~ (abe. Hypothalamus and Sleep vm —— y > According to the research conducted by Baron Economo: Gah ———_ + the Posterior hypothalamus promotes wakefulness. —— + the Anterior hypothalamus promotes sleep. — >The sleep-wake cycle is controlled by an area called the suprachiasmatic nucleus (SCN) within the hypothalamus. eeSuprachiasmatic Nucleus (SCN): - A part of hypothalamus + internal clock that tells people when to wake up and when to fall asleep. Mena Sate ee + is sensitive to changes in light. + influences the release of melatonin. _ Psol + As daylight fades, the SCN tells the pineal gland to secrete melatonin. - As melatonin accumulates, a person will feel sleepy. + As the light coming into the eyes increases; the SCN tells the pineal gland to stop secreting melatonin, allowing the body to awaken. ——— +SCN as part of the hypothalamus, also controls body temperature. + The higher the body temperature, the more alert people are; the lower the temperature, the sleepier iney are. —— — + When people are asleep at night, their body temperature is at its lowest seyelyOther Biological Areas and Sleep RIS >Reticular Formation and Sleep: ee PSS + Low levels of activity in the reticular formation produce sleep ae ne + High levels produce wakefulness: + That is why, reticular formation is commonly referred to as the reticular activating system... >Pons + Also contains a portion of RAS, therefore it also influences sleep, arousal and dreaming. EE»Serotonin and Sleep: + As the day goes by, serotonin levels in the nervous system increase and seem to bi d with sleepiness. + This correlation would explain why, at the end of the day, it is very hard for people to stay awake past their usual bedtime. + The serotonin level may be high enough at that time to produce an intense feeling of sleepiness.T > Two categories of sleep: i. REM (rapid eye movement) sleep i, Non-REM (NREM) sleep PES OF SLEEP REM SLEEP NREM SLEEP * Rapid Eye Movement (under the * Non-Rapid Eye Movement eyelids). + (active type Bf sleep when most ofa | *_much deeper, more restful kind of person’s dreaming takes place. sleep. _, * person’s body is free to move around. Eee * voluntary muscles are ited, person in es very little. —- BRAIN WAVES vtigta Waves! 4 >Theta Waves: WR EM + smaller and faster brain waves. + indicate the early stages of sleep. . typically indicating mental activity/wakefulness. + Above I3hertz es + 4to 8hz A ™ 7 »Delta Waves: Vy ‘ + Long and slow brain waves >Alpha Waves: + indicate the deepest stage of : indicate a state-of relaxation. sleep, — + 8to 13 hertz + Less than 4hz cement> tha(eean-wave Betty during the various stages of sleep is recorded through Electroencephalograph (EEG). > Other physiological measure of sleep are: aElectrooculogram; used in Electrooculography (EOG + device used in the process of recording the electric potential that exists between the front and back of the eye as fixation moves between two points. » Electromyogram: used in Electromyography (EMG) ee ectromyography (EMG) _. « measures muscle response or electrical activity in response to a nerve's stimulation of the muscle. + used to record atonia (muscular weakness) duritSTAGES OF SLEEP Awa tt enn Itt Wyte s Mon Vey Aan AN veces eaten Da Wy Aya a Oe i Api WAAL> Awake (beta and alpha waves) >NREM Stage 1: Light Sleep (theta waves) >NREM Stage 2: Sleep Spindles (theta waves continue) >NREM Stage 3 and Stage 4: Delta Waves >REM Sleep: Stage 5: Beta Waves minutes.NON-REM STAGE 1: LIGHT SLEEP > Activity of theta waves (4 to 8hz) increases and alpha wave activity fades away. eT >If people are awakened at this point, they will probably not believe that they were actually asleep. —————— »>Hypnogogic Images: +A dreamlike image, often vi and resembling a_ hallucination, experienced by a person in the transition state from wakefulness to sleep.>Hypnic Jerk: + also called sleep starts + are sudden, involuntary mus: ctions you may experience as you are falling asl F + much more common occurrence than hypnogogic images. QNo solid proof of why this occurs, many believe that it has something to do with the possibility that our ancestors slept in trees. + The relaxation of the muscles as one drifts into sleep causes a “falling” sensation, at which point the body jerks awake to prevent the “fall” from the hypothetical tree.NON-REM ST, 2: SLEEP SPINDLES ane ke > As people drift further info sleep, the body temperature continues to drop, heart rate slows, breathing becot gular, the EEG will show the first signs of sleep spindles. » Theta waves (4 to 8hz) still predominate in this stage. >if people are awakened during this stage, they will be aware of having been asleep.> Sleep Spindles: + brief bursts of ‘ity lasting only a second or fwo. >K-complex: + a brief, high-amy ike-and-rebound waveform often occur in response to environmental stimuli such as sounds in the bedroom. + K complexes can also be involved in nocturnal seizures. pe hii + Itis postulated that Sleep Spindles and K complexes may suppress sli and coggdinate memory consolidation K-Complex — Sleep Spindle voltage timeNON-REM emcee >In Stage 3, delta waves (Less than 4hz) make up only about 20 to 50 perc: of the brain-wave pattern, rest are still theta waves. » Once delta waves account for more than 50 percent of total brain activity, the person is said to have entered Stage 4 sleep. + the deepest stage of sleep; slowest brain waves, + The body Is af Hs lowest level of functionii + People in deep sleep are very hard to awaken. ee eels + If something does wake them, they may be very confused and disoriented first. . [Fis during this stage thai growth hormones ire released from the pituitary gland and reach their peak:REM SLEEP ee See » After spending some time in Stage 4, « the sleeping person will go back up through Stage 3, Stage 2, + and then into REM sleep noel + body temperature increases to near waking levels, + eyes move rapidly under the eyelids, + the heart beats much faster, and + brain waves resemble Geta, wavesSthe kind of brain activity that usually signals wakefulness, but the person is B. + Therefore, also known as Paradoxical sleep.> Usually, REM sleep arrives about an hour and a half (90 minutes) after you go to sleep. u—Y > REM periods occur about every 90 minutes throughout the night. > The first REM period lasts about| > Each REM stage that follows gets | . :M stag gets longer and longer. > The amount of REM sleep you experience changes as you age. ee > REM sleep increases after learning, thusenhances memory consolidation and there is an improvement in performance after REM sleep. ——— >REM Paralysis: ee + the inability of the voluntary muscles to move during REM sleep. ene la —_ > REM Rebound: + increased amounts on TA Hong yor being deprived of REM sleep on earlier nights. VCREM SLEEP and DR m > When a person in REM sleep is awakened, he almost always reports being in a dream state. + 90 ercenrot dreams actually take place in.REM sleep. . REM dreams tend to be more vivid, more detailed, longer, and more Gizarre ) than the dreams of NREM sleep. —— > People do have dreams in the(NREM| stages as well. + NREM dreams tend to be more like thoughts about daily occurrences and far shorter than REM dreams. nN Fa acy,> Emotionally Stressful Day: + people spend more time.in REM sleep. + Therefore, the dreams people have in REM sleep are a way of dealing with the stresses and tensions of that day. » Physically Exhasuting Day: a Pb + people spend more time in NREM déep sleep because physical activity would demand more time for recovery of the body. si A A SaSleep Disorders SLEEP PROBLEMS > Nightmares >Somniloquy SLEEP DISORDERS Dyssomnias: trouble falling or staying asleep. + Insomnia, Sleep Apnea, Narcolepsy, Restless Leg Syndrome, Periodic Limb Movement Disorder, Nocturnal Leg Cramps Parasomnias: abnormal activities during sleep. + Night Terrors, Sleep Walking (Somnambulism), Sleep Enuresis, REM Sleep Behavior DisorderNIGHTMARES » are bad dreams » Occur during REM sleep SOMNILOQUY > Sleep talking >verbalization during sleep, either in the form of mumbling or coherent speech. > occurs during NREM sleep >the sleeper is sometimes responsive to questions or commands. >It is generally not considered pathological and occurs at one time or another in most people.DYSSOMNIASINSOMNIA >the inability to get to sleep, stay asleep, or get a good quality of sleep. >The sleep disturbance causes clinically significant distress or impairment in social, occupational, educational, academic, behavioral, or other important areas of functioning. >The sleep difficulty occurs at least 3 nights per week. >The sleep difficulty is present for at least 3 months. >The sleep difficulty occurs despite adequate opportunity for sleep. » Psychological causes: worrying, trying too hard to sleep, or having anxiety etc. > Physiological causes: too much caffeine, indigestion, or aches and pain.SLEEP APNEA > Apnea: temporary cessation of breathing. >» Most common dyssomnia. > Sleep apneas is a disorder in which the person stops breathing for 10 seconds or more. » When breathing stops, there will be a sudden silence, followed shortly by a gasping sound as the person struggles to get air into the lungs. >» Occurs in REM sleep. » Many people do not wake up while this is happening, but they do not get a good, restful night's sleep because of the apnea. » Snoring loudly every night is associated with sleep apnea.NARCOLEPSY >is a kind of “sleep seizure” >the person falls immediately into REM sleep during the day without warning (especially when the person experiences strong emotions). > Another symptom is excessive daytime sleepiness (hypersomnia) that results in the person falling asleep throughout the day at inappropriate times and in inappropriate places. >These sleep attacks may occur many times and without warning, making the operation of a car or other machinery very dangerous for the narcoleptic.RESTLESS LEGS SYNDROME » Uncomfortable sensations in legs causing movement and loss of sleep. >a sense of uneasiness, twitching, or restlessness that occurs in the legs when at rest (i.e., sitting or lying) or after retiring for the night. >The cause is unknown, but it has been associated with a deficiency of iron, vitamin B12, or folic acid; nerve damage associated with rheumatoid arthritis, kidney failure, or diabetes; and the use of such drugs as lithium, anticonvulsants, antidepressants, and beta blockers. >Also called Ekbom's syndrome; Tachyathetosis; Wittmaack-Ekbom syndrome. >The main symptom is a nearly irresistible urge to move the legs.PERIODIC LIMB MOVEMENT DISORDER > repeated involuntary movement of the legs and sometimes the arms. »Many people, perhaps most, experience an occasional involuntary kick, especially when starting to fall asleep. » Leg movements are not a problem unless they become persistent. >In some people, mostly middle-aged and older, the legs kick once every 20 to 30 seconds for minutes or hours, mostly during NREM sleep. » Frequent or especially vigorous leg movements may awaken the person or his or her partner.NOCTURNAL LEG CRAMPS/ NIGHT LEG CRAMPS > Painful cramps in calf or foot muscles usually occurring while asleep. »Leg cramps are painful and incapacitating, lasting an average of nine minutes per episode. >The acute episode may be followed by hours of recurrent episodes and residual pain. > Experts don’t know the exact cause of nighttime leg cramps. + They could happen because your nerves send the wrong signals to your muscles. + For example, your brain might mistakenly tell your leg to move while you dream. That confuses your calf muscles and causes them to contract. + A person is more likely to have a leg cramp if he is: v 50 or older, Work his muscles too much, Sit too long without moving, Don't drink enough water, stand too long on hard surfaces.>The sudden REM attacks are especially dangerous because of the symptom of cataplexy, or a sudden loss of muscle tone. >This REM paralysis may cause injuries if the person is standing when the attack occurs. >The same hypnogogic images that may accompany Stage 1 sleep may also occur in the narcoleptic person. » May also be accompained by Sleep paralysis- + people with narcolepsy often experience a temporary inability to move or speak while falling asleep or upon waking. + These episodes are usually brief — lasting a few seconds or minutes — but can be frightening.PARASOMNIASNIGHT TERRORS >the person experiences extreme fear and screams or runs around during deep sleep without waking fully. >» Occurs in NREM deep sleep. >People may sit up, scream, run around the room, or flail at some unseen attacker. > Most people do not remember what happened during a night-terror episode. > Difference between Nightmare and Night Terror:- + A person who has had a nightmare, will actually be able to awaken and immediately talk about the bad dream. + occur during REM sleep which means that people don’t move around in a nightmare as they do in a night terror experience.SLEEPWALKING/SOMNAMBULISM > an episode of moving around or walking around in one’s sleep. > occurs during deep sleep. »much more common in childhood and also occurs more frequently in boys than in girls. > Sleepwalking episodes may involve walking around the house, looking in the refrigerator or even eating, and getting into the car. > Most sleepwalkers typically do not remember the episode the next day.SLEEP ENURESIS » Urinating in bed while asleep. >it occurs in children older than 4 or 5 years of age. >it is twice as common in boys. >is frequently associated with delayed bladder development, poor toilet training, and stressful situations.REM BEHAVIOR DISORDER > people with REM behavior disorder move around vigorously during their REM periods, apparently acting out their dreams. > They frequently dream about defending themselves against attack. > They may punch, or kick. > Most of them injure themselves or other people and damage property. > REM behavior disorder occurs mostly in older people, especially older men with brain diseases such as Parkinson's disease.