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11/3/2011
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SLEEPING

Stages of Sleep

Distinctive changes in the electrical

activity of the brain and accompanying

physiological responses of the body that

occur as you pass through sleep phases

Stages of Sleep

Electrical changes are measured via

EEG

Electroencephalogram

Stages of Sleep

Alpha Stage

Pre-Stage 1

Marked by feelings of being relaxed and

drowsy, usually with eyes closed

Stage 1

Transition from wakefulness to sleep

Lose responsiveness & begin sleeping

If awoken: “I wasn’t sleeping.”

Stages of Sleep

Stage 2

First real stage of actual sleep

Stages 3 & 4

Deep sleep

More and more difficult to be awakened

Physiological functions slow down

Stages of Sleep

Stages 1 – 4

Non-REM sleep (nREM)

Rapid Eye Movement

80% of sleep is spent in these stages

Stages of Sleep

REM Sleep

20% of sleep time

Eyes move quickly back and forth behind

closed lids

Similar EEG pattern as when awake

Physiologically aroused

Increased heart rate and blood pressure

Stages of Sleep

REM sleep (continued)

All voluntary muscles are paralyzed

Paradoxical Sleep

Time when you dream

Wake during REM = remember dream

In REM 5-6 times per night

Each period is 15-45 minutes

Get longer throughout the night

Movement Through Stages

Like a “roller coaster ride…”

1,2,3,4,3,2,REM

2,3,4,3,2,REM

2,3,2,REM

2,REM

2,REM

1

REM Rebound

Refers to individuals spending an

increased percentage of time in REM

sleep if they were deprived of REM on

previous nights



May indicate a need for REM

A need to dream…?

How Much Sleep Do I Need?

Infants

80% or more time is spent sleeping

50% of time in REM sleep

Approximately 17 hours per day

(GROWTH!)

Children

40% of time spent sleeping

30% in REM sleep

How Much Sleep Do I Need?

Adolescence

Need more sleep!

10 hours per night

Circadian clocks favor going to bed later

and getting up later

Sleep deprivation affects AM performance

How Much Sleep Do I Need?

Adulthood

Need 7-8 hours per night

Less than 20% is spent in REM

Old Age

6.5 hours per day

Slightly less REM than adults

Often report trouble getting to sleep and

staying asleep (due to daytime napping,

health, etc.)

Effects of Sleep Deprivation

On Body

Decreased immune functioning





On Brain

Irritability & Moodiness

Unhappiness

Interferes with tasks that require concentration

Hallucinations (extreme deprivation)

Sleep Disorders



Axis I psychological disorders



Disrupt functioning

Occupational, academic, social, personal

care, etc.

INSOMNIA

Difficulty falling asleep, staying asleep,

or getting a restful sleep



Treatments:

Environmental change

Medications

Therapy to reduce anxiety

Drug Treatments:

Benzodiazepines



Examples: Xanax, Valium, Ativan

Effective in short-term (3-4 weeks)

Prolonged use…

Daytime drowsiness, loss of memory,

tolerance, and dependence

Also help to reduce anxiety

Drug Treatments:

Non-Benzodiazepines

Examples: Ambien, Sonata, Lunesta,

Rozerem

Fewer side effects

Rapid-acting



Ambien CR (controlled release)

2 parts…help getting to sleep & staying

asleep

Sleep Apnea

Obstruction of air passages and halted

breathing with alternates with loud

snoring and moments of “wakefulness”



Treatments:

CPAP Mask (continuous positive airway

pressure)

Sleep Apnea

Sleep Apnea

CPAP Masks

Other Sleep Disorders

Hypersomnia

Excessive sleepiness or difficulty waking up





Narcolepsy

Falling asleep is sudden and unpredictable

Biological cause

Accompanied by some muscle tone loss

Other Sleep Disorders

Nightmare Disorder

Elaborate, frightening dreams that occur

during REM sleep



Sleep Terror Disorder

Episodes during nREM (stages 3 & 4) that

cause intense arousal and fright

Nighttime panic attack

No memory of episode in morning

Other Sleep Disorders



Sleepwalking Disorder

Occurs during nREM (stages 3 & 4) and

can involve actions from sitting up to

walking around and doing things

Can be dangerous…

Does not occur during DREAMING

Establishing an

Optimal Sleep Pattern



Go to bed only when tired

Turn lights out immediately

Do not read or watch TV

After 20 minutes…

Repeat as often as required

Establishing an

Optimal Sleep Pattern



Set the alarm for the same time each

morning

Do not nap during the day



After several weeks…

If sleep is no better, see a doctor for

evaluation



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