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.