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196 Cards in this Set
- Front
- Back
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Sleep Crises |
Sudden, unexpected need to stay up all night for critical task or emergency. |
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How to cope with sleep crises. (4) |
Kmowledge/ know your sleep need and bio rhythms. attempt to plan ahead. lower sleep debt previous to crisis if possible. avoid alcohol and farry foods before sleep.
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When is biological clock at lowest ebb? And what happens? |
In the middle of the night (3-4am) More prone to distraction, ST memory recall issues, slow RT |
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Type of nap that boosts power and alertness. |
10-20min nap |
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Nap that can cause sleep inertia |
30min nap. |
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Nap that helps creativity and non-declarative memory. |
90min nap (one sleep cycle) |
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Emergency Nap |
In hazardous situation and feel like crap. |
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Preventative nap |
Knowing you will have a late night |
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A selective, strategic 45min nap will... |
give you 6 hours of improved alertness. |
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Naps improve objective performance more than... |
subjective performance. |
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What is Jet Lag? |
A mismatch of the individual internal circadian clock with external local arrival clock. |
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Symptoms of Jet Lag? (11) |
hunger, fatigue, nausea, diarrhea, constipation, muscle soreness, headaches, distracted, disoriented, moody.
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How many people are not affected by Jet lag? |
1/3rd |
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Bodies circadian rhythm is behind local time, problems falling asleep at local bedtime, and difficult waking up in the morning |
Travelling East. |
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Vancouverite in Newfoundland at 11p, it's 6pm Van time... What happens? |
difficult to fall asleep. |
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Vancouverite arrive in Hawaii at 10pm, it's 1am Van time, what happens? |
Easier to fall asleep. |
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Recovery time for Jet Lag per time zone flying East and West? |
West: 1hr per time zone. East: 1.5hrs. |
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Best way to travel east? |
Take early flight, leave early in the day. |
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Best way to travel West? |
Take evening flight, sleep on the plane. |
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How long to sleeping pills last for? |
8hrs. |
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Types of shift work and their times. |
Day - 7/8am-4/5pm Evening/swing - 4pm-12am, 6pm-1am Graveyard - 11/12pm- 6/8am Split - 5/6am-10am AND 7-10/11pm. |
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Negative effects of shift work? (4) |
- Less job satisfaction. 55% higher than average number of MVA when driving back from work. 57% higher divorce rates. Higher reports of GI problems, CV disease, cancer., and mortality rates. |
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What happens when you sleep for over 12hrs? |
- Low efficiency very little N3 and get morr ALPHA. - Sleep inertia last 15-20min. |
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Symptoms of Sleep Disorders (7) |
1. unrefreshed sleep
2. excessive daytime fatique 3. difficulty staying or falling alseep 4. unusual/violent behaviour during sleep. 5. snoring, breathing irregularities. 6. motor restlessness in the evening/previous to sleep. 7. mood changed/issues (anxiety, fear, agitiation). |
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Insomnia nick name |
"The common cold" of sleep disorers |
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The 7 types of Sleep insomnia |
1. Sleep onset Insomnia 2. Sleep maintenance insomnia 3. Early awakening Insomnia 4. Sleep dissatisfaction 5. Idiopathic Insomnia 6. Psychophysiological Insomnia 7. Paradoxical Insomnia |
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Early Awakening Insomnia |
Sleep onset is rapid, sleep continuity is good, but awakening is much earlier than desired. |
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Sleep Dissatisfaction |
Not feeling refreshed after a night of seemingly sufficient sleep *likely due to something like Sleep Apnea. |
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Idiopathic Insomnia |
No found cause (15% of cases, childhood onset, life-long condition w/o treatment). |
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Psychophysiological Insomnia |
Chronically hyper-aroused; greater arousal at night + day restless, overactive, nervous, apprehensive; intense and persistent physiological arousal (e.g., higher body temp, HR, hormone release) |
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Paradoxical Insomnia |
(5-7% of cases) no daytime impairment, normal sleep length profile, but report no sleep, high vigilant, "thinking all night" *looks fine but report no sleep. When they wake up they report thinking. |
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What is Comorbid Insomnia? |
Caused by medications. |
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Cause for initial sleep disruption should be found, but not as relevant as... |
perpetual circumstances (what are the circumstances enabling this to continue). |
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Causes of insomnia (22) |
Medication, caffeine, alcohol, time zone changes, schedule changes, temperature regulation, pregnancy, menopause, different sleep environment, depression, anxiety, OCD, phobia, schizophrenia, marital problems. job stress, grief, trauma, PTSD
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Cognitive causes of Insomnia (5)
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1. Exaggerated concerns about not "enough sleep" 2. self-blame/guilt of lack of sleep 3. dread sleep time 4. pressure to sleep leading to hyper-vigilance 5. mental listing/rumination
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Insomnia Impact |
Sleep dep issues - concentration, irritability, jitters, inappropriate sleep location episodes, clumsiness. Impact on work, relationships, unpredictable in planning, purchase sleep aids. |
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Insomnia prevalence |
30-50% of Western pop. report mild or occasional insomnia. All of us atleasy once. |
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Percentage of people who report Insomnia as serious issue? |
6-10% |
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Insomnia in Children and Retirees? |
Children - very rare. Retirees: 25035% |
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Insomnia is ____X greater in woman than men |
1.5 |
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Reports of no insomnia. Women and men percentage.
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Women: 21%. Men: 25%. but women have 1.5 times more insomnia |
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Sleep onset insomnia is more prevalent in..... Sleep maintenance is more prevalent in..... |
Younger adults. Older adults. |
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Insomnia Treatments (8)
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Sleeping pills, OTC meds, antihistamine, acetaminophen, magnets, herbal treatments, prescription, hypnotics.
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How do hypnotics work on Insomnia? |
work on GABA receptors to promote sleep, relax muscles and reduce anxiety. |
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What is cognitive-behavioural treatment? |
CBT-1: Change thoughts, emotion, relearn to sleep. |
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How does cognitive-behavioural treatment work? What is the goal? |
Goal: alleviate perceived nighttime sleep issues. A few sessions to several weeks. Examine what contributes to issues (monitor number of awakenings, level of daytime sleepiness, naps, etc)_
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Narcolepsy appears in what stage of life?
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teens, early 20s can appear in adulthood
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What is narcolepsy? |
intractable sleep attack, without warning (minutes to hours in length) |
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What is cataplexy? How is it triggered? |
Weakness in limbs. face, speech muscles. triggered bu laughing, exhilaration, anger, crying. |
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15-20% have narcolepst w.o... |
cataplexy. |
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In Narcolepsy hallucinations paired with sleep paralysis is reported in... |
1/2 of sufferers. |
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What are the causes of Narcoplesy? - What is a autoimmune response? (5) |
- Genetic predispostion - brain damage, or other medical conditions. - autoimmune response: body attacking own tissue in lateral hypothalamus which manufactures orexin/hypocretin. - low/absent hypocretin in cerebral spinal fluid. - Marker of HLA (human leukocyte antigen)
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What causes cataplexy? |
Increased activity of acetylcholine (NT) and decreased activation of the locus coeruleus (plays roll in emotion and cog. control) |
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Narcolepsy Impact |
Work (fired for sleeping), social, dating, safety, appear dull and unmotivated, feel guarded and depressed. |
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Narcolepsy Treatment (6) |
No cure. - behavioural + pharmacolgical treatments necessary. - naps 15-20min 1-2x per day. - Good sleep hygiene - stimulants (Mondafinil) - SSRI or GHB to improve daytime sleepiness. - psychological support
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What is reported in Restless Leg Syndrome (RLS)? |
- unpleasant sensation at legs "creepy-crawly" to painful. - Legs move seated or lying - Daytime fatigue (some feel alert) |
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How is RLS relieved? |
Continuous movement. (walking, stretching) |
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How many people get RLS and who gets it more, men or women? |
5-15% of population. 2x more in women. |
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What other problems are related to RLS? |
1/3rd due to iron deficiency. - 15-40% of people on dialysis complain. 20% of pregnant women. |
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Causes of RLS? *disappears with fever (no one knows why) |
-Caffeine, warm rooms and exposure to cold. - dopamine depletion -iron deficiency - blood loss |
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RLS treatment *Same for PLM
(7) |
- improved sleep hygiene. - awareness of and control for exacerbating substances. - iron supplementation - aware of blood loss - stretching, relaxing massage - dopamine agonists (Mirapex, Requi) - Vicoden (oxicodon hydrocodone)
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What happens in Periodic Limb Movement (PLM's)? and how long? |
- jerking of arms or legs during sleep - short duration (.5-10s) at regular intervals (every 5-90sec_ several minutes to hours. |
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Which half of night does plm occur?
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first half of night.
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PLM's accompany other disorders |
OSA, narcolepsy, REM beh. disorder). |
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Percentage Who gets PLM?
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5% of pop. 1/2 are older adults.
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What is Bruxism? |
teeth clenching, grinding, crunching, scraping. |
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____% increase of Bruxism in young people |
10-20% |
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What causes bruxism? |
stress, pre-existing mandibular or maxillary condition. |
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When does bruxism occur? |
during N2 sleep or REM |
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What is sleep apnea? And how long must it last for?
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- Absence of breathing. - Cessation of breathing 10sec or longer during sleep, terminated with an arousal or oxygen desaturation.
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Sleep apnea is observable by___ and measurable by ____? |
Family Lab |
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Central Sleep Apnea: |
Absence of effort to breath, absence airflow in mouth and nose (rare). |
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Obstructive Sleep Apnea |
Persistent increasing effort to breathe, with absence of airflow in mouth and nose. |
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People with Obstructive Sleep Apnea have... |
- loud snoring, cessation of breathing, followed by gasp of breath. - night sweats, morning headaches, dry mouth. - sleep deeply and difficult to arouse (foggy headed) - no refreshed after more sleep |
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How does snoring occur? |
throat not completely open, causing air and throat tissue (uvula, soft palate) to vibrate as air is forced through narrow passage. |
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Obstructive Sleep Apnea is common in ___% of adults? |
50% |
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People with _________ (4 points) are more likely to have sleep apnea. |
Thick/adipose neck, face. obesity big tongue small jaw |
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Hypopnea |
Inspiration continues, with marked reduced volume of air, respitory effort increases. |
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Apnea/Hypopnea Index= |
# of ap or hip ending in arousal or 2 desat. hrs of sleep. e.g., 40 micro awakening divided by 8hrs of sleep = 5hrs sleep apnea index |
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Apnea/Hypopnea Index: Mild =_____ Moderate =_____ Severe =_____ |
5-10 15-30 45+ |
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___% of high BP suffer from OSA |
70% |
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Sleep Apnea can trigger_____ |
Mal seizure. |
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OSA problems- list 5. |
1. sleepiness affects work 2. depression, irritable 3. diminshed sexuality 4. concentration cog. issues 5. bed partner issues. |
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OSA treatment (list 8) |
1. avoidance of alcohol. 2. weight loss 3. sleeping different position. 4. surgery to produce chronic tracheostomy (in the past). 5. CPAP (continuous positive airway pressure). 6. Nasal Mask. 7. compliance issues. 8. oral appliance. |
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uvulopalatopharyngoplasty (UPPP): What is it and what can it do? |
resect uvula, tonsillar pillars, soft palate. - can worsen due to scar tissue. |
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Phased airway reconstruction: |
UPPP + advancing tongue, mandibular and maxillary advancement (pull jaw forward and re-attach tongue) |
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Parasomnias: |
Undesirable, unpleasant occurences during sleep. |
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Parasomnias takes place in waking NREM some in ______ the mechanism are _______ genetic factors _______ not related to _______ |
REM not always clear play a role psychopathology |
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How many distinct parasomnia? |
15 e.g., sleep chocking. |
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Samnabulism |
Sleep Walking |
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When does Somnabulism begin? Stage of sleep |
During NREM first 1/2-1/3rd of night. |
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How long does Somnabulism last? |
>1min 15min up. rarely >1hr |
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Signs of Somnabulism? (4) |
- No dream recall - move in bed, sit up, eyes open walk around the house, neighborhood. - Movements: clumsy (some can do complex things) - vocalized conversations
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Somnabulism is most common in? Onset and peak? Abates? |
Children (onset 4-6) Peak (11-12) abates (15-17) |
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___% somnabulism in adults? |
3-4% |
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What to do if someone sleep walks? (5)
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- keep out of harm - gently lead back to room, bed. - reduce triggers. make bedroom safe - schedule awakening (15-20min before typical occurrence) - In adults: medication, stress management.
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Some say _____ is a parasomnia and some say movement disorder? |
REM behaviour disorder. |
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What is REM behavioural disorder? |
Unusual vivid dreams/nightmares with activity and violent confrontations. |
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REM behavioural disorder frequency? When? And How many people? |
2-14x per week. every 90min. More in 2nd half of the night 1 in 200 people. |
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REM behavioural disorder is most common in? |
Older males. Onset 60's. * can take place in children. |
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REM behavioural disorder is a sign of.... |
brain degeneration (dementia, alzheimers, etc) |
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REM behaviour disorder treatment: |
Safety suppressing medication. calm voice.instructions. |
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What is Somniloguy? |
Sleep talking. |
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What happens in Somniloguy? |
Mumbling, garbled, some understandable word to full sentences, singing, laughing. |
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Somniloguy duration? |
second to minutes (rare over an hour) |
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Somniloguy is most common in ____ occurs in ____ |
children related family. |
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Somniloguy happens in which stages? |
N1 & N2, 10% during REM. |
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Nightmares (old meaning) |
night + mare (goblin + devil) |
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Nightmare: |
coherent dream sequences that seem real and become increasingly disturbing as they unfold. Emotions involve anxiety, fear, terror, or negative feelings. |
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Nightmare usually occurs during? (stage) and how long? |
2nd stage 1/2 of sleep period. 10min |
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Nightmare percentage in 3-5yrs? adults? |
10-50% 70-80% |
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Difference between nightmares and bad dreams? |
Nightmares: abrupt awakening, immediate and full recall. Bad dreams: do not awaken, but recall distrubing content. triggered by illness, fevers, indigestion, withdrawal. |
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Both nightmares and bad dreams are... (5) |
- response to psychological issues. - replicate memories exactly or metaphorically - soon after trauma. - fade away/return - more common in people absorbed in fantasy (writers, gamers, etc)
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Sleep Terrors: |
Incubus Attack |
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Sleep Terrors occur in childhood only ___% peaking ____ yrs, rare in _____ |
3% 3-5yrs adults. |
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____ more likely to get sleep terrors than ____ |
boys girls |
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Terrors usually happen during ____ and involve _____? |
Typically N3, 1st third of night. Scream, terrified facial expression, sweating, racing heart, wide open glassy eyes, dilated pupils, elevated HR |
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Children with night terrors will usually have no ____ |
recall of incident. |
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Night terrors can be due to.... |
stressors, being bullied, moving, etc. |
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Treatment for Nightmares & Bad Dreams? (9)
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- awareness of stressors, scheduled awakenings. - soothing location, away from bed when comforting. - reassurance that they cannot hurt you. - CBT (cognitive behavioural therapy) - drug to suppress REM - IRT (Imagry Rehearsal Therapy - writing, talk, paint, draw content. - hypnosis - if lucic, change and confront it. - safe, supportive relationship.
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Oneirnoants |
People who explore the dream world. |
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3 ways to conduct dream research: |
1. Measure over physiology via polysomnography. 2. Home - beeper, alrm clock and recorder 3. Analyze dream journals kept longitudianlly, within and across particpiants. |
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People are more honest dictating their dreams when_____ |
talking into a machine or writing the dreams down. |
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How many words needed for proper dream analysis? |
More than 50. |
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Who analyzed dream journals kept longitudinally? |
Mary Whiton Calkins. |
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How many dreams needed to assess indiv. patterns in dreaming? *look at cards before and write down differences even if right
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20 |
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How many dreams needed to compare content differences in people? |
Over 100 |
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Element consistency: |
What people dream about. |
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Challenges of dream research:
(7) |
- no direct access to dreams - simple awakening causes change in functional org. of the brain - if dream is longer than 15min, early part is forgotten. - no universal precise def. of "a dream" - NREM mention can occur. - subject bias (I want to recall vs. what happened) - we usually recall fragments, not the entire story. - cannot check the accuracy of dream recall. - subjects might not want to describe some content. - participants want to complete or fill in the story. |
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Describe the two ways we fill in detail of dreams? |
Reconstruction: transformed, embellished, or interpreted (possibly put emotions ino an image). Deduction: Fill in "links", "This happened due too." |
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Number of events increase and dreams become more accurate in last..... |
1/3rd of sleep. |
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Dreams that last for more that 9-10min compared to dreams that are less than 1min are.... |
More lively, vibrant, and more distorted. Also more emotional, antagonistic, and violent. |
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Repression Hypothesis: |
Censorship at the dreaming or waking state... conversly our dreams contain obnoxious, hateful, corrupt, behaviours. |
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Salience Hypothesis: |
The more vivid, bizarre, emotion filled the more likely to recall the dream (more vivid when 8-10hrs in bed) |
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Interference Hypothesis: |
distraction during/after awakening unrelated to dreaming, interrupts dream recall. |
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3 reasons for Non-Reporters: |
1. takes effort to focus, recall and report. 2. consistently sleep deprived 3. wake from N3 regularly. |
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Psychophysiological Parallelism |
How closely related are the physiological (brain body) and physical events (environment) with that of dream content. |
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When we dream what happens physiologically? 5 points |
- lack of motor output. - more activity in limbic system (emotion-fear, anger, joy, survival) - Dopamine increases in the midbrain, activate/initiate dreaming. - Less activation in prefontal cortex (provide reality checks) - Majority of frontal lobe cortex is inhibited. |
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Do external events enter a dream? |
Yes |
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A red light changes what in dream? |
the hue *but over days. |
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What happens when your own voice is heard as you sleep? And someone elses voice? |
Become more assertive, helpful and active. * Someone elses voice makes you more passive. |
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Does thirst and effect dream content? |
No. |
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Scanning Hypothesis: |
The extra-ocular muscular movement during REM is identical to the movements made when we scan our environment. |
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When do we scan the vertical plane? |
Objects falling or rising. |
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When do we scan the horizontal plane? |
Watching a wide field, people at social gathering. |
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People who are blind from birth show.... |
no eye movement, only EEG and EMG to indicate REM sleep. |
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Scanning Hypothesis counter-arguments: |
newborns- have eye movement in REM but their vision is not developed. - Cats eye movements are jerky, solely horizontal, and related to PGO sharp waves, not related to seeing. - Human adults - difficult to predict eye movements in any state. |
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Dream Functions: Release |
- Instinct "relief valves" for pent-up basic unacceptable drives. |
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Manifest content vs. latent content |
Manifest: actual content what you report. Latent: the hidden meaning. |
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Jung (dream function: facilitate Emotional Adaptation) |
psychic balance, dreams reveal and assist us. *Wanted to analyze the dream WITH the client. He said dreams arrive from out subconscious and our COLLECTIVE unconscious. |
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Adler (dream function: facilitate...) |
Personal problem solving function. Dreams are a waking reality but have been changed. We can solve personal problems via our dreams. "our dreams provide information on natural wisdom." |
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Hobson (facilitate...) |
FrMRI - activation of emotional centres of the brain during REM, shape content of dreams. REM increases after day/multiple days of stress, worry and intense learning. Work directly on emotional problem, without fear or ridicule, try different solutions. |
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Hartman (facilitate....) |
Dreams make emotions into visual metaphors. Dreams are guided by our emotions. Dreams help us explain in multiple ways why we feel and why we feel intensely. Dreams help us deal with emotion. |
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Kramer (facilitate.....) |
Mood regulatory hypothesis - after dreaming or mood and beh. can improve, particularly with major life events, pre-post measure of mood following sleep. |
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The 7 dream functions: |
1.None 2. Others 3. Memory consolidation 4.play 5. creativity 6. facilitate emotional adaptation 7. release. |
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Dream functions: creativity points (3) |
- suggest solutions for everday problems. - free from self-criticism, or concern for other impressions. - reality testing can occur. - dream could be offering a solution
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Dream functions: play Points (4) and who?
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- Enjoyable - free unpressured experimentation. - try out skills, events, social relationships different from serious life. - provide enhanced flexibility and prepare us for future. Who: Bulkeley
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Dream Function: Memory consolidation points. and who? |
- "offline" memory processing. - consolidation, assimilation information - dreams are portions of recent episodes mixed with older memories. - Who: Stickgold Hartmann: do not replay waking life but create new connections. - High protein synthesis in the brain during REM |
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Contrary evidence to memory consolidation |
anti-depressants get rid of REM and people still have full memory function. |
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Horne (Other functions): |
dreams distract the brain from waking up- the frontal cortex is not keeping stimulation orderly or testing reality, we accept our dreams as reality. |
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Revonsou (other functions): |
evolutionary purpose, dreams enable a rehearsal of threats "threat script" ways to avoid them; enhance probability of survival; REM leads to "pseudo-wake state to test environment for danger. |
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McGrath, Cohen (other functions): |
REM is for "system testing" of the nervous system beyond the brain (irregular activation of resp., CV, other autonomic systems.) |
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Dream Functions: None. Point and who? |
Who? Domhoff, Flanagan, and Foulks. Epiphenomena- no meaning. - we find pattern or relationship when there is non. |
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How much are dream like waking experiences? (3) |
- realistic stimulation of waking life but not reproductions or literal re-enactments of daily events. - the reduced capacity in frontal lobe makes it hard to distinguish reality from fiction. - in dream mind is focused on dream unlike when awake when we flip between internal and external stimuli.
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Who believes that dreams are a visit to another world? |
Pantani Malay, Inuit, Tajal of Luzon; |
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Borneo, Zulu, Kurdish believe dream world is... |
is connected to wakened world. A favour received in a dream requires you to give a gift in the real world. Same goes for apology and argument, |
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How much sound is in dreams? |
50% |
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How often do people feel touch in dreams? Plus pain sensation? |
8% Rare for pain. Usually wake before. |
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Complimentary content |
compensate or supplement to what has recently occurred in waking life in an attempt to bring overall balance or harmony. |
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Most characters come from _____? in dreams. Friends and colleagues appear more than _______ |
present life family (unless you still live with them) |
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Continuous content |
Themes, concerns, events of waking life are taken up again in our dreams (more prevalent) |
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What do we dream of? |
-The past - The future - the plausible - the absurd |
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What do kids 3-10 dream of? |
Animal characters, play, success, adventure and aggression increase as age. |
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What do young adults/middle age dream of? |
Sexuality |
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What do the elderly dream of? |
illness and death * same as younger people with clinical depression. |
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What do people in the US dream of? Vs. What do people in Japan dream of? |
More Aggression, cars/houses |
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Musicians are 2x more likely to dream of... People with low economic status dream of... |
Music. Failure. |
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Dreams in early and late pregnancy: |
Early: focus on self; changes. Later: pregnancy itself, baby, birthing, relationship with partner. |
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What do women dream of when pregnant vs men? |
Women: fertility, mothering, abnormal infant, labour, career issues. Men: Can also dream of being pregnant and partners worries. Men will also often dream about their own fathers and identity issues. |
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Content in dreams with Depression: |
- negativity in dreams - all my fault - objects not functioning - important items are lost. |
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REM and non REMs with depression- when does it happen and how? |
REM period is earlier, REMS evenly distributed and shorter through night. |
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Are dreams continuous within one night? |
Dream episodes appear to be unrelated throughout the night across REM period. We make the link ourselves. |
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Exact dream duplication is unusual unless... |
PTSD |
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When do recurring dreams usually begin? |
Adolescence or childhood. |
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How long are recurring dreams? |
Severl weeks to years. |
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Who first noted Lucid dreaming and who created the term? |
Aristotle F.W Van Eden (1913) |
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Who popularized lucid dreaming? |
C.Green and A. Faraday. |
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Who studied lucid dreaming with polysomnongraphy? |
S. LaBerge |
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In lucid dreaming you can change the behaviours but usually not the... |
people and places. |
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When does lucid dreaming usually occur? |
Later in the night. |
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What happens in the lab when researching lucid dreaming? |
give pre-arranged signal when lucid (sequence of eye movements, twitch a ginger a number of times) dreaming recorded on polysomnography. |
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A lucid dreamer can signal at exact time and experimenter can.... |
ask to perform action in the dream (and measure), and signal when complete. |
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Purposes of Lucid dreaming? (5) |
- uninhibited actions (public speaking, sexuality). - fulfilling wishes. - improve physical skills. - healing image cell repair or destruction. - assume control of nightmare content.
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How to lucid dream? |
- focus on regular recall - look for dream signs (cues of unrealistic things) - in wakefulness be more mindful. - while in dreams look at your hand and own body. |
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Who thought of dream incubation? |
Gayle Delaney. |
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How to perform dream incubation? (4)
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- write down topics and feeling you want to dream about, when prepping for sleep concentrate on the desired topic. - Create one line requests/question and repeat this as falling asleep, - when wake up write/ record as much detail as possible. - more easily achieved if related to personal current concerns.
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