BioSci 24237 BIOLOGICAL RHYTHMS AND SLEEP

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BioSci 24237BIOLOGICAL RHYTHMS AND SLEEP

• CLASS 17
• Sleep Disorders
• March 4, 2003

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Sleep Disorders

• Disorders of excessive daytime sleepiness
• Narcolepsy
• Sleep apnea
• Insomnia
• Adjustment sleep disorder
• Psychophysiological insomnia
• Idiopathic insomnia
• Parasomnia
• Circadian rhythm disorders

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Multiple Sleep Latency Test (MSLT)
Roth T Roehrs T, 2000.
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Narcolepsy

• Narrow definition
• 1. excessive daytime sleepiness
• 2. cataplexy an abrupt reversible total or
  partial
• loss of muscle tone
• 3. sleep paralysis upon falling asleep or
• waking up, the patient is briefly paralyzed
• 4. hypnagogic hallucinations
• 5. Sleep onset REM (SOREM) or ultra-short
• REM latency
• Broad definition
• 1. excessive daytime sleepiness
• 2. REM abnormalities SOREM hypnagogic
  hallucinations

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Narcolepsy

• Causes
• REM dysregulation atonia without REM sleep
• Treatment
• 1. Drugs that inhibit REM sleep mechanisms
• to treat cataplexy
• 2. Stimulants to treat sleepiness (poor
  nocturnal sleep)

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Sleep Disorders

• Disorders of excessive daytime sleepiness
• Narcolepsy
• Sleep apnea
• Insomnia
• Adjustment sleep disorder
• Psychophysiological insomnia
• Idiopathic insomnia
• Parasomnia
• Circadian rhythm disorders

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TOTAL SLEEP TIME (minutes)
AGE RANGES (years)
Changes per decade EA -gt ML ns ML -gt LL - 27
min
EFFECT OF AGE p 0.0001
EFFECT OF BMI ns
INTERACTION ns
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Parasomnias

• REM behavior disorder
• Nightmares
• Arousal from non-REM sleep
• Sleep walking
• Sleep talking
• Night terrors

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Circadian Sleep Disorders
NORMAL SLEEP.
DELAYED SLEEP PHASE SYNDROME
IRREGULAR SLEEP
FREE-RUNNING SLEEP-WAKE CYCLE IN BLIND SUBJECTS