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Sleep and the

Circadian Rhythm

Facts About Sleep


We spend around 25 years sleeping.
All mammals, birds and reptiles sleep
although only mammals and some birds
show REM sleep.
One theory suggests sleep is for restorative
purposes
One theory suggests sleep is for evolutionary
adaptation.

What is Sleep
2 types of activity during wakeful state
Beta waves
- more common were characterised by lowamplitude and very irregular (desynchronised) waves
that varied between 13 and 30 cycles (Hz) or beats per
second.
- This pattern occurred when subjects were
aroused, or engaged in some mental activity

What is Sleep
2 types of activity during wakeful state
Alpha waves - . During periods of rest and relaxation,
waves slowed down (812 Hz) producing a more
synchronised high-amplitude pattern

What is Sleep
2 types of activity during sleep state
Slow wave sleep (SWS) - beat was much slower than
that normally found during the awake state, and four
distinct stages (stages 14) could be distinguished

Alpha waves (8 12 Hz)

Theta waves (4 7 Hz)

Delta waves (1 4 Hz)

Delta waves comprise 50% of waves

What is Sleep
2 types of activity during sleep state
Rapid eye movement (REM)
- identified by EEG activity that resembled more closely the type of brain waves
found during waking.
- this type of sleep was accompanied by eye movements that could be seen
darting about under the eyelids
- occurs about 90 mins into SWS
- the main stage for dreaming

Cycle of
around 20
mins in 1st
REM to 40
mins in last
REM
Time spent in
SWS become less

Sleep across the life span

Sleep across the life span

Sleep cycle
REM
Amount of
sleep

Infant

Adult

1 hour approx.

90 mins

Upon falling
asleep
16 17
hours/day

90 mins into
onset
8 10 or less

Sleep across the life span


High amount of REM sleep occurs in the first year of life!
1st theory: REM sleep plays a role in the development of
the nervous system
2nd theory: REM sleep is necessary for the storage of
information in the brain to allow learning and memory to
take place

maturation of the sleep cycle


normally occurs by early
adolescence (6 8 hrs, in REM)

Sleep across the life span

Amount of time spent in sleep


especially in SWS lessens as you
grow older
Young adult
Old age

Sleep deprivation
a change in behaviour or decrease in performance
caused by keeping an individual awake can be attributed
to the lack of sleep.
sleep deprivation in humans has not been so easy to
interpret, because it appears to have relatively little
consistent effect other than make the person feel very
sleepy.
Studies show that sleep deprivation in humans does not

Sleep deprivation: Case 1


This is the case of Peter Tripp, a disc jockey who attempted
to stay awake for 200 hours as a publicity stunt to raise
money for charity. He made radio broadcasts from a glass
booth in New Yorks Times Square in full view of the public,
and was constantly attended in order to prevent sleeping.
However, it was only during the last days of his deprivation
that Tripp began to experience difficulties. The first signs were
slurred speech followed by night-time auditory hallucinations
and paranoia. By the end of his ordeal he believed that he
was being drugged and refused to cooperate with his helpers
(Dement 1976). However, it had taken about a weeks sleep
deprivation to produce these effects.

Sleep deprivation: Case 2


This is the case of a 17-year-old college student from San
Diego called Randy Gardner, who, in 1965, challenged the
world sleep deprivation record of 260 hours (10 days and 20
hours), which was, at the time, the world record in the
Guinness Book of Records. Gardner was constantly under the
scrutiny of two observers and, for the last five days, was
closely followed by William Dement and George Gulevich
from Stanford University. During his attempt, Gardner
experienced a number of difficulties including fatigue,
irritability and memory problems.

Sleep deprivation: Case 2


By the seventh day his EEG no longer showed the normal
patterns of alpha waves associated with being awake. But,
these symptoms showed considerable fluctuation and on the
last night he went to an amusement arcade for several hours
where he played William Dement at a penny basketball game
(about 100 games were played) and won every single game!
After breaking the world record, Gardner gave a coherent and
impeccable account of himself at a national press conference.

Sleep deprivation
Case 1 and 2 shows that the main effect appears to be on
the performance of complex mental or physiological
tasks requiring a steady degree of concentration.
The results from these studies do not provide convincing
evidence that sleep is a vital process.

Brain mechanisms of sleep


The main area of the
brain responsible for
the production of
sleep is located in the
brain stem
specifically in the
reticular formation
via a pathway of
axons called the
ascending reticular
activating system.

involved in a wide
range of functions,
including autonomic
activity, motor
reflexes and sensory
analysis, and
receives input from
many other brain
structures

laterodorsal
tegmental nucleus
(LTN) and the
pedunclopontine
tegmental nucleus
(PTN)
GTF receive
cholinergic projections
from LTN and PTN
thereby producing
REM sleep

site of noradrenaline-containing fibres

site of serotonin fibres

nhibition of cholinergic neurons in the LTN and PTN produces SWS

stimulation of this
region produces EEG
patterns of slow-wave
activity
receives information from
the stomach, liver,
duodenum and tongue,
and this may help to
explain why a large meal
often facilitates sleep

Reciprocal Model of REM Sleep


LTN and PTN

SWS
Sleep

Raphe Nuclei and


Lateral Coeruleus

REM
Sleep

GTF

NST

Circadian Rhythms
- Internal mechanisms that functions as a cycle of
physiological and biochemical activity
- Nearly all lifeforms has one form of circadian rhythm

Early in the
evening
(growth
hormone)
Waking time in the
morning
(cortisol and

Late in the
evening
(melatonin)
Late in the
afternoon
(adrenaline)

Neural basis for circadian rhythms


Three properties for a
circadian pacemaker
1. it receives information from
the senses (particularly
helpful would be visual
information concerning day
and night) to account for the
fact that circadian rhythms
can be reset by zeitbegers

Zeitbegers stimuli that are regulators of circadian rhythms (ex. light and dark)

Neural basis for circadian rhythms


Three properties for a
circadian pacemaker
2. it has an intrinsic
rhythm of its own so
circadian rhythms can be
free-running

Neural basis for circadian rhythms


Three properties for a
circadian pacemaker
3. it has output to other
regions of the brain that
are involved in circadian
types of behaviour, such
as the sleepwake cycle.

Neural basis for circadian rhythms


Suprachiasmatic nucleus (SCN)
- Circadian pacemaker in humans
- Discovered in 1972 by two groups (Stephan & Zucker
and Moore & Eichler)
- a small cluster of neurons in the front part of the ventral
hypothalamus
- Lies just above the optic chiasm

Neural basis for circadian rhythms

Optic
nerve

Retinohypothalamic tract

SCN

- If lesioned, it is found that light and dark cues are no


longer able to reset the circadian clock, although
animals still have normal vision

Neural basis for circadian rhythms


The most important
pathway is to the
pineal gland!
- Secretes the hormone
melatonin
- Controlled by a pathway
called the superior cervical
ganglion

Neural basis for circadian rhythms


SCN

superior cervical ganglion

Pineal gland

DARKNESS

*noradrenaline

Pineal cells (serotonin)

N - acetyltransferase

melatonin

*Light terminates this process

Sleep - Wake disorders*


- encompass 10 disorders or disorder groups
Ex.
insomnia disorder, hypersomnolence disorder, narcolepsy,
breathing-related sleep disorders, circadian rhythm sleepwake disorders, non-rapid eye movement (NREM) sleep
arousal disorders, nightmare disorder, rapid eye movement
(REM) sleep behavior disorder, restless legs syndrome, and
substance/medication-induced sleep disorder.
- often accompanied by depression, anxiety, and cognitive changes
that must be addressed in treatment planning and management.

Sleep - Wake disorders


Insomnia Disorder (DSM 5 780.52; ICD 10 G74.00)
- dissatisfaction with sleep quantity or quality with complaints
of difficulty initiating or maintaining sleep.
- Accompanied by clinically significant distress or impairment in
social, occupational, or other important areas of functioning.
- may occur during the course of another mental disorder or
medical condition, or it may occur independently
- the most prevalent of all sleep disorders and most frequently
observed as a comorbid condition with another medical
condition or mental disorder (40 50%)

Sleep - Wake disorders


Narcolepsy (DSM 5 347.00, .01, .10; ICD 10 G47.411, .419, .
429)
- recurrent daytime naps or lapses into sleep. Sleepiness typically occurs
daily but must occur at a minimum three times a week for at least 3
months (Criterion A).
- generally produces cataplexy, which most commonly presents as brief
episodes (seconds to minutes) of sudden, bilateral loss of muscle tone
precipitated by emotions, typically laughing and joking.
- affects 0.02%-0.04% of the general population in most countries, affects
both genders with a slight male preponderance
- can co-occur with bipolar, depressive, and anxiety disorders, and in rare
cases with schizophrenia.

Sleep - Wake disorders


Breathing Related Sleep Disorders
- Breathing disruptions during sleep
- obstructive sleep apnea hypopnea (DSM 5 327.23; ICD
10 G47.33)
- the most common breathing-related sleep disorder

- Central sleep apnea (DSM 5 327.21, 786.04, .57; ICD


10 G47.31, 37, R06.3)
- Sleep related hypoventilation (DSM 5 327.24, .25, .26;
ICD 10 G47.34, .35. .36)

Sleep - Wake disorders


Circadian Rhythm Sleep Wake Disorders (DSM 5
307.45)
- persistent or recurrent pattern of sleep disruption that is
primarily due to an alteration of the circadian system or to
a misalignment between the endogenous circadian rhythm
and the sleep-wake schedule required by an individuals
physical environment or social or professional schedule.
- Delayed sleep phase type, Advanced sleep phase type,
Irregular sleep-wake type, Non-24-hour sleep-wake type,
Shift work type

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