Sleep

K-Complex

Sudden sharp wave form

breathing

Children who suffer from sleep-disordered _________ in INFANCY were 40 - 100% MORE LIKELY to have behavioral problems, including INATTENTION, as well as DEPRESSION and ANXIETY at age 7 even if the disordered _________ had abated :(

neurodegeneration

Recent research indicates that sleep clears brain of DAMAGING MOLECULES associated with: (brain flushes out toxins during sleep)

Insomnia

Persistent problems in FALLING or STAYING asleep

Ritalin, antidepressants, modafinal

Treatment of Narcolepsy: Methylphenidate (____________) a stimulant, ___________: suppresses REM, ____________: newly developed drug that activates hypocretinergic neurons

glucose

Typical 18-year-old looks like 60-year-old in ability to metabolize _________ after 2 weeks of restricted sleep, increasing risk of diabetes. Study found that restricted sleep (4 hours per night) gain an average of 2 pounds per week.

Discrepancy

______ between subjects' reported failure to sleep and EEG indicants of sleep may be due to DECREASED deep sleep/REM Sleep and increased STAGE TWO sleep.

increases

Amount of time spent in REM during each cycle _________ as night progresses.

Sleep attacks

An irresistible urge to SLEEP during the day, after which the person awakes feeling REFRESHED

Stage 2

Characterized by SLEEP SPINDLES (bursts of waves) and K-Complexes (sudden sharp wave form)

60%

Nearly _____ _ of Americans say they experience some kind of INSOMNIA at least several nights a week.

chemicals

Sleeping patterns of the DOLPHIN brain suggest that sleep is controlled by _________ that are produced and act in the BRAIN, not in the blood

Stages 3 and 4

Slow-wave sleep. DELTA activity = regular, low-frequency, high amplitude waves of less than 4 Hz; occurs during deepest stages of sleep. Person cannot be easily awakened, and when awakened, s/he acts groggy and confused.

Fatal Familial Insomnia

A fatal inherited disorder characterized by progressive INSOMNIA

basic rest-activity cycle

90-minute cycles of REST and ACTIVITY (_____ ____-____ ______) have also been found for activities such as infant feeding, eating, drinking, smoking, heart rate, oxygen consumption, etc.

stress

About an HOUR before you WAKE UP, levels of ______ hormones begin to rise - sleep that is unpredictably FRAGMENTED (known that you may be aroused at any time) may be particularly ineffectual.

Medication treatment (hypnotics)

BENZODIAZEPINES! NON-benzodiazepine sleep aids, e.g., AMBIEN, Sonata, and Lunesta. LESS Likely to cause dependence; cognitive impairments, and interference with REM and deep sleep. HOWEVER, Ambien and Sonata are only FDA-approved for a max of 2 - 6 weeks of use. ANTIHISTAMINES - help with falling asleep but NOT with staying asleep and may produce HANGOVER effect of grogginess

Narcolepsy

Early onset REM; fragmented sleep

Sleep paralysis

Paralysis that occurs JUST BEFORE sleep or upon waking

pineal gland, melatonin

during the night, the SCN signals the ______ _______ to secrete ________ promoting sleep

metabolic, hormonal

sleep debt can also cause __________ and __________ changes that mimic aging and lead to OBESITY, HYPERTENSION, and MEMORY IMPAIRMENT.

25 hours

the biological clock of most mammals tends to run a bit slow, with a period of approximately _____ hours.

Nocturnal Enuresis

(SLOW WAVE Sleep Disorders): Bed-wetting. Treatment: Behavior therapy

Somnambulism

(Slow wave sleep disorders) - Sleep walking. Tends to RUN IN FAMILIES. Tends to diminish as children grow older. May be exacerbated by FATIGUE or sleep deprivation.

Sleep Deprivation

Causes irritability, fatigue, impaired concentration and creativity, greater vulnerability to accidents. Surprisingly, people are often times UNAWARE that their concentration, judgement etc. are impaired. _________ ___________ can produce HALLUCINATIONS, delusions, and paranoia.

melatonin

Bright LIGHT helps reset our biological clocks. Study found that light administered to back of KNEE CAP can help reset circadian clock - suggest that SKIN may also contain light sensitive proteins. Administration of ________ just BEFORE going to bed can significantly REDUCE the adverse effects of JET LAG and shifts in work schedule. It takes LONGER for melatonin levels to RISE IN TEENS than in younger kids or in adults.

Sleep Spindles

Bursts of waves

Hypothalamus, hypocretin

CAUSE of Narcolepsy: Hereditary disorder that during ADOLESCENCE, causes immune system to attack system of neurons in _____________ that secrete neuropeptide ___________ (orexin) that controls various aspects of sleep

Kleine-Levin Syndrome (Sleeping Beauty Syndrome)

Characterized by RECURRING PERIODS of excessive amounts of SLEEPING and EATING, usually appearing in adolescence. Person may sleep for weeks or months, waking only to eat and use the bathroom. During an episode, even when awake, person's whole demeanor is changed, appearing "SPACEY" or "CHILDLIKE." Often accompanies HYPERSEXUALITY in males and depression in females. Associated with reduced activity in the THALAMUS. Often misdiagnosed as depression, schizophrenia, or OTHER psychiatric disorder. Tends to spontaneously fade after a number of years.

Night terrors

Child awakens, suddenly with ANGUISHED SCREAMS< TREMBLING, a rapid pulse, and usually NO memory of what caused the terror. Treatment: In general, no treatment necessary beyond safety precautions (installing gates on stairways) - children tend to OUTGROW sleepwalking, and night terrors. In SEVERE CASES - Valium or Ativan may be prescribed

Anticholinergic

Common __________ drugs like BENADRYL have been found to be associated with a 54% higher risk of dementia and a 63% higher risk of Alzheimer's

Sleep Apnea

Disorder in which person intermittently STOPS breathing during SLEEP - may awaken 500x during the night. About 5% of the population have disorder. TREATMENTS: Surgical procedure that TIGHTENS the tissues of the soft palate and throat. Wearing MASK that delivers pressurized air to keep airways open during sleep. Recent study has found that people with disordered breathing due to APNEA during sleep become COGNITIVELY IMPAIRED an average of about 10 years years sooner than those without the disorder - unless they used a CPAP machine.

Lucid Dreams

Dream in which one is aware that one is dreaming and is thus able to direct the COURSE of the dream

non-REM (NREM)

Dreams also occur in ____-____ (______) sleep. However, REM sleep is associated more with "TRUE DREAMS" that have vivid SENSORY and MOTOR imagery and sense that "you are THERE;" _______ dreams tend to focus more on a THOUGHT (solving a problem), image, or emotion.

lost

Dreams are quickly _____ from memory UNLESS we catch them and think about them immediately upon awakening. To improve dream recall, keep a dream diary.

Second

Dreams during ______ half of sleep become MORE BIZARRE and EMOTIONALLY INTENSE; lucid dreams tend to occur in early MORNING hours

(Hobson and McCarley's) Activation-Synthesis hypothesis

Dreams serve NO purpose - just side effect of random FIRING of NEURONS that serve to develop and preserve NEURAL PATHWAYS through stimulation. PONS send randomly generated electrical SIGNALS to the FRONTAL cortex (activation). The frontal cortex THEN weaves these signals into a COHERENT STORY (synthesis)

REM Sleep

EEG pattern becomes IRREGULAR: resembles that of AWAKE STATE - heart rate increases, breathing becomes rapid and irregular, rapid eye movement (REM) becomes evident. Muscles remain PARALYZED - though CORTEX active, BRAINSTEM blocks its messages so that person is essentially paralyzed. Vaginal secretions INCREASE, penile erections occur ("postage stamp" test for erectile dysfunction). Sleeper is SENSITIVE to EXTERNAL STIMULI - easily aroused by sound of own name.

90 minutes

Each cycle of REM and non-REM sleep lasts approximately __ __________.

depression

Early onset REM: people with ________ tend to go into REM sleep EARLIER in the night. Also the more severe the _______, the GREATER the extent of this shortening of REM latency.

20

Federal Aviation Administration study found that pilots who took a _____ minute nap early in their 9 - 12 hour flight were significantly more alert as measured by reaction time task

acetylcholine, norepinephrine, serotonin, histamine, hypocretin

Five neurotransmitters appear to be important for alert, active wakefulness

effectiveness

In addition, _____________ of commonly prescribed sleep meds is QUESTIONABLE. Large NIH 2007 study concluded that sleep meds increase total sleep time on average by only 11 minutes. Many studies have indicated that CBT is just as effective and has more lasting overall benefit.

Paradoxical sleep

Internally your body is AROUSED while externally it remains CALM.

Beta activity

Irregular, low amplitude waves of 13 - 30 Hz; associated with a state of AROUSAL or ALERTNESS (waking state)

microsleeps

It is actually IMPOSSIBLE to totally deprive someone of sleep for prolonged period - EEG shows that people start to have ________ of 2 or 3 seconds

first

Most SLOW WAVE sleep occurs during ______ half of the night. Later cycles contain more STAGE 2 and REM sleep.

7 - 8

Most people need at least ___-____ hours of sleep a night. Leonardo da Vinci slept a mere 90 minutes a day, in catnaps of 15 minutes every FOUR hours. Salvador Dali liked to doze off, sitting up with a spoon in his hand. As he fell asleep, spoon would fall and clatter to the ground, and he would wake rejuvenated. Thomas Edison and Winston Churchill also thrived on catnaps. There are people who are able to function quite well on one or two hours of sleep a night...

REM Sleep Behavior Disorder

Neurological disorder in which person does NOT become paralyzed during REM and thus acts out dream. CAUSE - Neurodegenerative disorder with genetic component. Men over 50 most likely to develop, and about 1/3 develop PARKINSON's within 3 years of onset of disorder. Treatment - KLONOPIN (a benzodiazepine)

unreactive

People are ______ to ALL but the most INTENSE stimuli during slow wave sleep and IF aroused, are groggy and confused

40%

People with persistent INSOMNIA are ______% more likely to develop depression within a YEAR than those who sleep well.

suprachiasmatic nucleus (SCN)

Principle biological clock is located in the _____ ______ (____). LIGHT detected by special cells in the RETINAL that are NOT involved in visual perception, send signals to _______. During the night, the _____ signals the PINEAL GLAND to secrete MELATONIN promoting sleep

Alpha activity

REGULAR, medium-frequency waves of 8 - 12 Hz; associated with a state of RELAXATION.

five

Recent research has indicated that SLEEPING PILLS may pose serious LONG-TERM health risks. Popular sleeping pills such as AMBIEN + Restoril have been linked with a nearly _____ fold increased risk of early death. HEAVY users are NOT the only ones at risk - even those who took fewer than TWO pills monthly were THREE times more likely to die than non-users. (Also been associated with an increased risk of CANCER).

disturbed

Recent research indicates that most PSYCHOLOGICAL DISORDERS are associated with particular patterns of _______ sleep (Allison Harvey).

didgeridoo

Recent studies found that learning and practicing the ___________ helps reduce snoring and sleep apnea - probably by strengthening muscles in the upper airway, thus reducing their tendency to collapse during sleep.

Delta activity

Regular, low-frequency, high amplitude waves of less than 4 Hz

3 - 5

Research has indicated that daytime drowsiness tends to be GREATEST between ___-___ PM

45, 6; 1, 10

Research indicates that _____ minute nap improves alertness for __ hours, and __ hour nap for __ hours.

brain metabolism

Slow wave sleep LOWERS ______ ______ and permits it to REST: Regions that show HIGHEST levels of activity during the day show the LOWEST levels of activity during SLOW-WAVE SLEEP (except for hippocampal neurons). Stimulation of person's hand with vibrator caused activation of CONTRALATERAL SOMATOSENSORY CORTEX: more delta activity was shown in that region the next night

awakened

Studies have shown that patients with depression show improvement IF _________ whenever they enter REM sleep. Patients with depression are more likely to be in REMISSION a year later IF: * They show HIGH eye movement density and HIGH affect strength during their first REM period. * They report MORE negative dreams at the beginning of the NIGHT and FEWER negative dreams at the END of the night.

Nightmares

Studies suggest that individuals with frequent ________ tend to be CREATIVE and extremely SENSITIVE from childhood: open, vulnerable, with "THIN" personal boundaries. Often work as artists, teachers, and therapists. Can be treated with psychotherapeutic or lucid dream techniques.

memory consolidation

Subjects who were trained on visual search task or word learning, then deprived of REM sleep, performed significantly WORSE the next morning than subjects deprived of non-REM. REM sleep increases following stressful experiences or periods of INTENSE LEARNING (e.g., college students studying for final exams)

Cataplexy

Sudden PARALYSIS during which person remains FULLY CONSCIOUS; often precipitated by strong emotions or sudden physical effort.

2

Teenagers typically need 8 or 9 hours sleep, but they now average nearly ______ hours LESS sleep a night than 80 years ago.

Cognitive development t

The NEURAL ACTIVATION associated with dreaming aids _______ ___________. Peak of REM sleep occurs in 30 to 40 week old fetus, who spends almost 24 hours a day in this state.

Sleep debt

The brain keeps an accurate count of _____ ____ for at least TWO WEEKS. NIH study in which people given the opportunity to SLEEP for extended periods found that subjects averaged 12 hours or MORE per night for first few days, and then settled back to 7.5 to 9 hours sleep a night. Subjects felt more energized and happier at the END of the study.

Negative

This research suggests that _______ dreams occurring at the END of the night are indicative of a person's failure to work through problems and self regulate mood. Cartwright: These dreams can potentially be addressed in THERAPY, particularly as the last dreams of the night are those that the person is most likely to recall. NEW research suggests that virtually ALL major psychiatric disorders may be associated with CHARACTERISTIC PATTERN of sleep - not clear whether sleep problems are the CAUSE of the psychological disturbance, the effect, or BOTH?!

Drug dependency insomnia

Tolerance to drug may develop (in as few as THREE nights) and cause REBOUND SYMPTOMS if it is withdrawn. One of the most IMPORTANT causes of INSOMNIA seems to be sleeping medication. REBOUND SYMPTOMS - may include NIGHTMARES since many sleeping pills suppress REM. Medications may leave person GROGGY and INATTENTIVE the next day.

Hypnagogic stage

Transition between sleep and wakefulness

Theta activity

Transition between sleep and wakefulness (hypnagogic stage)

Behavioral Treatment for Insomnia *

Treatment of UNDERLYING PHYSICAL/PSYCHOLOGICAL problem. Behavioral Treatment - sleep restriction, stimulus control, relaxation response training. OTHER helpful practices: Exercise DAILY (preferably in late afternoon), but NOT right before bed. No caffeine after 5 PM Relax + dim lights 1 our or 2 hours before bedtime Consume MILK, sunflower seeds, or banana right BEFORE bed to raise SEROTONIN levels. Identify problematic thoughts and determine HOW to deal with them.

Circadian rhythm

Type of BIOLOGICAL RHYTHM controlled by internal BIOLOGICAL CLOCK. 24-hour cycle of increasing and decreasing AROUSAL. Body's built in sleep-wake cycle seems to include major period of sleep at night and smaller period of sleep in afternoon Body temperature lowest at 4 AM, rises as morning approaches, peaks during the day, dips for a time in early afternoon, and begins to drop again before we go to sleep Pulling an ALL-NIGHTER, we feel groggiest about 4 AM, but feel a second wind as our normal waking time approaches.

Hypnagogic hallucinations

Vivid dreams that occur JUST BEFORE a person falls asleep; accompanied by sleep paralysis

Adenosine

_____, an INHIBITORY neuromodulator, is released when BRAIN METABOLISM increases and glucose supply is DEPLETED so that neurons are obligated to utilize GLYCOGEN stored in LIVER and MUSCLES. Build-up of ______ increases need for sleep.

Dreams

______ occur during REM sleep: even those who claim they don't dream, if awakened during REM, will usually recall a dream when awakened from REM