Why Do We Sleep

 We all know how insistent the urge to sleep can be and

how uncomfortable we feel when we have to resist it and

stay awake.
 With the exception of the effects of severe pain and the

need to breathe ,sleepiness is probably the most insistent

drive that we can experience.

 Sleep come sooner or later no matter , how hard a person

tries to stay awake.

 Most researches believe that the primary
function of slow-wave sleep is to permit the
brain to rest.
 REM sleep appears to promote brain
development and learning , but how it might
do so is not yet understood.
Sleep And Its
Disorders
A Psychological and
Behavioral Description of
Sleep
 What is sleep?
Sleep is a behavior.
 This statement might seems peculiar,

because we usually think behavior as

activities involve movements such as
walking or talking.
 We tend to think of sleep more as state

of consciousness than as a behavior.

Researches on Sleep

 Electroencephalogram (EEG)
Experimenter prepares the sleeper for
electrophysiological measurements by
attaching electrodes to the scalp to
monitor.
 Electromyogram (EMG)

Electrodes attached to the chin to

monitor muscle activity.
 Researches on Sleep
Electro-oculogram (EOG)
Electrodes attach around the eyes to monitor the
eyes movements.
2 Basic Pattrens
during Wakefullness
The EEG of a normal person shows 2
patterns of activity
 Alpha activity

Smooth electrical activity of 8-12 Hz

recorded from the brain and it is
generally associate with the state of
relaxation .
 Beta activity
Irregular electrical activity of 13-30 Hz
recorded from the brain and it is generally
associated with a state of arousal.
Theta activity
EEG activity of 3.5-7.5 Hz that occurs
intermittently during early stages of slow
wave sleep and REM sleep.
 Sleep spindles
They are short bursts of waves of 12-14 Hz
that occurs between two and five times
during the four stages of sleep
 K complexes

They are sudden sharp wave forms occurs

during 2nd stage of sleep.
They represent an inhibitory mechanism
that protects the sleeper from awakening.
Stages of Sleep
 Delta activity
Regular, synchronous electrical activity of less
than 4 Hz recorded from the brain, occurs
during the deepest stages of low-wave sleep.
 REM Sleep

A period of desynchronized EEG activity

during sleep, at which time dreaming, rapid
eye movement and muscular paralysis occurs,
also called paradoxical sleep.
 Slow-wave Sleep
Non-REM sleep characterized by
synchrnized EEG activity during its
deeper stages.
 Non-REM Sleep

It is all stages of sleep except REM

sleep.
A typical pattern of the stages
of sleep during a single night.
Basic Rest-activity
Cycle
A 90 minutes cycle (in humans) of
waxing and waning alertness
controlled by a biological clock in
the caudal brain stem.
It controls the cycles of REM sleep
and slow-wave sleep.
Disorders Of Sleep
 Because we spend about one third of our lives
sleeping, sleep disorders can have a significant
impact on our quality life. They can also affect
the way we feel while we are awake. Two
disorders that are being discussed are:

INSOMNIA

NARCOLEPSY
INSOMNIA
 Insomnia is a sleep disorder that is
characterized by difficulty falling and/or
staying asleep. People with insomnia have
one or more of the following symptoms:
 Difficulty falling asleep
 Waking up often during the night and

having trouble going back to sleep

 Waking up too early in the morning
 Feeling tired upon waking
Types Of Insomnia
 There are two types of insomnia based on duration.
Acute insomnia is more common than chronic
insomnia:

 Acute Insomnia: This type of insomnia lasts for a

short time – from several nights up to three weeks –
and goes away on its on without treatment.
 Chronic Insomnia: Insomnia that lasts more than
three weeks is classified as chronic insomnia.
Nearly 1 in 10 people have chronic insomnia, which
often requires some form of treatment to go away.
Causes of Insomnia

 Illness
 Emotional or physical discomfort
 Environmental factors like noise, light, or extreme
temperatures (hot or cold) that interfere with sleep
 Some medications (for example those used to treat
colds, allergies, depression, high blood pressure, and
asthma) may interfere with sleep
 Interferences in normal sleep schedule (jet lag or switching
from a day to night shift, for example)
 Symptoms of Insomnia
 Sleepiness during the day
 General tiredness
 Irritability
 Problems with concentration or memory
NARCOLEPSY
 Narcolepsy is a neurological disorder that affects the control of sleep and
wakefulness.

 People with narcolepsy experience excessive daytime sleepiness and

intermittent, uncontrollable episodes of falling asleep during the daytime.

 These sudden sleep attacks may occur during any type of activity at any
time of the day.

 In a typical sleep cycle , we initially enter the early stages of sleep

followed by deeper sleep stages and ultimately (after about 90 minutes)
rapid eye movement (REM) sleep.
 For people suffering from narcolepsy, REM sleep occurs almost
immediately in the sleep cycle, as well as periodically during the waking
hours. It is in REM sleep that we can experience dreams and muscle
paralysis -- which explains some of the symptoms of narcolepsy.

 Narcolepsy usually begins between the ages of 15 and 25, but it can
become apparent at any age. In many cases, narcolepsy is undiagnosed
and, therefore, untreated.
Symptoms of narcolepsy include:
 Cataplexy: This symptom consists of a sudden loss of muscle tone
that leads to feelings of weakness and a loss of voluntary muscle
control. It can cause symptoms ranging from slurred speech to total
body collapse, depending on the muscles involved, and is often
triggered by intense emotions such as surprise, laughter, or anger.

 Hallucinations: Usually, these delusional experiences are vivid and

frequently frightening. The content is primarily visual, but any of the
other senses can be involved. These are called hypnologic
hallucinations when accompanying sleep onset and hypnopompic
hallucinations when they occur during awakening.

 Sleep paralysis: This symptom involves the temporary inability to

move or speak while falling asleep or waking up. These episodes are
generally brief, lasting a few seconds to several minutes. After
episodes end, people rapidly recover their full capacity to move and
speak.
REM Sleep Behavior Disorder (RBD)

“A neurological disorder in which the person

does not become paralyzed during REM sleep and thus
act out dreams”.
 REM sleep is the stage of sleep in which most vivid
dreaming occurs.

 The loss of motor inhibition leads to a wide spectrum

of behavioral release during sleep. This extends from
simple limb twitches to more complex integrated
movement, in which sufferers appear to
be unconsciously acting out their dreams.

 These behaviors can be violent in nature and in some

cases will result in injury to either the patient or their
bed partner.
Symptoms
 RBD is characterized by the dreamer acting out his or
her dreams. These dreams often involve kicking,
screaming, punching, grabbing, and even jumping out
of bed. When awoken, a person can usually recall the
dream they were having which will match the actions
they were performing, but they will not be aware that
they were moving.
 In a normal sleep cycle, REM sleep may be
experienced at intervals of between 90 minutes and 2
hours every night, which means RBD episodes, may
occur up to four times a night.
 In a rare case, they may only happen once a week or

once a month.
 Episodes occur more towards the morning hours

because that is when REM sleep is more frequent. The

actions in an episode can result in injuries to oneself or
one's bed partner.
Causes
 RBD appears to be neurodegenerative disorder with at
least some genetic component.

 It is often associated with better known

neurodegenerative disorders such s Parkinson’s
diesease and multiple symptom atrophy.

 It can be caused by adverse reactions to certain drugs

like drugs used to treat cataplexy will aggravate the
symptoms of RBD.
Treatment Of RBD
 REM sleep behavior disorder is usually
treated by Clonazepam and Benzodiazepine
 Problems Associated With Slow Wave
Sleep

 Some maladaptive behaviors occur during slow-wave

sleep, especially during its deepest phase.

 These behaviors include,

 Bedwetting (nocturnal enuresis)
 Sleep walking (somnambulism), and
 Night terrors (pavor nocturnus).

These behaviors occur most frequently in children.

 Treatments
• Bedwetting can be cured by training methods like having a
special electronic circuit ring a bell when the first few drops of
urine are detected in the bed sheet.

• Night terrors consist of anguished screams, trembling, a rapid

pulse and usually no memory of what caused that terror.

• Night terrors and sleepwalking can be cured when the child

gets older.
 Neither of these phenomena is related to REM sleep,
a sleep walking person is not acting out a dream.

 And when sleepwalking occurs in adulthood, it

means it is present as genetic component.
 Sleep Related Eating Disorder

 In 1991, nineteen cases were reported of eating during

the night while they were asleep.

 Almost half of the patients had become overweight

during night eating.

 An individual will sleep-walk leaving his or her bed in

the mid of the night seeking out for food, and will eat
having no memory of the event in the morning.
 Once the patients know about this behavior, they kept
their food materials in lock having alarm in it. So that
the patient when try to eat, alarm wake them up.

 This nocturnal eating throughout a family suggests that

heredity may be a potential cause of this disorder.
 Treatments of Sleep related
Eating Disorders
 Sleep-related eating disorder usually responds well to
dopaminergic agonists, anxiolytic drugs, or antianxiety
drugs.
 An increased incident of nocturnal eating in family

members with this disorder suggest that hereditary may

play a role.
 Some evidences suggest that nocturnal eating may be

associated with the use of some sleeping medications

used to treat insomnia.