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WHAT IS SLEEP?
In 1913, Henri Pieron defined three features of sleep: It is periodically necessary It has a rhythm relatively independent of external condition It is characterized by complete interruption of the sensory and motor functions that link the brain with the environment.
WHAT IS SLEEP?
Until late 1950 sleep was viewed as a lapse in the waking state when there is insufficient stimulation to keep the brain awake. This concept changed in the late 1950s when sleep began to be regarded as an active process characterized by a cyclic succession of different psycho- physiological phenomena. There are two stages of sleep distinguished by Electroencephalogram: The slow wave sleep (Non REM) and REM sleep with EEG Dissynchronization
REM SLEEP
This is defined by relatively low voltage, mixed (2-7H2) frequency EEG with episodic eye movement and absent EMG activity of all the skeletal muscles . EEG resembles but not identical to waking state. When people awaken from REM sleep they often recall vivid dreams. In REM sleep, the Hippocampal EEG is highly synchronized at theta waves
REM SLEEP
During REM sleep, monophasic sharp waves propagate rostrally from the Pons to the occipital lobes via the lateral geniculate body and are referred to as ponto-geniculo-occipital spikes. During REM sleep, threshold for arousal by environmental stimuli is increased. So by criteria of external arousability, REM sleep is the deepest sleep. At the same time a sleeping human is more likely to awake spontaneously from REM sleep. By criterion of internal arousability REM sleep is the lightest stage of sleep.
DREAMING
The discovery of a strong correlation between REM sleep and visual dreaming in humans has reversed many commonly held notes on about dreams. Every one dreams in regular cycles several times at night but they are not well remembered. The probability of recall in a dream falls to zero within 8 minutes of the ensuing slow wave sleep after REM sleep. As a result we usually remember only morning dreams, which also turn out to be those with most emotional/ psychological content.
MEANING OF DREAM
From ancient times dreams have been regarded as important and often believed to provide insight into the future. Because of this, dreams were extensively catalogued in antiquity. Sigmund Freud proposed that dreams were the royal road to the unconscious; that they revealed in disguised form the deepest elements of an individuals inner life. Many normal dreams are unpleasant. Calvin Hall catalogued over 10,000 dreams from normal people and found that approximately 64% were associated with sadness, apprehension, or anger. Only 18% were happy or exciting. Hostile acts by or against the dreamer out number friendly acts.
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MEANING OF DREAM
In 1977 Allan Hobson and Robert MacCarley proposed the activation synthesis hypothesis. They suggested that dreaming consists of association and memories elicited from the forebrain (Neocortex and associated structure) in response to random signals from the brain stem (ponto-geniculooccipital spikes). Dreams were merely the best fit the forebrain could provide to this random bombardment from brain stem. Hobson suggested that the sense or plot of dreams resulted from order that was imposed on the chaos of neural signals. That order is a function of our own personal view of the world, our remote memories.
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MEANING OF DREAM
In 1983, Francis Crick and Mitchison proposed the idea of reverse learning. They postulated that a complex associational neural network such as the Neocortex might become overloaded by vast amount of incoming information. Consequently, the Neocortex could then develop false or parasitic thoughts that would jeopardize the true and orderly storage of memory. REM sleep served to erase these spurious associations on a regular basis. Random brain stem waves impinged on the Neocortex resulting in erasure or unlearning of the false information. The process therefore allowed the orderly processing of memory. We dream to forget Crick and Mitchison wrote
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MEANING OF DREAM
However, they proposed a revision in 1986. Erasure of parasitic thoughts accounted only for bizarre dream content. Nothing could be said about dream narrative. There is evidence linking REM sleep with theta rhythm at the hippocampus. Theta rhythm encodes memories during REM sleep. Theta rhythm has been linked with encoding of long term memories. REM sleep provides a mechanism, allowing memory processing to occur off line. Each species of mammal could process the information most important for its survival.
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MEANING OF DREAM
In REM sleep, this information may be accessed again and integrated with past experience to provide an ongoing strategy for behaviour. Recently, Avi Karm et al at Weitzman Institute of Science Israel were able to show that memory processing occurs in humans during REM sleep. In their experiment, individuals learned to identify particular patters on a screen. The memory of this improved after a night with REM sleep. When subjects were deprived of REM sleep, memory consolidation did not occur.
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SLEEP ARCHITECTURE
Normal healthy young adults exhibit alternating cycles of NREM and REM sleep. A cycle of NREM followed by REM sleep is called asleep cycle. Sleep cycles typically last a mean of 90 to 110 minutes. Four to five cycles of NREM REM sleep are typical observed across the night of sleep? NREM sleep dominates the 1st third of a night of sleep and REM sleep the last third. REM sleep first occurs 70 to 90 minutes after sleep onset. The 1st REM sleep is usually short. The duration of REM lengthens across the night. NREM stage 3 (represented by 3 & 4) is usually confined to the first two cycles. Early morning sleep alternates between REM and NREM stage 2 sleep.
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Sleep architecture
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PATHOGENESIS OF SLEEP
Neural circuits governing sleep In 1949, Horace Magoun and Giusep Moruzi found that electrically stumulating a group of cholinergic neurons at the junction of the pons and midbrain causes a state of wakefulness and arousal. This region was named reticular activating system. The reticular activating neurons project to thalamocortical neurons and are characterized by high discharge in waking state. Noradrenergic neurons of locus coeruleus, serotonergic neurons of dorsal raphe and histamine containing neurons of tuberomamillary nucleus of hypothalamus promote wakefulness
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PATHOGENESIS OF SLEEP
Sleep induction A master switch in the brain that allows people to go to sleep was found by Clifford Saper in 1996. They found a cluster of cells in the Ventrolateral pre-optic area of the Hypothalamus (VLPO). Activation ofVPLO nucleus of hypothalamus contribute to onset of sleep. These cells appear to have connections to the bodys main arousal systems. When the Cluster is switched on, all brain cells involved in arousal and wakefulness turn off. When the cluster is switch off, brain cells involved in wakefulness turn on.
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PATHOGENESIS OF SLEEP
When activated the VLPO cells apparently send direct inhibitory messages to other nerve cells that contain neurotransmitters involved in wakefulness, such as histamine noradrenaline and serotonin thereby shuting down of the bodys arousal system. Histamine, for example is believed to be the primary chemical agent stimulating wakefulness, which is why antihistamines cause drowsiness. A healthy intact hypothalamus is critical for normal sleep. People who have trouble falling asleep may have a malfunction in the VLPO region of the hypothalamus Sleep promoting factors. These are Muramyl peptides, prostaglandins, interleukin 1, interferon alpha, tumor necrosis factors. Function of sleep state may be to optimized the process that counter infections
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PATHOGENESIS OF SLEEP
REM SLEEP Most Serotonergic neurons in the dorsal Raphe nucleus fire maximally during waking, decreases firing during non REM sleep and completely stop firing during REM sleep. Jouvet suggested that these neurons normally inhibit phasic REM events and that their silence during REM sleep indicates a termination of this inhibition. Another population of brain cells that may be involved in the induction or maintenance of REM sleep secretes acetylcholine. Hobson et al found that these cholinoceptive cells in the Gigantocelllular Tegmental field, fire rapidly in a phasic manner throughout REM sleep. The ponto-Geniculo-occipital (PGO) waves provide a useful marker for the beginning of REM sleep.
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CIRCADIAN RHYTHM
The timing of and need for sleep (and wakefulness) are governed by the shifting balance of two intrinsic regulatory process: The circadian rhythm of alertness and sleepiness; and the homeostatic drive for NREM sleep. The longer we are awake the greater our need for NREM Stage 3 sleep. The homoeostatic drive for NREM 3 sleep is particularly noticeable after 12 hours of prior wakefulness, typically peaking in the late evening for those who follow a day night schedule. If we entrained in the light/dark cycle, we tend to have decreased alertness between 2 a.m and 5 a.m with lesser dip in the midafternoon (2-5 pm), whereas in the early evening, we tend to be wide awake, finding it difficult to sleep.
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This greatly influence our desire or inability to sleep. It is easier to fall asleep as our circadian core body temperature is falling. We are more likely to awake from sleep on the rising limb of our core body temperature. In normal individual who awake during the day and sleep of night, the core body (CBT), typically begins to fall about 2 hours before the usual bed time and continues to fall, reaching its through at about 4.30am. Beginning about 6 am-6.30 a.m, the CBT begins to rise, and rise across the day dealing between noon and 1 p.m. Trying to fall asleep when the CBT is rising is a challenge.
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Sleep needs
Sleep needs of individuals vary from 4 to 11 hours per day. The proper amount of sleep is that which permits us to be awake, alert and energetic throughout the day. The number of hours a person needs to sleep depends on the persons somnotype. More recently, we have begun to understand that genetic and individual traits significantly influence who among us can better tolerate insufficient sleep, irregular sleep-wake cycles, and sleep deprivation. Brief sleepers spend proportionately less time than others in state 1 and 2 and more time in stage 3 and 4.
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Sleep needs
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Sleep needs are genetically determined: one cannot learn to sleep less. Human do not adapt to getting less sleep. Self reports of sleepiness are unreliable. Caffeine can help combat sleepiness. Effects occur with 5 to 30 minutes with a half life of 3 to 7 hours. Beneficial effects of caffeine during sleep loss are roughly equivalent to 3-4 hours prophylactic nap.
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