Psych Exam 2

Summarize the effects of caffeine and alcohol on sleep

-Caffeine=stimulant that should be avoided by most in the evening, or 2-5 hours before bed time -Alcohol=opposite of caffeine, initially promotes sleep onset but taken in avg amounts, it is metabolized out of the blood stream in 2-5 hours so that the individual awakes in the middle of the night and is unable to get back to sleep

When are naps a good idea and when are they a bad idea?

-Good if schedule permits because they reduce sleep debt and help you feel refreshed. -Naps in evening are less helpful -Not good if if your sleep problem is insomnia due to hyperarousal because afternoon naps will likely cause you to geel less fatigued when it is your normal bedtime

Are there counter arguments against the potential use of an artificial stimulant to suspend sleep?

-Good sleep promotes health, immune function, mood, vitality, possibly longevity, while chronic sleep debt promotes the opposite. -A safe drug to suspend sleep seems unlikely for a long time to come, if ever.

What are the possible causes of narcolepsy?

-Narcolepsy is a chronic disorder and thus far about the only form of treatment has been medication. Many victims receive Ritalin or amphetamine, both with stimulant effects, with some apparent success over the long term -It should be noted however, that Ritalin is the medication often used in treating ADHD in children, approach that has been criticized by some

What is a dream?

-Seem to come from outer space w/o any forethought or planning on our part. -Often involve bizarre characters/plots -Involuntary hallucinations unlike any experience that we have when we are awake -Some pleasant and some very upsetting -Often a strong emotional component

Imidazophridines

Imidazophridines Zolpidem (Ambien) is claimed to be the safest sedative to date, but not a cure all. An extensive listing of side effects includes increased tolerance (habituation), addiction, and harmful interactions with other drugs, including alcohol.

Primary Insomnia

Insomnia with no other associated disorder or secondary condition.

Summarize the incidence of narcolepsy.

It is not high, about 1 in every 2,000 people have it worldwide.

Do dreams ONLY occur in REM sleep?

No. Dreams can occur in Non-REM sleep as well as REM sleep, although 80-90% of dreaming does occur in REM sleep.

Medical conditions, emotional/behavioral issues and other sleep disorders have been identified as causes of _________ insomnia.

Persistent

Parasomnia

The prefix "para" means "along with" or "at the same time" -Those with parasomnia sleep normally but other things happen at the same time. -Ex) Sleep talking

How common is insomnia in society in general?

There seems to be little doubt that insomnia is far and away the most common sleep complaint. Estimates range into millions affected at any one time, but it likely affects all of us sooner or later.

Hyperarousal, shift work, and sleep environment are all frequent causes of _______ insomnia

Transient

What is the effect of poor sleep on a mood? What is the relationship between good sleep and mood? How does the effect of sleep on mood compare to the effect on cognitive function and performance?

-Numerous studies have shown that sleep deprivation leads to decreased happiness, increased stress, and increased grumpiness. -Good sleep leads to increase in positive mood. -Sleep deprivation seems to have a greater effect on negative mood than it does on cognitive performance measures.

What are 3 causes of transient insomnia? What is the most common cause out of these 3?

- Hyperarousal - Jetlag and schedule changes - Poor sleep environment -Most common: hyperarousal at least 1/2 of the time

What is the alternative view to Freud on the subject of dream interpretation?

-Allan Hobson, a sleep scientists who found that there are certain brain signals that occur in bursts during REM sleep in all animals (including humans), and that this burst apparently gives rise to random, meaningless cortical brain activity that we perceive as dreaming. -AKA dream content is random activity and reveals no deeply repressed ideals. -Says the Freud's view is harmful, misleading

How is it that other sleep disorders may produce persistent insomnia?

-Any sleep disorder that produced a restless or disrupted pattern at night is likely to produce persistent insomnia. -Restless legs syndrome, central apnea, and sleep state misperception all disrupt sleep and/or are associated with persistent complaints of poor sleep.

What is the relationship between sleep apnea and age?

-Apnea is age related -Incidence increases with age -Can happen in childhood, but it is uncommon -Peak in the elderly at about age 70

What are the major groups of parasomnias? What is the relationship of the parasomnias with age?

-Arousal disorders -sleep-wake transition disorders -Parasomnias associated with REM sleep -Other parasomnias -Some of the parasomnias are more common in children, such as sleep walking, night terrors, bed wetting

Ways to minimize jet lag-

-Arrive in city several days earlier -reset biological clock 2-4 days before trip

How do behavioral/emotional disorders produce persistent insomnia?

-Behavior disorders are frequently associated with persistent insomnia. One frequent example is depression-the incidence of which is very high nationally. There is no single depression sleep pattern-some report typical insomnia and some literally escape into sleep. Same is likely to occur with any behavioral disorder characterized by excessive energy and/or inner turmoil such as PTSD, ADHD, childhood autism, anxiety disorder, bipolar disorder, schizophrenia, drug/alcohol abuse, etc. -Treatment of the persistent insomnia depends largely on successful treatment of the behavior disorder.

Summarize Freud's thinking about interpretation and significance of dreams

-Book-Interpretation of Dreams -Described dreams as "royal road to the unconscious" implying that certain critical insights into one's inner self could be attained only via this route -Freud's thinking held credit for several decades-work was highly creative/original -Most sleep scientists today discredit Freud's thinking

What are the most common symptoms of sleep apnea?

-Daytime sleepiness/fatigue is both massive and pervasive; it significantly affects all aspects of their lives, risking dozing off at the wrong time like when driving. -Overall efficiency, productivity and freedom from error are well below optimum. -Routinely go to sleep in a mere minutes when given the Multiple Sleep Latency Test, a true indicator of daytime sleepiness, only to be awakened shortly by their snoring or gasping for breath. -High blood pressure -Hypertension

How do DSPS and ASPS lead to persistent insomnia?

-Either form of delayed sleep phase syndrome (lark or owl) could lead to apparent persistent insomnia. -Those with DSPS have persistent difficulty getting to sleep at the start of the night, and those with ASPS persistently wake up too early in the morning

Summarize the relationship between healthy sleep and learning.

-Experimental psychologists have shown that students who get a good night's sleep after studying for an exam remember the exam material better in the morning. -Healthy sleep habits in general promote better learning.

Examples of persistent insomnia due to medical conditions

-Gastric reflux disease and fibromyalgia -Other physical diseases could include arthritis, spinal disk injuries, any disease/injury associated with pain and discomfort.

What is Persistent Insomnia and how is it different than transient Insomnia?

-If transient insomnia is lasting up 2 weeks, the persistent insomnia is lasting more than 2 weeks. -Many cases of persistent insomnia are secondary to a diagnosed medical or behavioral disorder not encountered with transient insomnia -arbitrary distinction

Describe basic components of the immune system. Summarize the relationship between sleep, stress, and immune function.

-Immune system consists of a loosely defined collection of organs, tissues, and processes that protect the body from external invaders (bacteria, viruses, etc) It included the lymphatic system, which includes a highly effective array of white blood cells that arise in bone marrow, plus the thymus, tonsils, and spleen. -Lifestyle can have large effect on immune function -stress has been shown to have significant disruptive effects on immune system -Sleep researches are convinced that poor sleep is a stressful condition in and of itself, which increases the risk of immune system deficiency, which in turn places the individual at risk for numerous harmful, compromising effects.

What is a lucid dream? Is it common/does it help solve problems?

-In lucid dreams, the dreamer recognizes that the dream is taking place and consciously influences the flow of events. -This is pretty rare, but abut learnable -Individuals get better with effort and practice-the scientific or problem solving significance of this skill remains unclear

Is sleep apnea a rare disorder? Is there any relationship between apnea and heart attack/stroke?

-Incidence of sleep apnea appears to be quite high at about 40% of the population having some form of the disorder and 20% of the population being clinically significant. -The high incidence of hypertension means that they are at serious risk for cardiovascular disease and attendant complications during sleep/daytime hours -nearly 40 thousand fatal heart attacks and stroke occur each year in the US due to sleep apnea.

Is insomnia a symptom or a disorder?

-Insomnia is a symptom, NOT a disorder. Sleep scientists have known for a long time that sleep is a fragile process. Just about everything has to be right in order to see the progression of sleep stages in the normal 90 minute cycle. Disturb any of the many important requirements and poor sleep ensues. -It is a symptom just as a fever or headache is a symptom with many possible causes.

How is narcolepsy often treated, and with what kind of success?

-Likely to appear in young adult years -Typical victim is over age 20 -There is good evidence that the disorder has a genetic basis and the particular combo of the symptoms suggest that there may be a neurological defect in the brain center controlling REM sleep, although this has yet to be established

Summarize the research on the relationship between sleep and longevity. Is it established that sleep promotes longevity?

-Longevity is a product of many factors such as family history, gender, nutritional/exercise habits, and use of tobacco/alcohol. However, research seems to provide highly suggestive (but not conclusive) evidence that healthy sleep promotes longer life. -Reason for the ambiguous state of affairs is that the perfect study of the question would be very difficult. It would require a very large sample (thousands) of volunteers whose sleep and other habits would be monitored by totally objective methods over a period of decades. It would cost million and objective methods not validated at this time.

Transient Insomnia

-Loosely defined as insomnia lasting up to 2 weeks, although it can range considerably about and below this amount. -Accounts for 3/4 of all cases of insomnia, and therefore to say that this group is huge is no overstatement.

Summarize the effects of melatonin. What is the mechanism for its effects? Is it a recommended sleep aid?

-Melatonin=hormone secreted by the pineal gland located near the suprachiasmatic nucleus, the site of the biological clock. Research indicated that melatonin appears to have an effect on the setting of the biological clock. Found at higher levels near a normal bedtime and lower levels during the day and higher levels in the winter vs summer -Since melatonin is a natural substance, it is available on the same shelves as food additives/vitamin supplements. -Very little is known about helpful vs harmful effects of taking melatonin for an extended period of years -Temporary low-level use of melatonin may be advisable at times, however, long-term assistance likely create as many/more problems as it solves

Describe the CPAP procedure. What does the commentary state about it effectiveness?

-Numerous approaches to treating apnea have been introduced and evaluated. Many of these treatments have had a short life, fortunately, whereas others have stood the test of time -The most successful to date is continuous positive airway pressure (CPAP). In this condition, the victim wears a small face mask, covering the mouth and nose and air from an innocuous pump is thrust through the tubing to the mask at a continuous rate all night. The air pressure to the face mask is a sufficient to keep the upper airway passage open thereby preventing the obstructive episodes. -Though the procedure requires a certain period of adjustment, the general feeling among reporting victims is that the improvements is well worth it

What efforts have been made to identify a safe artificial stimulant? Name some of the substances that have been investigated/What has been the general result of the investigations.

-Numerous efforts made to find stimulating elixir that can be used safely to produce true excitatory effects without harmful addictive/other side effects -List has included: cocaine, amphetamine, caffeine, nicotine, dopamine, etc. -In spite of intense interest, small measures of success have been illusory at best -Any short-term gains are far outweighed by longterm harmful effects

What is the difference between obstructive sleep apnea and central sleep apnea? What is more common?

-Obstructive sleep apnea is due to an obstruction in the upper airway passage, which explains the relationship between apnea and snoring. Major contributing factors in causing the airway obstruction are buildups of fatty deposits, loss of airway muscle tone due to aging and swollen tonsils -The mere presence of snoring doesn't mean that the person has apnea; it does mean that the breathing is impaired/blocked airway -Obstructive sleep apnea is by far the most common form -Clinical apnea is much less common than obstructive form and is due to a defect in the central neural mechanisms that regulate the breathing reflex during sleep

Jet lag

-Occurs when we travel rapidly across a number of time zones. The more time zones, the greater the lag effect. -We experience jet lag only when we travel east or west but not north or south within one time zone. -A jet trip from Chicago to Rio would not produce jet lag, but a trip from Chicago to Baghdad would be likely to produce jet lag

Summarize the significance of the discovery of REM sleep and that dreams occur during REM periods.

-One of the most electrifying moments in history of sleep research was when Dement and Keltiman reported that dream reports occur about 90% of the time from REM awakenings. -Given the wide prexisting interest in dreaming, REM-dreaming report captured the imagination of many investigators. Here for the first time was an objective indicator (easily recorded eye movements) to measure the presence/absence of dreaming. -Dreaming apparently occurs every 90 mins every night, -Speculation raged over relationship btw REM sleep and schizophrenia.

Name and describe a sleep-wake transition paraomnia

-Perhaps the most common sleep-wake transition disorder is Sleep Starts -These are sudden total body jerks experienced by most people just as they are falling asleep -Can appear at any age and is regarded as benign unless associated with other sleep symptoms

What hypotheses have been suggested about a potential artificial substance to suspend the need for sleep? What scientific evidence is there to indicate that such a use might be feasible?

-Possibility to use modafinil to suspend the need for sleep. -Many sleep experts consider such a view unsubstantiated and reckless because it encourages a direction of harmful effects and experimentation. -Logically inconsistent to express great concern over the virtual pandemic of sleep debt that exists nationally, though encourages efforts to forego sleep entirely on the other hand.

How is the clock-dependent alerting function of the biological clock accomplished? What brain mechanism is responsible? Role of neurochemicals?

-Seems likely that the clock-dependent alerting function of the biological clock is accomplished through the brain's primary arousal system, (Reticular Activating System, RAM), located in the brain stem -Stimulation of the RAS produces an increase in excitatory neurochemicals in turn interface closely with the pleasure centers in the limbic system, and one theory at this time is that these neurotransmitter are restored by sleep.

What is the effect of sleep on tissue growth & repair? Can the opposite occur, namely can tissue growth an repair affect sleep?

-Sleep scientists discovered years ago that secretion of pituitary growth hormone increases during the night. This seems like a very practical arrangement bc it means that children experience most of their growth while they rest at night. -Repair of tissue damage also occurs at night for most part. Lab studies show that growth hormone promote sleepiness in lower animals, so one can make a case that sleep promotes tissue growth and improved immune function AND tissue growth and improved immune function promote sleep.

How many of the most important questions about sleep have been answered?

-Sleep scientists have learned the answers to many of the most puzzling questions about sleep and also made a number of important discoveries in the process. -The most important news is that there are many valuable benefits from a lifetime of healthy sleep -Bad news is that many of the most important questions about sleep remain unanswered at the time, but the worst of it is that a lifetime of poor sleep has many dire consequences.

Describe the scientific evidence that REM sleep promotes cognitive function and memory.

-Sleep scientists have speculated for many years that REM sleep might provide some form of support for cognitive function and long-term memory storage and/or help us discard useless memories, thereby freeing up space for important memories. -For various reasons these are very intriguing ideas and might help us answer the basic question as to the purpose of REM sleep in the first place. -Most of the evidence in support of the REM sleep in learning/memory is correlational (cause and effect). Simply because 2 events happen at the same time is not good scientific thinking. -Both REM sleep and memory activity may be the product of activity in the same brain structure, an untested, but plausible hypothesis.

Primary symptoms of narcolepsy

-So-called sleep attacks. They may fall asleep quite suddenly at any time, any place, and in any posture. -Vivid hypnagogic hallucinations with REM onset sleep -Cataplexy-sudden muscle weaknesses -Sleep attacks -significant daytime sleepiness

What are the OTC sleep medications? What are arguments for and against the use of these sleep aids?

-Some contain an aspirin supplement, and others contain and antihistamine known to produce drowsiness. These sleep aids have been shown to be safe when used as instructed; however they also have little direct on sleep. -Even an antihistamine-produced drowsiness doesn't lead to better normal sleep. Quite likely, the main results the OTC sleep aids have is a significant placebo effect. -When one recalls the most common sleep disorder is transient insomnia due to hyperarousal , then perhaps it is good that there is a readily available source of apparent (placebo-enhanced) relief. -The great use of OTC sleep aids=strong indicator of the under use of prescription sedatives.

Describe the common relationship between illness, sleep and return to health. Can this process work in more than one direction?

-Typical sequence: On avg., being sick (flu/fever for example) often leads to an increased desire for sleep; the ensuing sleep then has the effect of promoting the function of the immune system; a well-organized immune system in turn promotes the return to health -Opposite is also true: chronic sleep deprivation disrupts or impairs immune system function, placing the person at risk for future infectious diseases in addition to direct physical, mental, and emotional effects of sleep debt

What are sleep-related difficulties produced by swing shift work? What is the best way to minimize these sleep difficulties?

-Workers in certain industries commonly work a swing shift work schedule. That is, the work day is divided into 3, 8 hour shifts and workers change shifts every seven days. -Studies have shown that most swing shift workers never fully adjust to this arduous schedule and they carry a large sleep debt for extended periods

Is persistent insomnia likely to be a secondary cause? Is so, what are the secondary causes of persistent insomnia?

-Yes, largely due to secondary causes involving medical conditions, DSPS, ASPS, emotional/behavioral issues, and other sleep disorders.

Summarize the possible procedures that you might use to estimate your sleep debt and daily sleep need

-basic procedure for estimating your sleep debt is to use a home variation of the Multiple Sleep Latency Test. To do this at home...plate and spoon -Do it 3x a day, preferably during the late morning during the afternoon, and before your normal dinner hour. Avg. the minutes per trial per day and figure the avg. -Sleep need can be measured at home. Simplest method is to begin by setting a regular sleep schedule that will be close to your true sleep need

Summarize the behavioral control steps that one take to deal with transient insomnia

-bed/bedroom should be used for sleep/sex only -avoid all naps-but only if you are having trouble sleeping at night -set a regular wake up time and try your best to stick to it and not play "catch up" on the weekends -if you find that you're still awake 15-20 minutes after going to bed, get up and do something else -avoid stimulants, alcohol, big meals, unsusual strenuous exercise -turn off tv, radio, sterio -bedroom conditions optimal: temp., comfy sheets/blankets

Who is more likely to develop a common cold, a habitual good sleeper or a chronic poor sleeper?

-healthy sleep volunteers exposed to the cold virus are less likely to develop a cold compared to less healthy sleepers. -Probability also lies on immune system

What are some reasons why the majority of individuals with a sleep disorder never seek professional assistance?

-men in particular have reluctance to seeking help in general -most people fail to see the importance of fatigue as a primary symptom -most of us rarely witness our own sleep and are often poor reporters -People think that they'll be seen as weak/neurotic

Describe procedure for keep a sleep diary. Benefits/limitations? 1 week or longer?

-procedure used in labs and sleep clinics for many years -try this for at least 1 week and record so you can find your averages -after 1 week, calculate how much you slept each day as well as the daily avg. -most people believe they can get away with 5-6 hrs a night, but often play catchup on weekend to make it closer to an avg. of 8 hours -Use objective measures -Rate your degree of alertness periodically every date-you can assess peaks and valleys

3 groups of sedative hypnotic sleep medications

1) Barbiturates 2) Benzodiazepines 3) Imidazophridines

Name and describe 2 parasomnias in the "other" group of parasomnias.

1) Bruxism-pattern of teeth grinding during sleep. Strong enough to grind the teeth down to the gums and is treated by dentists with a rubber night guard worn during sleep. Common in females and can occur at almost any age beginning with childhood. Can be caused by stress 2) Bedwetting-symptom with genetic basis, more common in boys, and rare after 12-14 years old

Describe the behavioral approaches to treating primary insomnia. (5)

1) Improving Sleep Hygiene: following a set of reasonable rules, such as setting a regular sleep/wake schedule, avoiding caffeine, positive steps 2) Relaxation Techniques: relaxation training has long been known to help deal with hyperarousal and so it is a reasonable alternative to treating primary insomnias 3) Stimulus Control: this consists of avoiding upsets at bedtime an obvious part of good sleep hygiene anyway 4) Cognitive Techniques: this includes late-night reading and old ideas such as counting sheep 5) Alternative Therapies: massage, acupuncture, hypnosis, herbal remedies

Name and describe 2 parasomnias associated with REM sleep

1) Nightmares- unpleasent REM dream. In contrast to night terrors, nightmares occur at any age, occur in REM sleep, and no recall in AM. 2) sleep paralysis-complete loss of coluntary muscle function, generally lasting a few minutes. May appear in childhood, or develop in adulthood

2 forms of primary insomnia

1) Psychophysiological Insomnia 2) Idiopathic Insomnia

What are some primary physiological changes that occur uniquely during REM sleep, but not during sleep stages 2-?

1) Total loss of voluntary muscle tone. Physically impossible to sleepwalk during REM sleep. Also suggests that sleep paralysis may be some kind of physical extension of the loss of muscle tone in REM sleep. 2) Heart rate becomes notably more variable-higher peaks and lower valleys. 3) Depth/shallowness of respiration becomes variable. 4) In healthy males, penile erections appear in every REM sleep. 5) in healthy females, increased vaginal blood flow appears during REM sleep.

Name and describe 2 arousal disorders

1) sleep walking-walking/eating usually in a noteably disogranized manner. Common in children ages 5-15. Occurs in stages 3-4 sleep (NOT REM) and the person has no memory of it 2) Night terrors-associated with 3-4 sleep and there is no memory in the morning. Common with boys ages 5-8

Summarize relationship btw creativity, sleep and sleep debt.

A major point is that creativity takes, among other things, focused effort or motivation. Sleep debt on the other hand is clearly the enemy of motivation and it follows that creativity is impaired under conditions of sleep debt.

What is the definition of apnea?

Asleep apnea refers to a condition wherin the victim literally stops breathing periods up to one minute during sleep. May be repeated as often as 20x/hour all night long. Victims usually world class snorers meaning that their snoring is loud and can be hear by anyone close to their room.

___________ are substances that are known to be long-acting, addictive, and produce habituation, potentiation, hangover, and withdrawal effects.

Barbiturates

Barbiturates

Barbiturates secobarbital (Seconal) is well known to produce numerous undesirable side effects, mainly habituation, potentiation, hangover, addictive, and withdrawal effects. Occasionally can be fatal.

Benzodiazepines

Benzodiazepines triazolam (Halcion) was among the most prescribed in the US in the recent past. It's not long-acting and potentiation effects are minimal, compared to barbiturates. The risk of addictive/withdrawal effects does remain, plus there are inconsistent reports of alarming side effects such as increased risk of suicide.

What is the true source of vitality?

Biological clock through the process of clock-dependent alerting. This is important because after a good nights sleep, most of us expect some improvement in our feelings/behavior. BUT, it is a process of the clock-dependent alerting, driven by the biological clock, that is responsible for periods of energy and vitality.

A complaint of persistent insomnia from a patient who shows normal sleep on a sleep test is an example of what?

Sleep state misperception

CPAP designates a relatively successful form of treatment for _______.

apnea

_________ is a hormone that appears to have an effect on the biological clock.

Melatonin

Have there been anecdotal reports about the relationship between REM dreams/scientific discoveries?

Much anecdotal evidence exists and most of us have heard the stories of how important scientific discoveries made in the dreams of scientists. The questions remains as to how often this occurs and if there is anything that we can do to harness the process for our advantage.

OTC Sleep aids seem to produce a notable _______ effect.

Placebo

Improved sleep hygiene, relaxation techniques, and cognitive techniques are all behavioral treatments for treating __________.

Primary Insomnia

T or F: If falling asleep is the problem in cases of persistent insomnia, a circadian rhythm problem or DSPS is likely the cause

True

T or F: As a rule, studies have shown that a healthy diet/regular exercise promote good sleep.

True, though large meals should be finished 3-4 hours before bedtime, though small snack is ok