Wakefulness and Sleep

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In this module the students overview on how sleep is important to the human
body. The students also identify the different structures of the brain that are involved
during sleep. The students also discuss the difference between Non-REM sleep and
what are the stages of NREM sleep. The students also explain the two internal biological
mechanisms which are circadian rhythms and sleep- wake homeostasis. The students
also define what a dream is and how a dream becomes bad. The students learn some of
the sleep disorders.

Objectives: By the end of this module the students should be able to :

1. define what sleep is.
2. identify what is the sleep pattern over life span.
3. discuss how important sleep is in the human body.
4. compare REM and NREM.
5. determine the three stages of NREM sleep.
6. determine the brain chemicals that regulate sleep and waking.
7. illustrate the process on how the brain is regulated to activate sleep.
8. identify the different sleep disorders.

Lectures:
1. Sleep and Cognition
2. Sleep Pattern Over Life Cycle
3. The importance of Sleep
4. REM and NREM
5. Three Stages of NREM
6. Anatomy of Sleep and Brain Process of Sleep
7. Sleep Disorders

Reference
Kalat, J., (2018). Biological Psychology
Reading Supplements:
Leonard, J., (2023). What is REM
sleep?https://www.medicalnewstoday.com/articles/247927
National Institute of Neurological Disorders and Stroke (2023). Brain Basics:
Understanding Sleep. https://www.ninds.nih.gov/health-information/public-
education/brain-basics/brain-basics-understanding-sleep
Pacheco, D., & Wright, H., (2023).How Do Dreams Affect Sleep.
https://www.sleepfoundation.org/dreams/how-do-dreams-affect-sleep
Semeco, A., (2023). 20 Simple Tips That Help You Fall Asleep Quickly.
https://www.healthline.com/nutrition/ways-to-fall-asleep
Stibich, M., (2023). The Relationship Between Sleep and Life Expectancy.
https://www.verywellhealth.com/sleep-duration-and-longevity-2224291
Suni, E., & Singh, A., (2023). Stages of Sleep: What Happens in the Life Sleep Cycle.
https://www.sleepfoundation.org/stages-of-sleep
 Rhythms of Waking and Sleeping
Sleep is one of the important parts of our daily routines in life. It is like food and
water which are essential to survive as living organisms. One- third of our time we
spent sleeping. Maintaining the quality of sleep through getting enough sleep produces
new memories and is good for your health. Getting enough sleep can form harder
concentration and quick response. There are recent findings that sleep has
housekeeping rules that remove toxins in your brain which are built up when you are
awake (NIH,2023). When we sleep our body takes time to repair muscles, bones grow,
manage hormones, and classify memories.
Sleep affects our systems in the body and every type of tissue. Sleep is important
for the brain, heart, lungs, metabolism, mood, immunity,and resistance to diseases.
There are research studies that if a person is not getting enough sleep or lack of sleep
increases the risk of disorders like cardiovascular disease, high blood pressure, diabetes,
depression, and obesity.
A person is prone to fatal accidents due to lack of sleep. . According to a 2014
research study, if you sleep six hours of sleep per night 33% more likely to have a car
crash compared to those who sleep seven or eight hours at night. Motor vehicle
accidents happen 9% due to sleeping less than seven hours at night It is not only
with the little sleep that affects human life but also too much sleeping is a slo a sign of
health problems. Those who sleep at night more than ten hours are associated with
psychiatric diseases and higher levels of BMI but not other chronic related medical
conditions. To too little sleep. There are study that 23% of those who sleep eight to nine
hours at night 23% suffer from stroke compared to those who sleep seven to eight
hours at night. And those who sleep both sleep over nine hours and napped ninety -
plus minutes during the day, 85% risk of having a stroke. (Stibich, 2023).

Anatomy of Sleep
These are the following structures
which are involved when we sleep:
Hypothalamus, is a peanut- sized
structure located deep inside the brain.
Hypothalamus is made up of nerve cells. It
is the control center affecting sleep and
arousal. Inside the hypothalamus a
suprachiasmatic nucleus (SCN) is found.
Bunch of thousands of cells receive
information that controls light exposure
directly to the eyes and controls
behavioral rhythm . If the circadian
rhythms with the light- dark cycle do not
match it damages some people with their
SCN sleep uncertainty throughout the day.
Most of the blind are able to sense light and modify the sleep/ wake cycle.
The brainstem which is responsible for communicating with the
hypothalamus and found at the base of the brain, inhibits the transition between
sleep and wakefulness. The GABA , the brain chemical produced by the
brainstem which is the sleep- promoting cells within the hypothalamus. GABA
controls/reduces the activity of the arousal in the hypothalamus and the
brainstem. The brainstem (especially the pons and medulla) has an important
role in REM sleep and transmits signals for muscle relaxation important for body
posture and movements of the limbs so that it prevents us from acting out of our
dreams.
 The thalamus that relays messages from the senses to the cerebral
cortex (covers the brain that interprets and processes the information from the
short- to long-term memory). During the most stages of sleep, the thalamus is
quiet, letting the external world tune out. But throughout REM sleep, the thalamus
is activated, sending images of the cortex, sounds, and other sensations fills our
dreams.
The pineal gland, which is located within the two hemispheres of the brain,
receives signals from the SCN and production of the hormone melatonin
increases. Melatonin is a hormone that helps to sleep if the lights are off. Blinds
which are unable to coordinate to their natural wake- sleep cycle use natural light
that can stabilize the sleep patterns through taking small amounts of melatonin at
the same time each day. Scientists believe that melatonin is important to match
the body’s circadian rhythm of the light and darkness external cycle.
The basal forebrain which is found at the bottom and near in front of the
brain used to promote sleep and wakefulness which is the arousal system is the
part of the midbrain. Adenosine, a chemical byproduct of cellular foe energy
consumption, is released from the cells of the basal forebrain and likely other
regions support the sleep drive. Caffeine prevents sleep through blocking the
adenosine actions.
The amygdala , an almond- shaped structure used to process
emotions,during REM sleep becomes activated.

Sleep Cycle
Sleep cycle is not uniform but in total sleep consists of several rounds over
the course of the night. It is made up of four individual stages . In a typical night,
a person goes through four to six sleep cycles. The length of the sleep cycles but
it lasts about 90 minutes each.

Sleep is categorized into:

1. Non- REM (NREM) sleep. - The first
three stages of sleep are included..The last
stage of the non- REM sleep is when you
are in deep sleep which is difficult for you to
wake up.

Three Stages of NREM sleep:

Stage N1 - a person first falls asleep. It is a
stage in which a person is between awake
and asleep or it is a stage in which sleep is
very light and lasts normally between one to
seven minutes. At this stage the body has
not fully relaxed which the activities of the
brain and the body starts to slow with brief
movements. Brain activity with light changes related to falling asleep.
Stage N2 - characterized by a slightly deeper sleep in which the body
temperature drops and the heart rate slows down. The brain activity slows down,
bursts of activity become short, and resistance to wake up through external
stimuli. Sleep lasts for 10 to 25 minutes during the first cycle. People spent about
their sleep time in N2 sleep.
Stage N3 - it is a state of deep and restoration of sleep known as slow- wave
sleep or delta sleep. At this stage the muscles are relaxed, the supply of blood
in the muscles increases , body repairs, and tissues grow. A person spends the
N3 during the first half of the night and commonly lasts 20 to 40 minutes . As I
continue sleeping , it becomes shorter and more time spent with REM sleep.
2. Rapid eye movement (REM) sleep- happens after the first 90 minutes of
sleep. Dreams mostly happen in REM. There are several changes happening in
the brain and body at this stage that include rapid movements of the eyes, fast
and irregular breathing, heart rate increases, changes in body temperature ,
blood pressure increases, sexual arousal, and brain consumption of oxygen
increases.Sleep paralysis happens at this stage because the brain sends signals
so that the muscles in the arms and legs are relaxed. This leads to muscle
atonia ( lack of muscle activity) helps to remain still during rapid eye movement
(REM). With the presence of temporary sleep paralysis awareness is regained
but you cannot move. REM is beneficial for learning, memory, and mood. With
the presence of REM it has adverse effects for physical and mental health. REM
sleep is beneficial among infants for the development of the brain. There is some
research that REM is responsible for neural stimulation which is important for the
development of mature brain structure. This is how important infants need to
have a higher level of REM sleep and as people age the REM sleep decreases.
REM sleep is called the most vivid dream and has significance with brain activity.
Dreams happen at any stage but are less common and intense in NREM sleep.In
the first stage of REM it takes only free minutes and an hour at the later stage In
the total REM stages, it makes up 25% among adults.

Sleep Stages in a Normal Sleep Cycle

Sleep Stages Sleep Type Other Names Normal Length

Stage 1 NREM N1 1-7 minutes

Stage 2 NREM N2 10-25 minutes

Stage 3 NREM N3, Slow wave

sleep(SWS), delta 20- 40 minutes
sleep, deep sleep

Stage 4 REM REM Sleep 10-60 minutes

These are the following Affects Sleep Stages

1. Age - time of sleep over a person’s life. Newborns enter REM and spend
more time on REM as soon as they fall asleep. As they become older they
become similar to adults. Older people spend less time REM sleep.
2. Recent sleep patterns if a person gets insufficient or irregular sleep over
a period of days or more this can lead to abnormality in sleep cycle.
3. Alcohol - alcohol and other drugs decreases REM
4. Sleep Disorders - sleep apnea, restless legs syndrome (RLS), and other
conditions lead to multiple awakenings, controls the sleep cycle.
 . There are two internal biological mechanisms of sleep

1.Circadian rhythms
Circadian rhythm is a biological clock that makes a living organism like
plants, animals, and humans measure time changes either physical, mental, and
behavioral over a 24- hour cycle.It has an important role in the ability of a person
to sleep.In the evening the sun sets and the brain starts to produce melatonin, a
hormone responsible to a person to sleep. As the light increases at night, it stops
the production of melatonin, raises the body temperature, and promotes
wakefulness.There are some factors that affect the circadian rhythm such as
food intake, stress, physical activity, social environment, and temperature (NIH,
2023).Sleep refreshes and restores if the circadian rhythm, the natural cycle of
daylight and darkness, and align the sleep patterns. Circadian rhythm is the one
that controls the timing of sleep and makes a person sleep at night and has a
tendency to wake you up in the morning without the presence of an alarm clock.

These are the following important functions of circadian rhythm:

● Sleep patterns
● Hormone release
● Appetite and digestion
● Temperature

2.Sleep- wake homeostasis provides a path for sleep. Homeostatic sleep

reminds the body to sleep after the particular time and regulates the intensity of
sleep. There are factors that influence sleep- wake cycles and these are medical
conditions, medications,stress, sleep environment,and what we eat and drink and
the greatest influence is the light exposure.The retinas of the eyes is a process
that light and tells the brain if it is day or night and makes to advance or delay our
sleep- wake cycle. If a person is exposed to light it can make it difficult to sleep
and return to sleep. Night shift workers have difficulty falling asleep if they go to
bed and trouble staying awake at work because the natural circadian rhythm and
sleep- wake cycle is disrupted.

These are the following tips on having a quick sleep :

1. Lower the room temperature - increase the level of temperature in the
environment during sleep. It affects human thermoregulation (internal body
temperature) and has an impact with the quality of sleep.
2. Set the sleep schedule - your body has a 24 hours regulation system
which is known as circadian rhythm. The internal clock hints that you
become alert during the day and sleep at night. If you are doing it at the
same time of waking up and going to bed, it helps you to regulate the
internal clock.
3. Experience both daylight and darkness - published in 2022, exposure
to light influences your internal clock. Regulates sleep and wakefulness. It
commands you the quality, timing, and duration of sleep. Exposing
yourself during daytime increases fatigue and at night you fall asleep. Too
much light at night prevents you from falling asleep at night and blocks
melatonin production. Melatonin hormone makes your brain respond to
 darkness. Melatonin is best known for affecting sleep, lowers during
daytime and increases during night time that leads you to sleep.
4. Practice yoga, meditation, and mindfulness - if a person is exposed to
stress, Yoga has a positive effect on the quality, efficiency, and sleep
duration.
5. Avoid looking at your clock - waking up in the middle of the night is
normal but it is frustrating to fall back asleep. Those people with insomnia
look every time they wake up at their clock which is known as clock
watching or time- monitoring behavior.. If you develop this routine, you
will find out that you will wake up at the middle of the night every night.
Removing the clock in your room reduces the attack of sleep related
anxiety.
6. Avoid napping at day time.

Dreaming
Dreaming is healthy and still part of the healthy sleep. Good sleep helps to
have better cognitive and emotional functions. Dreams are mental, sensory, or
emotional experiences that happen during sleep.Each night you spend 2 hours
dreaming but mostly you may not remember your dreams. Dreams help to
process emotions and most people who undergo stress or anxiety are more likely
to have frightening dreams. During sleep your thoughts occupy thoughts during
sleep.Dreams are experienced in all stages but mostly in REM sleep.Expert
believes that dreaming is a reflection or a contributor to having a healthy sleep.
But dreams are not all produced equally. There are some dreams having a
negative impact on and bad dreams which are scary, traumatic, or threatening. If
a person is awakening from sleep thi considered as nightmares. Nightmares have
a negative impact on a human's life if these happen frequently or become
disturbing.

Sleep Disorders
Sleep disorders ( or sleep- wake disorders) occur if you have problems with
taking sleep regularly. Sleep disorders also occur along with medical conditions or other
health mental conditions like depression, anxiety, or cognitive disorders.
These are the following types of sleep disorders Some maybe came from underlying
health conditions.
Insomnia is when a person is unable to fall asleep or remains asleep due to stress, jet
lag, anxiety, hormones, or another condition. Insomnia is classified into three and these
are the following:
1. Chronic - if insomnia occurs on a regular basis for at least one month.
2. Intermittent - if insomnia occurs periodically.
3. Translent - if insomnia lasts a few nights at the same time.
Sleep apnea - if breathing ceases during sleep. It is a serious medical condition where
the body takes less oxygen supply. It makes you wake up at night.
Narcolepsy - is a sleep disorder that is characterized with an extreme sleep at daytime.
Parasomnias - a sleep disorder in which you have abnormal movements and
behaviors during sleep. Some of the manifestations are bedwetting, sleep walking,
nightmares, teeth grinding or talking while sleeping.