It may surprise you to know that sleep deprivation is associated with obesity, increased blood pressure, increased levels of stress hormones, and reduced immune functioning (Banks & Dinges, 2007). Insleepwalking, or somnambulism, the sleeper engages in relatively complex behaviors ranging from wandering about to driving an automobile. Two theories attempt to answer this question: One theory views hypnosis as dissociation and the other theory views it as the performance of a social role. 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. Toleranceis linked to physiological dependence, and it occurs when a person requires more and more drug to achieve effects previously experienced at lower doses. When he told me, I made him go see the college therapist. Our states of consciousness change as we move from wakefulness to sleep. THE INTERNAL STATE SCALE (ISS) Version 2 and the ChronoBook SCORING KEY AND SUMMARY Mark S. Bauer, MD . The three types of sleep apnea are central apnea, obstructive apnea (OSA), and a mixture of central and obstructive apnea. Recent research (Horikawa, Tamaki, Miyawaki, & Kamitani, 2013) has uncovered new techniques by which researchers may effectively detect and classify the visual images that occur during dreaming by using fMRI for neural measurement of brain activity patterns, opening the way for additional research in this area. Following the initial rush, users experience 46 hours of going on the nod, alternating between conscious and semiconscious states. Early attempts to treat her condition with a stimulant drug alone were unsuccessful. Freud made distinctions between the manifest content and the latent content of dreams. This will be followed by brief descriptions of the effects of some of the more well-known drugs commonly used today. (a) This is a statue of a meditating Buddha, representing one of the many religious traditions of which meditation plays a part. 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. 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). The pineal and pituitary glands secrete a number of hormones during sleep. This becomes a self-perpetuating cycle because increased anxiety leads to increased arousal, and higher levels of arousal make the prospect of falling asleep even more unlikely. Like many other stimulants, cocaine agonizes the dopamine neurotransmitter system by blocking the reuptake of dopamine in the neuronal synapse. Although she had been taking a prescription antidepressant, her symptoms of depression continued to worsen and she began to suffer physically, displaying significant warning signs of cardiovascular disease and diabetes. Insomnia, a consistent difficulty in falling or staying asleep, is the most common of the sleep disorders. Delusions. Upon a search of the premises, police found blood-stained clothes and a bloody knife in the trunk of Falaters car, and he had blood stains on his neck. As discussed by Siegel (2008), a definition of sleep must also include mention of the interplay of the circadian and homeostatic mechanisms that regulate sleep. It is not uncommon for people suffering from insomnia to experience increased levels of anxiety about their inability to fall asleep. Latent content, on the other hand, refers to the hidden meaning of a dream. Remarkably, Falater insisted that he had no recollection of hurting his wife in any way. While disruptions in circadian rhythms can have negative consequences, there are things we can do to help us realign our biological clocks with the external environment. 0. 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. In general, these drugs are not thought to possess the same sort of abuse potential as other classes of drugs discussed in this section. 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). Increased alertness, mild euphoria, decreased appetite in low doses. The pituitary gland also secretes growth hormone, during sleep, which plays a role in physical growth and maturation as well as other metabolic processes (Bartke, Sun, & Longo, 2013). a. Aside from the role that REM sleep may play in processes related to learning and memory, REM sleep may also be involved in emotional processing and regulation. Jet lag is a collection of symptoms that results from the mismatch between our internal circadian cycles and our environment. If we have biological rhythms, then is there some sort ofbiological clock? These drugs promote increased levels of neural activity. The hypnogram below (Figure 4.12) shows a persons passage through the stages of sleep. Thus we sleep in safe areas to reduce the chance of harm. This is an important factor because we can develop tolerance and experience withdrawal from any number of drugs that we do not abuse. 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. Those who continue to have insomnia, particularly if it affects their quality of life, should seek professional treatment. Wakefulnessis characterized by high levels of sensory awareness, thought, and behavior. One way that this happens involves traveling across multiple time zones. Some newer CPAP masks are smaller and cover only the nose. 1. The prevalence rates for somatic disorders are often difficult to determine; however, overall estimates of somatic symptom disorder are around 4-6%. While this is an intuitive explanation of sleep, there is little research that supports this explanation. These brain areas include the prefrontal cortex and basal ganglia. Typically, individuals suffering from night terrors will fall back asleep again within a short time. Acute alcohol administration results in a variety of changes to consciousness. There are individual differences in regard to our sleep-wake cycle. A) managed care Which of the following was an advance in science and medicine in the18th and 19th centuries? 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). Often, we are not completely aware of our surroundings, even when we are fully awake. Brainwave activity changes dramatically across the different stages of sleep. Pain relief, euphoria, sleepiness. This campaign is sponsored in part by the National Institute of Child Health and Human Development. It is not uncommon for people suffering from undiagnosed or untreated sleep apnea to fear that their careers will be affected by the lack of sleep, illustrated by this statement from another patient, Im in a job where theres a premium on being mentally alert. 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). The FDAs 2013 recommendation for tighter controls on opiate prescriptions left many patients addicted to prescription drugs like OxyContin unable to obtain legitimate prescriptions. Repeated use of these stimulants can have significant adverse consequences. The brains clock mechanism is located in an area of the hypothalamus known as thesuprachiasmatic nucleus (SCN). However, for some, its not because of all-night partying or late-night study sessions. Originally reported as a safe alternative to the known cancer-causing agents found in cigarettes, vaping is now known to be very dangerous and has led to serious lung disease and death in users. An important difference between mood disorders and normal mood fluctuation is: A) the particular medication used to treat the problem. . As one of their mechanisms of action, cocaine and amphetamines block the reuptake of dopamine from the synapse into the presynaptic cell. In other words, physical dependence in and of itself is of limited utility in determining whether or not someone has a substance use disorder. Interestingly, individuals who have increased levels of alpha brain wave activity (more often associated with wakefulness and transition into stage 1 sleep) during stage 3 often report that they do not feel refreshed upon waking, regardless of how long they slept (Stone, Taylor, McCrae, Kalsekar, & Lichstein, 2008). Jet lagis a collection of symptoms that results from the mismatch between our internal circadian cycles and our environment. By the end of this section, you will be able to: Consciousnessdescribes our awareness of internal and external stimuli. Depending on the population and sleep disorder being studied, between 30% and 50% of the population suffers from a sleep disorder at some point in their lives (Bixler, Kales, Soldatos, Kaels, & Healey, 1979; Hossain & Shapiro, 2002; Ohayon, 1997, 2002; Ohayon & Roth, 2002). Users experience increased energy, feelings of pleasure, and emotional warmth. Melatonin is thought to be involved in the regulation of various biological rhythms and the immune system (Hardeland et al., 2006). A) a mole that looks cancerous B) nasal congestion C) change in heart rate D) issues with breathing Which of the following American health care systems is most known for requiring a referral from a primary care doctor in order to see a specialist? Low doses increase relaxation, decrease inhibitions. This shift in policy may be in response to the scientific communitys recommendations and/or reflect changing public opinion regarding marijuana. Drug use disorders are addictive disorders, and the criteria for specific substance (drug) use disorders are described in DSM-5. Another theory regarding why we sleep involves sleeps importance for cognitive function and memory formation (Rattenborg, Lesku, Martinez-Gonzalez, & Lima, 2007). Psychological dependence on these drugs is also possible. In the central nervous system, it plays a role in arousal and reward mechanisms. There are a variety of drugs that treat restless leg syndrome: benzodiazepines, opiates, and anticonvulsants (Restless Legs Syndrome Foundation, n.d.). This section will present information relating to the use of various psychoactive drugs and problems associated with such use. I was really sleepy and having trouble concentrating. MDMA (3.4-methelynedioxy-methamphetamine, commonly known as ecstasy or Molly) is a mild stimulant with perception-altering effects. Therefore, no movement of voluntary muscles occurs during REM sleep in a normal individual; REM sleep is often referred to as paradoxical sleep because of this combination of high brain activity and lack of muscle tone. . The participant is told to be open to the process of hypnosis, trust the hypnotist and let go. Dreams and their associated meanings vary across different cultures and periods of time. These changes in brain wave activity can be visualized using EEG and are distinguished from one another by both the frequency and amplitude of brain waves (Figure 4.7). In the therapeutic setting, a clinician may use relaxation and suggestion in an attempt to alter the thoughts and perceptions of a patient. (a) Common paraphernalia for heroin preparation and use are shown here in a needle exchange kit. One or two nights of sleep difficulty is not unusual, but if you experience anything more than that, you should seek a doctors advice. b. absence of signs of malfunctioning. 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). These components include: These steps are conducive to being open to the heightened suggestibility of hypnosis. Alan Hobson, a neuroscientist, is credited for developing activation-synthesis theory of dreaming. Sleep apnea is defined as a reduction or cessation of breathing during sleep. In Falaters case, a jury found him guilty of first degree murder in June of 1999 (CNN, 1999); however, there are other murder cases where the sleepwalking defense has been used successfully. Given that withdrawal from a drug often involves an experience opposite to the effect of the drug, it should be no surprise that opioid withdrawal resembles a severe case of the flu. (2005) found that sleepwalking was not alleviated with the use of benzodiazepines. A womans menstrual cycle is an example of a biological rhythma recurring, cyclical pattern of bodily changes. The following describe internal states of symptoms EXCEPT? High doses can induce sleep, cause motor disturbance, memory loss, decreased respiratory function, and death. A hypnogram is a diagram of the stages of sleep as they occur during a period of sleep. These will soon, in all ordinary cases, subdue the most distressing symptoms, and effect a perfect cure in a day or two. Tolerance can cause the user to increase the amount of drug used to a dangerous leveleven to the point of overdose and death. These same women were awakened during REM sleep in order to provide a detailed account of their dream content. As mentioned earlier, lack of sleep can result in decreased mental alertness and cognitive function. She indicated that she had fallen asleep at inappropriate or dangerous times, including while eating, while socializing with friends, and while driving her car. Surprisingly, narcoleptic episodes are often triggered by states of heightened arousal or stress. It is administered alone or in conjunction with doses of melatonin (the hormone secreted by the pineal gland). The term was first coined by a physiologist named Walter Cannon in 1926. One hypothesis from this perspective might argue that sleep is essential to restore resources that are expended during the day. 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). Night terrorsresult in a sense of panic in the sufferer and are often accompanied by screams and attempts to escape from the immediate environment (Mahowald & Schenck, 2000). Natural opioids, calledopiates, are derivatives of opium, which is a naturally occurring compound found in the poppy plant. Cocaine can be taken in multiple ways. Question 2 1 / 1 pts Ling Fan finds that she has a difficult time tolerating alcohol and prefers to not even have small amounts , as she often becomes flushed , warm , and nauseous .Most likely , Ling Fan , like many other women and those of Asian descent , lacks the enzyme called alcohol _ _ _____. (credit: modification of work by new 1lluminati/Flickr), Medical marijuana shops are becoming more and more common in the United States. Still, people experiencing opioid withdrawal may be given methadone to make withdrawal from the drug less difficult. That includes exercise and bright light from devices. Stick to a sleep schedule, even on the weekends. Guilleminault et al. c. absence of subjective symptoms of disease. LINK TO LEARNING: To learn more about some of the most commonly abused prescription and street drugs, check out the, LINK TO LEARNING: Feeling stressed? At rather low doses, alcohol use is associated with feelings of euphoria. The heart rate slows . 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. In other words, dreaming involves constructing a virtual reality in our heads that we might use to help us during wakefulness. Infants younger than 12 months appear to be at the highest risk for SIDS, and boys have a greater risk than girls. Ethanol, which we commonly refer to as alcohol, is in a class of psychoactive drugs known as depressants (Figure 4.15). During periods of sleepwalking, sleepers often have their eyes open, but they are not responsive to attempts to communicate with them. typically follow the example of their parents more than their friends. Yarmila Falaters body was found in the familys pool with 44 stab wounds. Methamphetamine in its smokable form, often called crystal meth due to its resemblance to rock crystal formations, is highly addictive. Manifest contentis the actual content, or storyline, of a dream. Variations and adaptations in cognition and behavior make individuals more or less successful in reproducing and passing their genes to their offspring. In fact, it has been suggested that there is no reason to think that energetic demands could not be addressed with periods of rest and inactivity (Frank, 2006; Rial et al., 2007), and some research has actually found a negative correlation between energetic demands and the amount of time spent sleeping (Capellini, Barton, McNamara, Preston, & Nunn, 2008). 23. 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). 3. While amphetamines are often abused, they are also commonly prescribed to children diagnosed with attention deficit hyperactivity disorder (ADHD). The tendency to maintain a stable, relatively constant internal environment is called homeostasis. Brainwave activity changes dramatically across the different stages of sleep. Normal brain functioning is altered after repeated use of these drugs. You were capable of engaging in the all of the complex tasks involved with operating a motor vehicle even though you were not aware of doing so. Our experiences change dramatically while we are in deep sleep and once again when we are dreaming. Adenosine is a neurotransmitter that promotes sleep. To keep heroin affordable, many dealers began adding more potent synthetic opioids including fentanyl and carfentanyl to increase the effects of heroin. Popular portrayals of hypnosis have led to some widely-held misconceptions. In addition, these drugs can cause feelings of anxiety, hallucinations, and paranoia (Fiorentini et al., 2011). Although she did not experience any dream-like hallucinations, she was diagnosed with narcolepsy as a result of sleep testing. (West et al., 2009, p. 114). 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. Rotating shift workrefers to a work schedule that changes from early to late on a daily or weekly basis. Homeostatic regulation of sleep is evidenced by sleep rebound following sleep deprivation. Awareness of internal stimuli includes feeling pain, hunger, thirst, sleepiness, and being aware of our thoughts and emotions. Consider a patient who believed that as a result of his sleep apnea he had three car accidents in six weeks. 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. Methadoneis a synthetic opioid that is less euphorigenic than heroin and similar drugs. Sleep-wake cycles seem to be controlled by multiple brain areas acting in conjunction with one another. d. both b and c. 2. All of the following are true statements concerning the health of Americans EXCEPT: a. mortality rates from smoking have declined. REM sleep behavior disorder (RBD)occurs when the muscle paralysis associated with the REM sleep phase does not occur. The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission. In addition, the appearance of K-complexes is often associated with stage 2 sleep. Interestingly, since the advent of electric light, the amount of sleep that people get has declined. Despite the prevalence of caffeine use and the large number of people who confess to suffering from caffeine addiction, this was the first published description of soda dependence appearing in scientific literature. Nicotine is highly addictive, and the use of tobacco products is associated with increased risks of heart disease, stroke, and a variety of cancers. These individual differences in circadian patterns of activity are known as a persons chronotype, and research demonstrates that morning larks and night owls differ with regard to sleep regulation (Taillard, Philip, Coste, Sagaspe, & Bioulac, 2003). Perhaps our ancestors spent extended periods of time asleep to reduce attention to themselves from potential predators. In terms of brain wave activity, stage 1 sleep is associated with both alpha and theta waves. In her case, the fact that her cataplexy was confined to the right side of her body was quite unusual. The internal state of an object is the set of all its attributes' values. In general, smoking cessation programs may be effective in the short term, but it is unclear whether these effects persist (Cropley, Theadom, Pravettoni, & Webb, 2008; Levitt, Shaw, Wong, & Kaczorowski, 2007; Smedslund, Fisher, Boles, & Lichtenstein, 2004). It is much more difficult to awaken someone from sleep during stage 3 than during earlier stages. 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). Therefore, it is important to make a distinction between hypnosis as an empirically based therapeutic approach versus as a form of entertainment. The sleep and dreaming researcher Rosalind Cartwright, however, believes that dreams simply reflect life events that are important to the dreamer. that would be one of the problems that Ive encountered. Chronic insomnia is almost always associated with feeling overtired and may be associated with symptoms of depression. Generally, treatment for night terrors is unnecessary unless there is some underlying medical or psychological condition that is contributing to the night terrors (Mayo Clinic, n.d.). Describe the diagnostic criteria for substance use disorders, Identify the neurotransmitter systems impacted by various categories of drugs, Describe how different categories of drugs affect behavior and experience, Understand the similarities and differences of hypnosis and meditation. Why do we devote so much time to sleeping? (a) A typical CPAP device used in the treatment of sleep apnea is (b) affixed to the head with straps, and a mask that covers the nose and mouth. Adepressantis a drug that tends to suppress central nervous system activity. the ability to spend time, good time with them when youre not feeling absolutely exhausted . This discomfort is relieved by deliberately moving the legs, which, not surprisingly, contributes to difficulty in falling or staying asleep. Loss of appetite. These behaviors vary widely, but they can include kicking, punching, scratching, yelling, and behaving like an animal that has been frightened or attacked. (credit: modification of work by Mikael Hggstrm). This feeling of a depressed mood is also accompanied by two or more additional symptoms, to include changes in appetite, insomnia or hypersomnia, low energy or fatigue, low self-esteem, feelings of hopelessness, and poor concentration or difficulty with decision making. For example, Hobson (2009) suggests that dreaming may represent a state of protoconsciousness. Anopioidis one of a category of drugs that includes heroin, morphine, methadone, and codeine. For individuals who are especially open to the power of suggestion, hypnosis can prove to be a very effective technique, and brain imaging studies have demonstrated that hypnotic states are associated with global changes in brain functioning (Del Casale et al., 2012; Guldenmund, Vanhaudenhuyse, Boly, Laureys, & Soddu, 2012). a - a mole that looks cancerous. For instance, if a woman dreams about being chased by a snake, Freud might have argued that this represents the womans fear of sexual intimacy, with the snake serving as a symbol of a mans penis. When we are very young, we spend up to 16 hours a day sleeping. 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). The average EVD case fatality rate is around 50%. In Hilgards experiments, he induced participants into a state of hypnosis, and placed their arms into ice water. 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. 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. d. respond to illnesses much like the older adults do. People sleep better in cooler temperatures. Like NREM sleep, REM has been implicated in various aspects of learning and memory (Wagner, Gais, & Born, 2001; Siegel, 2001). We experience different states of consciousness and different levels of awareness on a regular basis. Some can cause heightened sensitivity to physical stimuli. Homeostasis refers to the body's need to reach and maintain a certain state of equilibrium. As already mentioned, the hypothalamus contains the SCNthe biological clock of the bodyin addition to other nuclei that, in conjunction with the thalamus, regulate slow-wave sleep. We might also experience unconscious states of being via drug-induced anesthesia for medical purposes. . c. deaths due to accidents have increased. The consequences of sleep debt include decreased levels of alertness and mental efficiency. Whilecaffeineis generally considered a relatively safe drug, high blood levels of caffeine can result in insomnia, agitation, muscle twitching, nausea, irregular heartbeat, and even death (Reissig, Strain, & Griffiths, 2009; Wolt, Ganetsky, & Babu, 2012). Some view a hypnotized persons behavior not as an altered or dissociated state of consciousness, but as their fulfillment of the social expectations for that role (Coe, 2009; Coe & Sarbin, 1966). Freud was not the only theorist to focus on the content of dreams. Fever. We spend approximately one-third of our lives sleeping. These synthetic drugs are so potent that even small doses can cause overdose and death. This pattern of temperature fluctuation, which repeats every day, is one example of a circadian rhythm. While we all experience altered states of consciousness in the form of sleep on a regular basis, some people use drugs and other substances that result in altered states of consciousness as well. For instance, the concentration of various ions in your blood must be kept steady, along with pH and the concentration of glucose. For instance, some people would say they are morning people, while others would consider themselves to be night owls. (a) A period of rapid eye movement is marked by the short red line segment. Individuals with insomnia often experience long delays between the times that they go to bed and actually fall asleep. Surprisingly, sleep apnea may exacerbate cardiovascular disease (Snchez-de-la-Torre, Campos-Rodriguez, & Barb, 2012). This often results in sleeping problems, and it can lead to signs of depression and anxiety. Unlike Freud and Jung, Cartwrights ideas about dreaming have found empirical support. (a) Delta waves, which are low frequency and high amplitude, characterize (b) slow-wave stage 3 and stage 4 sleep. Taking a different approach to explain hypnosis, the social-cognitive theory of hypnosis sees people in hypnotic states as performing the social role of a hypnotized person. A neighbor called the police after witnessing Falater standing over his wifes body before dragging her into the pool. Some forms of psychotherapy, such as cognitive-behavioral therapy, can help sufferers of insomnia. 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.