DEFINITION: Unconsciousness from which the person can be aroused by sensory or Other stimuli.

(Coma- unconsciousness from which person cant be aroused)

LEVELS AND TYPES: Levels: from very light to very deep sleep Types: 2 types 1) NREM (slow wave sleep)- Brain waves very strong and very low Frequency. 2) REM because eyes undergo rapid movements despite the fact that Person is still asleep. Each night alternate NREM and REM sleep NREM- occur in 1hr of sleep after long waking hours - deep restful sleep REM - 25% of sleep period, occur every 90 minutes - not restful and associated with vivid dreaming TOTAL - 4 to 5 cycles occur each night.

SLOW WAVE SLEEP (NREM): - Deep restful sleep - decrease in blood pressure by 10-30% - decrease in respiratory rate and basal metabolic rate - though called dreamless dreams(even nightmare) do occur. But dreams not registered so not remembered and no bodily movements occur in it. (opposite of REM) REM (PARADOXICAL SLEEP, DESYNCHRONIZED SLEEP): normal sleep- bouts of REM sleep of 5 to 30 mins after every 90 mins. Extremely sleepy- REM sleep short or even absent Rested person (gradually increasing hours of sleep)- more duration of REM bouts. CHARACTERISTICS:

EEG- Pattern of wakefulness. Paradoxical as person still asleep despite marked activity Of brain. Brain activity is not channeled in one direction-> so person not aware of his/her surroundings and thus he is truly asleep. Basic theories of Sleep:

1) Earlier theory-> reticular activating system(RAS) -> gets fatigue and thus sl induced called Passive theory of Sleep.

2) Neuronal centers, Neurohumoral substance, Mechanism that can cause s A possible specific role for serotonin. Stimulation of specific areas of brain produce condition similar to sleep. These areas are: i) Raphe nuclei -> lower half of Pons and medulla. Sheets of neurons in midlin Local network in reticular formation. wide spread network -> hypothalamus, thalamus, limbic system, neocortex & even spinal neurons(in posterior horn (inhibiting sensory stimulation, even pain).

Its neurons secrete serotonin. When drugs inhibit serotonin given > person cant sleep for several days. Thus serotonin is compound to induce sleep.(IN GUYTON) ii) Stimulation of nucleus tractus solitarius: iii) Stimulation of Rostral part of hypothalamus(suprachiasmal area) & some parts of thalamus. Stimulation of: 1) anterior hypothalamus-> induce sleep (release GABA) 2) Posterior hypothalamus-> arousal response (release histamine)

3)

Lesions of sleep promoting areas cause intense wakefulness:

Damage to raphe nuclei or damage to rostral medial area (suprachiasmal) of hypothalamus can cause intense wakefulness because inhibition pathways to reticular nuclei of mesencephalon region is lost which cause intense wakefulness & person may die of exhaustion.

Brain Circuits for sleep

(4) Potential Sleep Promoting Factors

Many also have immune functions

Muramyl peptides Nonapeptide Lipopolysaccharides Prostaglandin D2 Interleukin I Interferon alpha2 Tumor necrosis factor Delta sleep-inducing peptide Vasoactive intestinal peptide Serotonin/melatonin Prolactin

5) Recruitment response: Low frequency stimulation of Thalamus(20Hz)-> induces sleep. High frequency stimulation of Thalamus(200Hz)-> induces arousal response.
6) Habituation: One sensory stimulus given-> initially it arouses by activating RAS-> but Gradually habituation occurs-> and it no more stimulates RAS-> rather it induces Sleep by active inhibition of RAS. 7) Possible cause of REM sleep: Ach secreting neurons REM PGO spikes (ponto geniculo-occipital): Cholinergic neurons discharging In pons & pass rapidly to lateral geniculate body & from there to occipital cortex.

Parts of brain activated in REM sleep: Activation: Pontine area, amygdala, anterio Cingulate gyrus, visual association areas. Inhibition: prefrontal & parietal cortex, Primary visual cortex. So increase emotions & brain activity cut off from external World.

8) Cycle between Sleep & Wakefulness:

Wakefulness-> When sleep centers are not active reticular formation area is Released from inhibition. So send excitatory signals to cortex & Peripheral nervous System. These in turn stimulates RAS by positive feedback mechanism. So once Awake-> there is natural tendency to remain awake. Sleep-> later the neurons of RAS gets fatigue & sleep centers than take over -> Also positive feedback mechanism stops -> this leads to rapid transition from Wakefulness to sleep. In insomnia -> because persons mind is preoccupied with a thought & Wakefulness that is produced by bodily physical activity. MELATONIN SECRETION:

In dark-> no light on retina-> signals through retinohypothalamic Tract to SCN of hypothalamus -> from SCN through preganglionic sympathetic Neurons to superior cervical ganglion -> from SCG to pineal gland through Postganglionic sympathetic neurons -> release nor epinephrine in pineal gland ->Increase cAMP formation -> increa synthesis of melatonin -> melatonin released In blood -> rapidly metabolized in liver into 6-hydroxy conjugates & 6-sulfatoxy Melatonin. Opposite occur during daytime.

SCN Control of Circadian Rhythm

PHYSIOLOGICAL EFFECTS OF SLEEP:

1) CNS: Prolonged wakefulness-> decrease thought processing & abnormal Behaviora activities. (irritable or even psychotic) So sleep restores natural balances Among the neuronal centers. 2) CVS: Heart rate, Cardiac output, Vasomotor tone, Blood pressure -> Decreases 3) RS: Tidal volume, Respiratory rate, Pulmonary ventilation -> decreases 4) BMR: decrease by 10-15% 5) Urine: volume decrease & specific gravity increase (more concentrated) 6) Secretion: Salivary & lacrimal decreases, sweat increase, gastric-no change or increases. 7) Muscles: completely relax & minimum tone. 8) Eyes: Roll up & out (flaccidity of external ocular muscle). Pupil constrict. 9) Blood Volume: increases (dilution of plasma) 10) Endocrine: GHRH secretion highest during midnight. Promotes NREM sleep. CRH secretion minimum during midnight. Inhibits NREM sleep. So in elderly NREM sleep less due to less GHRH secretion.

BRAIN WAVES:

DEFINITION: Recording of electrical activity of brain by placing electrodes on scalp o even outer surface of brain is called EEG (electro encephalo gram). Brain waves may be having intensities from 0 to 200 v & frequency from 1 in few Seconds to 50 or more per second. Type of waves depend on: i) Activity in various parts of brain ii) Intensity of activity iii) State of wakefulness or sleep or coma normal healthy person -> ,,, waves. Alpha waves -> frequency- 8 to 13 /sec intensity -> 50 v state -> awake person with quite cerebration & closed eyes. area -> occipital (sometimes- parietal, frontal) disappear in deep sleep.

Beta waves ->

frequency 14 to 18 /sec intensity -> low state -> when directed towards one thought (i.e. active brain) or opening eyes-> disappearance of alpha waves (alpha block) area -> parietal, frontal regions

Theta waves -> frequency 4 to 7 /sec state -> in children, in adults during frustration & disappointments, brain degenerative diseases. areas -> parietal, temporal region.

Delta waves -> frequency < 3.5/sec intensity -> highest states -> infancy, very deep sleep, organic brain diseases, sub cortica transactions. Gamma oscillations> frequency 30 to 80 /sec state- aroused & focused attention on something highest level of brain activity.

ORIGIN OF BRAIN WAVES:

To record a brain wave -> millions/thousands of neurons should discharge in Synchrony. Intensity depends on 1) no. of neurons discharged 2) degree of synchronization If large no. of neurons fired in non synchronized way then very small waves produced Because they nullify each others effect because of opposing polarities. (e.g.. Eyes Closed , eyes opened ) Origin of waves -> it requires intact thalamo cortical system. Oscillation of signal Between thalamus & cortex leads to generation of waves & synchronous activation Of millions of cortical neurons. Origin of waves -> solely from cortex only. So even if thalamo cortical connection Lost waves may not be produced but waves will be produced. Thus, waves indicates Synchronous discharge at cortical level which has now no input signals from thalamus

EFFECTS OF VARYING LEVELS OF BRAIN ACTIVITY ON FREQUENCY:

Brain activity (unlike intensity which depends on synchronization also) So waves -> decrease brain activity waves -> highest brain activity Frequency

CHANGES IN EEG WITH TRANSITION FROM WAKEFULNESS TO SLEEP:

1) WAKEFULLNESS waves ( open eyes + thought processing) 2) WAKEFULLNESS waves (closed eyes + restful mind) 3) SLOW WAVE SLEEP (NREM): It has 4 stages. 1) 1st stage: frequency decreases gradually 2) 2nd stage: sleep spindles (k- complex) i.e. burst of waves occurs. Theta waves 3) 3rd stage: beginning of waves interspersed with sleep spindles. 4) 4th stage: only waves occur. 4) RAPID EYE MOVEMENT SLEEP (REM): - EEG very very similar to that of wakeful person - So difficult to determine state of mind from EEG. - Desynchronized brain neuronal discharge -> responsible for high frequency & low voltage EEG. So called Desynchronized sleep.

SLEEP DISORDERS:
1) NARCOLEPSY
Brains inability to regulate sleep-wake cycle. CHARACTERISTICS: - Sudden loss of voluntary muscle tone (cataplexy) - irresistible urge to sleep during day time - brief episodes of total paralysis at beginning or end of sleep - sleep begin with REM (normally NREM)

More common in Japan. Familial incidence associated with class II MHC on chromosome 6 at HLA-DR2/HLA-DQW1) Pathogenesis: Have fewer hypo cretin (orexins) producing neurons in hypothalamus. It is due to mutation in HLA complex which leads to attack on such neurons.

2) Obstructive sleep apnea syndrome- Daytime sleepiness due to fragmented sleep at night. - Breathing ceases for >10 sec due to upper airway obstruction (pharynx) due to Loss of muscle tone -> apnea occurs -> person gets wakened -> muscle tone establish-> breathing starts. - Patient complain of snoring.

PATHOPHYSIOLOGY-> decrease in neuromuscular tone at onset of sleep & chang Central respiratory drive.

3) Periodic limb movement disorders (PLMD) : Stereotypical rhythmical extension of big toe & dorsiflexion of ankle & Knee during sleep lasting for about 0-5 to 10s & recur at 20-90s interval. Movement Range from shallow, continual movement of ankle / toes to wild & strenuous kicking & flailing of the legs & arms. PLMD similar to restless leg syndrome where person has irresistible urge To move his legs while at rest all day long.

4) Sleep walking (Somnambulism)

- more common in male children - walk with eyes open & avoid obstacles. - when waked up cant recall the episode.

5) Bed wetting (nocturnal enuresis)

6) Night terrors ( parasomnias)

7) Sleep talking (Somniloque) 8) Insomnia

DREAMS

DREAMS AND MEMORY

WHY DO WE NEED DREAM?

Here are some of the more popular science theories on dreaming: 1. 2. 3. 4. 5. 6. 7. 8. To restore our body and mind. To help with learning and memory. To keep the brain at the right level of awareness/rest during sleep. To allow the mind to handle disturbances in the night without waking up. To keep our sense of self and wholeness through sleep. To allow ourselves some time to explore new and unusual areas of ourselves. To resolve conflicts that occur during the day. To contextualize emotions from waking.

The Biology of Dreaming

David Maurice, Ph.D. (1998), suggests that humans

experience REM sleep to supply oxygen to the cornea of the eye. The aqueous humor, the clear watery liquid in the chamber just behind the cornea, needs to be stirred to bring oxygen to the cornea. Without REM, our corneas would starve and suffocate while we are asleep with our eyes closed. Crick and Mitchison (1983) believe that the brains neural memory systems are easily overloaded and that REM eliminates cognitive debris. Dreams are a mechanism for the nervous system to clear the brain of unnecessary, even harmful memories. Remembered dreams are nothing more than an accidental by-product of this REM function.

The Freudian View

The dream represents an ongoing wish, along with the previous days activities. The dream may portray wishes that have been with us since early childhood. Every dream is partially motivated by a childhood wish. Dreams are derived from instinctual needs and personal experiences. Dreams occur in a state of ego collapse when the demands of the ID and Superego converge upon the EGO. If we have been too reliant on defense mechanisms in our waking life, the internal conflict continues to build and causes a dream to take place. The dream prevents us from building up intolerable states of psychological tension in waking life.

A Connection between the Physiological and the Psychoanalytic

Allen Braun, M.D. has discovered that regions of the brain which control emotion and motivation are highly active during REM sleep.

Regions of the brain central to self-discipline, delay of gratification, and impulse control, are relatively inactive. Thus, the prefrontal cortex is unable to carry out its waking task of censoring material.
Is it possible the person who is the most inhibited when awake would have the least active pre-frontal cortex when asleep? This would fit the model of psychoanalysis, which suggests that if you repress during the day, the material will most likely come oozing out during dreams.

Dream Symbolism
According to Jung, universal symbols are those

rooted to the experience of all humankind and are, therefore, common to everyone.
Jung considered the archetypes of the collective

unconscious to be universal symbols.

Common Universal Symbols

House: the self
Weather: what one is going through in life

Water: the emotions, the unconscious, the source of all

life. Type of water and movement of water give clues about what is happening in the feelings and the unconscious.
Time of day: the time of ones life or ones state of being.

(Dawn: youth, optimism; dusk: withdrawal, approaching death)

Dream Symbols Continued

People known to you: a particular quality of yourself
Strangers: qualities of yourself that you do not own

Animals: compulsive or habitual ways of thinking and

acting.
Death: change Black horse: refusal to exercise free will Vehicles: information about your physical body

Dream Symbol Dictionaries Are Useless

Even universal meaning and generalized definitions are of minimal value in relation to selfunderstanding and personal growth. Only through discovering ones own translations of symbols and images can the individual effect change or insight. Symbols change meaning according to the context in which they appear and the personal experiences of the dreamer

Dream Interpretation
What were you doing in the dream? What are the major contrasts and similarities in the dream and how do they relate? What are the major symbols and relationships between these symbols? What are the issues, conflicts, and unresolved situations in the dream? What relationship does this dream or the symbols

in the dream, have to do with any other dream?

REFERENCE: 1) 2) 3) 4) 5) 6) 7) 8) A.C. GUYTONS TEXT BOOK OF PHYSIOLOGY GANONGS REVIEW OF PHYSIOLOGY A.K. JAIN TEXT BOOK OF PHYSIOLOGY STARLING AND LOVATT EVANS PRINCIPLES OF HUMAN PHYSIOLOGY COLOR ATLAS OF PHYSIOLOGY WWW.AUTHORSTREAMS.COM WWW.EMEDICINE.COM OTHER INTERNET WEBSITES