REM Sleep

REM SLEEP:
  • Sleep Cycle(5 STAGES)
  • Stages 1 through 4 are also known as non-rapid eye movement sleep (NREM). 
  • 50% stage 2
  • 20% in REM.
  • A complete sleep cycle, an hour and a half. 
  • An adult normally sleeps more than 2 hours a night in REM
REM SLEEP:
  • Shows β rhytm on EEG
  • Brain is highly active and responsive
  • Rody is virtually paralyzed because of active inhibition of skeletal muscles
  • Rapid, low voltage, EEG activity
  • REM sleep decreases the secretion of GH
  1. Pontogeniculo-occipital spikes
  2. Dreams & nightmares 
  3. Neurotransmitter For REM sleep is acetylcholine
  4. 2 Phases:
  • Tonic stage: Desynchronized EEG, atonia of skeletal muscle groups, and suppression of monosynaptic and polysynaptic reflexes.
  • Phasic REM sleep: Rapid eye movements in all directions as well as transient swings in blood pressure, heart rate changes, irregular respiration, tongue movements, and myoclonic twitching of chin and limb muscles
REM Sleep Behaviour Disorder :
  • The absence of the normal muscle atonia during REM sleep
  • Prevalent in elderly men
  • According to the International Classification of Sleep Disorder the minimum diagnostic criteria of RBD include movement of the body or limbs associated with dreaming and at least one of the following:
  1. Potentially harmful sleep behavior
  2. Dreams that appear to be acted out
  3. Sleep behavior that disrupts sleep continuity
  4. (exp. Punching, wrapping up spouse in sheets, running into walls, jumping out of windows)
  • RBD can occur with 
  1. Dementia
  2. Parkinson’s Disease
  3. Autism 
SYMPTOMS & SIGNS:
  • Sleepwalking, sleep temors, and other sleep disorders
  • Rapid eye movement
  • Nightmares (remembered)
  • Narcolepsy
  • Nocturnal penile tumescence.
  • Often called paradoxical sleep because the brain waves are closer to those of being awake than to those of any other type of sleep.
  • Increased in heart rate,Respiration, blood pressure
  • Muscle twitches, 
  • Increased oxygen consumption, and gastric secretions.
  • Disturbances in sleep due to depression are associated with Decreased REM (rapid eye movement) latency
DIAGNOSIS:
  • Polysomnographic video recording is the most important diagnostic test in RBD.
  • EEG, ECG, Nasal flow, multiple electromyography channels
  • REM sleep normally is not seen on routine EEGs, because the normal latency to REM sleep (100 min) is well beyond the duration of routine EEG recordings (approximately 20-30 min). The appearance of REM sleep during a routine EEG is referred to as sleep-onset REM period (SOREMP) and is considered an abnormality. While not observed on routine EEG, REM sleep commonly is seen during prolonged (>24 h) EEG monitoring.
  • Imaging studies have not been a proven tool in the diagnosis of RBD
Exam Question
  • Brain is very active but muscles are virtually paralyzed in REM sleep
  • Irregular breathing,depressed Muscle tone in the body ,active dreaming are seen in REM sleep
  • Disturbances in sleep due to depression are associated with Decreased REM (rapid eye movement) latency
  • Bruxism is not seen in REM sleep
  • Neurotransmitter For REM sleep is acetylcholine
  • REM sleep Shows β rhytm on EEG
  • The condition known as REM sleep is Referred to as paradoxical sleep.
  • Nightmare is seen in REM sleep
  • Growth hormone secretion is decreased by REM sleep

Don't Forget to Solve all the previous Year Question asked on REM Sleep