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Characterized by three main features [4]: a low voltage, fast frequency electroencephalogram (eeg) pattern that resembles an active, awake eeg pattern. viagra without a doctor prescription This similarity is the reason that rem sleep is sometimes called paradoxical sleep. viagra no prescription Rapid eye movements. An atonic electromyogram (emg) indicating inactivity of all voluntary muscles, except the extraocular muscles. Atonia is the result of direct inhibition of alpha motor neurons. buy viagra Rem sleep can be classified as phasic rem sleep and tonic rem sleep. Phasic rem sleep is the portion of rem sleep during which there are phasic bursts of rapid eye movements, which may be associated with brief bursts of emg activity (sometimes called twitching) and/or sudden increases in sympathetic activity. buy viagra cheap Tonic rem sleep is the portion of rem sleep that exists between the phasic bursts. generic viagra online Rem sleep is a predominantly parasympathetic (ie, vagal) state. During phasic rem sleep, bursts of sympathetic nervous system activity occur, which may be associated with a sudden increase in arterial blood pressure, cardiac ischemia, cerebral ischemia, cardiac arrhythmias, heart rate, and/or respiratory rate [5-8]. Short central apneas, short central hypopneas, and long cardiac asystoles have also been reported [9]. Several sleep disorders may be related to abnormalities in rem sleep or the physiological events associated with rem sleep: narcolepsy – the role of rem sleep abnormalities in narcolepsy is described separately. (see "diagnosis and neurobiology of narcolepsy". compare viagra viagra viagra side effects ) obstructive sleep apnea – rem-related voluntary muscle atonia may impair upper airway patency, exacerbating obstructive sleep apnea [10]. cutting viagra pills half Pulmonary disease – rem-related atonia extends to the intercostal and accessory muscles of breathing. viagra for sale This has potentially important implications for patients whose abnormal respiratory mechanics render them dependent upon their intercostal and accessory muscles to maintain an acceptable level of ventilation (eg, patients with chronic obstructive pulmonary disease, a chest wall disorder, or a neuromuscular disorder). viagra drug mechanism During rem sleep, such patients may develop hypoventilation and oxyhemoglobin desaturation [11]. Rem sleep behavior disorder – individuals may act out their dreams if the muscle atonia of rem sleep is incomplete or absent [12,13]. Injuries to the patient or bed partner have been described. Rem sleep may be delayed or suppressed by alcohol, sedative-h. viagra 200mg pills