For example, a person may work from 7:00 a.m. to 3:00 p.m. on Monday, 3:00 a.m. to 11:00 a.m. on Tuesday, and 11:00 a.m. to 7:00 p.m. on Wednesday. While sleep apnea is less common in thin people, anyone, regardless of their weight, who snores loudly or gasps for air while sleeping, should be checked for sleep apnea. Night terrors apparently occur during the NREM phase of sleep (Provini, Tinuper, Bisulli, & Lagaresi, 2011). Some research suggests that species that face higher predatory risks sleep fewer hours than other species (Capellini et al., 2008), while other researchers suggest there is no relationship between the amount of time a given species spends in deep sleep and its predation risk (Lesku, Roth, Amlaner, & Lima, 2006). Physical dependenceinvolves changes in normal bodily functionsthe user will experience withdrawal from the drug upon cessation of use. Recommendations like these have helped to decrease the number of infant deaths from SIDS in recent years (Mitchell, 2009; Task Force on Sudden Infant Death Syndrome, 2011). Some animals never sleep (e.g., some fish and amphibian species); other animals sleep very little without apparent negative consequences (e.g., giraffes); yet some animals (e.g., rats) die after two weeks of sleep deprivation (Siegel, 2008). Awareness of external stimuli includes experiences such as seeing the light from the sun, feeling the warmth of a room, and hearing the voice of a friend. It is typically consumed in pill form. Just as bears hibernate in the winter when resources are scarce, perhaps people sleep at night to reduce their energy expenditures. While medical marijuana laws have been passed on a state-by-state basis, federal laws still classify this as an illicit substance, making conducting research on the potentially beneficial medicinal uses of marijuana problematic. Many of these drugs, and their relationships, are shown inTable 4.2. Among a variety of neurobiological evidence, John Hobson cites research on lucid dreams as an opportunity to better understand dreaming in general. Feeling tired. The participant is told to be open to the process of hypnosis, trust the hypnotist and let go. Loss of appetite. In addition to withdrawal, many individuals who are diagnosed with substance use disorders will also develop tolerance to these substances. There is quite a bit of controversy within the scientific community as to the extent to which marijuana might have medicinal benefits due to a lack of large-scale, controlled research (Bostwick, 2012). Understanding the impact of sleep on cognitive function should help you understand that cramming all night for a test may be not effective and can even prove counterproductive. Research indicates that included among these possible benefits are increased capacities for creative thinking (Cai, Mednick, Harrison, Kanady, & Mednick, 2009; Wagner, Gais, Haider, Verleger, & Born, 2004), language learning (Fenn, Nusbaum, & Margoliash, 2003; Gmez, Bootzin, & Nadel, 2006), and inferential judgments (Ellenbogen, Hu, Payne, Titone, & Walker, 2007). Insomnia, a consistent difficulty in falling or staying asleep, is the most common of the sleep disorders. As scary as it sounds, many sleep researchers believe that homicidal sleepwalking is possible in individuals suffering from the types of sleep disorders described below (Broughton et al., 1994; Cartwright, 2004; Mahowald, Schenck, & Cramer Bornemann, 2005; Pressman, 2007). Theta wavesare even lower frequency (47 Hz), higher amplitude brain waves than alpha waves. Our sleep-wake cycle, which is linked to our environments natural light-dark cycle, is perhaps the most obvious example of a circadian rhythm, but we also have daily fluctuations in heart rate, blood pressure, blood sugar, and body temperature. We experience different states of consciousness and different levels of awareness on a regular basis. Heroin users often shoot the drug directly into their veins. This disorder is associated with a number of neurodegenerative diseases such as Parkinsons disease. In her case, the fact that her cataplexy was confined to the right side of her body was quite unusual. To prevent withdrawal, many people turned to cheaper heroin, which could be bought for $5 a dose or less. Stage 2 sleep is characterized by the appearance of both sleep spindles and K-complexes. Restless leg syndrome is quite common and has been associated with a number of other medical diagnoses, such as chronic kidney disease and diabetes (Mahowald & Schenck, 2000). Sleep-wake cycles seem to be controlled by multiple brain areas acting in conjunction with one another. People who suffer from insomnia might limit their use of stimulant drugs (such as caffeine) or increase their amount of physical exercise during the day. a - a mole that looks cancerous. Heroin produces intense feelings of euphoria and pleasure, which are amplified when the heroin is injected intravenously. Historically, somnambulism has been treated with a variety of pharmacotherapies ranging from benzodiazepines to antidepressants. A person who has a substance use disorder often uses more of the substance than they originally intended to and continues to use that substance despite experiencing significant adverse consequences. This is illustrated by McCartys (2010) case study of a 50-year-old woman who sought help for the excessive sleepiness during normal waking hours that she had experienced for several years. Thirst. One of the most common treatments for sleep apnea involves the use of a special device during sleep. A number of risk factors have been associated with SIDS including premature birth, smoking within the home, and hyperthermia. These kinds of schedules are common for individuals working in health care professions and service industries, and they are associated with persistent feelings of exhaustion and agitation that can make someone more prone to making mistakes on the job (Gold et al., 1992; Presser, 1995). It is administered alone or in conjunction with doses of melatonin (the hormone secreted by the pineal gland). Manifest contentis the actual content, or storyline, of a dream. MDMA (3.4-methelynedioxy-methamphetamine, commonly known as ecstasy or Molly) is a mild stimulant with perception-altering effects. This is of such concern that people who are trying to overcome addiction to these substances should only do so under medical supervision. There are individual differences in regard to our sleep-wake cycle. Participants were told they would not feel pain, but they could press a button if they did; while they reported not feeling pain, they did, in fact, press the button, suggesting a dissociation of consciousness while in the hypnotic state (Hilgard & Hilgard, 1994). For example, around one third of individuals diagnosed with narcolepsy experience vivid, dream-like hallucinations during narcoleptic attacks (Chokroverty, 2010). There was a significant positive correlation between the degree to which women thought about their former spouses during waking hours and the number of times their former spouses appeared as characters in their dreams (Cartwright, Agargun, Kirkby, & Friedman, 2006). EVERYDAY CONNECTION: Solutions to Support Healthy Sleep, continuous positive airway pressure (CPAP). the ability to spend time, good time with them when youre not feeling absolutely exhausted . For instance, some people would say they are morning people, while others would consider themselves to be night owls. After dinner, he prepared some materials to use in leading a church youth group the following morning, and then he attempted to repair the familys swimming pool pump before retiring to bed. His children and his wifes parents all agreed that Falater had an excellent relationship with his wife and they couldnt think of a reason that would provide any sort of motive to murder her (Cartwright, 2004). As one of their mechanisms of action, cocaine and amphetamines block the reuptake of dopamine from the synapse into the presynaptic cell. However, alternative treatment options are being explored because consistent compliance by users of CPAP devices is a problem. At rather low doses, alcohol use is associated with feelings of euphoria. Has something like this ever happened to you? Sore throat. During periods of sleepwalking, sleepers often have their eyes open, but they are not responsive to attempts to communicate with them. Repeated use of these stimulants can have significant adverse consequences. Caffeine is another stimulant drug. Sleepis a state marked by relatively low levels of physical activity and reduced sensory awareness that is distinct from periods of rest that occur during wakefulness. Body temperature rises throughout the waking day, peaking in the afternoon, and falls during sleep with the lowest point occurring during the very early morning hours. Ahallucinogenis one of a class of drugs that results in profound alterations in sensory and perceptual experiences (Figure 4.18). Variations and adaptations in cognition and behavior make individuals more or less successful in reproducing and passing their genes to their offspring. When we are very young, we spend up to 16 hours a day sleeping. The term was first coined by a physiologist named Walter Cannon in 1926. In 2012, Kromann and Nielson reported on a case study of a 40-year-old woman who suffered significant ill effects from her use of caffeine. In other words, dreaming involves constructing a virtual reality in our heads that we might use to help us during wakefulness. For example, irritability, distractibility, and impairments in cognitive and moral judgment can occur with fewer than four hours of sleep. As mentioned earlier, lack of sleep can result in decreased mental alertness and cognitive function. While opioid withdrawal can be extremely unpleasant, it is not life-threatening (Julien, 2005). The researchers showed that these states correspond to distinct strategies, and then they identified . (b) Heroin is cooked on a spoon over a candle. The participant is encouraged to use his or her imagination. However, when a stimulant drug was used in conjunction with a popular antidepressant, her condition improved dramatically. Individuals who do rotating shift work are also likely to experience disruptions in circadian cycles. Asleep spindleis a rapid burst of higher frequency brain waves that may be important for learning and memory (Fogel & Smith, 2011; Poe, Walsh, & Bjorness, 2010). Humans have an endogenous opioid neurotransmitter systemthe body makes small quantities of opioid compounds that bind to opioid receptors reducing pain and producing euphoria. Stick to a sleep schedule, even on the weekends. Some can cause heightened sensitivity to physical stimuli. The pineal and pituitary glands secrete a number of hormones during sleep. Again, this is an intuitive and appealing explanation for why we sleep. During this time, an individuals heart rate and respiration slow dramatically. More specifically, homeostasis is the body's tendency to monitor and maintain internal states, such as temperature and blood sugar, at fairly constant and stable levels. While "internal state" or impulsivity are terms more generally discussed in psychology or neuroscience, the concept is familiar to anyone. Research shows that the most severe effects of sleep deprivation occur when a person stays awake for more than 24 hours (Killgore & Weber, 2014; Killgore et al., 2007), or following repeated nights with fewer than four hours in bed (Wickens, Hutchins, Lauk, Seebook, 2015). In recent years, methamphetamine (meth) use has become increasingly widespread. Whether lark, owl, or somewhere in between, there are situations in which a persons circadian clock gets out of synchrony with the external environment. One popular hypothesis of sleep incorporates the perspective of evolutionary psychology. The suprachiasmatic nucleus (SCN) serves as the brains clock mechanism. Primary signs and symptoms of Ebola often include some or several of the following: Fever. Keep your bedroom temperature between 60 and 67 degrees. Central sleep apnea is caused by a failure of the brain to activate the muscles of breathing during sleep. The brain waves associated with this stage of sleep are very similar to those observed when a person is awake, as shown inFigure 4.11, and this is the period of sleep in which dreaming occurs. Depletion of certain neurotransmitters can lead to mood dysphoria, cognitive problems, and other factors. The average EVD case fatality rate is around 50%. As you will learn when you study social roles, peoples behavior can be shaped by their expectations of how they should act in a given situation. Melatonin is thought to be involved in the regulation of various biological rhythms and the immune system (Hardeland et al., 2006). Avoid alcohol, cigarettes, caffeine, and heavy meals before bed. Marijuana may also have some promise in the treatment of a variety of medical conditions (Mather, Rauwendaal, Moxham-Hall, & Wodak, 2013; Robson, 2014; Schicho & Storr, 2014). Although she did not experience any dream-like hallucinations, she was diagnosed with narcolepsy as a result of sleep testing. We also alter our consciousness through the use of various psychoactive drugs. Confusion. While there are variations, there are four parts that appear consistent in bringing people into the state of suggestibility associated with hypnosis (National Research Council, 1994). While people are often unaware of their sleep apnea, they are keenly aware of some of the adverse consequences of insufficient sleep. An agonist facilitates the activity of a neurotransmitter system, and antagonists impede neurotransmitter activity. Historically, heroin has been a major opioid drug of abuse (Figure 4.17). For example, she and her colleagues published a study in which women going through divorce were asked several times over a five-month period to report the degree to which their former spouses were on their minds. This section will describe several sleep disorders as well as some of their treatment options. d. both b and c. 2. A neighbor called the police after witnessing Falater standing over his wifes body before dragging her into the pool. Caffeine is found in many common medicines (such as weight loss drugs), beverages, foods, and even cosmetics (Herman & Herman, 2013). Like many other stimulants, cocaine agonizes the dopamine neurotransmitter system by blocking the reuptake of dopamine in the neuronal synapse. These sleep episodes are often associated withcataplexy, which is a lack of muscle tone or muscle weakness, and in some cases involves complete paralysis of the voluntary muscles. Although individuals suffering from night terrors appear to be awake, they generally have no memories of the events that occurred, and attempts to console them are ineffective. This created a black market for the drug, where prices soared to $80 or more for a single pill. Stage 1 sleepis a transitional phase that occurs between wakefulness and sleep, the period during which we drift off to sleep. Rotating shift workrefers to a work schedule that changes from early to late on a daily or weekly basis. How does hypnosis work? Because GABA has a quieting effect on the brain, GABA agonists also have a quieting effect; these types of drugs are often prescribed to treat both anxiety and insomnia. Opioid addiction reached crisis levels in the United States such that by 2019, an average of 130 people diedeach dayof an opioid overdose (NIDA, 2019). Rather, the ISS r ecognizes mixed states and depressive symptoms during manic and hypomanic episodes. Lucid dreamsare dreams in which certain aspects of wakefulness are maintained during a dream state. 22. Comparative research indicates, however, that the relationship that exists between predatory risk and sleep is very complex and equivocal. Ethanol, which we commonly refer to as alcohol, is in a class of psychoactive drugs known as depressants (Figure 4.15). By the late 19th century, German psychiatrist SigmundFreudhad become convinced that dreams represented an opportunity to gain access to the unconscious. Awareness of external stimuli includes experiences such as seeing the light from the sun, feeling the warmth of a room, and hearing the voice of a friend. Beyond being awake or asleep, there are many other states of consciousness people experience. This is similar to the kind of paralysis experienced by healthy individuals during REM sleep (Burgess & Scammell, 2012; Hishikawa & Shimizu, 1995; Luppi et al., 2011). 23. Mindfulness meditation has recently become popular. Freud made distinctions between the manifest content and the latent content of dreams. A womans menstrual cycle is an example of a biological rhythma recurring, cyclical pattern of bodily changes. c. deaths due to accidents have increased. Many people experience disturbances in their sleep at some point in their lives. There is a tremendous amount of variability among sufferers, both in terms of how symptoms of narcolepsy manifest and the effectiveness of currently available treatment options. However, for some, its not because of all-night partying or late-night study sessions. Rapid eye movement (REM)sleep is characterized by darting movements of the eyes under closed eyelids. Weakness and fatigue. Generally, alcohol is associated with decreases in reaction time and visual acuity, lowered levels of alertness, and reduction in behavioral control. Treatment. Sleepwalking most often occurs during slow-wave sleep, but it can occur at any time during a sleep period in some affected individuals (Mahowald & Schenck, 2000). This figure illustrates some of the negative consequences of sleep deprivation. Drug use disorders are addictive disorders, and the criteria for specific substance (drug) use disorders are described in DSM-5. Often, however, people wishing to learn to meditate receive some training in techniques to achieve a meditative state. Acontinuous positive airway pressure (CPAP)device includes a mask that fits over the sleepers nose and mouth, which is connected to a pump that pumps air into the persons airways, forcing them to remain open, as shown inFigure 4.13. Meditative techniques have their roots in religious practices (Figure 4.21), but their use has grown in popularity among practitioners of alternative medicine. Thecollective unconscious, as described byJung, is a theoretical repository of information he believed to be shared by everyone. This causes blood vessels to dilate, and the skin may feel warm and flushed. These drugs share in common their ability to serve as agonists of the gamma-Aminobutyric acid (GABA) neurotransmitter system. Normal brain functioning is altered after repeated use of these drugs. One way that this happens involves traveling across multiple time zones. In fact, ameta-analysis, which is a study that combines the results of many related studies, conducted within the last decade indicates that by the time we are 65 years old, we average fewer than 7 hours of sleep per day (Ohayon, Carskadon, Guilleminault, & Vitiello, 2004). In addition, the appearance of K-complexes is often associated with stage 2 sleep. Access for free athttps://openstax.org/books/psychology-2e/pages/1-introduction. Amphetamines have a mechanism of action quite similar to cocaine in that they block the reuptake of dopamine in addition to stimulating its release (Figure 4.16). They can be helpful for people working night shifts or for people affected by seasonal variations in light. A) managed care The crisis actually began in the 1990s, when pharmaceutical companies began mass-marketing pain-relieving opioid drugs like OxyContin with the promise (now known to be false) that they were non-addictive. Site has information/education resources on a broad range of topics, including asthma, birth defects, radiation, sanitation, lead in blood, and more. Physiologically, the body can become addicted to opiate drugs in less than a week, including when taken as prescribed. Meditationis the act of focusing on a single target (such as the breath or a repeated sound) to increase awareness of the moment. describes our awareness of internal and external stimuli. These components include: These steps are conducive to being open to the heightened suggestibility of hypnosis. 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. This hypnogram illustrates how an individual moves through the various stages of sleep. Methamphetamineis a type of amphetamine that can be made from ingredients that are readily available (e.g., medications containing pseudoephedrine, a compound found in many over-the-counter cold and flu remedies). This final section will consider hypnotic and meditative states as additional examples of altered states of consciousness experienced by some individuals. This is an important factor because we can develop tolerance and experience withdrawal from any number of drugs that we do not abuse. Vaping uses battery-powered devices, sometimes called e-cigarettes, that deliver liquid nicotine and flavorings as a vapor. In addition, sleep deprivation often results in depression-like symptoms. The participant is made comfortable and is directed to be relaxed and sleepy. The tendency to maintain a stable, relatively constant internal environment is called homeostasis. Some people might turn to over-the-counter (OTC) or prescribed sleep medications to help them sleep, but this should be done sparingly because many sleep medications result in dependence and alter the nature of the sleep cycle, and they can increase insomnia over time. To keep heroin affordable, many dealers began adding more potent synthetic opioids including fentanyl and carfentanyl to increase the effects of heroin. Contrary to popular belief, individuals undergoing hypnosis usually have clear memories of the hypnotic experience and are in control of their own behaviors. Natural opioids, calledopiates, are derivatives of opium, which is a naturally occurring compound found in the poppy plant. Sleep is also associated with the secretion and regulation of a number of hormones from several endocrine glands including: melatonin, follicle stimulating hormone (FSH), luteinizing hormone (LH), and growth hormone (National Institutes of Health, n.d.). Cognitive-behavioral therapy has been demonstrated to be quite effective in treating insomnia (Savard, Simard, Ivers, & Morin, 2005; Williams, Roth, Vatthauer, & McCrae, 2013). Think meditation might help? For instance, the concentration of various ions in your blood must be kept steady, along with pH and the concentration of glucose. Recently, a new EPAP (expiratory positive air pressure) device has shown promise in double-blind trials as one such alternative (Berry, Kryger, & Massie, 2011). These initiatives include increasing access to treatment and recovery services, increasing access to overdose-reversal drugs like Naloxone, and implementing better public health monitoring systems (NIDA, 2019). Withdrawal from opioids includes pain, which patients often misinterpret as pain caused by the problem that led to the original prescription, and which motivates patients to continue using the drugs. These effects can occur as a function of accumulated sleep debt or in response to more acute periods of sleep deprivation. Codeineis an opioid with relatively low potency. Alertness is associated with higher body temperatures, and sleepiness with lower body temperatures. With excessive alcohol use, a person might experience a complete loss of consciousness and/or difficulty remembering events that occurred during a period of intoxication (McKim & Hancock, 2013). Wakefulnessis characterized by high levels of sensory awareness, thought, and behavior. Common definitions of health include: a. optimal weight and endurance. This shift in policy may be in response to the scientific communitys recommendations and/or reflect changing public opinion regarding marijuana. This chart illustrates the circadian change in body temperature over 28 hours in a group of eight young men. Diarrhea. Some people who have injected many times into their arms will show track marks, while other users will inject into areas between their fingers or between their toes, so as not to show obvious track marks and, like all abusers of intravenous drugs, have an increased risk for contraction of both tuberculosis and HIV. For example, the National Institutes of Drug Abuse has sponsored research that suggests the misuse and abuse of the prescription pain killers hydrocodone and oxycodone are significant public health concerns (Maxwell, 2006). Given the average life expectancy for U.S. citizens falls between 73 and 79 years old (Singh & Siahpush, 2006), we can expect to spend approximately 25 years of our lives sleeping. Devices like this are designed to provide exposure to bright light to help people maintain a regular circadian cycle. The effects of all psychoactive drugs occur through their interactions with our endogenous neurotransmitter systems. In addition, these drugs can cause feelings of anxiety, hallucinations, and paranoia (Fiorentini et al., 2011). In the variation of mindful meditation, the meditators attention is focused on some internal process or an external object (Zeidan, Grant, Brown, McHaffie, & Coghill, 2012). When he told me, I made him go see the college therapist. These drugs promote increased levels of neural activity. Brainwave activity changes dramatically across the different stages of sleep. For example, body temperature fluctuates cyclically over a 24-hour period (Figure 4.2). Medical marijuana is legal in over half of the United States and in the District of Columbia (Figure 4.19). These symptoms include fatigue, sluggishness, irritability, andinsomnia(i.e., a consistent difficulty in falling or staying asleep for at least three nights a week over a months time) (Roth, 2007). While it is probably the most commonly used drug in the world, the potency of this particular drug pales in comparison to the other stimulant drugs described in this section. Research indicates that meditation may help reduce blood pressure, and the American Heart Association suggests that meditation might be used in conjunction with more traditional treatments as a way to manage hypertension, although there is not sufficient data for a recommendation to be made (Brook et al., 2013). Sleep is not a uniform state of being. Sleep debt and sleep deprivation have significant negative psychological and physiological consequencesFigure 4.5. For example, withdrawal from sedative drugs often produces unpleasant arousal and agitation. AK-complexis a very high amplitude pattern of brain activity that may in some cases occur in response to environmental stimuli. The chapter will close with discussions of altered states of consciousness produced by psychoactive drugs, hypnosis, and meditation. Upon admission to an outpatient clinic for treatment of mood disorders, she met all of the diagnostic criteria for substance dependence and was advised to dramatically limit her caffeine intake. Fever. These synthetic drugs are so potent that even small doses can cause overdose and death. Medical marijuana is marijuana that is prescribed by a doctor for the treatment of a health condition. This discomfort is relieved by deliberately moving the legs, which, not surprisingly, contributes to difficulty in falling or staying asleep. 1. Narcolepsy is associated with reduced levels of the signaling molecule hypocretin in some areas of the brain (De la Herrn-Arita & Drucker-Coln, 2012; Han, 2012), and the traditional stimulant drugs do not have direct effects on this system. Clonazepam, an anti-anxiety medication with sedative properties, is most often used to treat RBD. There is a trend that females report more somatic symptoms than males; thus, more females are diagnosed with somatic symptom disorder than males (APA, 2022). High doses can induce sleep, cause motor disturbance, memory loss, decreased respiratory function, and death. 0. The brain waves associated with REM sleep, outlined in the red box in (a), look very similar to those seen (b) during wakefulness. The typical episode can last from a minute or two to half an hour. While cognitive deficits may be the most obvious, many body systems are negatively impacted by lack of sleep. In our discussion of the mental symptoms I reported as an illustration of the suggestive treatment of the drug passion the case of a morphinist. Here are some tips to maintain healthy sleep: Aparasomniais one of a group of sleep disorders in which unwanted, disruptive motor activity and/or experiences during sleep play a role. Once she was able to limit her use to less than 12 ounces of soda a day, both her mental and physical health gradually improved. If someone stays awake for 48 consecutive hours, they could start to hallucinate. Hypnosisis a state of extreme self-focus and attention in which minimal attention is given to external stimuli. These will soon, in all ordinary cases, subdue the most distressing symptoms, and effect a perfect cure in a day or two. Nicotine is highly addictive, and the use of tobacco products is associated with increased risks of heart disease, stroke, and a variety of cancers. While awake, we feel alert and aware of the many important things going on around us. Alan Hobson, a neuroscientist, is credited for developing activation-synthesis theory of dreaming. This often results in sleeping problems, and it can lead to signs of depression and anxiety. While we have discussed the negative outcomes associated with sleep deprivation, it should be pointed out that there are many benefits that are associated with adequate amounts of sleep. This is known as the REM rebound, and it suggests that REM sleep is also homeostatically regulated.
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