Understanding Insomnia and Sleep Stages

Questions and Answers

What categories for the causation of insomnia were discussed by Lichstein and Fischer in 1985?

Psychiatric (correct)

Psychological (correct)

Chemical (correct)

Medical-biological factors (correct)

Which other disorders might one find comorbid with an individual suffering from chronic insomnia?

Depression (correct)

Anxiety (correct)

What are some of the medical conditions believed to impair sleep?

Chronic respiratory disease (correct)

Sleep apnea (correct)

Restless legs syndrome (correct)

Which three substances are known to interfere with sleep and aggravate insomnia?

Alcohol Signup and view all the answers

'Jet Lag' and shift change are considered possible __ which cause insomnia in some people.

environmental conditions Signup and view all the answers

What are the following examples listed below examples of? Onset during childhood, some people with fibrositis syndrome, and still other individuals who with only a subjective element of unsatisfactory sleep?

chronic insomnia with uncertain etiology Signup and view all the answers

Before the advent of the EEG, what was the basic assumption of sleep?

The initial assumption of sleep was that it was a passive state. Signup and view all the answers

How was the expression of 'falling asleep' found to be erroneous after the advent of the EEG?

Data demonstrated that sleep was not a passive activity. Signup and view all the answers

Sleep is NOT synonymous with ____, and thinking does not stop sleep, even though there are changes in awareness and .

unconsciousness; recollection Signup and view all the answers

Dreams can be influenced by?

waking thoughts Signup and view all the answers

Why is sleep not considered to be a purely automatic and involuntary process?

Sleep can be improved by proper knowledge and good sleep habits. Signup and view all the answers

What is the sleep cycle normally composed of?

A series of changes in the level of sleep. Signup and view all the answers

What is the approximate duration of each level or stage of the sleep cycle?

90-minutes Signup and view all the answers

How many slow-wave sleep (SWS) stages are there in the sleep cycle?

Four Signup and view all the answers

Describe the characteristics of the first stage of slow-wave sleep (SWS).

Feelings of drowsiness, but still have awareness of surroundings. Signup and view all the answers

What are the characteristics of the second stage of slow-wave sleep?

EEG shows slowing of brain waves and beginning of the sense of being asleep. Signup and view all the answers

What are the characteristics of the third and fourth stages of slow-wave sleep?

Deeper stages with increased slowing of brain wave activity. Signup and view all the answers

Which stage(s) are important for a person to feel refreshed in the morning?

Third and fourth Signup and view all the answers

What is the stage of rapid eye movement (REM) also known as?

Paradoxical sleep Signup and view all the answers

Which stage of the sleep cycle is recognized by a marked change in the EEG pattern?

Rapid eye movement sleep Signup and view all the answers

During the rapid eye movement (REM) stage, there is a profound inhibition of except for rolling eye movements.

muscle tone Signup and view all the answers

During the rapid eye movement (REM) stage, there are marked fluctuations in _________ activity.

autonomic Signup and view all the answers

A majority of dreams an individual experiences during rapid eye movement or paradoxical sleep are __ and _.

complex; vivid Signup and view all the answers

What occurs after an individual, who is asleep, progresses through the slow-wave sleep stages?

Reversal of EEG rhythms and the first episode of rapid eye movement. Signup and view all the answers

How do cycles succeeding the initial stages of slow-wave sleep (SWS) and rapid eye movement (REM) differ?

Smaller proportions of stages 3 and 4, longer REM periods. Signup and view all the answers

What is the approximate overall percentage of rapid eye movement sleep an individual experiences during the sleep cycle?

25% Signup and view all the answers

What is the approximate percentage of rapid eye movement (REM) sleep an individual experiences during the first stage of slow-wave sleep (SWS)?

5% Signup and view all the answers

What is the approximate percentage of rapid eye movement (REM) sleep an individual experiences during the second stage of slow-wave sleep (SWS)?

50% Signup and view all the answers

What is the approximate percentage of non-rapid eye movement (non-REM) sleep an individual experiences during the sleep cycle?

20% Signup and view all the answers

Which factors can influence the delicate pattern of sleep that can all be improved by educated problem-solving?

Disturbances in circadian rhythm Signup and view all the answers

What is the singular most prominent factor that influences sleep efficiency?

Circadian rhythm Signup and view all the answers

What key functions of our circadian rhythms are at their lowest levels in the early morning before normal waking hours?

Psychomotor efficiency Signup and view all the answers

What are a few of the many hormones that noticeably fluctuate during the early morning?

Cortisol Signup and view all the answers

What are the major factors that accomplish the synchronization of the circadian rhythm?

Daytime exposure to light Signup and view all the answers

What is the average rate of time it takes to change the timing of one's circadian rhythm?

One day for every hour of change Signup and view all the answers

It is easier to adjust the timing of one's circadian rhythm by _ the biological day than to _ it.

lengthen; shorten Signup and view all the answers

It is easier for a worker to change from _ shift to __ shift, and then to _ shift, than it is to do the reverse.

day; afternoon; night Signup and view all the answers

Which direction of travel is easiest for a person to adjust to a new time zone?

West rather than east Signup and view all the answers

What time of the circadian cycle when an individual is most disposed to sleep are there the greatest problems in mood and mental efficiency if the person is awakened?

4:00 am Signup and view all the answers

What are the adverse conditions that can surface if the circadian rhythm is disturbed?

Development of chronic problems in mood and sleep efficiency Signup and view all the answers

What is one example of how some insomniacs develop irregular sleep times?

Their inability to get sleep causes them to stay up late. Signup and view all the answers

How might day napping effect an individual with insomnia?

Potential for the fragmentation of day and night patterns of sleep. Signup and view all the answers

Due to the fragmentation of their day and night sleep patterns, what might individuals with insomnia develop a chronic habit of?

Periodically getting up at night due to restlessness. Signup and view all the answers

What is a key to restoring a normal sleep pattern?

Keeping the sleeping environment dark Signup and view all the answers

What can an individual partake in daily and for how long to strengthen a good circadian rhythm?

Vigorous exercise for 20 to 60 minutes each day. Signup and view all the answers

What is a more subtle issue of using hypnotics to 'fix' sleep disturbance?

Serious disturbance of the normal pattern of sleep. Signup and view all the answers

Many sedatives also suppress __, rapid eye movement (REM) sleep, eventually leading to REM _.

dreaming; rebound Signup and view all the answers

Why does rapid eye movement (REM) rebound due to the prolonged use of sedatives cause a vicious cycle?

Individual takes more drugs, leading to more unsatisfactory sleep. Signup and view all the answers

What potential danger do barbiturates have?

Abuse and addiction. Signup and view all the answers

Which classification of drugs supplanted barbiturates to help sleep during the past 50 years?

Benzodiazepines. Signup and view all the answers

Benzodiazepines with a longer half-life have a tendency to produce progressive accumulation in the _, and congeners with a shorter half-life have a high propensity for ____.

serum; addiction Signup and view all the answers

What might be required if an individual begins to experience states of severe anxiety due to withdrawal of certain benzodiazepines?

Intensive psychiatric treatment. Signup and view all the answers

Although alcohol has some of the same problems as other sedatives when used as a sleep aid, which examples are unique to only the use of alcohol?

Wakening the individual in the middle of the night Signup and view all the answers

What do painkillers such as opiates have which can therefore cause sleep disturbance?

Short duration of action. Signup and view all the answers

What occurs in 5% of people taking nonsteroidal anti-inflammatory drugs often used to treat arthritis?

Significant nervous system effects. Signup and view all the answers

What might antidepressants sometimes be used to offset?

Symptoms that come from nonrestorative sleep. Signup and view all the answers

How might amitriptyline help fibrositis symptoms?

Increases stage 4 sleep. Signup and view all the answers

What are some downsides to using antidepressants as a sleep aid?

May cause nightmares and a hung-over feeling. Signup and view all the answers

Due to sleep being such a delicate mechanism, what are the lasting effects of relying long-term on the use of drugs to aid in sleeping?

Sedatives can seriously disturb sleep in the long term. Signup and view all the answers

What is the best drug I can use to make me sleep better or cure my insomnia?

Nothing. Signup and view all the answers

How can the brain benefit from exercising at least 20 to 60 minutes a day?

Better mental attitude and reduce anxiety. Signup and view all the answers

What will hasten the adaptation of an individual when traveling to a new time zone?

Exercising during the daytime can reduce jet lag. Signup and view all the answers

What are two common misconceptions regarding sleep?

That people stop thinking when they are asleep. Signup and view all the answers

What is sleep?

A state of ever-varying activity of neurological and physiological systems. Signup and view all the answers

When is the brain inactive?

Never. Signup and view all the answers

What is the term used to describe the filtering of thoughts by the brain with the preservation of sleep?

Dreaming Signup and view all the answers

Study Notes

Insomnia Overview

Categories of insomnia causation: psychological, psychiatric, chemical, and medical-biological factors.
Comorbidities with chronic insomnia often include depression and anxiety.

Medical Conditions and Influences

Conditions impairing sleep: chronic respiratory disease, sleep apnea, restless legs syndrome.
Substances interfering with sleep: sedatives, alcohol, and stimulants.
Environmental conditions like "jet lag" and shift changes can also cause insomnia.

Understanding Sleep

Early assumptions viewed sleep as a passive state; EEG data revealed it is an active process.
Sleep is distinct from unconsciousness; awareness changes, but thinking persists during sleep.
Sleep involves cycles of changing levels, typically lasting around 90 minutes.

Sleep Stages

Four stages of slow-wave sleep (SWS); characterized by gradual changes in brain wave activity.
First SWS stage: feelings of drowsiness with environmental awareness.
Second SWS stage: slowing EEG, onset of sleep sense, may declare awareness upon waking.
Third and fourth SWS stages are deeper phases with minimal dreaming, marked by unawareness and increased brain wave slowing.

REM Sleep

Known as paradoxical sleep; characterized by low-voltage, high-frequency EEG changes similar to awake states.
REM sleep features significant inhibition of muscle tone, with rolling eye movements and fluctuating autonomic activity.
Majority of vivid and complex dreams occur during REM.

Sleep Cycles

Post 90 minutes of SWS, a reversal occurs leading to the first REM episode.
Subsequent cycles show reduced stages 3 and 4, with longer and more frequent REM periods.
Overall REM sleep constitutes approximately 25% of the sleep cycle, varying across stages.

Factors Affecting Sleep Patterns

Key influences on sleep include circadian rhythm, drug use, activity effects, and sleep-avoidance habits.
Circadian rhythm is the most significant factor affecting sleep efficiency and is regulated by exposure to light, meal times, and exercise.
Timing adjustments take about one day per hour of change.

Sleep Disorders and Habits

Insomniacs may exhibit irregular sleep patterns due to staying awake to combat insomnia, leading to exhaustion.
Daytime napping can fragment night sleep patterns, worsening insomnia.
Regular bedtime and rising times, along with a dark sleeping environment, are vital for restoring sleep patterns.

Drug Use and Sleep

Long-term use of sedatives like benzodiazepines can disrupt normal sleep patterns, leading to dependency and tolerance.
Alcohol uniquely disrupts sleep through nighttime awakenings and suppression of dreams, causing rebound effects.
Short-acting painkillers and antidepressants can also interfere with sleep quality and recovery.

Sleep Science Insights

Sleep comprises an active state of varying neurological and physiological activities rather than low arousal.
The brain remains active at all times, and dreaming plays a critical role in filtering thoughts while preserving sleep.
Misconceptions about sleep include the belief that thinking stops when asleep and that minimal bodily movement is ideal for sleep quality.

Conclusion

No single drug can effectively cure insomnia; cessation of existing drug use and improving lifestyle choices are recommended.
Regular exercise can enhance brain function, improve mood, reduce anxiety, and facilitate adaptation to new time zones.

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Description

Explore the multifaceted causes of insomnia, including psychological, chemical, and medical influences. Learn about the dynamics of sleep, its stages, and the impact of various conditions on sleep quality in this comprehensive quiz.