1.Define sleep 2.Identify the differences between REM and NREM 3.Describe what takes place in the body during sleep 4.Explain the different sleeping disorders.

Sleep  How many hours of sleep do you get a night?  Do you sleep with any electronics nearby?  Why is sleep important to you?  How do you feel when you haven’t gotten enough sleep?

 The deep relaxation of the body and mind  Sleep is the body’s recovery period; damaged tissues are repaired.  Sleep gets you mentally and physically rejuvenated.  As you sleep your body and brain undergo changes that make up the sleep cycle.

 Snoozing in class, shortens attention span, reduces motor skills, and brain power = BAD GRADES  SNOOZING AT THE WHEEL= CAR ACCIDENTS  Lowers coordination = DETRIMENTAL TO ATHLETES  Depression = COULD RESULT IN SUICIDE  Annoyed & Angry= FAMILY AND FRIEND PROBLEMS  Increased Cortisol Levels = INCREASED BLOOD PRESSURE AND WEIGHT.

Nonrapid Eye Movement (NREM)  Your eyes move very little and your body gradually reaches a state of deep relaxation.  Stage one = Drowsiness. Muscles start to relax and heartbeat slows.  Stage two =Light Sleep.  Stage three = Deep Sleep. Your muscles become more relaxed and your blood pressure drops.  Stage four- Deepest Sleep. Your body barely moves. People who exercise spend most of their sleep in stage four. Total relaxation.

Rapid Eye Movement (REM)  Rapid flickering of your eyes behind closed eyelids.  A very high level of brain activity  You dream in this stage  REM is 25% of your total sleeping time.

 SLEEP STAGES BEGIN WITH NREM AND PROGRESS INTO REM, AND THEN CYCLE BACK AND FORTH THROUGH ALL OF THE STAGES OF SLEEP.

Stages of Sleep  There are FIVE stages of sleep  It is split up between two categories  REM (Rapid Eye Movement)  NREM (Non-rapid Eye Movement)  One sleep cycle is around 90 minutes long  It usually occurs in this order –  NREM 1, NREM 2, NREM 3, NREM 4, and REM

Stages of Sleep  NREM Sleep  Split into 4 stages:  NREM 1  is the first stage of sleep – and normally lasts for a few minutes  Experienced as you drift off to sleep  May experience strange noises, lights or sensations which are known as hypnogagic hallucinations  Also may experience random twitches – which wakes you as you fall asleep – known as hypnic jerks  Both hypnogagic hallucinations and hypnic jerks are harmless but startling

 NREM 2  Second stage of sleep  Characterized by a total loss of consciousness  You cease to be aware of your surroundings as you fall into a deep, restorative sleep

 NREM 3 –  Is also known as a slow-wave sleep or delta sleep  Stage 3 and 4 was combined in 2004  Delta waves is a amplitude of brain activity  In stage 3 – delta waves were less than 50%  In this stage, parasomnias, such as night terrors and sleep walking occur

 NREM 4 –  Known for slow wave sleep stage  In stage 4 – delta waves were more than 50% This is a screen shot of a patient during Slow Wave Sleep (stage 3). The high amplitude EEG is highlighted in red. This screen shot represents a 30 second epoch (30 seconds of data).

 REM  The fifth stage  Most important of all the stages because that is when we dream  In the first few sleep cycles the REM time is short – only a few minutes  But as the night goes on, you begin to spend longer in REM (possibly 30 minutes)

REM  Babies spend most of their time sleeping in REM  But as we get older our time in REM state decreases  As an adult, you spend around 20-25% of your total sleep in REM  During REM sleep, your body causes the paralysis of the skeletal muscles – which is a good thing – because it stops you from acting out your dreams in real life

REM  REM can lead to sleep paralysis – which is when you are aware and conscious – but your body is paralyzed  This is an episode in which a person is usually transitioning from wake to sleep or sleep to wake and they find that they can not move  Characterized by hallucinations, vibrations, loud ringing, pressure on the chest or choking sensations

Hypnogram showing sleep cycles from midnight to 6.30 am, with deep sleep early on. There is more REM (marked red) before waking.

Comparison of Physiological Changes Physiological ProcessDuring NREMDuring REM brain activitydecreases from wakefulnessincreases in motor and sensory areas, while other areas are similar to NREM heart rateslows from wakefulnessincreases and varies compared with NREM blood pressuredecreases from wakefulnessincreases (up to 30 percent) and varies from NREM blood flow to braindoes not change from wakefulness in most regions increases by 50 to 200 percent from NREM, depending on brain region respirationdecreases from wakefulnessincreases and varies from NREM, but may show brief stoppages (apnea); coughing suppressed airway resistanceincreases from wakefulnessincreases and varies from wakefulness body temperatureis regulated at lower set point than wakefulness; shivering initiated at lower temperature than during wakefulness is not regulated; no shivering or sweating; temperature drifts toward that of the local environment sexual arousaloccurs infrequentlyincreases from NREM (in both males and females)

A typical hypnogram from a young, healthy adult. Light-gray areas represent non–rapid eye movement (NREM) sleep.

 Most high school students average 6 hours a night.  Most high School students really need 8-9 hours a night.  The hours of sleep you miss add up.  The Average American is carrying around hour sleep deprivation.

1. Establish a regular sleep pattern! 2. Exercise regularly! 3. Do something relaxing before bedtime! 4. Do not eat heavy before bedtime! 5. Avoid caffeine before bedtime! 6. Avoid Mood altering drugs like marijuana and alcohol 7. Do not rely on sleep altering medications 8. Change your environment

 Difficulty falling asleep and staying asleep.  Major cause of stress  Causes might include: illness, medication, jet lag, pain, environmental noise.  43% of adults are affected a few nights a week.

Sleep Disorders  Parasomnias  Parasomnia is a broad term used to describe various uncommon disruptive sleep-related disorders. They are intense, infrequent physical acts that occur during sleep. Some common parasomnias include sleepwalking, sleep talking, sleep terrors, nightmares, and teethgrinding.  Hypersomnia  Hypersomnia refers to either excessive sleepiness during the day or extended, overly long periods of nighttime sleep. Other words that are synonymous with hypersomnia are excessive daytime sleepiness (EDS), excessive sleepiness, or somnolence.

Sleep Disorders  Jet-lag syndrome  Jet lag is a condition marked by fatigue, insomnia, and irritability that is caused by air travel through changing time zones. It alters your sleep pattern— sleepiness during the day, and insomnia during the night.  Limit-setting Sleep Disorder  primarily a childhood issue, it is with inadequate enforcement of bedtimes by a caretaker, with the patient than stalling or refusing to go to bed at a time that is conducive to good health

 When breathing stops for short periods of time during sleep and then resumes.  This can happen times a night without the individual being aware of it.  It is characterized by loud snoring  Causes Include: enlarged tonsils, chronic nasal congestion, deviated nasal septum.  Affects more than 12 million Americans.

 When a person falls asleep for short periods of time without warning.  These sudden sleep attacks may occur during any type of activity at any time of the day.  Ex. Dad stop sign  Affects 300,000 Americans

 Physical obstruction of the flow of air through the mouth and nose.  Clogged nasal passage  45% of adults snore occasionally, while 25% are considered habitual snorers.

 Tends to run in families  Causes include: Stress, Change in Environment, Exhaustion.

1. Sitting and reading never (0)slight (1) moderate (2) high(3) 2.Watching TV never (0)slight (1) moderate (2) high(3) 3. Sitting, in an inactive place (theater, school, meeting) never (0)slight (1) moderate (2) high(3) 4. As a passenger in a car for an hour without a break never (0)slight (1) moderate (2) high(3) 5. Lying down to rest in the afternoon never (0)slight (1) moderate (2) high(3) 6. Sitting and talking to someone on the phone never (0)slight (1) moderate (2) high(3) 7. Sitting quietly after lunch never (0)slight (1) moderate (2) high(3) 8. In a car while stopped for a few minutes in traffic never (0)slight (1) moderate (2) high(3) MEASURING YOUR SLEEP DEBT. How likely are you to doze off or fall asleep in the afternoon during the following situations?

0-5: EXCELLENT Keep up the good work! 6-11: OK Not too bad, but try and go to bed ½ hour earlier. You will be surprised what that will do :WARNING You are about to enter the Danger Zone. Catch up on those zzz’ s. A good night’s sleep is essential for good health. 18+ :DANGER You have entered the danger zone. You are running on empty. Take a sleep vacation before you get sick!