Sleep, Dreams and Drugs
Natural cycle
• Circadian rhythm
– the biological clock
– regular bodily rhythms that occur on a 24 hour cycle
– wakefulness
– body temperature
Circadian drift
Jet lag
Role of sleep
• Essential for survival.
• Total sleep deprivation fatal.
• Restorative function. R and R.
• Activation of cortex.
• Dreaming as a result of activity.
• Important that cycle be preserved.
• Sleeping pills and alcohol disrupt cycle.
EEG/EMG/EOG
EEG in sleep
Cortex in sleep
Sleep and Dreams
• REM (Rapid Eye Movement) Sleep – recurring sleep stage
– vivid dreams
– paradoxical sleep
• muscles are generally relaxed, but other body systems are active
Dreams- Freud• Sigmund Freud- The Interpretation of
Dreams (1900)– wish fulfillment – discharge otherwise unacceptable feelings
• Manifest Content– remembered story line
• Latent Content– underlying, uncensored meaning
Dreams• Information Processing
– helps consolidate day’s memories
– stimulates neural development
• REM Rebound– REM sleep increases following REM sleep
deprivation
Sleep waves
Sleep Stage
• First REM period about 90 minutes into sleep
• More REM later in sleep cycle
0 1 2 3 4 5 6 7
4
3
2
1
Sleepstages
Awake
Hours of sleep
REM
Typical Nightly Sleep Stages
Hours of sleep
Minutesof Stage 4 and REM
1 2 3 4 5 6 7 80
10
15
20
25
5
Decreasing Stage 4
Increasing REM
RAS
REM brain stem structures
Sleep thru life
Sleep Deprivation• Effects of Sleep Loss
– fatigue– impaired concentration– immune suppression– irritability– slowed performance
• accidents– planes– autos and trucks
Sleep Deprivation and Traffic Accidents
2,400
2,700
2,600
2,500
2,800
Spring time change(hour sleep loss)
3,600
4,200
4000
3,800
Fall time change(hour sleep gained)
Less sleep,more accidents
More sleep,fewer accidents
Monday before time change Monday after time change
Accident frequency
Canada, 1992
Sleep Disorders
• Insomnia– persistent problems in falling or
staying asleep
• Narcolepsy– uncontrollable sleep attacks
Narcolepsy
• Sleep Attack• Sudden loss of
consciousness• Loss of muscle tone• Paralysis• Hallucinations• NREM or REM?• Treatment: stimulants
Insomnia
• Any failure in getting asleep and staying there
• Many causes (stress, anxiety)• Drug related• Stimulants• Depressants during withdrawal • Alcohol DT’s may be REM
episodes
Alcohol and sleep
• Fall asleep faster• Depress REM sleep.• More awakenings per night.• Also reduce the restorative part of sleep.• Pressure for REM becomes stronger.• More sleep disruptions.• During withdrawal, hallucinations and delusions.
Part of DT’s.
Insomnia Treatment
• Barbiturates and Alcohol• Suppress REM sleep• REM rebound when stop• Begin again• Physical Dependence• Tolerance• Withdrawal may be life
threatening
Changing Behavior• Avoid caffeine and alcohol in evening.• Exercise regularly (but not within 3 hrs of
bedtime).• Avoid daytime naps.• Develop routine to program body for sleep.• Go to better an hour or two later.• Don’t try too hard. Can’t force sleep.• Change your attitude. De-emphasize your
sleep problem.
Sleep Apnea
• Life-threatening disorder
• Stop breathing for up to a minute
• 200-300 times a night.
• Airway closes due to excess or relaxed tissue in throat.
• Stop breathing gasp for air fall asleep.
• Severe snoring.
• Made worse by sedatives, alcohol and sleeping pills.
Sleep Apnea
Treating sleep apnea
• Mild cases:• Avoid alcohol and
sedatives.• Use Decongestants• Sleep on side.• Lose weight.
• Severe cases:• Surgery to open
airway.• Face mask that forces
air to keep the airway open. APAP.
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