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.
REM: active brain in paralyzed body; regulated by pons.

sleep stages
Sleep cycle regulated by: superchiasmatic nucleus (SCN).

First half of the night: NREM stages 1, 2, 3, 4.
Last half of the night: REM.

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.

During 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. The Limbic System
12. Sleep Disorders
13. Autonomic Nervous System
14. Cranial Nerves and Parasympathetic Ganglia
15. Cells of the Nervous System
16. Cerebrospinal fluid
17. Additional short notes on Cerebrum
18. Functions and Diseases of Cerebrum
19. Subcortical Grey Matter
20. Notes on The Spinal Cord
21. Regulation of Heart Rate by Autonomic Nervous System
22. Action Potentials, Axon Conduction, and Neuromuscular Junction

Related Topics

1. Nervous System Disorders
2. Histology of Nervous Tissue

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