Notes on Sleep Disorders

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NREM and REM

NREM:

• Stages 1, 2, 3, 4; 3, 4 are delta sleep; idle brain in active body. First half of the night.

REM:

• Active brain in paralyzed body; regulated by pons. Last half of the night.

Sleep Stages:

sleep stages

Sleep Cycle Regulation:

• Sleep cycle regulated by: superchiasmatic nucleus (SCN).

Effects of Sleep Deprivation:

• Greatly affects cerebral cortex.

• Rest of body is unaffected.

• Lymphocyte levels decline and cortisol levels rise.

• Learning complex tasks becomes difficult.

REM:

• Memory consolidation by hippocampus.

Neurotransmitters of Sleep:

• Increased GH, prolactin, and serotonin; decreased dopamine and TSH.

• Delta sleep increases after exercise.

Melatonin

• Induces feelings of sleepiness.

• Causes eye-sensitivity to light.

• Circadian rhythm.

• Causes jet lag.

Sleep disorders:

Narcolepsy:

• Excessive daytime sleepiness; REM disorder; earlier REM onset; deficiency of hypocretin protein (orexin) transport; treatment: CNS stimulants and tricyclic antidepressants.

Sleep apnea:

• Absent breathing during sleep.

• Treatment: weight loss, respiratory stimulants, continuous + airway pressure (CPAP).

SIDS:

• Unexplained death of children less than 1 year old.

• Baby placed on chest.

Insomnia:

• Poor sleep cycle.

• Treatment: triazolam (halcion), zelpidem, nonbenzodiazepine.

Night terrors:

• Occur in NREM.

• Not recalled on awakening.

Nightmares:

• Occur in REM.

• Recalled on awakening.

Enuresis:

• Bedwetting; treat with imipramine.

Sleep-related Neurotransmitters:

Serotonin:

• Initiates sleep.

ACh:

• High in REM; erections.

NE:

• Low in REM.

Dopamine:

• Rises with waking.

Additional Readings:

Basic Neurology

1. Peripheral Nervous System
2. Central Nervous System
3. The Ventricular System
4. The Spinal Cord
5. The Brain Stem
6. The Cerebellum
7. Visual Pathways
8. Diencephalon
9. Basal Ganglia
10. Cerebral Cortex
11. Sleep Disorders
12. Autonomic Nervous System
13. Cranial Nerves and Parasympathetic Ganglia
14. Cells of the Nervous System
15. Cerebrospinal fluid
16. Additional short notes on Cerebrum
17. Functions and Diseases of Cerebrum
18. Subcortical Grey Matter
19. Notes on The Spinal Cord
20. Regulation of Heart Rate by Autonomic Nervous System
21. Action Potentials, Axon Conduction, and Neuromuscular Junction
22. Types of Seizures

Neurology Videos

1. Video of Neurology Examination in a Clinical Setting

Medical Images

Useful Medical Images & Diagrams (link opens in a new window)

Related Topics

1. Nervous System Disorders
2. Histology of Nervous Tissue
3. Cranial Nerve Reflexes
4. Motor System Examination

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