Sleep Inversion
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Sleep Inversion
Sleep inversion or sleep-wake inversion is a reversal of sleeping tendencies. Individuals experiencing sleep-wake inversion exchange diurnal habits for nocturnal habits, meaning they are active at night and sleep during the day. Sleep-wake inversion, when involuntary, can be a sign of a serious disorder. Presentation Individuals with the delayed sleep phase type of the disorder exhibit habitually late sleep hours and an inability to change their sleeping schedule consistently. They often show sleepiness during the desired wake period of their days. Their actual phase of sleep is normal. Once they fall asleep, they stay asleep for a normal period of time, albeit a period of time that starts and stops at an abnormally late time. Causes Sleep inversion may be a symptom of elevated blood ammonia levels and is often an early symptom of hepatic encephalopathy. Sleep inversion is a feature of African trypanosomiasis, after which the disease takes its common name, "African sleeping ...
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Sleep
Sleep is a sedentary state of mind and body. It is characterized by altered consciousness, relatively inhibited sensory activity, reduced muscle activity and reduced interactions with surroundings. It is distinguished from wakefulness by a decreased ability to react to stimuli, but more reactive than a coma or disorders of consciousness, with sleep displaying different, active brain patterns. Sleep occurs in repeating periods, in which the body alternates between two distinct modes: REM sleep and non-REM sleep. Although REM stands for "rapid eye movement", this mode of sleep has many other aspects, including virtual paralysis of the body. Dreams are a succession of images, ideas, emotions, and sensations that usually occur involuntarily in the mind during certain stages of sleep. During sleep, most of the body's systems are in an anabolic state, helping to restore the immune, nervous, skeletal, and muscular systems; these are vital processes that maintain mood, memory, ...
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Diurnality
Diurnality is a form of plant and ethology, animal behavior characterized by activity during daytime, with a period of sleeping or other inactivity at night. The common adjective used for daytime activity is "diurnal". The timing of activity by an animal depends on a variety of environmental factors such as the temperature, the ability to gather food by sight, the risk of predation, and the time of year. Diurnality is a cycle of activity within a 24-hour period; cyclic activities called circadian rhythms are endogenous cycles not dependent on external cues or environmental factors except for a zeitgeber. Animals active during twilight are crepuscular, those active during the night are nocturnal and animals active at sporadic times during both night and day are cathemerality, cathemeral. Plants that open their flowers during the daytime are described as diurnal, while those that bloom during nighttime are nocturnal. The timing of flower opening is often related to the time at which ...
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Nocturnality
Nocturnality is an animal behavior characterized by being active during the night and sleeping during the day. The common adjective is "nocturnal", versus diurnal meaning the opposite. Nocturnal creatures generally have highly developed senses of hearing, smell, and specially adapted eyesight. Some animals, such as cats and ferrets, have eyes that can adapt to both low-level and bright day levels of illumination (see metaturnal). Others, such as bushbabies and (some) bats, can function only at night. Many nocturnal creatures including tarsiers and some owls have large eyes in comparison with their body size to compensate for the lower light levels at night. More specifically, they have been found to have a larger cornea relative to their eye size than diurnal creatures to increase their : in the low-light conditions. Nocturnality helps wasps, such as ''Apoica flavissima'', avoid hunting in intense sunlight. Diurnal animals, including squirrels and songbirds, are active d ...
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Hyperammonemia
Hyperammonemia is a metabolic disturbance characterised by an excess of ammonia in the blood. It is a dangerous condition that may lead to brain injury and death. It may be primary or secondary. Ammonia is a substance that contains nitrogen. It is a product of the catabolism of protein. It is converted to the less toxic substance urea prior to excretion in urine by the kidneys. The metabolic pathways that synthesize urea involve reactions that start in the mitochondria and then move into the cytosol. The process is known as the urea cycle, which comprises several enzymes acting in sequence. It is greatly exacerbated by common zinc deficiency, which raises ammonia levels further. Signs and symptoms Complication Hyperammonemia is one of the metabolic derangements that contribute to hepatic encephalopathy, which can cause swelling of astrocytes and stimulation of NMDA receptors in the brain. Overstimulation of NMDA receptors induces excitotoxicity. Diagnosis Types Primary vs. secon ...
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Hepatic Encephalopathy
Hepatic encephalopathy (HE) is an altered level of consciousness as a result of liver failure. Its onset may be gradual or sudden. Other symptoms may include movement problems, changes in mood, or changes in personality. In the advanced stages it can result in a coma. Hepatic encephalopathy can occur in those with acute or chronic liver disease. Episodes can be triggered by infections, GI bleeding, constipation, electrolyte problems, or certain medications. The underlying mechanism is believed to involve the buildup of ammonia in the blood, a substance that is normally removed by the liver. The diagnosis is typically based on symptoms after ruling out other potential causes. It may be supported by blood ammonia levels, an electroencephalogram, or a CT scan of the brain. Hepatic encephalopathy is possibly reversible with treatment. This typically involves supportive care and addressing the triggers of the event. Lactulose is frequently used to decrease ammonia levels. Cert ...
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African Trypanosomiasis
African trypanosomiasis, also known as African sleeping sickness or simply sleeping sickness, is an insect-borne parasitic infection of humans and other animals. It is caused by the species ''Trypanosoma brucei''. Humans are infected by two types, ''Trypanosoma brucei gambiense'' (TbG) and '' Trypanosoma brucei rhodesiense'' (TbR). TbG causes over 98% of reported cases. Both are usually transmitted by the bite of an infected tsetse fly and are most common in rural areas. Initially, the first stage of the disease is characterized by fevers, headaches, itchiness, and joint pains, beginning one to three weeks after the bite. Weeks to months later, the second stage begins with confusion, poor coordination, numbness, and trouble sleeping. Diagnosis is by finding the parasite in a blood smear or in the fluid of a lymph node. A lumbar puncture is often needed to tell the difference between first- and second-stage disease. If the disease is not treated quickly it can lead to death. P ...
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Jet Lag
Jet lag is a physiological condition that results from alterations to the body's circadian rhythms caused by rapid long-distance trans-meridian (east–west or west–east) travel. For example, someone flying from New York to London, i.e. from west to east, feels as if the time were five hours ''earlier'' than local time, and someone travelling from London to New York, i.e. from east to west, feels as if the time were five hours ''later'' than local time. The phase shift when traveling from east to west is referred to as phase-delay of the circadian circle, whereas going west to east is phase-advance of the circadian circle. Most travelers find that it is harder to timezone adjust when traveling to the east. Jet lag was previously classified as one of the circadian rhythm sleep disorders. The condition of jet lag may last several days before the traveller is fully adjusted to the new time zone; a recovery period of one day per time zone crossed is a suggested guideline. Jet l ...
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Shift Work Sleep Disorder
Shift work sleep disorder (SWSD) is a circadian rhythm sleep disorder characterized by insomnia, excessive sleepiness, or both affecting people whose work hours overlap with the typical sleep period. Insomnia can be the difficulty to fall asleep or to wake up before the individual has slept enough. About 20% of the working population participates in shift work. SWSD commonly goes undiagnosed, so it's estimated that 10–40% of shift workers have SWSD. The excessive sleepiness appears when the individual has to be productive, awake and alert. Both symptoms are predominant in SWSD. There are numerous shift work schedules, and they may be permanent, intermittent, or rotating; consequently, the manifestations of SWSD are quite variable. Most people with different schedules than the ordinary one (from 8 AM to 6 PM) might have these symptoms but the difference is that SWSD is continual, long-term, and starts to interfere with the individual's life. Health effects There have been many ...
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Circadian Rhythm
A circadian rhythm (), or circadian cycle, is a natural, internal process that regulates the sleep–wake cycle and repeats roughly every 24 hours. It can refer to any process that originates within an organism (i.e., Endogeny (biology), endogenous) and responds to the environment (Entrainment (chronobiology), entrained by the environment). These 24-hour rhythms are driven by a circadian clock, and they have been widely observed in animals, plants, fungi and cyanobacteria. The term ''circadian'' comes from the Latin ''wikt:circa#Latin, circa'', meaning "approximately", and ''dies'', meaning "day". Processes with 24-hour cycles are more generally called diurnal rhythms; diurnal rhythms should not be called circadian rhythms unless they can be confirmed as endogenous, and not environmental. Although circadian rhythms are endogenous, they are adjusted to the local environment by external cues called zeitgebers (German for "time givers"), which include light, temperature and redox cy ...
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Delayed Sleep Phase Disorder
Delayed sleep phase disorder (DSPD), more often known as delayed sleep phase syndrome and also as delayed sleep–wake phase disorder, is a delaying of a person's circadian rhythm (biological clock) compared to those of societal norms. The disorder affects the timing of biological rhythms including sleep, peak period of alertness, core body temperature, and hormonal cycles. The diagnosis of this disorder is currently a point of contention among specialists of sleep disorders. Many insomnia-related disorders can present significantly differently between patients, and circadian rhythm disorders and melatonin related disorders are not well understood by modern medical science. The orexin system was identified only in 1998, yet it appears intimately implicated in human sleep-wake systems. Evidence for the plasticity of human circadian rhythm cycles has been provided by multiple studies. In one example, several dozen volunteers spent many months underground in a French cave, ...
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Encephalitis Lethargica
Encephalitis lethargica is an atypical form of encephalitis. Also known as "sleeping sickness" or "sleepy sickness" (distinct from tsetse fly-transmitted sleeping sickness), it was first described in 1917 by neurologist Constantin von Economo and pathologist Jean-René Cruchet. The disease attacks the brain, leaving some victims in a statue-like condition, speechless and motionless. Between 1915 and 1926, an epidemic of encephalitis lethargica spread around the world. The exact number of people infected is unknown, but it is estimated that more than one million people contracted the disease during the epidemic, which directly caused more than 500,000 deaths. Most of those who survived never returned to their pre-morbid vigour. Signs and symptoms Encephalitis lethargica is characterized by high fever, sore throat, headache, lethargy, double vision, delayed physical and mental response, sleep inversion and catatonia. In severe cases, patients may enter a coma-like state ( akinet ...
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Fatigue (medical)
Fatigue describes a state of tiredness that does not resolve with rest or sleep. In general usage, fatigue is synonymous with extreme tiredness or exhaustion that normally follows prolonged physical or mental activity. When it does not resolve after rest or sleep, or occurs independently of physical or mental exertion, it may be a symptom of a medical condition that may become severe or progressive. Fatigue can be a feature of a mental disorder such as depression; may be associated with conditions of chronic pain such as fibromyalgia; it may also feature in conditions of chronic low-level inflammation, and be a disease-related symptom in many other conditions. Fatigue often has no known cause, and is recognised as being very complex in nature. Fatigability describes a susceptibility to fatigue. Physical fatigue results from muscle fatigue brought about by intense physical activity. Mental fatigue results from prolonged periods of cognitive activity which impairs cognitive abil ...
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