SLEEP AND WAKING

 Physiological mechanism of sleep and waking- Stages and functions

of sleep: REM and NREM
 Stages of sleep
• Stage 1 sleep is a transitional phase
• Occurs between wakefulness and sleep, the period during which we drift off to sleep.
During this time, there is a slowdown in both the rates of respiration and heartbeat. In
addition, stage 1 sleep involves a marked decrease in both overall muscle tension and
core body temperature.
• Associated with both alpha and theta waves.
• The early portion of stage 1 sleep produces alpha waves, which are relatively low
frequency (8–13Hz), high amplitude patterns of electrical activity (waves) that become
synchronized. This pattern of brain wave activity resembles that of someone who is
very relaxed, yet awake.
• As an individual continues through stage 1 sleep, there is an increase in theta wave
activity. Theta waves are even lower frequency (4–7 Hz), higher amplitude brain waves
than alpha waves. It is relatively easy to wake someone from stage 1 sleep; in fact,
people often report that they have not been asleep if they are awoken during stage 1
sleep.
 Stage 2
• The body goes into a state of deep relaxation.
• Theta waves still dominate the activity of the brain, but they are interrupted
by brief bursts of activity known as sleep spindles. A sleep spindle is a rapid
burst of higher frequency brain waves that may be important for learning and
memory.
• In addition, the appearance of K-complexes is often associated with stage 2
sleep.
• A K-complex is a very high amplitude pattern of brain activity that may in
some cases occur in response to environmental stimuli. Thus, K-complexes
might serve as a bridge to higher levels of arousal in response to what is going
on in our environments.
 Stage 3 & 4
• Referred to as deep sleep or slow-wave sleep because these stages are
characterized by low frequency (up to 4 Hz), high amplitude delta waves.
During this time, an individual’s heart rate and respiration slow dramatically.
• It is much more difficult to awaken someone from sleep during stage 3 and
stage 4 than during earlier stages.
• Interestingly, individuals who have increased levels of alpha brain wave
activity (more often associated with wakefulness and transition into stage 1
sleep) during stage 3 and stage 4 often report that they do not feel refreshed
upon waking, regardless of how long they slept (Stone, Taylor, McCrae,
Kalsekar, & Lichstein, 2008).
 REM SLEEP
• Marked by rapid movements of the eyes.
• The brain waves associated with this stage of sleep are very similar to those observed
when a person is awake and this is the period of sleep in which dreaming occurs.
• It is also associated with paralysis of muscle systems in the body with the exception of
those that make circulation and respiration possible. Therefore, no movement of
voluntary muscles occurs during REM sleep in a normal individual;
• REM sleep is often referred to as paradoxical sleep because of this combination of high
brain activity and lack of muscle tone.
• Like NREM sleep, REM has been implicated in various aspects of learning and memory
(Wagner, Gais, & Born, 2001), although there is disagreement within the scientific
community about how important both NREM and REM sleep are for normal learning
and memory (Siegel, 2001).
 Theories of sleep
• Two kinds of theories for sleep have been proposed:
1. Recuperation theories
2. Adaptation theories
The differences between these two theoretical approaches are revealed by
the answers they offer to the two fundamental questions about sleep:
a) Why do we sleep?
b) Why do we sleep when we do?
Recuperation theories
• The essence of recuperation theories of sleep is that being
awake disrupts the homeostasis (internal physiological
stability) of the body in some way and sleep is required to
restore it.
• Various recuperation theories differ in terms of the
particular physiological disruption they propose as the
trigger for sleep.
• For example, the two most common recuperation theories
of sleep are that the function of sleep is to:
 Restore energy levels that decline during wakefulness
 Clear toxins from the brain and other tissues that
accumulate during wakefulness. However, regardless of the
particular function postulated by recuperation theories of
sleep, they all imply that sleepiness is triggered by a
deviation from homeostasis caused by wakefulness and that
sleep is terminated by a return to homeostasis.
 Adaptation theories
• Adaptation theories of sleep focus more on when we sleep than on the
function of sleep.
• According to these theories, early humans had enough time to get their
eating, drinking, and reproducing out of the way during the daytime, and
their strong motivation to sleep at night evolved to conserve their energy
resources and to make them less susceptible to mishap (e.g., predation) in
the dark.
• Adaptation theories suggest that sleep is like reproductive behavior in the
sense that we are highly motivated to engage in it, but we don’t need it to
stay healthy.
 Effects of sleep deprivation
The stress problem: When you sleep substantially less than you are used to,
the next day you feel out of sorts and unable to function as well as you usually
do. Although such experiences of sleep deprivation are compelling, you need
to be cautious in interpreting them.
In Western cultures, most people who sleep little or irregularly do so because
they are under stress (e.g., from illness, excessive work, shift work, drugs, or
examinations), which could have adverse effects independent of any sleep loss.
Even when sleep-deprivation studies are conducted on healthy volunteers in
controlled laboratory environments, stress can be a contributing factor
because many of the volunteers will find the sleep-deprivation procedure itself
stressful.
Prediction of recuperation theories: Because recuperation theories of sleep
are based on the premise that sleep is a response to the accumulation of some
debilitating effect of wakefulness, they make the following three predictions
about sleep deprivation:
• Long periods of wakefulness will produce physiological and behavioral
disturbances.
• These disturbances will grow worse as the sleep deprivation continues.
• After a period of deprivation has ended, much of the missed sleep will be
regained.
 Case studies: sleep deprivation
• The case of sleep deprived students- Most of the volunteer students subjected to total sleep deprivation by

Kleitman experienced the same effects. During the first night, they read or studied with little difficulty until after

3:00 a.m., when they experienced an attack of sleepiness. At this point, their watchers had to be particularly

careful that they did not sleep. The next day the students felt alert as long as they were active. During the

second night, reading or studying was next to impossible because sleepiness was so severe, and as on the first

night, there came a time after 3:00 a.m. when sleepiness became overpowering. However, as before, later in

the morning, there was a decrease in sleepiness, and the students could perform tasks around the lab during

the day as long as they were standing and moving. The cycle of sleepiness on the third and fourth nights

resembled that on the second, but the sleepiness became even more severe. Surprisingly, things did not grow

worse after the fourth night, and those students who persisted repeatedly went through the same daily cycle.
• Case of Randy Gardner - Randy Gardner and two classmates, who were entrusted with keeping him awake,
planned to break the then world record of 260 hours of consecutive wakefulness. Dement learned about
the project and, seeing an opportunity to collect some important data, joined the team, much to the
comfort of Randy’s parents. Randy did complain vigorously when his team would not permit him to close
his eyes. However, in no sense could Randy’s behavior be considered disturbed. Near the end of his vigil,
Randy held a press conference, and he conducted himself impeccably. Randy went to sleep exactly 264
hours and 12 minutes after he had awakened 11 days before. And how long did he sleep? Only 14 hours the
first night, and thereafter he returned to his usual 8-hour schedule. Although you may be surprised that
Randy did not have to sleep longer to “catch up” on his lost sleep, the lack of substantial recovery sleep is
typical of such cases.
 Circadian rythms
• The world in which we live cycles from light to dark and back again once every
24 hours. Most surface-dwelling species have adapted to this regular change in
their environment with a variety of circadian rhythms (circadian means “lasting
about a day”). For example, most species display a regular circadian sleep–wake
cycle. Humans take advantage of the light of day to take care of their biological
needs, and then they sleep for much of the night; in contrast, nocturnal
animals, such as rats, sleep for much of the day and stay awake at night.
• Although the sleep–wake cycle is the most obvious circadian rhythm, it is
difficult to find a physiological, biochemical, or behavioral process in animals
that does not display some measure of circadian rhythmicity.
• Each day, our bodies adjust themselves in a variety of ways to meet the
demands of the two environments in which we live: light and dark.
• Our circadian cycles are kept right on their once-every24-hours schedule by
temporal cues in the environment. The most important of these cues for the
regulation of mammalian circadian rhythms is the daily cycle of light and dark.
Environmental cues, such as the light–dark cycle, that can entrain (control the
timing of) circadian rhythms are called zeitgebers (pronounced “ZITE-gay-
bers”), a German word that means “time givers.”
 What happens to sleep–wake cycles and other circadian
rhythms in an environment that is devoid of zeitgebers?
• Under conditions in which there are absolutely no temporal cues, humans
and other animals maintain all of their circadian rhythms.
• Circadian rhythms in constant environments are said to be free-running
rhythms, and their duration is called the free-running period.
• Free-running periods vary in length from individual to individual, are of
relatively constant duration within a given individual, and are usually
longer than 24 hours—about 24.2 hours is typical in humans living under
constant moderate illumination.
• It seems that we all have an internal biological clock that habitually runs a
little slow unless it is entrained by time-related cues in the environment.
 Disruptive effects of jet lag and shift work
on circadian rhythmicitiy
• Jet lag occurs when the zeitgebers that control the phases of various circadian
rhythms are accelerated during east-bound flights (phase advances) or
decelerated during west-bound flights (phase delays).
• In shift work, the zeitgebers stay the same, but workers are forced to adjust
their natural sleep–wake cycles in order to meet the demands of changing
work schedules.
• Both of these disruptions produce sleep disturbances, fatigue, and deficits on
tests of physical and cognitive function. The disturbances can last for many
days; for example, it typically takes about 10 days to completely adjust to the
phase advance of 10.5 hours that one experiences on a Tokyo-to-Boston flight.
Disorders of sleep
SLEEP DISORDER
- IATROGENIC
- SLEEP APNEA
INSOMNIA
- NARCOLEPSY
- REM SLEEP
HYPERSOMNIA DISORDER

SLOW WAVE SOMNAMBULISM

SLEEP DISORDER NIGHT TERROR

NOCTURNAL
ENEURESIS
• Many sleep disorders fall into one of two complementary categories:
insomnia and hypersomnia.
• Insomnia includes all disorders of initiating and maintaining sleep.
Hypersomnia includes disorders of excessive sleep or sleepiness.
• A third major class of sleep disorders includes all those disorders that
are specifically related to REM-sleep dysfunction.
• Both insomnia and hypersomnia are common symptoms of
depression and bipolar disorders.
Causes of Insomnia
• iatrogenic (physician- created): In large part because sleeping pills
(e.g., benzodiazepines), which are usually prescribed by physicians,
are a major cause of insomnia.
• At first, hypnotic drugs may be effective in increasing sleep, but soon
the patient may become trapped in a rising spiral of drug use, as
tolerance to the drug develops and progressively more of it is
required to produce its original hypnotic effect. Soon, the patient
cannot stop taking the drug without running the risk of experiencing
withdrawal symptoms, which include insomnia.
 Case of Iatrogenic Insomnia
• Mr. B. was studying for an exam, the outcome of which would affect his life. He was
under stress and found it difficult to sleep. He consulted his physician who prescribed
a moderate dose of barbiturate (i.e., sodium amytal) at bedtime. Mr. B. found the
medication to be effective for a few nights, but after a week, he started having trouble
sleeping again. So, he decided to take two sleeping pills each night. Twice more this
cycle was repeated, so that on the night before his exam he was taking four times the
original dose. The next night, with the pressure off, Mr. B. took no pills, but he
couldn’t sleep. Accordingly, Mr. B. decided he had a serious case of insomnia and
returned to the pills. By the time he consulted a sleep clinic several years later, he was
taking approximately 1,000 mg sodium amytal every night, and his sleep was more
disturbed than ever. Patients may go on for years with ever-increasing doses of one
medication after another, never realizing that their troubles are caused by the pills.
• Sleep apnea : The patient with sleep apnea stops breathing many times each night. Each
time, the patient awakens, begins to breathe again, and drifts back to sleep.
• Sleep apnea usually leads to a sense of having slept poorly and is thus often diagnosed as
insomnia. However, some patients are totally unaware of their multiple awakenings and
instead complain of excessive sleepiness during the day, which can lead to a diagnosis of
hypersomnia.
• Sleep apnea disorders are of two types: (1) obstructive sleep apnea results from
obstruction of the respiratory passages by muscle spasms or atonia (lack of muscle tone)
and often occurs in individuals who are vigorous snorers; (2) central sleep apnea results
from the failure of the central nervous system to stimulate respiration.
• Sleep apnea is more common in males, in people who are overweight, and in the elderly
(see Badran et al., 2015).
• Two other specific causes of insomnia are related to the legs: periodic limb
movement disorder and restless legs syndrome.
• Periodic limb movement disorder is characterized by periodic, involuntary
movements of the limbs, often involving twitches of the legs during sleep.
Most patients suffering from this disorder complain of poor sleep and daytime
sleepiness but are unaware of the nature of their problem.
• In contrast, people with restless legs syndrome are all too aware of their
problem. They complain of a hard-to-describe tension or uneasiness in their
legs that keeps them from falling asleep. Once established, both of these
disorders are chronic.
 Hypersomnia- Narcolepsy
• Narcolepsy is the most widely studied disorder of hypersomnia.
• It occurs in about 1 out of 2,000 individuals and has two prominent
symptoms.
• First, persons with narcolepsy experience severe daytime sleepiness and
repeated, brief (10- to 15-minute) daytime sleep episodes.
• Individuals with narcolepsy typically sleep only about an hour per day more
than average; it is the inappropriateness of their sleep episodes that most
clearly defines their condition.
• Most of us occasionally fall asleep on the beach, in front of the television, or
in that most soporific of all daytime sites—the large, stuffy, dimly lit lecture
hall. But individuals with narcolepsy fall asleep in the middle of a
conversation, while eating, while scuba diving.
• Sleep paralysis is the inability to move just as one is falling asleep or
waking up.
• Hypnagogic hallucinations are dreamlike experiences during
wakefulness. Many healthy people occasionally experience sleep
paralysis and hypnagogic hallucinations.
 SLEEP
ATTACK

NARCOLEPSY

HYPNOGOGIC
CATAPLEXY HALLUCINATION
REM sleep- related disorders
• Some patients experience REM sleep without core muscle atonia. This
condition is known as REM-sleep behavior disorder and is common in
individuals with Parkinson’s disease.
• It has been suggested that the function of REM-sleep atonia is to
prevent the acting out of dreams.
Case study
(The patient was dreaming about football.) The quarterback lateraled
the ball to me and I was supposed to cut back over tackle and—this is
very vivid—as I cut back there is this 280-pound tackle waiting, so I
gave him my shoulder and knocked him out of the way. When I awoke I
was standing in front of our dresser. I had knocked lamps, mirrors, and
everything off the dresser; hit my head against the wall; and banged my
knee against the dresser.