The History and Physiology of Sleep: From Ancient Times to Modern Research, Exams of Nursing

Download The History and Physiology of Sleep: From Ancient Times to Modern Research and more Exams Nursing in PDF only on Docsity! Sleep Exam 1Questions with Answers Latest Update 2024 Test 3 Basic Points about Sleep Universality - Correct Answers 1. As far as we know, throughout history, all humans have slept 2. Sleep is universal, but there are many varieties in sleep across cultures 3. Many animals, when they do sleep, sleep very differently from humans You have already slept about ____ hours - Correct Answers 70,000 Imamura - Correct Answers "Sleeping while present" in Japan T/F: Sleep is totally universal through mammals - Correct Answers True Hypnos - Correct Answers Greek god of sleep Hypnos's mother was the goddess ___ ("___") - Correct Answers Nix ("night") Hypnos's twin brother was ___, the god of ___ - Correct Answers Hantan’s; death Morpheus - Correct Answers God of dreams Ancient Greeks believed Morpheus gave visions of what? - Correct Answers the future What did Ancient Egyptians (1000-3000 BCE) believe about sleep? - Correct Answers Like death, the soul travels away from the body during sleep and talks to souls in the afterlife Rest means ? and is represented by what? - Correct Answers "dreams" (also "awaken") is represented by an open eye Who recognized sleep as a biological need? - Correct Answers Aristotle Who said vapors from food decomposition rise to brain to cause sleep and you awaken when digestion is complete? - Correct Answers Aristotle Father of modern sleep research - Correct Answers Nathaniel Kleitman University of Chicago Who wrote the very first textbook on sleep (entitled "sleep and wakefulness (1939)"? - Correct Answers Nathaniel Kleitman Who discovered sleep stages and standardized sleep analysis in the 1950s-1960s? - Correct Answers Kleitman, Dement, Asterisk, and Reshtschaffen Father of sleep medicine - Correct Answers Bill Dement Who opened the first narcolepsy clinic in 1964? Turned into sleep disorders clinic - Correct Answers Bill Dement Who founded SLEEP journal and co-founded associated professional sleep societies AND taught the first undergraduate sleep class? - Correct Answers Bill Dement T/F: Many humans throughout history haven't had what we think of as a mattress - Correct Answers true T/F: Almost all humans today have beds - Correct Answers False How did the industrial age cultures affect sleep? (3 reasons) - Correct Answers Electric lighting More work hours Increase in global communication Huge effect of ___ life (lighting) on bedtimes (urban/rural/suburban) - Correct Answers urban Roger Kerch discovered that people used to sleep in segments - Correct Answers "First sleep", watching period, second (or "morning" sleep) Roger Kerch discovered that... - Correct Answers humans used to sleep in segments, long time ago T/F: some cultures may still show "segmented sleep" - Correct Answers true Almost ___% of Spaniards have never had a siesta and research shows that Spaniards put in more work hours each year than ____ & ____ - Correct Answers 60 Brits and Germans It ____ (does/doesn't) seem like we're "biologically" supposed to segment sleep - Correct Answers doesn't What percent of Americans prioritize sleep? - Correct Answers 10% Cultural attitudes toward "co-sleeping" - Correct Answers Americans see it as dangerous Across the world, it is very common to sleep with baby, some consider it neglect if you don't Rate of SIDS is just as common in both cultures sleep is a reversible behavioral state of perceptual disengagement from and unresponsiveness to the environment...usually marked by... - Correct Answers physiological changes and homeostatic regulation/rebound three basic points about the measurement of sleep - Correct Answers 1. sleep questionnaires don't just measure sleep, they measure perception, complaints, and a whole lot else 2. Fit bit and apps cannot tell if you're asleep (very well), but wristband actigraph can 3. polysomnography is the gold standard GPA is predicted by self-reported sleep times in first month of college - Correct Answers students who got 7-9 hours of sleep get the highest GPA if you report <7 hours of sleep, you are twice as likely to be on academic probation common self-report/subjective measures - Correct Answers 1. Pittsburgh Sleep Quality Index (PSQI) 2. Epworth Sleepiness Scale (ESS) 3. Karolin’s Sleepiness Scale (KSS) 4. another approach is to maintain a sleep diary every day most cited self-report - Correct Answers PSQI a global PSQI score above ___ indicates clinical poor sleep quality - Correct Answers 5 What percent of college students reach PSQI clinical levels of poor sleep? - Correct Answers 60% "how long does it take you to fall asleep?" - Correct Answers Sleep onset latency (SOL) TIB - Correct Answers time in bed TST - Correct Answers total sleep time sleep efficiency - Correct Answers TST/TIB WASO - Correct Answers wake after sleep onset Epworth Sleepiness Scale (ESS) - Correct Answers interested in average sleep propensity on most days (how sleepy you are) Karolina Sleepiness Scale (KSS) - Correct Answers how alert you feel right now What are the advantages/disadvantages of sleep diaries relative to retrospective questionnaires? - Correct Answers more context lie -> forget to do it What are the advantages/disadvantages of retrospective questionnaires? - Correct Answers provides snapshot of extent of insomnia inexpensive useful for screening and assessment few compliance problems represents "typical" sleep easy scoring susceptible to memory distortion What are the advantages/disadvantages of on-going sleep questionnaires? - Correct Answers can reflect night-to-night variability useful for tracking sequences of events good for monitoring therapeutic progress measures taken close in time to events of interest may reflect atypical sleep experiences number of nights needed for "accuracy" not known may be reactive compliance problems perceived phonotype scales determine what? - Correct Answers the propensity to sleep at a particular time during 24-hour period Perceived phonotype scales (2) - Correct Answers morningness-eveningness questionnaire (MEQ) Munich phonotype (MCTQ) MEQ study with Baylor students - Correct Answers N = 1,120 Baylor students self-described "night owls" take 20% more naps, drink significantly more caffeine after 5pm, and spend 25% longer on social media in bed Munich Phonotype (MCTQ) - Correct Answers how you sleep when you have work/school in the morning v how you sleep on weekends midpoint of sleep (free) - midpoint of sleep (work) = - Correct Answers social jet lag Fit bit on normal mode ____ TST by ___ minutes, ____ WASO by ___ minutes, and _____ SE by ___% - Correct Answers overestimated; 79 underestimated; 66 overestimated; 16 Clinical/medical equipment can only exist if what? - Correct Answers they are proven to work What are the advantages/disadvantages of clinical-grade actigraph bands? - Correct Answers -accelerometer technology (tracks movement) -durable -easy to use -easy analysis -detects different light wave lengths -battery life -expensive -no sleep staging How act-watch data is presented? - Correct Answers teal = sleep black spikes = movement aqua = in bed, awake Actigraph monitoring of Baylor students - 8 hour challenge - Correct Answers people can change their sleep people who sleep 8+ hours during finals perform better Intraindividual variability in sleep - Correct Answers how much does sleep vary within an individual? IIV is associated with worse ___ and ____ even when accounting for amount of sleep gotten - Correct Answers stress and depression in design majors, IIV is linked to worse ____ - Correct Answers creativity people almost always overestimate how much sleep they're getting by ___-___ minutes - Correct Answers 45-60 When is actigraph less accurate? (2 reasons) - Correct Answers motionless and people with poor sleep quality Disadvantages of actigraph band - Correct Answers copycat commercial devices expensive battery changes/maintenance no sleep stages Who invented the EEG? - Correct Answers Hans Berger in 1924 EEG applied to sleep in what year? - Correct Answers 1950s -> termed polysomnography Who discovered REM sleep? - Correct Answers Asterisk "deep sleep" delta waves & slow oscillation feel extremely groggy when you wake up from SWS slow oscillations - Correct Answers < 1 Hz SWS was first noticed by who? - Correct Answers scientists at the university of Chicago SWS also showed less responsive to ____ ____ - Correct Answers auditory stimuli amplitude matters, speed matters larger & slower waves = - Correct Answers healthy and best REM sleep - Correct Answers "paradoxical sleep" EMG line = flat (muscle atonic) EEG is low amplitude, mixed frequency, may include "saw tooth waves" REMs co-occur with "saw tooth" waves phasic v tonic REM - Correct Answers phasic: eyes are moving rapidly (dreams occur in phasic) tonic: still in REM sleep but eyes aren't moving do blind people still have REM? - Correct Answers yes REM waves are - Correct Answers mixed frequency Drawbacks of PSG - Correct Answers how do you score sleep? PSG cost ($1,600-$5,000) time from referral and treatment (3-12 weeks) PSG "first night effect" how stable is PSG from night to night? does PSG predict how one feels they slept? How do you "score sleep" - Correct Answers EPOCH epoch - Correct Answers 30 second epoch (time period), determine if there's a spill, what's the majority? you lose some information delta Hz - Correct Answers 0.5 - 4 theta Hz - Correct Answers 4 - 7 alpha Hz - Correct Answers 8 - 12 sigma Hz aka sleep spindles - Correct Answers 12 - 14 beta Hz - Correct Answers 14 - 30 gamma Hz - Correct Answers 30 + topographical spectral analysis - Correct Answers where in the brain is this occuring? PSG explained ___-___% of the variance in subjective sleep quality - Correct Answers 11-17 Best matric of predicting how one feels they slept v PSG - Correct Answers WASO PRC for melatonin - Correct Answers taking melatonin right before bed is ineffective phase response curves (PRCs) - Correct Answers dose & time dependent light triggered phase advance or phase delay depends on timing relative to temperature nadir Three basic points about the neurobiology of sleep - Correct Answers 1. going to sleep is as easy as "flipping" a switch, neurobiological speaking 2. we think we're either asleep or awake but actually sleep may be more "local" than global 3. NREM and REM sleep are qualitatively different Constantine von Economy - Correct Answers studies patients with Encephalitis Lethargic damage to ____ ____ cause drowsiness - Correct Answers posterior hypothalamus damage to ___ ____ caused severe insomnia - Correct Answers anterior hypothalamus Fredric Bremen (1930s) - Correct Answers encephala insole (maintain sleep/wake) cereal insole (continuous sleep -> SWS) dissected cat brain Wake and REM sleep are controlled in the ____ ____ - Correct Answers reticular formation how does the brain go to sleep? - Correct Answers "flip flop" switch two "global" system --Sleep-ON cells --Sleep OFF cells ___ and ___ are key to NREM - Correct Answers thalamus and hypothalamus sleep-ON cells are represented as - Correct Answers black squares (VLPO and MP) general characteristics of NREM sleep (5) - Correct Answers -inhibit acetylcholine (basal forebrain) -decreased cortisol -increase in growth hormone releasing hormone -high arousal threshold (at least in SWS) -slow, rhythmic breathing (at least in SWS) synaptic downscaling - Correct Answers beginning of day -> synaptic neurons are thin build up during the day with increasing hours awake (not sustainable) decreases with increasing hours asleep connections change daily but overall synaptic levels maintain a homeostasis (large synaptic weights are maintained) local sleep theory - Correct Answers one part of brain is fully asleep and the other awake one part of brain is more taxed during wake, needing greater SWS density night watch in one brain hemisphere during sleep associated with first night effect in humans - Correct Answers only left hemisphere in first night micro sleeps - Correct Answers brain falls asleep, but eyes stay open can part of the brain be asleep and another part be awake? (3 responses) - Correct Answers 1. unihemispheric sleep 2. REM sleep behavior disorder -> you're asleep but you're acting out your dreams 3. sleep paralysis -> conscious level has woken up except for part of brain that controls muscles *SLEEP ON* Ventrogluteal peptic nucleus (VLPO) - Correct Answers uses gamma-amino butyric acid (GABA) neurotransmitters to inhibit arousal promoting centers also uses galantine (neuropeptide) to inhibit *SLEEP OFF* Ascending Reticular Activating System (ARAS) - Correct Answers serotonin, dopamine, acetylcholine, histamine, glutamine, norepinephrine, and origin/hypocrite activating ARAS meant that sleep must be an ___, not ___ process - Correct Answers active; passive t/f: some ARAS neurotransmitters go nearly silent during sleep - Correct Answers true ex. norepinephrine sleep gate - Correct Answers a time window in which process s and process c allow you to sleep "double raster plots" are used to... - Correct Answers illustrate circadian desynchrony studies solid = sleep, dotted = wake, trough = lowest body temp shows 2 day (48 hours) temporal isolation - Correct Answers day after day, your schedule delays, after 3 weeks, you've cycled through 24 hour condition Kleitman lived underground with his student for 1 month imposed 28-hour day -> forced desynchrony - Correct Answers body temperature still fluctuated on 24 hour cycle Because of social zeitgebers the cave studies Michel Suffer - Correct Answers lived underground in isolation at 23 years old for 2 months lost track of time by 25 days repeated stage in TX for 6 months his sleep/wake cycles lasted between 18-52 hours he grew depressed and suicidal repeated study at 61 years old lasted 73 days off by 2 days process C is represented by ___ - Correct Answers REM sleep minimum core body temperature always happens during ... - Correct Answers REM sleep lux at sunrise: lux at noon: - Correct Answers 750 81,000 lux indoors at home lux indoors at office - Correct Answers 200-500 400-700 DLMO is assessed at ... lux - Correct Answers < 20 we need light or other "zeitgebers" to set (entrain) our biological clocks, otherwise... - Correct Answers our process C is imperfectly correlated to 24 hour day Kreisler says 24 hours and 11 minutes - Correct Answers inter-individual variability all within 16 min dendritic spines are... - Correct Answers very plastic constantly changing shape, volume, and number larger dendritic spine = - Correct Answers more strength (spine head volume) post synaptic density - Correct Answers number of proteins, such as AMPA receptors retinohypothalamic pathway - Correct Answers pigment that responds to light (absorbs light), triggers cell firing, sends signal to hypothalamus, triggering SCN retinal ganglion cells containing melanopsin what happens if you cut the optic nerve before the optic chiasm? - Correct Answers cannot entrain light SCN influences the ____ ____ - Correct Answers pineal gland K. ishimori (1909) - Correct Answers inject "sleepy CSF" or control CSF dogs fell asleep within 2-6 hours; control dog remained alert Pepperheimer - Correct Answers sleep deprive a goat (or let it sleep normally) extract CSF from cisterna magna inject "sleepy CSF" into cats and rats cats and rats fall asleep it's universal! caffeine works in opposition to... - Correct Answers adenosine t/f: even with caffeine, adenosine doesn't go away - Correct Answers true adenosine is a hallmark process ___ substance, but there are many others - Correct Answers S process S is reflected by the amount of ___ ____ and ___ ____ ____ - Correct Answers early SWS; delta spectral power more sleep deprived = - Correct Answers denser SWS (more delta waves) napping effects - Correct Answers sleep pressure will be lower lower amplitude delta waves and takes longer to SWS REM tends to reflect process ___ more than it reflects process ___ - Correct Answers C; S the "master clock" - Correct Answers suprachiasmatic nucleus (SCN) "chiasm" "Supra" - Correct Answers optic chiasm sets "supra" (on top) of optic chiasm ____ neurons are inactive at night, start to fire at dawn, and fire at slow, steady pace, all day - Correct Answers SCN SCN removal does not change ___, but it affects ... - Correct Answers TST; many rhythms transplanting SCN from one hamster to another does what? - Correct Answers 'transplants' their rhythms transcription translation negative feedback loop - Correct Answers CLOCK + BMAL1 = PER + CRY this whole process takes ~24 hours discovered by Hall and Rosback What all fluctuates across 24 hours? - Correct Answers basically everything physiologically what is the classic way to measure circadian rhythms - Correct Answers body temperature body temperature is lowest at what time - Correct Answers 3-4am Dim Light Melatonin Onset (DLMO) - Correct Answers most accurate marker for assessing circadian pacemaker need high melatonin to fall asleep cortisol also fluctuates across the 24-hour period "cortisol awakening response" - Correct Answers highest point in the day is as soon as you wake up post-prandial dip - Correct Answers "did the meal cause it?" manipulated giving lunch at 12pm, 11am, or 2pm identical performance at 1pm regardless of eating meal thus, post-prandial dip is a misnomer wake maintenance zone (WMZ) - Correct Answers time when it's close to impossible to fall asleep and you have high alertness happens 6-9 hours before your core body temperature minimum: around 7pm-10pm (when sun is setting and nocturnal animals come out) melanopsin is most sensitive to what kind of light? and has a peak sensitivity to light with a wavelength of about how many nanometers? - Correct Answers visible short- wavelength 'blue light' 480 prices contain a light-sensitive pigment called - Correct Answers melanopsin blue-light therapy in the morning has been shown to be effective in the treatment of what disorder? - Correct Answers seasonal affective disorder under normal conditions light exposure around 18:00-6:00 hours causes a phase ___ of the clock - Correct Answers delay light exposure around 6:00-18:00 will phase ___ the clock - Correct Answers advance what is the major biochemical correlate of darkness and provides an internal representation of the environmental night length? - Correct Answers pineal melatonin Melatonin is synthesized from - Correct Answers Tryptophan how long does it take to shift about 1 hour under real-world conditions? - Correct Answers 1 day basic problem in shift work - Correct Answers shift pattern changes more rapidly than the circadian system can adapt to trying to sleep at the wrong circadian phase does what (3 things) - Correct Answers 1. alters the type and quality of sleep 2. reduces sleep duration 3. affects hormone levels and metabolism clinical symptoms of shift-work disorder - Correct Answers insomnia or excessive sleepiness associated with the night-work schedule for at least a month Baseball team example - jet lag - Correct Answers when visiting team travelled west ('with' their body clock), they won 44% of their games when visiting team travelled east ('against' their body clock), they won 37% of their games when not crossing time zones, the visiting team won 46% of the time how to fix shift work problem - Correct Answers number of consecutive night shifts should be minimized rotating shifts should cycle in a delay direction (from morning to evening) the phase-delaying and -advancing effects of the light are greatest about __ hours before and ___ hours after ____ - Correct Answers 3; 3; 6:00 sleep structure - Correct Answers process of diverse environmental stimuli and dynamic endogenous interactions SNC - Correct Answers suprachiasmatic nucleus frontal part of the hypothalamus cluster of around 20,000 cells T/F: each cell in the SCN is a separate clock what? - Correct Answers true; they co-coordinate their individual electrical activity to give the overall near 24-hour rhythmic output from the SCN T/F: most cells in the body possess the ability to generate a circadian oscillation independently of the SCN - Correct Answers true uniqueness of the SCN - Correct Answers coordinates the clocks in other tissues and it alone is the only part of the brain able to restore rhythmicity when transplanted into an SCN-lessoned host the retinohypothalamic tract projecting to the SCN releases what two things? - Correct Answers glutamate pituitary acetylate cyclase-activting polypeptide (PACAP) what involves the activation of neuronal clusters within the brainstem, hypothalamus, and basal forebrain which in turn promote arousal, which has been linked to an inhibitory switch controlled by GABA/galantine-containing neurons in the ventrogluteal peptic region (VLPO) of the anterior hypothalamus? - Correct Answers wakefulness Irene Toiler - Correct Answers developed a series of non-EEG behavioral criteria to try and help define sleep Sleep rebound is the most important in addition to their SCN, birds, reptiles, amphibians, and fish have... these are regulated by... - Correct Answers circadian clocks within the eyes and pineal gland extra-retinal photoreceptors current model of choice to try and understand the biology of sleep - Correct Answers Drosophila (fruit fly) holy grail of sleep biology - Correct Answers understand why sleep evolved 3 theories why animals sleep - Correct Answers 1. cellular restoration 2. energy conservation 3. consolidation of memory and learning t/f: the brain is more active during awake state than during REM - Correct Answers false problems with the consolidation of learning and memory hypothesis (3) - Correct Answers 1. theory relates only to those species with a complex brain 2. memory and learning can also occur in the absence of sleep 3. if sleep evolved simply to allow the formation and consolidation of memory, then one would predict that those animals w/ the largest and most complex brains would sleep more the chance of gaining insight is almost __x higher if an individual is allowed to sleep - Correct Answers 3 What kind of sleep has been shown to be hypo metabolic - involves a lower metabolic cost than being awake - Correct Answers NREM ___ activity is associated with global decrease in brain activity/metabolism - Correct Answers delta General model of SWS - Correct Answers 1. reduced sensory input 2. frontal delta waves 3. hippocampal ripples 4. metabolic clearance ? sharp-wave-ripple complexes (SWRs) Hz? How long? - Correct Answers 140-220 Hz Lasts 100ms What is the link between hippocampal SPW-R and cortical cells? - Correct Answers Spindle In REM, acetylcholine goes ___ In NREM, it goes ___ - Correct Answers up; down In REM, noradrenaline/serotonin goes ___ In NREM, it goes ___ - Correct Answers up; stays the same In REM, cortisol goes ___ In NREM, it goes ___ - Correct Answers up; down Cholinergic agonist ___ REM sleep - Correct Answers increases Serotonin agonist ____ REM sleep - Correct Answers inhibits General characteristics of REM (4) - Correct Answers -eye movement -chaotic blood pressure