Physiological basis of sleep
227 important questions on Physiological basis of sleep
What are the key components involved in sleep and wakefulness regulation?
The regulation involves:
- Multiple neurotransmitters and neuromodulators
- Neural pathways
- Complex physiological processes
- Network dysregulation can disrupt sleep/wake quality
- Desired and unwanted pharmacotherapy effects
What is chronobiology and its importance in human health?
Chronobiology studies biological rhythms, primarily circadian rhythms. Significant points include:
- Underpins human physiology and health
- Influences sleep-wake patterns
- Impacts mental and physical wellbeing
How do pharmacological treatments influence sleep-wake states?
Pharmacological treatments act on:
- Multiple pathways within sleep-wake circuits
- Intended to improve disturbed sleep/wake functions
- Can induce unwanted actions that disturb sleep
- Duration, dosage, and properties affect outcomes
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What are the key gender differences in sleep according to the summary of the research?
- Significant gender differences exist in sleep quality and disturbances.
- Women experience more sleep disturbances than men.
- Specific female conditions (e.g., menstruation, pregnancy, menopause) affect sleep.
- Recovery sleep is greater for women post-deprivation.
- Sleep-disordered breathing (SDB) is more common in men before menopause.
How is the circadian timekeeping system organized in mammals?
The system exhibits hierarchical organization:
- Master clock in the hypothalamus
- Receives light inputs from retinal photoreceptors
- Synchronizes endogenous rhythms with light-dark cycles
What factors determine the effects of pharmacotherapies on sleep-wake states?
Important determining factors include:
- Site of action
- Dosage
- Duration of treatment
- Pharmacokinetic properties
- Pharmacodynamic properties
What are the key developmental changes in sleep from infancy to adulthood?
Changes in sleep occur at various stages:
- Sleep duration decreases significantly in the first year.
- Sleep architecture matures from precursor stages to adult-like sleep.
- Regulation processes—homeostatic and circadian—establish during infancy, evolve during childhood and adolescence.
- Gradual decline in sleep quality and quantity occurs with age.
How do sex steroids influence sleep according to the research findings?
- Sex steroids, including oestrogen, affect sleep regulation by acting in the brain.
- They modulate neurotransmitter systems (e.g., GABA, serotonergic, dopaminergic).
- For instance, oestrogen promotes REM sleep in humans but has a wake-promoting effect in rodents.
- Testosterone therapy in older men disrupts sleep.
What factors influence individual differences in chronotypes?
Variations among individuals arise from:
- Period length
- Circadian amplitude
- Phase or light sensitivity
- Impacts sleep timing and structure, termed chronotypes
What is the role of neurotransmitter systems in sleep regulation?
The regulation involves:
- Interactions of various systems
- Monoaminergic and cholinergic contributions to wakefulness
- GABAergic neurons promoting NREM sleep
- Adenosine linking sleep to energy metabolism
What are the key characteristics of dreaming and how do they contrast with waking experiences?
Dreaming exhibits distinct features that separate it from wakefulness:
- Takes place during sleep
- Involves sensorimotor disconnection
- Typically characterized by heightened emotions
- Low reflective consciousness and lack of judgment
- Bizarre elements and continuity with waking life
How does sleep architecture differ between infants and adults?
Sleep architecture evolves over time:
- Infants have quiet sleep (QS) and active sleep (AS).
- AS becomes REM sleep and QS becomes NREM sleep by 2 months.
- Subdivisions of NREM into N1, N2, and N3 occur in older infants (4-6 months).
What hormones besides sex steroids have gender-dependent effects on sleep?
- Hormones like prolactin (PRL), growth hormone (GH), cortisol, and melatonin exhibit gender differences.
- Women generally have higher PRL levels and diurnal GH concentrations.
- Oestrogen and progesterone can indirectly modulate melatonin production.
- Aging affects these hormone levels variably across genders.
What are the two processes regulating sleep-wake cycles?
Sleep-wake regulation involves two interrelated processes:
- Process S: Homeostatic mechanism based on prior sleep duration
- Process C: 24-hr intrinsic rhythm driven by the circadian pacemaker
What are the mechanisms of benzodiazepines and non-benzodiazepine medications on sleep?
These medications:
- Shorten sleep latency
- Increase total sleep time
- Reduce wakefulness after sleep onset
- Improve subjective sleep quality
- Cause alterations in sleep patterns
What are the negative effects of sleep deprivation on mood and emotional states?
Effects include:
- Increased sleepiness and fatigue
- Impaired emotional processing
- Elevated anxiety and confusion
- Cumulative mood disturbance
- Higher risk of depression among insomniacs
How do dream experiences vary across different sleep stages?
Experience changes throughout the night:
- Gradual onset of hypnagogic hallucinations
- Slow-wave sleep brings short, vague experiences
- REM sleep features vivid, narrative dreams
- Daytime activities affect early dream content
What role does the electroencephalogram (EEG) play in sleep assessment?
EEG is crucial for assessing sleep stages:
- Tracks electrical activity in the brain.
- Distinguishes sleep states: QS, AS, IS.
- Shows changes in slow-wave activity and emergence of sleep spindles.
What differences in sleep architecture are noted between genders?
- Research shows distinct male and female sleep patterns.
- Men tend to have more time in stage 1 sleep, while women experience more slow-wave sleep (SWS).
- Women report needing more sleep but similar total sleep duration as men.
- Age-related changes impact sleep quality more significantly in men.
How does circadian medicine aim to improve health outcomes?
This emerging field focuses on:
- Optimizing interventions targeting the circadian system
- Enhancing health beyond sleep
- Includes chronotherapeutics and chronopharmacological approaches
What are the main physiological processes involved in sleep and wakefulness?
Complex physiological processes encompass:
- Multiple neurotransmitters
- Neuromodulators
- Neural pathways
- Affecting brain and body functions
- Dysregulation leads to disturbed sleep and waking quality.
What methods should be used to assess sleep in various disorders?
- Video-polysomnography is essential for:
- - Parasomnias
- - Nocturnal epileptic seizures
- - Suspected narcolepsy
- Respiratory polygraphy for diagnosing sleep-related breathing disorders.
- Use wrist/foot actigraphy for insomnia and sleep-wake rhythm disorders.
How does sleep deprivation affect cognitive performance?
Cognitive performance impacts:
- Decreased subjective alertness
- Impaired sustained attention
- Reduced working memory
- Effects differ between partial and total sleep deprivation
- Performance deterioration linked to prolonged wakefulness
What role do EEG activities play in the generation of dreams?
EEG relates to dreaming through:
- Slow waves and neuronal off-periods disrupt dream generation
- Intermittent arousal system activation aids dream recall
- High-frequency EEG in prefrontal regions correlates with content recollection
- Different sleep stages exhibit variable EEG patterns related to dreams
What processes regulate sleep during different life stages?
Sleep regulation involves two main processes:
- Homeostatic process reflects sleep pressure, measurable via slow-wave activity.
- Circadian process ensures correct sleep timing within a 24-hour period.
- Both processes undergo significant changes from infancy to adolescence.
How prevalent are sleep disorders among genders, and what distinctions exist?
- Insomnia is more commonly reported by women (1.3–1.6 times more than men).
- Lower socioeconomic status correlates with poorer sleep for both genders.
- Sleep-disordered breathing (SDB) is diagnosed later and with higher BMI in women.
- Women present atypical symptoms, making diagnosis challenging compared to men.
What is the role of Zeitgebers in circadian entrainment?
Zeitgebers synchronize internal clocks with environmental changes:
- Photic signals (light) are the most powerful
- Non-photic signals (e.g., meal timing) are weaker
- Essential for the daily adjustment of internal rhythms
What is the goal of pharmacological treatments for primary sleep-wake disorders?
The primary aim of pharmacotherapy is to:
- Rectify disturbed sleep
- Improve waking functions
- Manage sleep-wake disturbances in various patient populations.
What are the main theories regarding the functions of sleep discussed in Bódizs' chapter?
The chapter presents several theories on sleep functions:
- Ecological hypothesis: Optimizes timing of activity
- Energy conservation: Saves energy
- Recovery: Detoxification and restoration
- Memory consolidation: Strengthens memories
- Neural network maintenance: Maintains neural connections
- Immune function: Enhances immunity
How does sleep impact cognitive functions according to the study?
- Sleep is crucial for:
- - Memory consolidation
- - Emotional regulation
- Disruption can lead to:
- - Impaired cognitive abilities
- - Reduced emotional expression.
What hormones are affected by sleep loss, and what is their impact?
Hormones influenced by sleep loss:
- Leptin - decreases
- Ghrelin - increases
- Alters appetite
- Heightens food cravings
- Linked to weight gain
What are common alterations in dreaming associated with sleep disorders?
Sleep disorders can significantly alter dreaming by:
- Insomnia and sleep apnea affecting dream quality
- Altered slow wave activity influencing content
- Narcolepsy patients frequently experiencing lucid dreams
- Parasomnias causing dream enactment
How does sleep change during adolescence?
Adolescence features distinct changes:
- Circadian process experiences a steady phase delay.
- Homeostatic process shows marked dynamics and characteristics changes.
- Sleep architecture continues to mature, replicating adult patterns.
What is the typical clinical presentation of sleep-disordered breathing in women?
- Women frequently report atypical symptoms, such as fatigue, mood disturbances, and insomnia.
- They report less snoring and are less likely to recognize apneas than men.
- Women are symptomatic with lower AHI numbers compared to men.
- Distinctive comorbidity profiles complicate the diagnosis of SDB in women.
Describe the structure of circadian clocks in biological systems.
Circadian clocks consist of:
- Hierarchical multi-oscillator systems
- Central clock in the suprachiasmatic nucleus (SCN)
- Peripheral clocks synchronized by the central SCN
What are some common effects of pharmacological treatments on sleep-wake states?
Pharmacological treatments can lead to:
- Desired actions, e.g., sleep promotion
- Unwanted effects, e.g., insomnia
- Interference with sleep-wake states depending on dosage and treatment duration.
What physiological variables define behavioral states in relation to sleep?
Different physiological variables are integrated during behavioral states, including:
- Somatomotor, autonomic, and endocrine systems' activity
- Assessment of values in respiratory, cardiovascular, and metabolic parameters
- Maintenance of body homeostasis via hypothalamic integration
What are the beneficial effects of sleep according to the chapter?
Sleep has many benefits, including:
- Enhancing memory consolidation
- Supporting immune function
- Aiding in emotional regulation
- Conserving energy
- Facilitating recovery of brain functions
What are the effects of sleep deprivation on attention and executive functions?
- Vigilance and sustained attention are significantly affected.
- Executive functions suffer from:
- - Increased task-switch costs
- - Reduced cognitive flexibility.
- Tasks like the Psychomotor Vigilance Test (PVT) highlight these impairments.
How is sleep deprivation associated with metabolic syndrome?
Sleep deprivation effects on metabolic syndrome:
- Increases risks of:
- Increases risks of:
- Heart disease
- Stroke
- Type 2 diabetes (T2D)
How do concepts like the day-residue effect and dream-lag effect contribute to dream content?
These concepts indicate that:
- Day-residue effect links dreams to prior daytime events
- Dream-lag effect reflects integration of older events, up to a week prior
- Both effects highlight temporal influences on dream manifestation
What are typical sleep modifications in the elderly?
Aging affects sleep quality and duration:
- There is a reduction in sleep quality and quantity.
- EEG spectral power during NREM decreases after age 30.
- Circadian rhythms may show a phase advance with aging.
What are the main factors causing gender differences in sleep?
- Significant differences in sleep-regulating hormones
- Fluctuations of hormone levels in women
- Women report more sleep disturbances than men
- Specific conditions: menstruation, pregnancy, menopause
What are the key components of the molecular clockwork in mammals?
The molecular clockwork involves:
- Transcription factors: CLOCK and BMAL1
- Repressor complexes: CRY and PER proteins
- Mechanisms of feedback loops to maintain rhythm
How do neurotransmitter systems interact in regulating sleep and wakefulness?
Regulation relies on:
- Complex interactions of multiple neuromodulators
- Organized neuronal ensembles
- Monoaminergic and cholinergic neurons in the brainstem and hypothalamus.
What characterizes rapid eye movement (REM) sleep, also known as paradoxical sleep (PS)?
It is defined by several features:
- Presence of REM movements
- Electroencephalographic (EEG) activation
- Muscle atonia
- Associated with dream activity
How is non-rapid eye movement (NREM) sleep characterized physiologically?
During NREM sleep:
- Minimal energy expenditure and motor activity occur
- Cardiovascular and thermoregulatory variables stabilize at lower levels
- Autonomic nervous system drives physiological regulation to maintain homeostasis
What are some major theoretical proposals regarding the functions of sleep?
The theories on sleep functions include:
- Ecological hypothesis - Timing of activity
- Energy conservation
- Recovery - Detoxification and emotional restoration
- Memory consolidation
- Neural maintenance
How does working memory relate to sleep deprivation?
- Sleep deprivation reduces activity in areas associated with:
- - Dorsolateral prefrontal cortex
- - Posterior parietal cortices.
- This affects working memory's speed and accuracy.
- Performance variability exists among individuals based on sleep vulnerability.
What inflammatory markers are affected by sleep deprivation?
Inflammatory markers impacted include:
- Cytokines
- C-reactive protein (CRP)
- Disruption of immune responses
- Increased risk of infection
- Impaired adaptive immune system function
What is dreaming primarily associated with in terms of consciousness?
Dreaming is a type of consciousness that occurs during sleep and is characterized by:
- Disconnection from the environment.
- Both motor and sensory detachment.
- Internal generation of experiences.
What is the significance of sleep spindles and K-complexes in sleep maturation?
These EEG hallmarks are essential for brain maturation:
- Sleep spindles correlate with thalamocortical interplay.
- K-complexes are indicators of cognitive processes.
- Both emerge during the transition from neonatal to infantile sleep.
How does slow-wave sleep (SWS) differ between genders?
- Women have more SWS than men
- After sleep deprivation, women experience more recovery sleep
- Men generally report less sleep disturbances
How can melatonin act as a Zeitgeber?
Melatonin serves as a non-photic Zeitgeber, helping to adjust circadian rhythms by:
- Facilitating entrainment in blind individuals
- Timing affects for both sighted and non-sighted people
- Recommended for delayed sleep phase syndrome
What promotes wakefulness according to the “standard model” of sleep-wake circuitry?
Wakefulness is primarily promoted by:
- Monoaminergic neurons
- Cholinergic neurons
- Information relay from hypothalamic orexin-producing neurons.
Which neuronal networks are responsible for paradoxical sleep (PS)?
The neuronal networks include:
- PS-on glutamatergic neurons in the SLD
- Glycinergic/GABAergic premotoneurons in the ventro-medial medulla
- PS-off GABAergic neurons in the ventrolateral periaqueductal gray
What changes occur in physiological regulation during rapid eye movement (REM) sleep?
REM sleep features:
- Loss of posture control and unstable autonomic activity
- Increased heart rate and blood pressure surges
- Irregular breathing and depressed thermoregulation
What characterizes sleep according to the proposal of sleep as adaptive inactivity?
Characteristics of sleep include:
- Stereotyped and species-specific postures
- Increased sensory thresholds
- Eye closure
- Homeostatic and circadian regulation
What role does sleep play in learning efficiency?
- Prior sleep enhances encoding and memory creation.
- Sleep disruptions can lead to:
- - Reduced hippocampal activity
- - Impaired learning and retrieval strategies.
- Sleep quality influences long-term memory performance.
Why is understanding the effects of sleep deprivation important?
Importance of understanding sleep deprivation:
- Helps improve public health awareness
- Can trigger lifestyle modifications
- Reduces social and economic costs
- Enhances individual and societal productivity
- Addresses mental well-being and health risks
Can dreams occur during all stages of sleep?
Yes, dream experiences can occur in any sleep stage. However, there are:
- Quantitative differences between stages.
- Qualitative differences in the content of dreams.
- Distinct characteristics associated with REM and NREM sleep.
What are the significant changes in sleep during human development?
Sleep experiences drastic changes:
- Sleep duration decreases primarily during infancy.
- Sleep architecture alters in early childhood.
- Sleep regulation changes significantly during adolescence and adulthood.
What sleep changes occur during a woman's menstrual cycle?
- Rapid eye movement (REM) sleep is modulated
- No overall sleep cycle changes in healthy women
- Premenstrual syndrome can severely disturb sleep
Which neurons are responsible for promoting non-rapid eye movement (NREM) sleep?
NREM sleep is primarily promoted by:
- Melanin-concentrating hormone-producing neurons
- GABA-ergic neurons in specific hypothalamic nuclei
- Neurotransmitters inhibiting arousal during sleep.
How is muscle atonia generated during REM sleep?
Muscle atonia occurs through:
- Activation of SLD glutamatergic neurons
- Direct projections to glycinergic neurons in the ventromedial medulla
- Co-release of GABA and glycine
Describe the impact of sensory processing during sleep.
Sensory processing is affected during sleep through:
- Thalamic gating system modulating sensory information access
- Increased arousal threshold for intense stimuli
- Variable brain activity in response to auditory stimuli across sleep stages
How does sleep support energy conservation?
Sleep promotes energy conservation by:
- Decreasing cerebral glucose metabolism up to 40%
- Reducing oxygen consumption by about 25%
- Associating body cooling effects
What tests are recommended for assessing sleepiness and vigilance?
- Use a combination of tests such as:
- Multiple Sleep Latency Test (MSLT) for sleepiness
- Maintenance of Wakefulness Test (MWT) for staying awake.
How does prolonged wakefulness compare to alcohol intoxication in performance?
Prolonged wakefulness effects:
- Performance deterioration similar to alcohol intoxication
- After 17 hours awake, impairment like blood alcohol level at 0.05%
- Significant correlation between time awake and cognitive performance
How do slow waves in the EEG relate to dreaming?
EEG slow waves and neuronal off-periods can:
- Interfere with dream generation.
- Have a stronger impact in posterior brain regions.
- Influence sleep-related conscious experiences.
What are the two main processes that regulate sleep?
The regulation of sleep involves:
- Homeostatic process - reflects sleep pressure assessed by slow-wave activity.
- Circadian process - responsible for sleep timing within a 24 hr cycle.
How does pregnancy affect sleep quality?
- Sleep efficiency decreases from the first trimester
- Increased risk for mood symptoms and complications
- Sleep problems also affect the foetus and offspring
How is the circadian timing system organized?
The organization includes:
- Master clock in the hypothalamus
- Photoreceptors in the retina for light input
- Synchronization of internal rhythms to light-dark cycles
How is rapid eye movement (REM) sleep regulated?
REM sleep regulation involves:
- Basal forebrain activation
- Brainstem nuclei containing acetylcholine
- Interaction between wake-on and REM-on mechanisms.
What role do GABAergic neurons play during wakefulness and slow-wave sleep in REM sleep regulation?
GABAergic neurons inhibit:
- Activation of SLD PS-on neurons
- These neurons have a tonic GABAergic tone during waking and slow-wave sleep
- Removal of this tone leads to PS onset
How does motor control of skeletal muscles change across wake-sleep states?
Muscle control varies as follows:
- High activity during active wakefulness
- Reduced activity in quiet wakefulness and NREM sleep
- Muscle atonia in tonic REM sleep; only respiratory muscles remain active
What is the physiological significance of slow-wave sleep (N3)?
Slow-wave sleep serves to:
- Significantly reduce energy and oxygen consumption
- Indicate importance in detoxification
- Correlate with recovery of neurocognitive functions
What conditions require video-polysomnography for sleep assessment?
Sleep assessment through video-polysomnography is necessary for:
- Parasomnias
- Nocturnal epileptic seizures
- Suspected narcolepsy
- Other central hypersomnias
- Non-organic hypersomnia
What are the significant risks posed by chronic sleep restriction and acute total sleep loss in modern society?
- Impacts quality of life
- Affects mental well-being
- Reduces cognitive performance
- Harms physical health
- Becomes a public health concern
What enhances the recall of dream content?
Recall of dream content is facilitated by:
- Intermittent activation of arousal systems.
- High-frequency EEG power increases in prefrontal regions.
- Strong stimuli during sleep that can awaken the sleeper.
How do sleep characteristics change from childhood to adulthood?
Changes include:
- Circadian process delays during childhood and adolescence.
- Homeostatic process dynamics undergo significant marked changes.
- Both processes stabilize in early adulthood.
What are the sleep challenges faced during menopause?
- Increased sleep problems, especially with vasomotor symptoms
- Hormone therapy can improve sleep quality
- Sleep-disordered breathing (SDB) prevalence rises
What role do Zeitgebers play in circadian rhythms?
They provide signals for synchronization, including:
- Primary Zeitgeber: Light
- Non-photic Zeitgebers: Rest-activity cycles, meal timing, social time
- Essential for circadian entrainment
What advances have been made in understanding sleep-wake neurobiology?
New experimental technologies have:
- Enhancements in understanding wake-sleep neurobiology
- Indicated the complexity of neurotransmitter interactions
- Shifted focus to GABA and glutamate as key players.
How do monoaminergic neurons influence paradoxical sleep (PS)?
Monoaminergic neurons:
- Serotonergic and noradrenergic neurons cease firing during PS
- This firing pattern indicates reciprocal inhibition of PS-on neurons
- Drugs enhancing these neurotransmitters suppress PS
What defines and identifies behavioral states according to physiological variables?
Different physiological variables shape bodily functions according to:
- Somatic system
- Autonomic system
- Endocrine system
- Integrated activity at the hypothalamic level
What are the proposed detoxification functions of sleep?
Detoxification functions of sleep include:
- Removing toxic compounds from the brain
- Supporting recovery of prefrontal cortical functions
- Regulating mood, particularly during REM sleep
What method is suggested for diagnosing sleep-related breathing disorders?
Respiratory polygraphy is used for diagnosing:
- Sleep-related breathing disorders
- Other central hypersomnias
How does chronic sleep deprivation affect mood states and emotional processing?
- Increases sleepiness
- Causes fatigue and confusion
- Leads to tension
- Results in total mood disturbance
- Impairs emotional processing
What aspects are shared between dreaming and waking experiences?
Broad perceptual categories in dreams are similar to waking experiences, including:
- Faces
- Spatial settings
- Movement
- Speech
- Thoughts
What are typical modifications of sleep in the elderly?
The elderly experience:
- Decreased sleep quality and quantity.
- Gradual decrease in EEG spectral power during NREM sleep after age 30.
- Changes linked to brain structure and cognition decline.
How do sex hormones influence sleep regulation?
- They affect brain functions including cognitive performance and mood
- The effects of sex hormones differ between males and females
- Estrogen increases REM sleep in females
What are the two processes regulating sleep-wake cycles?
Sleep-wake cycles are regulated by:
- Process S: Homeostatic sleep–wake counter
- Process C: Intrinsic 24-hr rhythm (circadian)
Why are pharmacological treatments significant in managing chronic insomnia?
Pharmacological treatments provide:
- A major approach when CBT-I is ineffective
- Various compounds affecting central nervous system pathways
- Solutions to promote sleep or reduce wake-promoting effects.
What is the effect of GABA on serotonergic and noradrenergic neurons during PS?
GABA application during PS leads to:
- Tonic firing restoration of serotonergic and noradrenergic neurons
- This indicates GABA input responsible for their inactivation during PS
- Areas involved include vlPAG and lateral nuclei
How are wakefulness, NREM sleep, and REM sleep recognized physiologically?
The recognition of these WS states is based on:
- Values of electroencephalogram (EEG) rhythms
- Muscle tone
- Presence of eye movements
- Assessment of respiratory, cardiovascular, and metabolic parameters
What does the ecological hypothesis suggest about sleep?
The ecological hypothesis proposes:
- Sleep optimizes the timing and effectivity of behavior
- It reflects adaptive inactivity when active adaptation is low
Which conditions are generally not indicated for polysomnography?
Conditions that typically do not require polysomnography include:
- Insomnia
- Sleep-wake rhythm disorders
- Restless legs syndrome
What are the cognitive outcomes most affected by repeated partial sleep loss?
- Subjective alertness
- Sustained attention
- Working memory
- Emotional processing
- Decision-making capabilities
How do sleep disorders affect dreaming?
Sleep disorders can alter dreaming by:
- Changing slow waves.
- Influencing arousal systems' activity.
- Resulting in nightmares or other dream disturbances.
What happens to sleep duration in the first year of life?
Total sleep time dramatically:
- Decreases significantly across the first year.
- Initial precursor sleep stages become more like adult sleep stages.
What are the roles of prolactin (PRL) and growth hormone (GH) in sleep?
- Women have higher levels of PRL and GH than men
- PRL levels peak in luteal phase
- GH levels decrease with age in both sexes
How does circadian medicine use knowledge of biological rhythms?
It aims to improve health by:
- Targeting the circadian system
- Utilizing chronotherapeutics
- Implementing chronopharmacological approaches for medication timing
What are the categorized pharmacological treatments for insomnia?
Major drug categories include:
- Benzodiazepines
- Non-benzodiazepine agonists (Z-drugs)
- Both focus on shortening sleep latency and enhancing total sleep time.
What are the neurochemical systems involved in wakefulness?
Wakefulness is induced by multiple neurochemical systems:
- Serotonergic neurones in the dorsal raphe nucleus.
- Noradrenergic neurones in the locus coeruleus.
- Cholinergic neurones in the pontine tegmentum and basal forebrain.
- Histaminergic neurones in the tuberomammillary nucleus.
- Hypocretins/Orexins in the lateral hypothalamus.
What characterizes rapid eye movement (REM) sleep?
The state known as REM sleep is marked by:
- Rapid eye movements (REMs)
- Electroencephalographic (EEG) activation
- Muscle atonia
How do physiological functions affect body homeostasis during NREM sleep?
Homeostasis is maintained through:
- Stable autonomic systems
- Minimal energy expenditure
- Cardiovascular and respiratory variables driven by the autonomic nervous system
What is the relationship between sleep and memory consolidation?
Sleep aids memory consolidation through:
- REM sleep activating cortical areas
- NREM sleep reactivating memories
- Strengthening synapses during REM
What tool can be useful for assessing insomnia and related disorders?
Wrist or foot actigraphy is recommended for:
- Insomnia
- Sleep-wake rhythm disorders
- Restless legs syndrome
Which appetite-regulating hormones are influenced by sleep loss?
- Leptin (decreased)
- Ghrelin (increased)
- Altered expression impacts appetite
- Leads to food cravings
What is the day-residue effect in dreaming?
The day-residue effect refers to:
- Incorporation of daytime events into dreams.
- Occurring in the day preceding the dream.
- Influence of prior experiences on dream content.
What characterizes the circadian and homeostatic processes in infants?
They are:
- Established during infancy.
- Crucial for regulating sleep duration and timing.
- Subject to evolutionary development as infants grow.
What is the impact of melatonin on sleep?
- Women show higher melatonin amplitude than men
- Rhythm peaks earlier in women
- Menstrual cycle does not significantly change secretion patterns
What are the major types of biological rhythms in chronobiology?
Different rhythms observed include:
- Ultradian: < 24 hr
- Circadian: ~ 24 hr
- Infradian: > 24 hr
- Relevant across various organisms
What are the potential negative effects of long-term use of sleep-inducing medications?
Negative effects may include:
- Altered sleep patterns
- Changes in sleep electroencephalogram (EEG)
- Non-physiological sleep mechanisms.
How does the balance between NREM sleep and waking occur?
This balance is maintained through:
- Reciprocal inhibitory projections between NREM-promoting and wake-promoting neurones.
- Experimental studies indicating a multi-circuit origin for NREM sleep.
- Heterogeneous profiles of wake and NREM sleep-active cells.
What are the proposed neuronal mechanisms for muscle atonia during REM sleep?
Muscle atonia arises from:
- Activation of PS-on glutamatergic neurons in the caudal pontine sublaterodorsal tegmental nucleus (SLD)
- Glycinergic/GABAergic premotoneurons in the ventro-medial medulla (vmM)
What occurs to physiological regulation during REM sleep?
In REM sleep, physiological regulation is characterized by:
- Loss of posture control
- Unstable autonomic activity
- Surges in heart rate and blood pressure
- Irregular breathing and depressed thermoregulation
How is sleep viewed from the lens of neural network maintenance?
Neural network maintenance theories suggest:
- Sleep maintains neuronal connections
- It incorporates new stimuli during sleep cycles
- It prevents network dysfunction during inactivity
What is essential for accurate sleep recording?
Important aspects for accurate sleep recording are:
- Careful electrode placement
- Continuous adjustments for artefacts
- Ongoing video camera positioning
How is sleep deprivation linked to metabolic syndrome?
- Increases risks of heart disease
- Raises stroke likelihood
- Heightens risk of type 2 diabetes
- Modulates inflammatory markers
What characterizes the sensorimotor disconnection during sleep?
Sensorimotor disconnection is marked by:
- Disengagement from surroundings.
- Increased arousal thresholds.
- A hallmark feature of sleep.
How does the EEG change as neonatal sleep transitions to infantile sleep?
Key changes include:
- EEG evolving from discontinuous patterns to more continuous recordings.
- Introduction of sleep spindles and K-complexes.
- Increased synchronization in spindle activity over time.
What trends have been observed concerning gender differences in sleep disorders?
- Women report more insomnia than men
- Higher prevalence of sleep-disturbing diseases in women
- Socioeconomic status strongly correlates with sleep quality
Why is light considered the most powerful Zeitgeber?
Light's significance arises from:
- Its ability to reset the circadian clock
- Providing direct information about the solar day
- Influencing alertness, mood, and cognition
What should be considered regarding the duration of pharmacotherapy for sleep disturbances?
Important considerations include:
- Dosage
- Duration of treatment
- Potential for unwanted side effects over time.
What characterizes waking in mammals?
The waking state is characterized by:
- High-frequency (40–300 Hz) and low-amplitude (desynchronized) EEG activity.
- Sustained EMG activity.
- Ocular movements.
- Distinct from NREM and REM sleep states.
Why must sleep stage analysis be manually reviewed?
Automatized analysis must be manually reviewed to:
- Ensure accuracy
- Correct errors in analysis
How are SLD neurons inactivated during waking and slow-wave sleep (SWS)?
SLD neurons are inactivated by:
- PS-off GABAergic neurons in the ventrolateral periaqueductal gray
- Adjacent deep mesencephalic reticular nucleus
What is the role of the hypothalamus in physiological regulation across sleep states?
The hypothalamus is essential for:
- Integrated control of physiological functions
- Homeostasis maintenance
- Regulation of energy expenditure
- Autonomic cardiovascular control
What factors influence sleep patterns according to ecological variables?
Influencing factors on sleep patterns include:
- Environmental light conditions
- Temperature variations
- Behavioral activities in relation to survival value
What negative health outcomes are associated with insufficient sleep?
- Weight gain and obesity
- Type 2 diabetes
- Cardiovascular disease
- Hypertension
- Increased inflammation
Describe hypnagogic hallucinations.
Hypnagogic hallucinations are typically experienced during:
- The transition into light sleep.
- Often perceived as “snapshots” or short sequences.
- Reported by 80%–90% of individuals awakened during this stage.
How can sleep stages in newborns be assessed?
Sleep stages are assessed using:
- EEG for electrical activity.
- EMG for muscle tone.
- EOG for eye movement tracking, along with behavioral observation.
How prevalent is sleep-disordered breathing (SDB) in men vs. women?
- SDB prevalence is higher in men (2x)
- After menopause, women's rates approach men's
- Specific risk factors include polycystic ovary syndrome and gestational diabetes
What happens when the relationship between process S and C is disrupted?
Potential consequences of disruption include:
- Sleep-wake disturbances
- Metabolic dysfunction
- Increased risk of diseases
- Pathophysiology in health
What role does GABA play in NREM sleep?
GABA mediates:
- Tonic inhibition of wake-active neurones during NREM sleep.
- Inhibition is evidenced by the application of GABAA receptor blockers.
- Ensures typical wake-related firing impacts during NREM and REM sleep.
What role do GABAergic neurons play in PS onset and maintenance?
They contribute by:
- Inhibiting PS-off neurons in the posterior hypothalamus
- Ventrolateral periaqueductal gray
- Lateral and dorsal paragigantocellular reticular nuclei
What is meant by the term "physiological regulation"?
Physiological regulation refers to:
- Integrated neural control mechanisms
- Underlying physiological functions during different WS states
- Maintenance of body function stability
What is the role of REM sleep in emotional regulation?
The role of REM sleep in emotional regulation involves:
- Active mood restoration
- Processes related to emotional memory
- Complex interactions with other brain regions
What tests are recommended to assess daytime sleepiness?
To assess daytime sleepiness, it is advised to use:
- Sleepiness tests
- Vigilance tests
- Clinical findings
How does sleep deprivation contribute to accident risks?
- Increased incidence of sleepiness
- Impairs decision-making
- Elevates accident rates
- Associated errors in judgment
- Surpasses alcohol and drugs as a cause
How does dreaming relate to neurological terms?
Dreaming is identified as a:
- Hallucinatory state characterized by false perceptions.
- Form of delirium without significant control.
- Experience with reduced reflective consciousness.
What are the three sleep states observed in infants?
The sleep states include:
- Quiet sleep (QS)
- Active sleep (AS) - becomes REM sleep.
- Indeterminate sleep (IS) - not clearly classified.
What challenges exist in diagnosing SDB in women?
- Symptoms often differ from men
- Women diagnosed at older ages and with higher body mass index (BMI)
- Clinical presentations are often atypical, leading to underdiagnosis
How does the suprachiasmatic nucleus (SCN) function as the central clock?
The SCN coordinates timekeeping by:
- Generating circadian rhythms
- Sending signals to peripheral clocks
- Acting as a master clock for synchronizing bodily organs
Which brain regions are implicated in waking control?
Key implicated regions include:
- Lateral hypothalamus (LH) for physiological and behavioral homeostasis.
- Diverse neuronal populations with complex neurochemical profiles.
- Recorded activities correlate with REM, waking, and NREM states.
How can the propensity to fall asleep best be measured?
The Multiple Sleep Latency Test (MSLT) is best for measuring:
- Propensity to fall asleep
- Propensity to fall asleep
Which areas of the brain are activated during paradoxical sleep?
A select few regions are activated during PS:
- Claustrum
- Supramammillary nucleus
- Limbic cortical structures
What are the adaptations of respiratory and cardiovascular functions during sleep?
Adaptations include:
- Decrease in cardiovascular activity during NREM
- Atonia in respiratory muscles during REM
- Altered energy expenditure during sleep states
How do the theories on sleep functions complement each other?
Theories complement each other by:
- Addressing different aspects of sleep
- Offering a more complete understanding of physiological roles
- Exploring mutual processes in sleep functions
What are the impacts of prolonged wakefulness on performance?
- Psychomotor impairment
- Reduced cognitive performance
- Increased error rates
- Deteriorated emotional state
- Altered risk-taking behavior
What are some common characteristics of dreams?
Common characteristics of dreams include:
- True perceptual quality (seeing color, movement).
- Emotional intensity, especially in nightmares.
- Bizarre and unpredictable storylines.
What EEG characteristics define active sleep (AS) in infants?
Characteristics of AS include:
- Continuous mixed theta and delta activity.
- Low amplitude muscle tone with irregular respiration.
- Presence of slow and rapid bursts of eye movements.
How does hormone therapy influence sleep in women?
- Menopausal hormone therapy (MHT) is effective for sleep problems
- Can also be given for mild climacteric symptoms
- No improvement within 3 months indicates need for other options
What characterizes different chronotypes in humans?
Distinctions among chronotypes include:
- Variants in sleep period length
- Differences in circadian amplitude
- Variability in light sensitivity and phase of entrainment
What mechanisms underlie the onset of NREM sleep?
NREM sleep onset involves:
- Activity of multiple cell populations across brain areas.
- Increased discharge rates of sleep-promoting neurones.
- The role of ventrolateral preoptic nucleus (VLPO) and its reciprocal connections.
How are glutamatergic neurons involved in triggering REM sleep?
They reside in:
- Sublaterodorsal tegmental nucleus (SLD)
- Contribute to paradoxical sleep initiation and maintenance
How does auditory processing change during sleep?
Auditory processing is characterized by:
- Reduced transmission of sensory information
- Thalamic gating that modulates sensory access
- Increased arousal threshold required to awaken
What is one limitation mentioned regarding sleep and energy conservation?
A noted limitation is that:
- Sleep is less effective in energy conservation compared to torpor or hibernation
- It involves complex brain activities rather than just rest
What tests assess the ability to remain awake?
To measure the ability to stay awake, the following tests are used:
- Maintenance of Wakefulness Test (MWT)
- Vigilance tests
- Driving simulators
What brain regions are altered during sleep deprivation according to neuroimaging studies?
- Prefrontal Cortex (PFC)
- Amygdalae
- - Altered activation during emotional stimuli
- - Impacts emotional processing and response
What defines the shift from slow-wave sleep to REM sleep?
The transition from slow-wave sleep to REM sleep is characterized by:
- Increase in vivid and hallucinatory experiences.
- Daily narrative structure in dreams.
- Marked differences in consciousness levels.
What sleep characteristics differ between young men and women?
- Young women experience higher melatonin rhythm amplitude
- Men spend more time in stage 1 sleep
- Age-related sleep changes differ: more prominent in boys
How do circadian rhythms influence physiological functions?
Circadian rhythms regulate:
- Cellular functions in brain and body
- Metabolomic and proteomic activities
- Behavioral functions like sleep and appetite
How does optogenetic activation affect sleep states?
Optogenetic activation of certain neurones can cause:
- Rapid transition from sleep to waking.
- Impact on diverse neurones within various brain nuclei.
- Strong correlational relationships with alertness and arousal.
What determines the incidence of PS in models of sleep deprivation?
Muscle atonia correlates with:
- Activation of glutamatergic neurons in SLD
- Modulation through cholinergic and GABAergic systems
What happens to somatosensory processing during sleep?
Somatosensory processing is:
- Reduced during sleep
- Influenced by presynaptic GABAergic and postsynaptic glycinergic mechanisms
- Altered access during NREM and REM sleep
What cumulative factors characterize sleep as a complex process?
Cumulative factors include:
- Multiple macro and microstates
- Various physiological processes
- Interaction of behavioral and neural aspects
What factors affect safe driving and sleepiness perception?
The following factors are relevant for driving safety and sleepiness perception:
- Tested sleep-wake axis
- Clinical judgement
What has research shown about the correlation between sleep deprivation and depression?
- Insomnia significantly predicts depression
- Non-depressed insomniacs have doubled risk of depression
- Sleep deprivation exacerbates negative mood states
What hypothesis suggests dreams serve to resolve emotional problems?
The selective mood regulation theory posits that:
- Dreams metaphorically address emotionally charged issues.
- Result in mood improvement upon awakening.
- Help in resolving emotional conflicts.
What constitutes the clinical presentation of SDB in women?
- Reports include atypical symptoms: insomnia, nocturia, fatigue
- Classic symptoms like loud snoring are less reported
- Women remain symptomatic even with low apnea-hypopnea index
What neurotransmitter systems are involved in maintaining wakefulness?
Multiple neurotransmitter systems contribute to wakefulness:
- Serotonergic neurones in the dorsal raphe nucleus
- Noradrenergic neurones in the locus coeruleus
- Cholinergic neurones in the pontine tegmentum
- Others like histamine and hypocretin (Hcrt/Ox)
What neurotransmitter influences the maintenance of muscle atonia during PS?
Glycine is crucial due to its:
- Role in hyperpolarizing motoneurons
- Co-release with GABA by premotoneurons in vmM
What is the significance of cortical event-related potentials (ERPs) during sleep?
ERPs reflect:
- Changes in sensory processing based on WS state
- Specific negative and positive waves during NREM sleep
- Sleep-protection processes initiative
What determines the need for sleep in relation to energy metabolism?
The need for sleep is linked to:
- Increased adenosine levels post neuronal activity
- Induction of sleep via inhibition of arousal systems
How does sleep impact cognitive functioning?
Sleep's effects on cognitive functioning include:
- Decrease in cognitive abilities
- Difficulty regulating emotions
- Impaired learning capabilities
What are the subjective experiences reported by individuals who undergo sleep deprivation?
- Increased sleepiness
- Enhanced anxiety
- Loss of vigor
- Fatigue
- Confusion
How are gender differences in sleep architecture characterized?
- Adult sleep comparisons are complex due to reproductive life conditions
- Women report longer sleep than men, yet PSG shows minimal duration differences
- More slow-wave sleep in women than in men
What drugs have been shown to enhance PS onset?
Substances like:
- Cholinergic agonist carbachol
- GABA antagonists such as bicuculline
What characterizes non-rapid eye movement (NREM) sleep?
NREM sleep is defined by:
- Low-frequency (0.5–4 Hz)
- High-amplitude (synchronized) EEG oscillations
- Low EMG activity without ocular movements
How does muscle control vary across different sleep stages?
Muscle control varies by:
- High activity during active wakefulness
- Progressive reduction in NREM sleep
- Complete atonia in tonic REM sleep
- Intermittent twitches during phasic REM sleep
How does hibernation compare with sleep in terms of brain activity?
Hibernation differs from sleep as it exhibits:
- Strikingly low brain activity during inactivity
- Minimal sleep-like features compared to slow-wave sleep
What impact does sleep disruption have on daytime functioning?
Disrupted sleep can lead to:
- Impaired vigilance
- Reduced executive functions
- Increased emotional reactivity
What recommendations are made to mitigate the effects of sleep deprivation?
- Aim for sufficient sleep duration
- Create regular sleep schedules
- Limit screen time at night
- Address lifestyle causes of sleep loss
- Educate on sleep health benefits
How does dreaming differ from consciousness in waking life?
Dreaming differs from waking consciousness due to:
- Lack of judgment and control over the narrative.
- Absence of chronological awareness.
- Evening dependence on internally generated experiences.
What factors may contribute to sleep disturbances in women?
- Higher levels of depression correlate with sleep issues
- Socioeconomic status impacts sleep quality as women typically earn less
- Reproductive phase disorders contribute to perceived sleep quality issues
How do GABAergic neurones influence sleep?
GABAergic neurones play a key role in sleep by:
- Mediating tonic inhibition of wake-active neurones
- Leading to the low-frequency, high-amplitude delta EEG activity of NREM sleep
Which brain structures contain neurons that inhibit PS-on glutamatergic neurons?
Key structures include:
- Ventrolateral periaqueductal gray (vlPAG)
- Dorsal deep mesencephalic reticular nuclei (dDpMe)
Which muscles are not inhibited during REM sleep?
Muscles spared from inhibition include:
- Diaphragm (respiratory muscles)
- Middle ear musculature (to modulate auditory inputs)
What is the influence of sleep deprivation on metabolic processes?
Sleep deprivation affects metabolism by:
- Increasing energy expenditure
- Decreasing glucose tolerance
What cognitive process is importantly linked to sleep?
The following are vital cognitive processes linked to sleep:
- Memory consolidation
- Emotional processing
What can trigger alterations in dream experiences in narcolepsy patients?
Narcolepsy patients often experience:
- Frequent lucid dreams.
- Changes in dream content and frequency.
- Effects related to the instability of sleep states.
What are the implications of hormone levels on sleep in men and women?
Hormone levels significantly impact sleep; key points include:
- Women have higher prolactin levels.
- Growth hormone (GH) levels are greater in women.
- Cortisol levels vary by age and sex.
- Melatonin secretion differs, women have higher rhythms.
- Sex steroids play crucial roles in sleep regulation.
What role does the anterior hypothalamus play in sleep?
The anterior hypothalamus, particularly the
- Preoptic area (POA), is essential for:
- Preoptic area (POA), is essential for:
- Producing normal sleep
- Inducing NREM sleep via specific neurones
How do monoaminergic neurons affect REM sleep?
Their firing patterns indicate:
- Serotonergic and noradrenergic neurons cease activity during PS
- Suggests a reciprocal inhibitory mechanism with PS-on neurons
What characterizes the transition from wakefulness to NREM sleep?
This transition is characterized by:
- A progressive reduction in muscle activity
- Changes in physiological regulation
- Maintenance of body stability
What are the major theoretical proposals regarding the functions of sleep?
Key proposals include:
- Ecological Hypothesis: Optimizes timing and effectiveness of activity.
- Energy Conservation: Saves energy during sleep.
- Recovery Theory: Detoxification and restoration of functions.
- Memory Consolidation: Strengthens memories and immunity.
- Neural Network Maintenance: Maintains neural architecture.
How do attentional functions relate to sleep?
Attention is crucial for cognitive efficiency; disrupted sleep can lead to:
- Attentional deficits
- Impaired memory encoding
How do researchers document dreaming during non-REM sleep?
Dreaming in non-REM sleep can be documented by:
- Open-ended questioning methods.
- Reports showing up to 70% of subjects recall dreams.
- Identifying qualitative aspects of dreams from these stages.
Mention key neuronal populations involved in NREM sleep.
Important neuronal populations for NREM sleep include:
- Ventrolateral preoptic nucleus (VLPO) neurones
- Median preoptic nucleus (MnPn) neurones
- Discharge rates correlate with sleep depth
What is the role of GABAergic neurons during REM sleep?
GABAergic neurons notably:
- Inactivate serotonergic and noradrenergic neurons during PS
- Provide tonic inhibition to maintain sleep state
What factors influence sensory information access during sleep?
Factors influencing access include:
- Intensity of stimuli
- Level of cerebral arousal
- Thalamic gating mechanism
What tasks assess sustained attention related to sleep?
The psychomotor vigilance test (PVT) assesses:
- Sustained attention deficits
- Effects of sleep deprivation
What is the typical EEG pattern during waking?
Waking is characterized by:
- High-frequency (40–300 Hz)
- Low-amplitude (desynchronized) EEG activity
Which types of neurons are predominant in SLD during PS?
The SLD predominantly contains:
- Glutamatergic PS-on neurons
- Few GABAergic neurons indicated by cFos markers
How is energy expenditure related to sleep states?
Energy expenditure varies as follows:
- Minimal during NREM sleep
- Increased demands during wakefulness
- Fluctuates based on physiological state
How does sleep deprivation affect executive functions?
Sleep deprivation can lead to impairments in:
- Cognitive flexibility
- Planning actions
- Monitoring responses
What is the relationship between VLPO and SCN?
The relationship between VLPO and SCN includes:
- Synchronized activity patterns
- Interconnectedness to modulate sleep-wake cycles
What is the role of sleep in learning efficiency?
Prior sleep significantly influences:
- Memory creation
- Development of learning strategies
How do cholinergic neurons influence PS occurrence?
They are linked to:
- Modulation of REM sleep
- Activating PS but not solely responsible for initiating it
What is the role of sensory stimuli in disrupting sleep?
Sensory stimuli can disrupt sleep if they:
- Are intense enough
- Coincide with sufficient arousal levels
- Override thalamic gating functions
How does the lateral hypothalamus contribute to sleep-wake regulation?
The lateral hypothalamus contributes by:
- Housing diverse neuronal populations
- Regulating physiological and behavioral homeostasis
- Inhibiting sleep-promoting neurones
Regarding glycine and GABA, what is their combined role in PS?
They work together to:
- Sustain muscle atonia
- Hyperpolarize motoneurons in ventromedial medulla (vmM)
How does the autonomic nervous system regulate functions during sleep?
Regulation occurs through:
- Stable autonomic dominance in NREM
- Unstable autonomic responses in REM
- Maintenance of respiratory and cardiovascular parameters
How does deep NREM sleep affect hippocampal function?
Deep non-rapid eye movement (NREM) sleep is essential for:
- Restoring hippocampal functioning
- Favoring optimal learning processes
What are hypocretins and their role in sleep?
Hypocretins are neuropeptides involved in:
- Promoting wakefulness
- Regulating energy homeostasis
What conditions enhance PS after sleep deprivation?
Enhanced PS occurs due to:
- Specific activation of glutamatergic neurons
- Inhibition of GABAergic inputs
What effects do GABA antagonists have during PS episodes?
Their administration results in:
- Increased PS quantity
- Enhanced motor activity
Which brain region is critical for REM sleep?
The brain region critical for REM sleep includes:
- The pedunculopontine tegmental nucleus (PPT)
- Known for GABA, glutamate, and acetylcholine release
What happens to neurotransmitter activity during REM sleep?
During REM sleep:
- Some dopaminergic neurones remain active
- Monoaminergic neurones decrease activity
What anatomical pathway connects vmM neurons to motoneurons?
This connection involves:
- Descending projections from glycinergic neurons
- Targeting lumbar spinal motoneurons
What is the current understanding of neurons during sleep-wake transitions?
Current understanding indicates that:
- Hypocretin neurones first activate
- Exciting waking systems and inhibiting NREM-active neurones
Describe the role of the thalamus in sleep regulation.
The thalamus is involved in sleep regulation through:
- Integration of incoming information from various brain regions
- Influencing cortical activity during sleep-wake transitions
What experimental evidence supports the roles of the POA in sleep?
Experimental evidence shows that:
- POA lesions induce insomnia
- Stimulation of the POA increases NREM sleep
What is the significance of c-Fos immunoreaction in the context of sleep?
c-Fos immunoreaction significance includes:
- Acts as a marker of neuronal activity
- Correlates with the quantity and consolidation of sleep
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