Pak-AIMS

Chapter no. 5- State of Consciousness

Consciousness consists of all the sensations, perceptions, memories, and feelings you

are aware of at any instant.It has been defined as: “a state of awareness, subjectivity,

the ability to experience or to feel, wakefulness, and the executive control system of

the mind”.

We spend most of our lives in waking consciousness. In waking consciousness we

perceive times, places, and events as real, meaningful, and familiar. But states of

consciousness related to fatigue, delirium, hypnosis, drugs, and euphoria may differ

markedly from “normal” awareness. Everyone experiences at least some altered states,

such as sleep, dreaming, and daydreaming . In everyday life, changes in

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consciousness may also accompany long-distance running, listening to music, making

love, or other circumstances.

Altered States of Consciousness

How are altered states distinguished from normal awareness? During an altered state

of consciousness(ASC), changes occur in the quality and pattern of mental activity.

Typically there are distinct shifts in our perceptions, emotions, memories, time sense,

thoughts, feelings of self-control, and suggestibility.

Factors that can alter consciousness

1: Sleep

“Sleep is a naturally recurring state of mind characterized by altered consciousness,

relatively inhibited sensory activity, inhibition of nearly all voluntary muscles, and

reduced interactions with surroundings”. It is distinguished from wakefulness by a

decreased ability to react to stimuli.

Why Do We Sleep?

Sleep is a requirement for normal human functioning, although, surprisingly,

we don’t know exactly why. It is reasonable to expect that our bodies would require a

tranquil “rest and relaxation” period to revitalize themselves, and experiments with

rats show that total sleep deprivation results in death.

How long could a person go without sleep?

With few exceptions, 4 days or more without sleep becomes hell for everyone. The

world record is held by Randy Gardner, who at age 17 went 264 hours (11 days)

without sleep. Surprisingly, Randy needed only 14 hours of sleep to recover.

What are the costs of sleep loss?

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At various times, Randy’s speech was slurred, and he couldn’t concentrate, remember

clearly, or name common objects. Sleep loss also typically causes trembling hands,
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drooping eyelids, inattention, irritability, staring, increased pain sensitivity, and

general discomfort.

Severe sleep loss can cause a temporary sleep-deprivation psychosis (loss of contact

with reality). Confusion, disorientation, delusions, and hallucinations are typical of

this reaction.

Sleep types:

Mammalian sleep occurs in repeating periods, in which the body alternates between

two highly distinct modes known as non-REM and REM sleep. REM stands for

"rapid eye movement".

Measures of electrical activity in the brain recorded by EEG (electroencephalogram)

show that the brain is quite active during the night. It produces electrical discharges

with systematic, wavelike patterns that change in height (or amplitude) and speed (or

frequency) in regular sequences. There is also significant physical activity in muscle

and eye movements. People progress through a series of distinct stages of sleep during

a night’s rest known as stage 1 through stage 4 and REM sleep moving through the

stages in cycles lasting about 90 minutes.

Sleep Stages

The two most basic states of sleep, then, are non-REM (NREM) sleep (which occurs

during stages 1, 2, 3, and 4) and REM sleep, with its associated dreaming. When you

are awake and alert, the EEG reveals a pattern of small fast waves called beta waves.

Immediately before sleep, the pattern shifts to larger and slower waves called alpha

waves. As the eyes close, breathing becomes slow and regular, the pulse rate slows,

and body temperature drops. Soon after, we descend into slow-wave sleep through

four distinct sleep stages.

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Stage 1

As you enter light sleep (stage 1 sleep), your heart rate slows even more. Breathing

becomes more irregular. The muscles of your body relax. This may trigger a

reflex muscle twitch called a hypnic (HIP-nik: sleep) jerk. (This is quite normal, so

have no fear about admitting to your friends that you fell asleep with a hypnic jerk.)

In stage 1 sleep the EEG is made up mainly of small, irregular waves with some alpha.

Persons awakened at this time may or may not say they were asleep.

Stage 2

As sleep deepens, body temperature drops further. Also, the EEG begins to include
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sleep spindles, which are short bursts of distinctive brain-wave activity. Spindles
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seem to mark the true boundary of sleep. Within 4 minutes after spindles appear, most

people will say they were asleep.

Stage 3

In stage 3, a new brainwave called delta begins to appear. Delta waves are very large

and slow. They signal a move to deeper slow wave sleep and a further loss of

consciousness.

Stage 4

Most people reach deep sleep (the deepest level of normal sleep) in about 1 hour.

Stage 4 brainwaves are almost pure slow-wave delta, and the sleeper is in a state of

oblivion. If you make a loud noise during stage 4, the sleeper will wake up in a state

of confusion and may not remember the noise.

REM Sleep

Several times a night, when sleepers have cycled back to a shallower state of sleep,

something curious happens: the sleeper’s eyes occasionally move under the eyelids .

Their heart rate increases and becomes irregular, their blood pressure rises, and their

breathing rate increases. Most characteristic of this period is the back-and-forth

movement of their eyes, as if they were watching an action-filled movie. This period

of sleep is called rapid eye movement, or REM sleep, and it contrasts with stages 1

through 4, which are collectively labeled non-REM (or NREM ) sleep. REM sleep

occupies a little more than 20% of adults’ total sleeping time.

The Function of NREM Sleep

NREM sleep is dream-free about 90 percent of the time and is deepest early in the

night during the first few stage 4 periods. Stage 1 sleep usually lacks REMs and

dreams. Later stage 1 periods typically include a shift into REM sleep. Dreamless

slow-wave NREM sleep increases after physical exertion and may help us recover
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from bodily fatigue. It also appears to “calm” the brain during the earlier part of a

night’s sleep.

Function of REM sleep

There is good reason to believe that REM sleep plays a critical role in everyday

human functioning. Dreams during REM sleep tend to be longer, clearer, more

detailed, more bizarre, and more “dream-like” than thoughts and images that occur in

NREM sleep. Also, brain areas associated with imagery and emotion become more

active during REM sleep.

NREM sleep “calms” the brain, REM sleep appears to “sharpen” our memories of the

previous day’s more important experiences. Daytime stress tends to increase REM

sleep, which may rise dramatically when there is a death in the family, trouble at work,

a marital conflict, or other emotionally charged events. The value of more REM sleep

is that it helps us sort and retain memories, especially memories about strategies for

solving problems. This is why, after studying for a long period, you may remember

more if you go to sleep, rather than pulling an all-nighter. It allowing us to rethink and

restore information and emotional experiences that we’ve had during the day.

“Let me sleep. And I’ll give you an

answer in the morning.”

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Sleep Disturbances: Sleep Wars :(

Hypersomnia “Excessive daytime sleepiness”.

It is a common problem during adolescence. This can result from depression,

insomnia, narcolepsy, sleep apnea, drug abuse, and other problems.

Insomnia: “Difficulty in getting to sleep or staying asleep”

At one time or another, almost all of us have difficulty sleeping a condition known as

insomnia. It could be due to a particular situation, such as the breakup of a

relationship, concern about a test score, or the loss of a job. Some cases of insomnia,

however, have no obvious cause. Some people are simply unable to fall asleep easily,

or they go to sleep readily but wake up frequently during the night. Insomnia is a

problem that afflicts as many as one-third of all people. Women and older adults are

more likely to suffer from insomnia, as well as people who are unusually thin or are

depressed. Some people who think they have sleeping problems actually are mistaken.

For example, researchers in sleep laboratories have found that some people who

report being up all night actually fall asleep in 30 minutes and stay asleep all night.

Other sleep problems are less common than insomnia, although they are still

widespread.

Sleep apnea“is a condition in which a person has difficulty breathing while sleeping”

The result is disturbed, fitful sleep, and a significant loss of REM sleep, as the person

is constantly reawakened when the lack of oxygen becomes great enough to trigger a
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waking response. Some people with apnea wake as many as 500 times during the

course of a night, although they may not even be aware that they have wakened. Not

surprisingly, such disturbed sleep results in extreme fatigue the next day. 20 million

people suffer from sleep apnea.

Sleep apnea also may play a role in sudden infant death syndrome (SIDS), a

mysterious killer of seemingly normal infants who die while sleeping. .

Night terrors “are sudden awakenings from non-REM sleep that are accompanied by

extreme fear, panic, and strong physiological arousal”.

Usually occurring in stage 4 sleep, night terrors may be so frightening that a sleeper

awakens with a shriek. Although night terrors initially produce great agitation, victims

usually can get back to sleep fairly quickly. They are far less frequent than nightmares,

and, unlike nightmares, they typically occur during slow-wave, non-REM sleep. They

occur most frequently in children between the ages of 3 and 8.

Nightmare “is simply a bad dream that takes place during REM sleep. Frequently

occurring nightmares (one a week or more) are associated with higher levels of

psychological distress”.

Was It a Nightmare or a Night Terror?

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Narcolepsy “is uncontrollable sleeping that occurs for short periods while a person is

awake”.

No matter what the activity holding a heated conversation, exercising, or driving, a

narcoleptic will suddenly fall asleep. People with narcolepsy go directly from

wakefulness to REM sleep, skipping the other stages. The causes of narcolepsy are

not known, although there could be a genetic component, because narcolepsy runs in

families.

We know relatively little about sleep talking and sleepwalking, two sleep

disturbances that are usually harmless. Both occur during stage 4 sleep and are more

common in children than in adults. The sleepwalker’s eyes are usually open, but a

blank face and shuffling feet reveal that the person is still asleep.Sleep talkers and

sleepwalkers usually have a vague consciousness of the world around them, and a

sleepwalker may be able to walk with alertness around obstructions in a crowded

room.

2- Hypnosis

Q:What is hypnosis?

Hypnosis is often defined as “an altered state of consciousness, characterized by

narrowed attention and an increased openness to the suggestions of others”.

The term hypnosis was coined by English surgeon James Braid. The Greek word hypnos

means “sleep,” and Braid used it to describe the hypnotic state. Today we know that

hypnosis is not sleep. Confusion about this point remains because some hypnotists give the

suggestion, “Sleep, sleep.” However, EEG patterns recorded during hypnosis are different

from those observed when a person is asleep or pretending to be hypnotized.

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Q:How is someone hypnotized?

Typically, the process follows a series of four steps:

First, a person is made comfortable in a quiet environment.

Second, the hypnotist explains what is going to happen, such as telling the person that

he or she will experience a pleasant, relaxed state.

Third, the hypnotist tells the person to concentrate on a specific object or image, such

as the hypnotist’s moving finger or an image of a calm lake. The hypnotist may have

the person concentrate on relaxing different parts of the body, such as the arms, legs,

and chest.

Fourth, once the subject is in a highly relaxed state, the hypnotist may make

suggestions that the person interprets as being produced by hypnosis, such as “Your

arms are getting heavy” and “Your eyelids are more difficult to open.” Because the person

begins to experience these sensations, he or she believes they are caused by the hypnotist and

becomes susceptible to the suggestions of the hypnotist.

Despite their compliance when hypnotized, people do not lose all will of their own. They

will not perform antisocial behaviors, and they will not carry out self-destructive acts. People

will not reveal hidden truths about themselves, and they are capable of lying. Moreover,

people cannot be hypnotized against their will despite popular misconceptions.

There are wide variations in people’s susceptibility to hypnosis. About 5% to 20% of

the population cannot be hypnotized at all, and some 15% are very easily hypnotized.

Most people fall somewhere in between. Moreover, the ease with which a person is

hypnotized is related to a number of other characteristics. People who are readily

hypnotized are also easily absorbed while reading books or listening to music,

becoming unaware of what is happening around them, and they often spend an

unusual amount of time daydreaming.

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3- Drugs-Altered State of Consciousness

The most common way to alter human consciousness is to administer a psychoactive

drug :”a substance capable of altering attention, judgment, memory, time sense, self-

control, emotion, or perception”.

Categories of psychoactive drugs:

The three major categories of psychoactive drugs are stimulants, depressants and

hallucinogens all do their work at the brain synapses. They stimulates or inhibit the

brain activity of the brain’s own chemical messengers, the neurotransmitters.

Stimulants (upper) are drugs such as caffeine and nicotine excite neural activity and

arouse body function.

Depressants (downer) are drugs such as alcohol, barbiturates and opiates that calm

neural activity and slower body function.

Hallucinogens are drugs distort perception and evoke sensory images in the absence

of sensory input. Some such as cannabis, marijuana, hashish are natural substance

whereas LSD and MADMA( Ecstasy) are synthetic.

Why is drug abuse so common in Pakistan?

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Why is drug abuse so common?

People seek drug experiences for many reasons, ranging from curiosity and a desire to

belong to a group or an escape from feelings of inadequacy. Many abusers turn to drugs in a

self-defeating attempt to cope with life. All the frequently abused drugs produce immediate

feelings of pleasure. The negative consequences follow much later. This combination of

immediate pleasure and delayed punishment allows abusers to feel good on demand.

Because drugs that can ease pain, induce sleep, or end depression have a high potential for

abuse, the more powerful psychoactive drugs are controlled substance

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