answers

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

All of the above Signup and view all the answers

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

Avoid taking it with MAOIs Signup and view all the answers

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

Increases bioavailability Signup and view all the answers

Which neurotransmitters promote wakefulness within the RAS?

Serotonin and norepinephrine Signup and view all the answers

What are Z-drugs?

Non-BZD agonists Signup and view all the answers

What is the possible mechanism of action of Valerian?

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

Which of the following is an adverse effect of Valerian?

All of the above Signup and view all the answers

What should be avoided when taking Valerian?

Other CNS depressants, such as alcohol Signup and view all the answers

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

Non-REM sleep Signup and view all the answers

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

Increasing GABA transmission Signup and view all the answers

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

Non-BZD agents 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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Description

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.