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 REM Rebound 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 stages First REM period about 90 minutes into sleep More REM later in sleep cycle Awake 1 2 3 REM 4 1 2 3 4 5 6 7 Hours of sleep

Typical Nightly Sleep Stages Hours of sleep Minutes of Stage 4 and REM 1 2 3 4 5 6 7 8 10 15 20 25 Decreasing Stage 4 Increasing

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 Narcolepsy 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.