SLEEP

Muhammad Haider Maqsood

Osman Khan
Raja Fahad Asghar
Danyaal Raza
INTRODUCTIO
N
 Sleep is a behavioral and neurobiological state which is
characterized by a change in the state of
consciousness and bodily as well as neurological
behavior.


 Sleep is divided into REM (Rapid Eye Movement) sleep

and NREM (Non-Rapid Eye Movement) sleep.


 The different characteristics of the neurobiological states

in humans are distinguished by:
Environmental Responsiveness.
General Physiology.
EEG waveforms (of muscle and eye movement).
Muscle tones.
Mental activity.

 PRINCIPAL
CHARACTERISTICS OF REM
SLEEP AND NON-REM SLEEP
REM SLEEP SLOW - WAVE / NREM SLEEP
EEG De-synchrony (irregular, rapid EEG Synchrony (slow waves)
waves)
Lack of Muscle Tones Moderate Muscle Tones
Rapid Eye Movement Slow or Absent Eye Movement
Genital Activity Lack of Genital Activity
Dreams (Lucid) -
 PHYSIOLOGICAL
MECHANISM OF SLEEP
 The natural cycle of sleep and wakefulness is regulated
by the nervous system.

 The hypothalamus secretes various hormones which
influence the sleep and wake state of mind.
Suprachiasmatic nucleus is a structure in the
hypothalamus which is specifically involved in the
regulation of circadian rhythms.


 Benington, Kodali and Heller (1995) suggested that a

nucleoside neurotransmitter, adenosine, could be
one of the primary controlling agents of sleep. The
increase of adenosine increases the amount of delta
activity during sleep.
FUNCTIONS
OF SLEEP
 The primary function of NREM sleep is to provide the
brain with rest while REM sleep supports brain
development and learning.


 FUNCTIONS OF REM SLEEP

Development of brain
Memories
Learning


 FUNCTIONS OF SLOW WAVE SLEEP

Effects of Sleep Deprivation
Effects of Mental Activity on Sleep
Effects of Exercise on Sleep

STAGES OF
SLEEP
 Sleep stages are measured by gross brain waves,
muscle tones and eye movement.


 The sleep cycle begins with stages of slow brain wave

sleep called Non-REM sleep. While the other state
of sleep called REM sleep.


 The time distribution of sleep of a normal adult:

 NREM (75%)
 Stage 1 – 5%
 Stage 2 – 45%
 Stage 3 – 12%
 Stage 4 – 13%
 REM (25%)

 STAGES OF NON-REM
SLEEP
 STAGE 1: This is the initial stage of sleep in
which the sleeper “drifts off” and enters a
period which could be called the “twilight
time”. The brain waves become slower,
smaller and somewhat irregular. The sleeper
could be easily awakened and deny having
slept. The characteristics are:
 Breathing becomes slow and even.
 The heartbeat becomes regular.
 Blood pressure falls.
 Brain temperature decreases.
 Blood flow to the brain is reduced.
 Little or no body movement. (Anonymous, 2007)

 STAGE 2: This is the intermediate stage of sleep
and lasts about 20 minutes in most sleepers.
The sleeper falls deeper into sleep, gradually
becomes less aware of the external
environment and progressively becomes
harder to awaken. The characteristics of stage
2 are:
Larger brain waves and occasional quick bursts of
activity.
The sleeper will not see anything even if the eyes
are opened.
Bodily functions slow down.
Blood pressure, metabolism, secretions, and
cardiac activity decrease. (Anonymous, 2007)

 STAGE 3: This stage of sleep lasts up to 30
to 45 minutes after falling asleep. It is the
beginning of deep sleep. It is characterized
by slow brain waves (at the rate of 0.5 to 4
per second). The brain waves also become
quite large, at least five times the size of
waves in Stage 2. These brain waves are
known as delta waves.

 STAGE 4: Deepest sleep takes place in this
stage. Stage 4 is characterized by:
The brain waves (called delta brain waves) are
quite large.
The sleeper experiences virtual oblivion. If the
sleeper is a sleepwalker or a bed-wetter,
those activities will begin in this phase
Bodily functions continue to decline to the
deepest possible state of physical rest.

 REM SLEEP
 During the REM stage of sleep, brain activity
becomes more active while the body is paralyzed
of any voluntary muscle movement. Non-REM is a
progressive state of relaxation but during REM
sleep body functions perk up constantly. Some
main characteristics of REM sleep are as follows:
 Brain waves are small and irregular, with big bursts of
eye activity.
 Pulse rates increase in an irregular way.
 Breathing becomes irregular and oxygen consumption
increases.
 The face, toes and fingers may twitch.
 The sleepers' large muscles are literally paralyzed.
 The body seems to have abandoned its effort to
regulate its temperature during the REM phase.
 EEG PATTERNS AND
NEUROBIOLOGICAL

STATES
EEG patterns of brain activity differentiate the neurobiological
states of human based on the following brain activities:
 Alpha activity: Regular, medium frequency waves of 8-12 Hz.
 Beta activity: Irregular, low-amplitude waves of 13-30 Hz.
 Theta activity: High-amplitude waves of 3.5-7.5 Hz.
 Delta activity: Regular, Synchronous waves of less than 4 Hz.

 Wakefulness: desynchronized beta activity.
 Relaxation and drowsiness: alpha activity.
 Stage 1 sleep: periods of alpha activity, irregular fast activity and
theta activity.
 Stage 2 sleep: sleep spindles and k complexes and lacks alpha
activity.
 Stage 3 sleep: 20-50% delta activity
 Stage 4 sleep: more than 50% delta activity.
 REM sleep has desynchronized, rapid and irregular waves.

 SLEEP
DISORDERS
 DISORDERS OF
SLEEP
 According to the Diagnostic and Statistical
Manual of Mental Disorders 4th Edition
Test Revised, the sleep disorders are
organized into four major categories:
Primary Sleep Disorders
Sleep Disorders Related to Another Mental
Disorder
Sleep Disorder Due to a General Medical
Condition
Substance-Induced Sleep Disorder

 PRIMARY SLEEP
DISORDERS
 Primary Sleep Disorders are those
disorders whose etiologies (causes)
are unknown and also doesn’t fall into
the other three categories of Sleep
Disorders.
 Primary Sleep Disorders can be broadly
characterized into two categories
namely
Dysomnias
Parasomnias

 DYSOMINAS: Dysomnias are characterized by
abnormalities in the amount, quality or timing of
sleep.


 Under Dysomnias the sleep disorder that fall into it

according to DSM-IV-TR are as follows:
 Primary Insomnia
 Primary Hypersomnia
 Narcolepsy
 Breathing-Related Sleep Disorder
 Circadian Rhythm Sleep Disorder (formerly known as
Sleep-Wake Schedule Disorder)
○ Delayed Sleep Phase
○ Jet Lag type
○ Shift work Type
 Dysomnias Not Otherwise Specified.
 PARASOMNIAS: Parasomnias are
characterized by abnormal behavior or
physiological events occurring in association
with sleep, specific stage of sleep stages or
sleep-wake transitions.


 Under Parasomnias the sleep disorder that fall

into it according to DSM-IV-TR are as follows:
Nightmare Disorder (formerly Dream Anxiety
Disorder
Sleep Terror Disorder
Sleepwalking Disorder
Parasomnias Not Otherwise Specified

 SLEEP DISORDERS RELATED
TO ANOTHER MENTAL
DISORDER
 Sleep Disorders Related to Another Mental
Disorder involves a prominent complaint of
sleep disturbance that result from
diagnosable mental disorder, most
commonly Mood Disorder and Anxiety
Disorder, but that is sufficiently severe to
warrant an independent clinical attention.


 According to DSM-IV-TR the disorders that

further fall under this category are as follow:
 Insomnia Related to Another Mental Disorder
 Hypersomnia Related to Another Mental
Disorder

 SLEEP DISORDER DUE TO A
GENERAL MEDICAL
CONDITION
 Sleep Disorder Due to a General Medical
Condition involves a prominent complaint of
sleep disturbance that result from the direct
physiological effects of a general medical
condition on the sleep-wake system.


 According to DSM-IV-TR the subtypes are as

follow:
 Insomnia type
 Hypersomnia type
 Parasomnia type
 Mixed type

 SUBSTANCE-INDUCED
SLEEP DISORDER
 Substance-Induced Sleep Disorder involves
prominent complaints of sleep disturbance that
result from the concurrent use, or recent
discontinuation of use, of substance which would
also include medication.According to DSM-IV-TR
the subtypes are as follow:
 Insomnia type
 Hypersomnia type
 Parasomnia type
 Mixed type


 Specifiers:
 With Onset During Intoxication
 With Onset During Withdrawal

CAUSES AND
TREATMENTS
 CAUSES AND
TREATMENTS OF SLEEP
 CAUSES:
DISORDERS
 Illness
 Medication
 Caffaine
 Stress
 Anxiety
 Depression
 Lack of activity
 Poor sleep habits


 TREATMENTS:
 Sleeping Pills
 Alcohol
 Intervention and Explanation
 Relaxation Training and Exercise
 Cognitive-Behavioural Treatment
 REFERENCES
Davidson, G.C., Neale, J.M., & Kring, A.M. (2002). Abnormal psychology. (9th ed). USA: Wiley & Sons.


Carlson, N.R. (2005). Foundations of physiological psychology. (6th ed.). India: Dorling Kindersley.


American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR.


Washington, DC: American Psychiatric Association.



Buysse, D.J. (2005). Sleep disorder and psychiatry. USA: American Psychiatric Publication.



Sadock, V.A., & Kaplan H.I. (2008). Kaplan & Sadock's concise textbook of clinical psychiatry. (3rd ed.). UK:


Lippincott Williams & Wilkins.



Anonymous. (2007). Sleep. Retrieved March 14, 2009 from

 http://www.holisticonline.com/Remedies/Sleep/sleep_stages-REM.htm


Anonymous. (2007). Sleep. Retrieved March 14, 2009 from



http://www.holisticonline.com/Remedies/Sleep/sleep_stages-1-4NREM.htm
