WEEK 5 - 7 Flashcards

(87 cards)

1
Q

~WEEK 5~

A
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2
Q

Central Physiology

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Brain tem rituclar formation
= - thalamus
- hypothalamus - basal forebrain

The main areas involved in sleep are:

  • the brain stem,
  • hypothalamus,
  • pineal gland,
  • the limbic system,
  • and the cortex
  • The brain stem reticular formation branches out to the thalamus and the hypothalamus
  • the hypothalamus contains the sleep switch so it is a key area for sleep
  • The suprachiasmatic nucleus is the coordinator of Process C and is located at the anterior of the hypothalamus alongside the pineal gland where melatonin is secreted
  • melatonin sets the stage for sleep several hours later
  • The thalamus is a sensory relay system and although information continues to arrive via the senses during sleep, it is important to have a sensory blockade so that meaningless information is not processed all through the night
  • Without this blockade we would wake up continuously
  • The basal forebrain branches out from the hypothalamus to other cortical areas
  • cortical areas responsible for logic and planning, such as the prefrontal area, are largely inhibited during sleep
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3
Q

Where Does Sleep Emanate/originate from?

A
  • the seat of wakefulness is the ascending reticular activating system (ARAS)

The ARAS is a system that includes:

  • the pons,
  • brain stem,
  • reticular formation,
  • pontine,
  • mesencephalic tegmentum,
  • and caudal diencephalons
  • The pontine and midbrain areas also project to hypothalamocortical areas
  • Much of what we know about these systems we learned by stimulating different circuits to produce wakefulness
  • In other words, the cells within this system produce wakefulness

The cells implicated in wakefulness include (not an exhaustive list):

  1. Noradrenergic cells in the locus coeruleus (LC):
    - We know this because when we monitor a single cell in an experiment, we observe that these cells fire at their highest rate when awake and decrease while falling asleep
    - These cells completely stop firing during REM
    - administering drugs that stimulate noradrenergic cells in the LC produces wakefulness
  2. Serotonergic (5HT) cells in the raphe nuclei (RN)
    - Like the noradrenergic cells, single cell experiments tell us that serotonergic cells fire at their highest rate when awake and decrease while falling asleep
    - they completely stop firing during REM
  3. Cholinergic cells in the pedunculopontine tegmentum:
    - Activating these cells promotes wakefulness
    - a series of cat studies by Garcia-Rill and colleagues showed that electrical stimulation of this area of the brain caused wakefulness
  4. Dopaminergic cells in the substantia nigra and ventral tegmental area:
    - If you administer a dopamine antagonist (an antagonist is a drug that blocks the action of that chemical), you can produce sleep, including SWS
    - So, if you block dopamine and it produces sleep—it means that this cell’s function is the opposite, which is wakefulness
  5. Hypocretins/orexin:
    - Their discovery was around the same time and two different labs named this chemical two different things, so it is always confusing as to whether you should call it orexin or hypocretin
    - For the sake of convenience, we will always refer to it as orexin in this class**
    - Orexin is produced in the hypothalamus, and these cells have projections into the LC and dorsal raphe
    - They are excitatory peptides
    - They appear to consolidate sleep and integrate metabolism and sleep
    - If you block orexin, you fall asleep
    - Those with narcolepsy have deficits in orexin and fall asleep involuntarily or lose muscle tone like they are asleep, even when awake
    - Remember the video of a Doberman Pinscher with an orexin deficiency
  6. Histamine:
    - Histamine is produced in the hypothalamus and is an excitatory neuron
    - It is blocked by GABA when sleep is produced
    - When you have a cold or allergies, you may take a drug that blocks histamine (an antihistamine) and antihistamines have sedating properties
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4
Q

Sleep occurs when the ascending reticular activating system (ARAS) is deactivated and when the sleep switch in the hypothalamus is turned on. There are a variety of chemicals associated with sleep and sleepiness. For example:

A
  1. Adenosine:
    - When cells are working, they produce a byproduct called adenosine that accumulates in the basal forebrain over the waking hours
    - from the moment you are awake and your cells start to work and produce this chemical, you begin building a drive for sleep that night
    - The greater the amount of adenosine build-up, the greater the drive for sleep (the sleepier you become)
    - While this build-up of Process S occurs, you are also receiving alerting signals from the clock at increasing intensity across the day so that you will not continuously fall asleep because of the adenosine build-up
    - You want a sufficient build-up of adenosine in order to sleep deeply, so chemicals that block the build-up interfere with sleep quality
    - One such chemical is caffeine
    - Caffeine blocks adenosine and interferes with sleep quality
  2. GABA:
    - Gamma-aminobutyric acid (GABA) is one of the primary sleep chemicals
    - GABA inhibits wakeful chemicals such as histamines, 5HT, and acetylcholine activity
    - GABA promotes sleep by exerting effects in the basal forebrain and hypothalamus
    - it exerts effects on the sleep switch in the ventrolateral preoptic area (VLPO)
    - Most sleeping pills act on GABA
  3. Melatonin:
    - Produced by the pineal gland with receptors in the SCN and hypothalamus (where thermoregulation occurs)
    - Exogenous melatonin has sedative properties when endogenous melatonin is not present
    - This means that if you took a melatonin pill when melatonin was not present (e.g., 4 p.m.) you could expect some sedation
    - If you took the same melatonin pill at your normal bedtime (e.g., 11 p.m.), the pill would have little effect because melatonin was secreted hours earlier
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5
Q

Respiration During Sleep

A
  • Let’s move away from central physiology to consider cardiovascular physiology
  • In order to meet the metabolic needs of the body, we exchange gases and regulate the balance between CO2, O2, and the pH in the blood = we breathe
  • Breathing is rhythmic; we take in/inhale O2 and expel/exhale CO2
  • although breathing rates can increase or decrease, the rhythm more or less remains constant
  • When we are awake we have some control over our breathing—we can even hold our breath for a certain amount of time
  • However, during sleep, breathing is not volitional
  • During sleep, breathing is a steady rhythm generated by pontomedullary neurons
  • During wakefulness, there is limbic, motor cortex, and pontine input into breathing but during sleep, breathing is under brain stem control
  • During slow wave sleep, breathing slows down considerably and is the most rhythmic
  • During REM sleep breathing can become less regular and more closely resembles breathing during wakefulness
  • There can be inter-breath variability; blood pressure increases as does heart rate, but the most important thing to note is the variability
  • The unusual variability in REM sleep may relate to the phasic activity (e.g., PGO spikes) or even to dream content
Wakefulness
reflective (brainstem)
behavioural (motor cortex)
emotional (limbic system)
= respiratory muscles

Sleep
brainstem = respiratory muscles
NOT motor cortex or limbic system

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6
Q

Obstructive Sleep Apnea

A

Obstructive Sleep Apnea (OSA):

  • a breathing disorder in which breathing stops for a minimum of ten seconds and the brain wakes up (often outside of awareness) to reinitiate breathing
  • OSA is caused by an obstruction or narrowing of the airway
  • there may be too much soft tissue in the palate or upper airway or hypertrophy of the muscles in the upper airway (e.g., hypertrophied adenoids or tonsils) or abnormal bony structures
  • Imagine that your airway is like a cloth tube, if there is air being pushed or sucked through it, the tube is open but once the air stops the tube deflates
  • The pharynx, or pharyngeal muscle, loses tone during sleep, particularly in REM sleep wherein we lose muscle tone through most of our body
  • Other factors influencing collapsibility is weight, particularly in the neck
  • Weight pushing down on the airway narrows the path for which air can enter and leave
  • During the day, people can compensate for an obstruction in the airway by stiffening the airway but this does not occur at night and they cannot compensate for the reduced flow coming through a small airway
  • The result of apneic events is severe sleep deprivation as well as cardiovascular and insulin problems
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7
Q

SIDs

A

Sudden Infant Death Syndrome or SIDS:

  • occurs in the less than 1% of babies under the age of one-year-old
  • It is unknown as to what causes SIDS but it is believed that the baby asphyxiates and is unable to reinitiate breathing or to wake up to eliminate the obstruction (e.g., if the baby is face-down they may not wake up to unblock their nose or mouth)
  • There may be a vulnerability to SIDS (e.g., abnormal brain stem 5HT receptors or immature respiratory system because of premature birth) that interacts with environmental problems such as sleeping face-down or smoking in the home
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8
Q

Blood Pressure (BP) and Heart Rate (HR)

A
  • HR and BP are lower during sleep and BP dips by about 10%
  • If you deprive someone of sleep they do not show the dipping so it may not be circadian—it may relate to sleep itself
  • BP and HR decrease from stages 1 to 3/4NREM
  • NREM is a time of parasympathetic activity
  • In REMS both increase and there is considerable variability
  • Arousals are associated with sympathetic activity
  • Thus disturbances in sleep are associated with sympathetic activity
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9
Q

Endocrinology and Sleep

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  • Sleep is an active time for your endocrine system
  • Growth hormone (GH), a hormone important for tissue restoration and protein anabolism, is secreted for the most part exclusively at night
  • GH secretion occurs very close to sleep onset and most often coincides with slow wave sleep (SWS)
  • GH is associated with a healthy build-up of sleep drive, which you learned about when you learned about the homeostatic system
  • Because of its association with SWS and the observed increases after sleep deprivation, some use it as evidence that sleep serves a restorative function
  • GH production drops off over the course of the night and GH concentration is quite low in the second half of the night (this is associated with SWS production or lack thereof in the second half of the night)
  • Men have a single GH secretion peak but women have several peaks of secretion
  • GH is related to the hypothalamic-pituitary-somatotrophic (HPS) system
  • Cortisol is a hormone associated with stress—it is released in response to stress but also exhibits a circadian rhythm
  • Cortisol reaches its lowest point or nadir in the twenty-four-hour period around sleep onset
  • Cortisol stays low but then begins to circulate again around 2 to 3 a.m. and increases towards waking
  • Corticotropin-releasing hormone is released by the hypothalamus, which stimulates cortical production in the adrenal cortex—part of the hypothylamic-pituitary-adrenal (HPA) system
  • Thus the HPS and HPA systems reciprocally interact with one another to regulate sleep
  • Melatonin reaches its peak in the early morning hours and begins secretion in response to the offset of light in the evening
  • Renin is a hormone related to the REM/NREM cycle
  • Renin oscillates throughout the night and peaks during NREM and reaches a trough (acrophase) during REMS
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10
Q

Sleep and the Autonomic Nervous System

A
  • The autonomic nervous system (ANS) is active during sleep
  • The ANS has two branches: the parasympathetic (PNS) and sympathetic (SNS)
  • The sympathetic branch is known for its fight or flight response
  • it enables us to deal with emergencies by inhibiting less important bodily processes and mobilizing resources to respond to threats
  • Parasympathetic activity is known for the conservation or maintenance of resources
  • During sleep, the parasympathetic activity is less active except for NREM; for example, digestion slows
  • Bodily waste still moves through the body but very slowly
  • Saliva is not produced and we do not have a swallowing reflex
  • Our blood pressure decreases and our breathing slows
  • The one exception is that during REMS, the PNS becomes more active
  • Our SNS decreases during sleep, particularly during NREM
  • The exception is that during REMS, there can be bursts of activity, described as a storm, wherein there are dramatic and irregular surges of activation/deactivation of organs
  • When this SNS activity occurs, we are more prone to arousals and wake ups
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11
Q

Is There an Alarm Hormone?

A
  • Born and colleagues (1999) monitored the blood levels of adrenocorticotropin (A) levels of fifteen people for three nights
  • Adrenocorticotropin (A) is a hormone that is secreted just before rising and communicates to the adrenal gland to release cortisol
  • Cortisol starts to rise in the morning hours
  • Once the researchers collected the baseline levels, their independent variables were a combination of instructions and forced wake-up times
  • The dependent variable was what happened to A levels
  • In the first condition, they were told the night before that they had to get up at 6 a.m. and they were indeed woken up at 6 a.m
  • In this group, A increased in the hour before the scheduled wake-up time
  • In the second group, they were told the night before that they had to get up at 9 a.m. and they were indeed woken up at 9 a.m
  • Similarly, A increased in the hour before the scheduled wake-up time of 9 a.m
  • In the final group, they were told the night before that they had to get up at 9 a.m. but they were woken up (unexpectedly) at 6 a.m
  • The result was that there was no rise in A before the unexpected 6 a.m. wake-up time
  • This suggests that there is a chemical “expectation” of sorts of rise time and it prepares your body for an awakening
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12
Q

Summary WEEK 5

A

There are several neurochemicals associated with sleep and wakefulness. These include:

  • noradrenaline in the locus coeruleus (LC)
  • serotonin in the raphe nuclei (RN)
  • acetylcholine in the pedunculopontine tegmentum
  • dopamine in the substantia nigra and ventral tegmental area
  • hypocretins/orexin and histamine in the hypothalamus
  • adenosine in the basal forebrain
  • GABA in the basal forebrain and hypothalamus (especially the ventrolateral preoptic area)
  • melatonin in the pineal gland
  • Breathing during sleep is rhythmic and no longer under volitional control
  • During REM sleep, breathing, heart rate, and blood pressure become less regular and more closely resemble breathing during wakefulness

The endocrine system is active during sleep. Key hormones include:

  • Growth hormone: the chemical associated with SWS
  • Cortisol: a hormone associated with stress that exhibits circadian rhythmicity
  • Melatonin: a hormone associated with light offset which also exhibits circadian rhythmicity
  • Renin: a hormone related to the REM/NREM cycle
  • During sleep, autonomic nervous system activity is low
  • During NREM we have increased PNS activity
  • During tonic REMS, the PNS becomes more active and during phasic REMS, there are surges of organ activation (SNS activity)

Tonic REM:
- a parasympathetically driven state with no eye movements, decreased EEG amplitude, and atonia

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13
Q

~WEEK 6~

A
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14
Q

Ryecast video: Sleep and dreams

A
  • we don’t know what’s causing dreams/what’s going on in the brain when we dream
  • When looking at the brain during REM sleep, the midline of the brain lights up = all the regions involed in emotions
  • looks like when we are sleeping, the logic part of our brain is turned off and the part of our brain that remembers events and sequences is turned off, and cranks up the emotional system

The brain dreams about 3 main things:

  1. things that are recent
  2. things that are repetitive
  3. things that are emotional important
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15
Q

Neurobiology of Dreams

A
  • Dreams in REMS are associated with a greater rate of recall than other stages so most of what we know about dreams from a physiological standpoint has been collected from REMS
  • We can discern a lot about dreams from brain activation studies
  • Some areas of the brain are not active during dreaming, for example, the prefrontal cortex (PFC)
  • The PFC is an area associated with planning and purpose, thus with the PFC largely “asleep,” dreaming is associated with a loss of volition and logic
  • There are several areas that are active while dreaming
  • limbic structures, associated with emotionality, are highly active during dreaming
  • The pontine and midbrain reticular activating system (RAS) areas associated with consciousness are active during dreaming
  • The hypothalamus and basal forebrain areas are active, which may explain the primitive instinctual content in dreams
  • Visual imagery may be associated with the activity observed during dreams in the visual association cortex
  • the cerebellum, an area associated with movement, and primary motor cortices, and areas associated with sensation and movement, are all active during dreaming
  • Essentially, during REMS dreaming, acetylcholine, a chemical associated with arousal is active
  • Emotion and sensory areas are active but the prefrontal cortex which is associated with planning and volition is quiet
  • As the text says, this is why we may be missing the “reality check” in our dreams
  • It explains the emotional, instinctual, primitive nature of our dreams as well as the vividness of our dreams
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16
Q

Do We Dream Only in REMS?

A
  • We appear to dream in both REMS and NREM although this is somewhat contested
  • The discovery of dreams was during REMS, so there has been a perception that we only dream in this stage of sleep
  • There is evidence that we may also dream in NREM, although the recall of dream content is less than half of that of dream content when awoken from REMS
  • Some view the activity during NREM to be less consistent with dreams
  • There are differential areas of the brain activated during dreaming from REMS versus NREM
  • In both REMS and NREM people recall “dreams,” although, as stated above, there is less likelihood of recall when awoken out of NREM
  • The type of dream most typically reported out of NREM is one of mundane, brief descriptions of events, sometimes with some of the details obscured

Consider the following dream recalls:

a) Episodic memory sources (hippocampal): “I was at the cottage, but it wasn’t the cottage, during the summer, with Joan, but Joan was someone else.”
b) Emotional content (emotion structures): “I was scared. Maybe someone was after me?”

Which recall is most likely from REMS?

  • The answer is B
  • It is primarily emotional and less mundane
  • Option A is likely NREM because it is an attempt to recall a fairly mundane event without much emotional context, along with some potentially nonsensical material
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17
Q

Why Do We Dream?

A

There are three general types of theories of dreaming:

  1. Psychodynamic theories
  2. Biological theories
  3. Cognitive theories
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18
Q
  1. Psychodynamic Theories
A
  • Freud believed that dreams reveal people’s secret wishes and desires and are thus important
  • Dreaming was an important activity because it released tension we experience from all of our “unacceptable” wishes
  • Our “unacceptable” wishes were thought to appear in a disguised version
  • For example, dreaming about a knife was supposed to be a dream about a penis
  • Thus, part of Freud’s work was dream interpretation; that is translating disguised dreams into what he believed to be their “actual” meaning
  • There is of course no evidence for this**
  • Contemporary psychoanalysis continues the tradition of dream interpretation albeit typically with less of an emphasis on sex
  • Carl Jung was a contemporary of Freud who broke away from Freud because of differences of opinion
  • Both interpreted dreams but one major departure was labelled in the text as “dreams reveal, not conceal”
  • The idea here is that Jung thought that dreams were not merely disguising unwanted wishes; sometimes dreams help people to solve waking problems
  • This is a more positive view of dreams
  • Although there is no evidence for dream interpretation per se, interestingly Dr. Rosalind Cartwright has shown that dreams may have emotionally adaptive purposes

Do we dream to cope?

  • Dr. Rosalind Cartwright suggests that during dreams we are trying to “work through” emotional issues
  • One of her studies showed that dream content about one’s spouse predicted improvements in depression in women following divorce
  • The suggestion is that the dream process was somehow helpful in processing information related to the divorce that ultimately ameliorated the depression
  • Sleep may help with emotional adaptation to negative experiences
  • If research participants are shown negatively valenced pictures, they show increased negative arousal; that is the pictures are upsetting
  • When the same participants sleep that night, those with the greater degree of REMS report better adaptation (i.e., less reactivity) to the pictures the next day
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19
Q
  1. Biological Theories
A
  • The activation-synthesis hypothesis (Hobson, Pace-Schott, & Stickgold, 2000) explains dreams as a result of particular areas of the brain activating and the brain attempts to create a narrative that synthesizes/integrates the activated material
  • For example, during sleep areas of the brain associated with emotion, instincts, sensation of where the body is in space and movement, memory, emotion, sensation (although incoming information is blocked) are activated/firing
  • Other areas of the brain are not active—for example, the prefrontal cortex
  • Remember that the prefrontal cortex is an area of the brain associated with logic, planning, and executive functioning
  • there is plenty of activity in the brain, as areas are firing through the night, and the brain attempts to connect the information into a narrative but the area of the brain that might be able to integrate this most logically, is essentially asleep
  • This may be why dreams can be so illogical
  • So dreaming can be interpreted to be meaningless using this theory
  • However, this theory does not necessarily mean that dreams are meaningless because the narrative is being created by your brain, using your memories, so it is unique to you
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20
Q
  1. Cognitive Theories
A
  • Cognitive theories of dreaming essentially focus on how information processing differs or is similar to wakeful information processing
  • Whereas psychodynamic theories focus on dreams as a clue to the unconscious, and biological theories view dreams as neural activity, cognitive theories see dreams as a type of thought
  • Cognitive dream researchers wake participants repeatedly throughout the night and participants speak about their thoughts while being monitored via PSG
  • Thought content (i.e., dreams) is reported whenever being awakened but the content becomes more visual and can be hallucinatory
  • Another characteristic of cognition in this study is that thought is not under voluntary control as people enter sleep (as verified by the PSG)
  • Thus, dreams can be seen as mental content similar to wakefulness but different in the visual experience (i.e., it can be hallucinatory) and not under volitional control
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21
Q

What is Lucid Dreaming?

A
  • Lucid dreaming is when one is aware that one is dreaming while dreaming
  • The methodology to study lucid dreaming is essentially to train research participants to signal the experimenter using an eye movement code to signal lucidity
    ex. looking left two times and then right once to signal awareness while dreaming
  • The experimenter then looks at the physiological activity or nature of the subjective recall during this period as compared to a non-signaled segment of time
  • There is some evidence that brain activity is different during lucid versus non-lucid dreaming
  • The electrical activity during lucidity is characterized by higher frequency activity during lucidity
  • research participants shift their EEG power, especially in the 40-Hz range to a higher frequency activity and especially in frontal regions of the brain
  • Frontal activity and increased higher frequency activity is most typical of wakefulness; thus, lucid dreaming is best described as a mixed state of REMS and wakefulness
  • Those interested in lucid dreaming believe that lucid dreaming could unlock more potential, including clinical potential
  • For example, many think that lucid dreaming could be used clinically to work through emotional issues
  • The most obvious group in mind are those with post-traumatic stress disorder (PTSD)
  • People with PTSD often complain of nightmares, and effective treatments include exposure to the trauma event and a reprocessing/integration of the trauma material
  • behavioural sleep medicine specialists have been helping people with PTSD to restructure their dreams for years without invoking the idea of the lucid dreaming label
  • The technique is called imagery rehearsal and retraining therapy (IRT)
  • In this therapy, nightmares are presumed to be a learned (involuntary) behaviour that can be modified by mentally rehearsing alternative dream scenarios
  • Patients are told to write down a nightmare and then write out a dream with alternate content
  • They then practice (by using their imagination) the new dream over and over again
  • The new content is expected to appear in dreams in place of nightmare content
  • Research supports that IRT reduces the number of nights with a nightmare, and results in improved self-reported sleep quality disturbance
  • So, invoking the lucid dreaming concept is probably unnecessary
  • Moreover, of people that respond to experiment advertisements for this type of study, only a proportion of people can be successfully trained to lucid dream
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22
Q

Can You Intensify Your Dreams?

A
  • There are many medications and substances that can lead to reports of “intensified” dreaming, increased dreaming, or more unusual dream content
  • For example, some antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) can have this impact on dreaming
  • In addition, when quitting smoking, use of transdermal nicotine (i.e., the patch) can be associated with an increased dreaming report
  • Those taking cardiovascular medications called beta blockers, or those with neurologic disorders such as periodic limb movement disorder or restless leg syndrome who take dopaminergic drugs, can report dream intensification as a side effect
  • Lastly, drinking alcohol before bed diverts resources to metabolize the alcohol which temporarily suppresses REM sleep
  • When REMS is suppressed, pressure builds for REM sleep, such that when REM is permitted to occur, it occurs with greater intensity, and people can report dream intensification
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23
Q

Problems With the Study of Dreams

A
  • There are many challenges in conducting dream research
  • We are asking people to tell us about their dreams, but in doing so, they are verbally describing their experience; an experience that is audiovisual
  • We must assume that their visual experience of “seeing an elephant” is the same as what we would see as an elephant during wakefulness
  • Similarly, we have no way of knowing that someone’s recall of their dreams while awake is a good match for the content while they are dreaming
  • Recall relies on memory and our memory may not work in the same way when waking up from a dream
  • It is also documented that there is a recency effect in the recall of dreams = we remember the parts closest to the time at which we were awakened
  • there may be an expectancy effect in dream recall

Imagine someone agrees to participate in a dreaming study:

  • Do you think that people who volunteer for a dreaming study might be different than those who would not volunteer for a dream study?
  • What do you think they would expect the experimenter wants?
  • There might be an expectation to have a dream so the participant might be particularly attentive to dream-related material when awakening, searching their memory for any potential dreams
  • Perhaps there might be some pressure to report a good dream
  • If the participant had a dream wherein they were looking over a grocery list, can you imagine that they might feel the need to embellish?
  • although there is plenty of dream-related research, there are significant challenges inherent in this type of research
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24
Q

Summary Week 6

A
  • Psychodynamic theories of dreaming emphasize that dreams help to conceal unwanted wishes
  • Dreams are interpreted by psychoanalysts because they are viewed as key for emotional growth
  • There lacks empirical support for interpreting dreams
  • Biological theories of dreaming emphasize spontaneous neuronal firing with an attempt to connect the information into a narrative
  • Cognitive theories of dreaming treat dreams as a form of information processing that is different from wakeful processing, e.g., dreams are a type of thinking that tends to be more visual than wakeful thought
  • Lucid dreaming is dreaming with an awareness of dreaming. It involves a state between wakefulness and sleep

There are several problems with dream research, including:

  • Dreams are mainly a visual experience whereas recall is a verbal endeavor—so we cannot be sure if someone’s verbal (recalled) report is a match for what they actually dreamed
  • There may be problems with recall, including a bias towards recency
  • There may be expectancy effects
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25
~Chapter 6: The Body During Sleep~
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6.1 The Normal Physiology of Sleep
- Prior to the latter half of the twentieth century, it was assumed that the physiology of the body was the same when asleep as it was when awake - the discovery of REMS prompted scientists to view sleep differently and look for things in sleep that they never thought of looking for earlier - we do not sleep simply because our body wears out while awake and needs sleep to reverse this effect - It is now realized that changes in any of several physiological processes may either facilitate or impede sleep the body during NREMS: - Things are quiet and at a generally low level as it would be for the body to rest and recuperate - The feedback systems of the various organ systems are working well but maintaining steady levels somewhat lower than during quiet waking when resting - Any internal or external disturbances are quietly compensated for by these feedback mechanisms the body during REMS: - It is a time of irregular activation of many bodily processes - Local reflexes are operating the organ systems of the body, but their control is frequently being overridden by lower parts of the brain - the brainstem controls this operation with a general unresponsiveness to feedback about what is going on in the body - As a result, REMS is anything but restful and recuperative - REMS entails a bit of a risk to the welfare of the body, since things are a bit out of control and can fluctuate wildly
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6.1.1 Central Nervous System
- The central nervous system is composed of the entire brain plus the spinal cord - During NREMS, many neurons in the central nervous system have a lower rate of activity than they do during waking - the overall metabolic rate in the brain is lower than during waking - It is as if most of the brain is just active enough to keep things going at a basic, low level, much like a car idling - there is still a lot of mental processing going on - There are a few areas that are more active than they are during waking - These are the areas that assume control in order to actively produce NREMS - During tonic REMS, the cells in several areas in the brain are actually more metabolically active than they are during NREMS or waking - Not only are these areas active because they are causing REMS, but there is quite a lot of mental activity going on in REMS - during phasic REMS, the cells in some regions of the brain, especially the visual areas, are sporadically wildly active
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6.1.2 Autonomic Nervous System
The autonomic nervous system, ANS, is responsible for controlling many of our internal physiological processes such as: - the heart, - lungs, - stomach, - intestines, - and many glands The ANS is composed of two parts: 1. the sympathetic nervous system, SNS - prepares our body to deal with emergencies and threats - When awake and faced with a perceived emergency or threat, the SNS: - increases heart rate, - blood pressure, - and the speed and depth of respiration, - but diminishes digestion 2. the parasympathetic nervous system, PNS - does the opposite of what the SNS does - It functions to conserve and maintain the body resources in the absence of any perceived emergencies or threats by: - slowing the heart, - decreasing blood pressure, - slowing respiration, - but facilitating digestion - It is important to note that seldom is the only SNS or only the PNS completely in control - Typically, the entire SNS is relatively more or less active, while individual portions of the PNS are more or less active - During sleep the PNS generally increases in activity while the SNS generally decreases in activity - However, the relative balance is more related to the stage of sleep than any real or perceived threats or stresses NREMS is characterized by: - an active PNS - with a relatively quiet and stable SNS During tonic REMS: - the PNS is at the same level as in NREMS, - the SNS operates at an even lower level than during NREMS During phasic REMS: - the PNS is more active, - and the activity of the SNS has been described as a storm—variable but with intense activity - the result is dramatic and irregular surges of activation of many of the internal organs during REMS
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6.1.3 Cardiovascular
During NREMS: - heart rate is slower - and blood pressure is at a slightly lower than when awake - most areas of the brain have relatively less blood flow - However, there are few areas that are actively in control of sleep that have slightly to significantly increased blood flow During tonic REMS: - blood pressure and heart rate are even lower than during NREMS - unlike other organs of the body most brain areas have a substantial increase in blood flow over what is present during waking - with some brain areas getting as much as 200 % of waking levels During phasic REMS: - heart rate has noticeable surges and pauses - average blood pressure is generally higher but more variable with considerable peaks than resting level - there are even greater transient increases in blood flow in the brain
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6.1.4 Respiration
- Primarily, breathing brings oxygen into the body and expels carbon dioxide. - Much of our respiration is under automatic control for this purpose but can be overridden or captured by conscious control - such as when talking or holding breath to dive underwater, or by other automatic control mechanisms, such as when sneezing - There are separate but partially overlapping mechanisms for automatic and behavioral breathing - Throughout NREMS the control of breathing is entirely automatic, functioning to mainly maintain the level of carbon dioxide in the blood but at a slightly higher level than when awake and to a lesser extent oxygen at a slightly lower level than when awake - There is a moderate decrease in air volume entering and leaving the lungs per minute during NREMS - On the other hand, breathing rate and breathing volume are automatically varied as the levels of carbon dioxide or oxygen vary - Overall, breathing, especially during N3, is regular and slightly deeper - Breathing during REMS is another story - Breathing rate and depth are very irregular with a rapid and shallow pattern tending to prevail - Pauses in breathing may occur - The average air intake is about the same or less than that of NREMS - The control is much more behavioral with levels of blood carbon dioxide and oxygen having little, if any, influence - As a result, the level of oxygen in the blood may be about the same or lower than that in NREMS and lower than during wakefulness - During all sleep, the cough response is suppressed - If the irritation in the air passages is great enough, you will awaken to cough - Additionally, because of the changes in breathing regulation, many people, especially the elderly, when falling asleep alternate several deep breaths with several shallow breaths even to the point of stopping breathing for a few seconds - This pattern continues for 10 or 20 or even 60 min until the person is solidly asleep
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6.1.5 Sex Organs
- The penis is erect in REMS and sometimes during NREMS in adolescents - The percent of REMS accompanied by erections reaches a peak in the mid-teen years and declines after that - Vaginal enlargement and lubrication also occur during REMS in females though not to the extent that penis erections do in males
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6.1.6 Body/Brain Temperature
- While 98.6 F is your average body temperature, it varies by about a degree warmer or cooler depending on the time of nychthemeron and whether or not you are sleeping - Normally the peak temperature occurs between 6 and 8 pm and the lowest temperature around 4–5 a.m - It would seem that the lower body temperature is due to the immobility during sleep, but people who are paralyzed, bed ridden, or just inactive in bed for the entire nychthemeron still have about half of the average body temperature drop during night sleep - Also, people who remain awake and active during their regular night bedtime also experience about half of the average nightly body temperature drop - Maybe you have noticed becoming cold during the night when you were pulling an all-nighter - Thus the nightly body temperature drop during sleep is due to both a circadian body temperature fluctuation plus reduced heat producing muscle movement During NREMS: - your body continues to regulate its temperature using the same several methods as it does when you are awake - A portion of the hypothalamus functions as a thermostat, receiving temperature input from sensors throughout the body as well as monitoring its own temperature - It has outputs to the parts of the brain that control temperature regulation mechanisms in the body - If you are too warm, more blood is sent to the surface of the body where it can be radiated to the air. - If really hot, you will sweat - When you are cool, less blood is sent to the body surface to avoid losing heat - If really cold, you may shiver - The only difference between sleep and wake is during NREMS when your body temperature set-point, like a thermostat setting, is a bit lower than when awake and your metabolic rate decreases - When you first fall asleep, blood may be sent to the surface of your body to help bring your temperature down to the sleeping set-point - If you are too warm at sleep onset, you may sweat for a while - Whether you realize it or not you sweat a lot when asleep, even if your bedroom is cool - Total sweat may be half a quart or more on a typical night Body temperature during REMS: - Your metabolic rate is the same or greater than when in NREMS - However, there is no regulation of your body temperature - It’s the difference between having a room with a thermostat that turns on the heater or air conditioner to keep the room temperature steady versus having an unregulated fireplace with a nice fire going in it - With only the fireplace going when it is warm outside, the room will tend to get warmer, but when it is very cold outside, the room may tend to get cooler - The same thing happens during REMS; if you are in a warm room, your body temperature may go up a bit, but the opposite can happen in a cool room - The body makes little, if any, attempt to regulate its temperature, such as by sweating or shivering during REMS - In point of fact we are functioning almost as cold-blooded animals, such as snakes, during REM sleep - However, if your body gets too cold or too warm, you will wake up and begin regulating again - Your brain temperature, like your body temperature, will decline a bit in NREMS, but it tends to warm up during REMS - because of the high amount of neuronal activity and increased blood flow during that state, which burns so much energy - It may even get warmer than it typically is when awake - The relationship between sleep and body temperature has yet another level of complexity - Our tendency to sleep and to sleep well depends on our body temperature - We have a propensity to sleep when body temperature is low or dropping but to be awake when body temperature is high or rising Sleep onset: - is 6 h before our core body temperature low point, - about 6 a.m in the average young adult Sleep offset: - follows about 2 h after the temperature low point when body temperature is rising - Interestingly, in the lab, heating the head by blowing warm air on the face increases N3 sleep - A 20 min warm bath a couple of hours before bed for a couple of weeks can do the same thing - It is not only relaxing but also increases body temperature a bit requiring the body to cool itself down more rapidly, promoting sleep - On the other hand if the bed is too warm, such as having an electric blanket set to the maximum, the body has more difficulty cooling down making falling asleep more difficult - An alternative to using too many warm blankets is to wear socks to bed; footwear can be comforting yet not increase body temperature too much
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Box 6.1 Body Temperature at Sleep Onset
- The temperature of your body when you begin sleep has an effect on your sleep Consider the following experiment, which is actually a combination of several research projects done by Jim Horne and colleagues in the mid-1980s: - You and some of your physically fit friends show up at the sleep research lab during the evening - Some of your friends have to run hard on a treadmill in a warm room with little air movement until their body temperature increases 2 C. - Others of your friends are luckier, because while they have to run as long as the first group, they can have a fan blowing on them, and they only gain 1 C of body temperature - But you and a few others are luckiest of all, because you get to soak in a hot tub until your temperature goes up 2 C - Finally, another group of friends are not so lucky; they get in a different tub only to discover that the water is not hot. They have to stay in it as long as you stay in yours - After a bit, all of you are prepared for a night of sleep recording in the lab - Before going to sleep, all of you are asked how sleepy you feel - The results are that you and the other hot tubbers and the hot exercisers felt sleepier, slept a bit longer, and got more N3 than the cool exercisers and cool tubbers - The next week, you all come in during the day for the same exercise or tub experience - Then you return later that night to sleep in the lab - By the time you go to bed, there are no differences in sleepiness or actual sleep because by this time the increase in body temperature has dissipated Conclusion: - if your body temperature is a bit elevated when you go to bed you may fall asleep more quickly and easily - Actually heating up just the brain works as well - Jim Horne placed a hood that had warm air blowing through it on volunteer’s heads in his lab - The duration of the head warming was thought to be sufficiently long to heat up the brain a bit. - They subsequently had deeper and longer sleep - Outside of the lab, warming up the brain to obtain better sleep is impractical - However, brain activity can have the same effect on sleep, but it is the type of brain activity that is important Jim Horne has well stated: "‘Brain exercise’ leading to deeper sleep comes not so much from crosswords or Sudoku but from spending a few hours walking in a changing, interesting environment, looking around and absorbing what is going on. Window shopping, sightseeing; anything new and different enough to hold your attention will do. Having conversations and meeting new people add the important ingredient of novelty, putting further agreeable demands on one’s mind and brain. All this new stimulation makes the brain work harder than staying indoors surrounded by familiarity. Reading or watching TV only engages relatively small parts of the brain, unlike getting out and about. Similarly, seeing an exciting film is still too passive—one has to be moving purposely, interacting with your surroundings. In contrast, jogging, while staring at the ground in front and listening to an iPod, is quite a repetitive and boring activity for the brain"
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Body Temp CONT'd
- When we try to sleep during a different phase of our temperature rhythm, we may encounter difficulties - If we go to bed later than usual, we can fall asleep easily but may awaken too early or find our sleep fragmented as our body temperature does its typical circadian rise - There is a bit of a mid-afternoon drop in body temperature corresponding to the mid-afternoon dip during which a brief nap can be beneficial If we try to get all of our nycthemeral sleep during the day when our body temperature is high, we may find that we have: - trouble falling asleep, - remaining satisfactorily asleep, - or getting enough sleep - REMS and rapid eye movements are more likely when circadian body temperature is low and less likely when it is high - we have more REMS in the early morning hours - Room temperature also affects both sleep quantity and quality - REMS is generally more sensitive to room temperature than NREMS - As a rule of thumb, people sleep best when the room is about 29 C (84 F) but without covers or clothes - When protected by pajamas and covers, a lower room temperature is best - Sleep is still quite good when the room temperature is in the range of slightly above the ideal to several degrees below the ideal - the further room temperature gets from this range, the more sleep deteriorates - Also, people show long-term adaptation to air temperature, so during the winter, a lower room temperature would be best compared to the summer
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6.1.7 Hormones
- Hormones and sleep have a complex relationship - Some hormones can affect sleep and sleep can affect some hormones Several hormones can enhance sleep such as: - progesterone, - melatonin, - neuro-peptide y, - and growth hormone releasing hormone - Adrenalin and cortisol can inhibit sleep or make it more restless - Somatostatin, corticotropin-releasing hormone, and ghrelin can reduce N3 sleep - prolactin, estrogen, and vasoactive intestinal peptide are thought to increase REMS Hormones that increase during sleep: - parathormone, - aldosterone, - and antidiuretic hormone Hormones that decrease during sleep: - thyrotropin, - insulin, - and aldosterone - N3 increases growth hormone in young males and prolactin in everyone - REMS decreases prolactin - Renin increases during NREMS but decreases during REMS - insulin levels are higher during NREMS than during REMS - during the first half of the sleep period there is an increase in growth hormone but decreases in cortisol and adrenal cortical tropic hormone - these relationships reverse during the second half of the sleep period - Some hormones are tied to rhythms Those tied to the circadian rhythm take several days to adapt to a change in the sleep schedule, such as following jet lag, including: - cortisol, - melatonin, - prolactin, - and thyrotropin - Cortisol release primarily follows a circadian rhythm beginning to rise about 2 h prior to intended awakening time - Sleep, especially N3, does seem to have an attenuating effect on its release - when sleep is delayed a bit, the low point of cortisol release is also slightly delayed and the peak level mildly attenuated - In women, levels of follicle stimulating hormone and estradiol show a circadian pattern - Other hormones, growth hormone and possibly aldosterone, are more tied to process S and are immediately affected by changes in sleep schedule - Leptin and insulin are affected by both process C and process S, as is thyrotropin - For example, there is an elevation in insulin during the typical sleep period that occurs even when awake, although it is attenuated - there is an elevation of insulin when sleep occurs during the typical waking period - In adult men, release of luteinizing hormone may be related to the ultradian NREM-REM cycle, but in women it depends on sleep and the phase of the menstrual cycle - Sleep influences hormones involved in appetite regulation - During sleep elevation of levels of leptin, which reduces appetite, and decreasing levels of the hormone that increases hunger, ghrelin, result in less hunger - Further, glucose regulation, a combination of glucose production by the liver and insulin levels, shows a circadian pattern of a reduction during the typical sleep period, but it is also reduced whenever sleep occurs Sleep deprivation adversely affects: - glucose regulation - decreases the levels of leptin, thyrotropin, and to some extent growth hormone - increases levels of ghrelin - Sleep deprivation or sleep fragmentation diminishes levels of leptin and increases levels of ghrelin - The result of all of these changes is an increase in appetite and unhealthy food choices with the potential for weight gain
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Box 6.2 Awakening Without an Alarm (Part 2)
- the ability of people to awaken at their desired time without using an alarm clock - A question that followed from this work was just how can people do this? - Part of the answer was discovered in subsequent research by Born and colleagues at the University of Lübeck in Germany - They found that the level of the hormone adrenocorticotropin increased during the hour before people were told they would be awakened the next morning - Perhaps this change in this hormone level helps awaken a person - Born and colleagues wondered if the expectation of awakening at a certain time influences the secretion of adrenocorticotropin, which tells the adrenal glands to release cortisol - They monitored 15 people during three nights of sleep starting at midnight - For one of the nights, these people were told they could sleep till 6 a.m - For the other two nights, they were told they could sleep until 9 a.m - but on one of those nights were surprised by being awakened earlier at 6 a.m - The amount of adrenocorticotropin in the blood was sampled frequently during their sleep - It began to rise sharply the hour before the early-expected awakening time but not in those expecting the later awakening time but actually were awakened earlier - Born and colleagues conclude that the increase in adrenocorticotropin is a part of the preparation by the body for awakening at a predetermined time - Still unanswered is how the brain keeps track of time during sleep to be able to cause this release of adrenocorticotropin prior to the anticipated time of awakening - Polysomnographic study of their sleep revealed no difference, including brief arousals, in any of the three conditions - So it was not a change in their pattern of sleep that made a difference in adrenocorticotropin levels - But just what keeps track of time during sleep remains a mystery
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6.1.7.1 Melatonin
- Melatonin can facilitate sleep and has been shown to act as a zeitgeber (a rhythmically occurring natural phenomenon which acts as a cue in the regulation of the body's circadian rhythms) - It is released by the pineal gland located in the middle of the brain about 14 h after awakening - This is normally two hours before sleep onset - Melatonin reaches its peak near the middle of the sleep period, returning to its low waking levels by the end of sleep - Its release is strongly controlled by process C and light - Its release is strongly controlled by process C and light but if there is an advance or delay in the schedule of light and dark, it will take several days before the release of melatonin follows Melatonin has been shown to mildly cause: - sleepiness, - speed sleep onset, - and facilitate sleep maintenance - When ingested in pill form, it may have some sleep promoting effects depending on the time of day when it is taken - It promotes sleep when taken several hours before typical sleep time - it seems to have little effect on sleep in normal sleepers when taken near or during the typical time of nocturnal sleep - This is perhaps because the pineal gland is already releasing it - Also, depending on time of day, melatonin ingestion may increase REMS or decrease NREMS - Melatonin also has mild zeitgeber properties and can cause phase changes of the circadian rhythm for sleep/wake - However, it has a weaker effect than light as a zeitgeber
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6.1.7.2 Age Changes
- As we age, there appear to be two phases during which the relationship between sleep and hormones changes - The gradual decline of N3 correlates with the decline in growth hormone through about 50 years of age - After age 50, correlated with what some researchers see as a decline in REMS, cortisol levels increase - These changes in endocrinology with age may be the cause of some aging effects such as memory impairments and reduced response to insulin
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6.1.8 GI Tract
- Generally, digestive processes are slower during sleep - Gastric acid production is decreased in the latter sleep period except in those with duodenal ulcers - They produce 3 to 20 times the levels of gastric acid produced in people without ulcers - Swallowing rate decreases in sleep, and the swallowing reflex is absent - Saliva is not produced during sleep - Generally, there is a decrease in the speed at which food and waste move through the GI tract during sleep, but some of this process may be circadian rather than a direct sleep effect
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6.1.9 Renal
- Smaller quantities of urine are produced during NREMS, but it is more concentrated. - Production is further decreased and concentration further increased during REMS
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6.1.10 Endogenous Sleep Factors
- There is evidence for several substances in the body that influence sleep such as cytokines and adenosine and other substances that are thought to also affect sleep - Some of these substances are found primarily in the cerebral-spinal fluid, while others can be found in the blood - This idea is a derivative of a very old ‘‘hypnotoxin’’ notion about what causes sleep - This notion held that during wakefulness a chemical builds up that eventually poisons the brain, resulting in sleep - During sleep, this chemical is degraded or eliminated allowing the return of waking - Some of the earliest experiments in the twentieth century on sleep occurred when Papenheimer removed cerebral-spinal fluid from a sleepy animal and injected it into the ventricles1 of an awake animal - The recipient appeared to fall asleep - However, relatively little research attention was directed toward such substances until the last two decades of the twentieth century - It turned out to be not all that is easy to do - Often, when techniques were available to isolate components of the fluid from the donor and inject only that into the ventricles of the recipient, the result was not genuine sleep but a kind of coma - However, some substances did seem to produce genuine sleep, yet none seemed to be necessary and sufficient for sleep - Rather, they appear to be one of many things that facilitate sleep - As of this time, adenosine is the only substance that satisfactorily meets all the criteria for a ‘‘hypnogenic’’ substance**
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6.1.11 Genetic
- Since the 1980s, evidence has been accumulating that there is a genetic basis for normal and abnormal sleep - The most convincing data comes from the studies of twins - Identical twins, even if not raised together, have more similar sleep patterns and characteristics than non-identical twins - However, these same studies also show that environment plays a large role in some sleep/ wake variables - More extensive genetic studies of sleep in animals reinforce these findings - Species-specific sleep patterns have been shown to be highly stable, strongly suggesting a genetic basis - Some studies have included using genetically similar versus genetically dissimilar animals - Other studies used selective breeding techniques to show a genetic basis for sleep characteristics, especially total sleep, total REMS, and aspects of circadian rhythms of sleep/wake - Studies in rats show that the amounts of N3 and REMS are inherited via different genes - Studies involving direct genetic manipulation of certain genes in mice resulting in consequences for their sleep are noteworthy - More recently research has shown the genetic basis of the effects of circadian rhythms on sleep - Specific genes with interesting names, such as clock, period, and timeless have been identified - Whether a person tends to be a lark or an owl has, in part, been shown to have a genetic basis
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Box 6.3 Effects of Sleep Deprivation on the Body
- Eve Van Cauter, PhD, research associate and professor at the Department of Medicine of the University of Chicago, and her colleagues have shown the negative physiological effects of chronic sleep deprivation on the physiology of the body - Prior to her work, it was shown that the release of growth hormone is severely reduced during sleep deprivation but rebounds when sleep is subsequently obtained - Her studies looked at sleep deprivation effects involving other hormones, especially insulin - 11 young adult males were allowed to sleep for only four hours per night for six nights, and then as much as they wanted while in bed for 12 h for the subsequent six nights - Naps were not allowed They found that during the sleep deprivation: - it took 40 % longer to regulate blood sugar levels after a high-carbohydrate meal, - a 30 % decrease in insulin secretion ability, - and 30 % drop in ability to respond to insulin— all characteristics of early diabetes - Van Cauter and colleagues concluded from these and other observations that sleep deprivation mimics human aging and can speed it up Van Cauter’s studies of people who maintained that they had adapted to chronic shortened sleep again showed: - a 40 % decrease in insulin sensitivity, - unusual cortisol release, - a decrease in leptin, - a hormone that reduces hunger, - and greater sympathetic nervous system activity - There is also an increase in insulin secretion causing more storage of fat that then causes more secretion of insulin that causes more storage of fat and on and on - Chronic shortening of sleep also results in elevated evening cortisol levels and increases sympathetic nervous system activity The long-term results of chronic partial sleep deprivation are: - obesity, - high blood pressure, - diabetes, - and memory impairments Insufficient sleep: - reduces the functioning of the immune system, - increases susceptibility to the common cold, - and renders vaccinations less effective
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6.2.1 Health and Illness
- No research is needed to confirm that sleep and sleepiness often increase when illness strikes - It has been assumed by mothers and doctors that this increase in sleep is beneficial, but little research has actually been done to confirm this assumption - In contrast, the common belief that sleep deprivation can increase susceptibility to illness has research support - Little research was directed at these questions until the late 1980s, but continuing efforts since then have begun to provide answers. - It is now well established that bacterial infections lead to changes in sleepiness, N3, REMS, and sleep maintenance - An increase in sleepiness is an early and enduring symptom of infections involving the whole body - N3 time and the amount of delta waves typically increase for a day or two following infection, followed by decreases to below normal levels - In contrast, REMS is decreased for the duration of the infection - Sleep maintenance is disrupted, but other aspects of sleep, such as the NREM-REMS circadian cycles, appear to remain unchanged It has been shown that this occurs because of: - increases of certain biochemicals, - especially the cytokines, - that impact the sleep controlling areas in the brain - A moderate level of these biochemicals is ever-present in our bodies - Their source comes from our body constantly fighting off bacteria in our GI tract - During illness, their quantities are increased, resulting in exaggerated effects on sleep The degree and timing of these effects depends on: - the nature of the bacteria, - how it got into the body, - and the state of the immune system at the time - For example, drugs that increase or decrease the immune system also change sleep during an infection - Fungal, viral, and protozoan-induced illnesses have effects on sleep that are similar to those of bacterial infections - There is some research that supports the notion that sleep during illness aids recovery It is likely that extra sleep with more N3: - enables the body to devote more resources to healing, - to the high metabolic demands that fever causes, - and to reduce the possibility of spread of a localized infection - sleep deprivation compromises the immune system - Prolonged sleep deprivation decreases host defenses such as natural killer cells and interleukins - Experiments have also shown that sleep deprivation will increase vulnerability to viral illnesses - Even some lost sleep on one night results in a reduction of natural immune responses - it has been shown that sleep deprivation significantly decreases the effectiveness offlu vaccine for several weeks - Complaints of daytime fatigue and sleep problems are among the earliest signs of HIV infection, the agent that causes AIDS, and worsen as the disease progresses - During this phase, there is an increase in N3 and other changes and the N3 is more evenly distributed during the sleep period - As the infection worsens, the daytime sleepiness gets worse and sleep onset and maintenance problems continue to get worse - N3 now decreases as does sleep efficiency - The NREM-REMS cycles become more and more disorganized - During the advanced stages of the disease, sleep quality is very poor, and fatigue and lethargy are great - N3 is absent or nearly so, and sleep efficiency is very poor - There are no recognizable NREM-REMS cycles - the need for sleep greatly increases - Those with HIV who show fewer disturbances of N3 survive longer - The exact mechanisms by which HIV causes these sleep changes is unknown, but changes in cytokine levels that occur during HIV infection are suspected
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Box 6.4 Sleep Hygiene (Moorcroft 2007)
- our wake time affects our sleep time just as much as our sleep time affects our wake time There are guidelines to follow when we are awake that can make our sleep come easier and be more effective and less of a problem: - It is best to attempt sleep only when you are drowsy. Trying to sleep when you are not ready for sleep may make it more difficult - Avoid looking at the clock when in bed. It usually makes people anxious and upset - If you are unable to sleep and become upset, get out of bed and go to another room and do something you planned ahead of time that takes your mind off of trying to sleep and that will allow you to relax. Return to bed when you feel drowsy or after about half an hour - Get up in the morning at the same time every day, even on weekends and holidays. Going to bed at the same time is a good idea, also. Irregular sleep times can causes changes in your circadian clock that can make future sleep difficult. Choose these times so that you get around 8 h of sleep per night more or less depending on your individual sleep needs - Reserve the use of the bed for sleep. Using it for pleasurable sex is also appropriate, but do not use it to watch TV, read, work, or for other nonsleeping activities. Your conscious and unconscious mind needs to associate bed with being asleep, not awake - Avoid excessive napping. A brief, 20 min or so, mid-afternoon nap can be refreshing and natural. More than this amount can cause sleep problems later that night because it can diminish your sleep drive too much. - Try to relax for an hour before bedtime. Also have a pre-sleep routine close to bedtime that is calming and separates going to sleep from the activities of waking. This routine might include bathing and teeth cleaning, reading, meditating, or praying. - Regular exercise in the late afternoon or early evening can help you sleep. Morning exercise is alright if it is the only available time. However, avoid rigorous activities and aerobic exercise a couple of hours prior to bedtime. Even better is to get the exercise outdoors in bright sunlight. - Refrain from consuming caffeine for several hours or more before bedtime if you are especially sensitive to it - Do not drink alcohol prior to bedtime and especially do not use it as a sleep aid. While alcohol makes people sleepy, it also causes disturbed sleep, especially later in the sleep period - Do not smoke for several hours before bedtime. Reduce or stop smoking if you awaken during the night because you need to smoke - If you find yourself worrying after you go to bed, tell yourself that you will worry tomorrow and then think of or imagine something else that is calming and relaxing. If worrying in bed nevertheless occurs, you may want to choose a time earlier in the day to write out potential problems and their possible solutions - Arrange the bedroom to make sleeping easier. A comfortable bed in a dark and quiet bedroom with comfortable temperature, humidity, and air circulation can greatly help sleep
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6.2.2 Stress
- Stress, whether negative or positive, can affect sleep - Both acute and chronic stress can distrupt sleep, fragment sleep, and change the amounts of some of the sleep stages - Stress causes an increase of several hormones including adrenal cortical tropic hormone and cortisol that can disrupt sleep continuity and stages - Stress also affects the immune system that, as we have seen, also impacts sleep - Animal studies show that recovery from acute stress includes an increase in both NREM and REMS
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6.2.3 Drugs
- Some drugs prescribed for non-sleep related problems, especially those that act on the brain, affect sleep/wake in one way or another - Some drugs may cause insomnia and other problems with sleeping - Others may cause sleepiness, sedation, and/or fatigue - Some drugs prescribed for specific sleep or wake problems may have effects that carry over into the succeeding wake or sleep period, respectively - Other drugs may affect sleep/wake for a period of time after they have been discontinued Drugs that commonly have significant effects on sleep/wake: - depression, - schizophrenia - anxiety, - breathing disorders, - cardiovascular problems, - or those drugs that manipulate histamine or steroid production Drugs that affect daytime sleepiness and/or nighttime sleep: - Some over-the-counter drugs including nasal decongestants, - pain relievers with caffeine, - and antihistamines - Nicotine increases alertness and reduces sleepiness - Smokers get these benefits during the day, but one-pack-a-day smokers also have more difficulty getting to sleep and have lighter sleep - Although no differences in amounts of REMS and NREMS are seen in smokers, many have more difficulty staying asleep - Quitting smoking results in the shortening of the amount of time to fall asleep and an increase in N3 and REMS - Some reports also say there is a decrease in waking during sleep, but other reports say there is an increase in arousals for a number of nights
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6.2.4 Pain and Other Sensory Stimuli
- Pain, either sudden or chronic, affects sleep, but sleep also affects pain - Laboratory studies have confirmed that people in pain may find it more difficult to get to sleep and/or not sleep as well, have less N3 and experience more awakenings - Not sleeping well can make pain worse since it is known that sleep restriction can decrease the pain threshold - Stimuli such as loud or disturbing noise, including stimulating or annoying music, can make it more difficult to get to sleep and even disturb sleep - bright or changing light can disrupt sleep onset as can irregular bumping and jarring of the body, like when riding in a car on poor roads - Some people report that some smells can cause problems with sleep, while other smells facilitate it - Indigestion, too, can cause fragmentation of sleep
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6.2.5 Exercise
- Exercise can mean many different things to different people such as aerobic or non-aerobic, mild to intense, and causing sweat or not - fitness level and age make a difference in the effects of exercise on sleep - While most exercise is generally recognized as beneficial to the body, it can also cause injury, which in turn can affect sleep Overall experimental evidence shows that exercise four to eight hours before bedtime that is sufficient to raise body temperature can: - increase total sleep time, - slightly delay REMS onset, - increase N3, - and slightly reduce REMS - Reduced exercise in trained athletes can produce the opposite effects - Many sleep specialists caution against exercise in the evening close to bedtime because it may be too arousing, making falling asleep difficult
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6.2.6 Sexual Activity
- Many men report that orgasm aids them in falling asleep - In contrast, sexual activity and orgasm are arousing, not relaxing, for many women - Not only can this difference affect sleeping, it can also affect relationships - Men fall asleep after sex because of biological-based tendencies, not insensitivity - Women do not share the same tendencies and like loving attention, not sleep, following sexual activity
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6.2.7 Nutrition
- Throughout recorded history, sleepiness has been thought to be a consequence of eating a big meal - Not only how much you eat, but also what you eat has been thought to contribute to sleepiness and influence subsequent sleep - Scientific research has confirmed some but not all of these relationships - William C. Orr, Ph.D., Director and CEO of The Lynn Health Sciences Institute at the University of Oklahoma Health Sciences Center, has reviewed the published reports covering the influence of eating on sleep - He concludes that many people report experiencing sleepiness after eating - They also report that this is true after an especially large meal - Studies by others in animals show that larger meals result in longer N3 and REMS periods - Excess food intake increases sleepiness because of increased absorption of bacteria and bacteria products into the blood - Orr also concluded that sleepiness is greatest after an hour and a half to two hours after a meal - However, when lipids are consumed, the maximal sleepiness is delayed by three to three and one half hours - On the other hand a study published in 2011 concluded that, while more research is needed, late dinner or snacking correlated with poorer sleep - Even the little research that has been done—much of it on specific foods and how they effect sleep—is very controversial and poorly replicated - There is one study that was well done - Orr and colleagues investigated sleep onset times following different types of meals - They had 10 male subjects take five polysomnographically recorded naps over a period of more than four hours - Between the first and second nap, they ate a meal that was either high-fat, or high-carbohydrate, or a mixture of the two - For another group of 10 males, the meals were either solid, liquid, or an equivalent amount of water - There were no significant differences in sleep latencies as a result of consuming the high-fat, high-carbohydrate, or mixed meals - but the solid meals, unlike the liquid meal or plain water, resulted in shorter sleep onset times - Weight loss as a result of malnutrition or dieting has the opposite effect on sleep than weight gain When losing weight, there is an: - increase in the time it takes to get to sleep, - less time spent asleep, - and a decrease in N3 - there is more fragmentation of sleep when losing weight During the time a person is gaining weight: - total sleep time increases because of - increases in both N3 and REMS as well as - less fragmentation of sleep - Skipping a single meal or several meals prior to bedtime increases the amount of N3 but also increases sleep fragmentation - A light snack such as cereal and milk, yogurt, or crackers prior to bedtime tends to increase sleep duration and reduce the amount of wake time during the sleep period - For example it is now well established that nighttime heartburn can cause significant sleep disruption and subsequent daytime sleepiness - Iraki and associates have found that Moslems experience decreases in daytime alertness resulting from changes in sleep habits during the month of Ramadan, when they give up eating and drinking between sunrise and sunset - Although sleep is typically a long period of fasting, glucose levels in the blood do not decrease - They do decrease during a similar period of fasting while quietly lying down awake - This difference occurs because glucose is used more slowly during night sleep - A minimum of glucose usage occurs during mid-sleep but begins to increase as morning approaches - Two-thirds of the decrease in glucose usage occurs because of the lower metabolic rate of N3 - other factors also play a role, such as a decrease in muscle tone and changes in hormone levels during sleep - The gradual increase later in sleep occurs because of less N3 during that time
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6.2.7.1 Caffeine
- Caffeine has been confirmed to combat the effects of sleep deprivation but also to disrupt sleep - It works by reducing the effects of adenosine in the brain - Although it has little effect on people who are not sleep deprived or not dependent on it, caffeine can increase arousal and decrease sleepiness in sleep-deprived people - It can make performance more efficient and more accurate in people who are sleep deprived - The degree of the effects depends upon the amount of caffeine consumed Generally, good effects are seen with 100 mg, although its effects can vary with: - individual sensitivity, - the type of task, - and the level of sleepiness - Consumption of caffeine every few hours has improved alertness and performance over that of a placebo for 40 to 48 continuous hours without sleep Notice carefully what this statement says; - caffeine did not restore alertness and performance to the level it would have been with normal sleep, but it did make things better - Caffeine consumed before bed, even several hours before bed in some people, will disrupt sleep - This disruption can occur even in people who have no awareness of the effects caffeine is having on them - It increases the time it takes to get to sleep, - sleep fragmentation, - and the frequency and duration of wakefulness during the sleep period - Considerable caffeine is found in many popular drinks but is also in many foods and medicines - It reaches its peak concentration in the body about –1 h after consumption - with half still present after an additional 2–6 h - It may not be totally cleared out of the body for 8–14 h - In some individuals, children, pregnant women, and the elderly, it stays active even longer, sometimes much longer - Regular consumption of caffeine can lead to tolerance and dependence That is, it becomes less effective, yet the person experiences negative withdrawal effects such as: - headaches, - lethargy, - sleepiness, - fatigue, - and performance decreases for a few days without it Amount of caffeine in some common products: ``` Coffee, brewed 100–150 mg Tea, cup 60–75 mg Cola soft drinks, 12 oz 40–75 mg Chocolate, 1 oz 36–47 mg Pain medicines, over-the-counter 32–65 mg Cold remedies 15–60 mg Stimulants, over-the-counter 100–200 mg Energy drinks 0–2352.9 mg/oz (most of them 5–100 mg/oz) ```
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6.2.7.2 Alcohol (e.g., Roehrs and Roth 2001)
- Like caffeine, alcohol affects waking, daytime sleepiness and nighttime sleep During waking, the effects of alcohol can be described as having two phases; 1. it is initially arousing followed by 2. a sedating effect - The higher the alcohol level in the blood, the shorter the MSLT sleep onset times - But its effects on sleepiness also depend on the degree of prior sleep deprivation and the circadian time of the nychthemeron (a full period of a night and a day) - It has been calculated that three drinks (drink = 1 oz of 80 proof liquor, 12 oz of beer, or 4 oz of wine) are the equivalent of six drinks in a person who has had five successive nights of only five hours of sleep - In contrast, people who have extra prior sleep are made less sleepy by alcohol than a person who has averaged eight hours of sleep per night - Alcohol produces a greater sleepiness when consumed during the night or mid to late afternoon, such as during happy hour, when the body’s circadian rhythm for sleepiness is higher - Blood alcohol levels as little as one-fifth of the legal limit in the United States have been found to impair driving in sleepy people in the early morning hours - Surprisingly, the sleepiness produced by alcohol has been shown to outlast the presence of alcohol in the blood for several hours or until sleep is obtained - It is as if alcohol flips a sleepiness switch in the brain that stays that way until it is switched off again - Thus, experiments have shown that a sleepy person who has a few drinks during happy hour can be a dangerous driver long after their blood alcohol level returns to zero - Since alcohol causes relaxation and sleepiness, it is widely used by people to help them sleep at night - Unfortunately, this practice, too, is a problem because of the two-phased effect - After drinking moderate amounts of alcohol that brings the blood concentration to 0.05 at bedtime, the time to get to sleep is much shorter, and N3 time often is initially increased - However, there is a delay in getting to the first REMS period, and total REMS in the first half of the night is reduced - By the second half of the night, blood alcohol level is at or close to zero, since the body clears about one drink per hour - At this point there is a rebound effect - Sleep is generally disturbed and restless, there is more wakefulness or N1, and REMS is increased - The net effect can be a relatively poor night of sleep - After several consecutive nights of going to bed following moderate drinking, the first-half-of-the-night effects are diminished but not the second-half-of-the-night effects - Subsequently, the night or nights of sleep not preceded by drinking alcohol may contain excessive amounts of REMS
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6.2.7.3 Tryptophan
- Tryptophan is an amino acid prevalent in foods like dairy products, fowl, beans, some nuts, and bananas - It is also the raw material used in the brain to manufacture the neurotransmitter serotonin - Since early research implicated serotonin with sleep and anecdotes prevail about the sleep inducing properties of foods like turkey and a warm glass of milk, it was thought that ingestion of tryptophan could promote sleep onset - While research was being conducted to test this hypothesis, many people tried taking easily available, unregulated tryptophan pills during the 1980s as an alternative to other sleeping pills - But a serious side effect, possibly from contaminants in the unregulated tryptophan pills, quickly caused them to be removed from availability in the United States in 1991 - This ban was loosened in 2001 but only for tryptophan manufactured in the US - It was suggested that some of the research used too low of a dose or that it was tested on normal sleepers in whom it would be hard to show an improvement in sleep - Later studies suggested that it could help about half of insomniacs get and stay asleep if they took doses of one to two grams - Since there are problems with the pill form of tryptophan, can eating foods rich in it before going to bed help your sleep? - The answer is unclear - It is not all that simple for tryptophan in food to get to your brain, and often there simply may not be enough of it that gets there to make a significant difference - It has to go through the digestive process that may be too slow when a lot of other food is also being digested - Finally, it competes with other amino acids to get into the brain; if there are many competitors, little gets in - At best, it takes about an hour for the brain to manufacture serotonin from newly arrived tryptophan - In the end, it seems that even if all goes well, the effect of consuming tryptophan-rich food is a mild one that does not always work - So consume something like milk or bananas an hour or more before bedtime if you like - It might help you sleep simply because having a little something in the stomach can be relaxing, but do not count on it simply because of the extra tryptophan you take in
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6.2.7.4 Herbs and Supplements
- The use of herbs and supplements to obtain better sleep has become very popular with many ‘‘natural substance experts’’ offering advice on what is effective - However, the information provided is too often conflicting, actual scientific evidence from well-designed research studies to back up the claims is sparse - sometimes dangerous interactions of these herbs with one another or with drugs are becoming apparent The most frequently mentioned herbs are: - passionflower for temporary insomnia, - the aroma of lavender for calming, - and valerian or kava for promoting sleep For sleep disorders: - catnip, - chamomile, - lime flowers, - gotu kola, - cowslip flowers, - hops, - lemon balm, - lady’s slipper, - and skullcap Supplements suggested for sleep include: - melatonin, - GBL, - magnesium - and serotonin for good sleep - Valerian has been used for centuries for its reputed relaxing and calming effects as a way to relieve insomnia - There has been some good research done on it, but the results are equivocal - For example, Donath had 16 people with insomnia, 4 males and 12 females, take valerian extract for 1 day or 14 consecutive days preceded or followed by a look-alike placebo for another 1 day or 14 consecutive days - Neither the subjects nor the researchers knew when the subjects were taking the valerian extract or placebo until the experiment was completed - Polysomnographic recordings were made before and after taking the course of valerian or placebo, and subjective ratings of sleep and daytime performance were also obtained at these times - The one-day dose of valerian extract had no effect on any of the measures - The 14-day use of valerian extract resulted in no difference in sleep efficiency, but a more rapid onset of N3 and an increase in the amount of N3 were seen - Subjects reported they fell asleep more quickly - They also noted few side effects from taking valerian extract - The authors concluded that valerian extract might be useful for the treatment of mild insomnia - However, other studies have not shown such clear-cut or even positive results - Yet there are potential problems with available valerian extract in purity and actual strength as well as with its stability - A study by by an independent lab that evaluates nutrition products and dietary supplements and independently confirmed by a second lab showed that 4 of 17 products claiming to contain valerian actually had none, and another 4 contained about half of what was stated on the label. - Cautions about the use of other herbs and supplements have been issued because of preliminary or inconclusive research data on their effectiveness and the potential for bad side effects - Kava has also received research attention - It has been shown to reduce the time to get to sleep and promote deeper sleep - However, cautions about liver damage following use of Kava have been issued - Studies of the long-term effects of taking valerian and kava are needed Other folk and natural remedies for improved sleep have included: - rubbing garlic on your soles, - putting a cut raw onion under your pillow, - or sleeping on a small pillow filled with hops flowers - avoid foods with a lot of tyramine, the raw material the brain uses to make norepinephrine, before bedtime This list includes: - cheese, - sauerkraut, - wine, - cured meats, - eggplant, - spinach, - and tomatoes There appears to be little if any scientific research to back up the use of any of these remedies**
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6.3 Effects of the Weather on Sleep
- Except for the effect of air temperature there has been little research done on the effects of weather on normal sleep - It is thought that weather extremes or obvious changes in the weather can have effects, generally negative, on sleep But there is also some evidence that more subtle differences in things like: - barometric pressure, - ionic fields, - lunar phase, - and solar disturbances also affect sleep
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6.4 Conclusion
Many of the physiological systems of the body such as: - the autonomic nervous system, - the cardiovascular system, - the respiratory system, - hormonal system, - and the control of body temperature function differently to some or a great extent during sleep - This provides many benefits But the health of the body and what is put into it such as: - food, - drugs, - caffeine, - and alcohol also affects sleep timing and quality - Depending on the choices made by an individual these effects can be beneficial or detrimental
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~WEEK 7~
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The Circadian System
- The circadian system (Process C) is an important component of the Sleep/Wake regulatory system - Process C determines the timing of sleep (i.e., the window of optimal sleep), especially REMS timing, and the timing of alertness - The circadian clock regulates sleep/wake by sending alerting signals of varying strength across the 24-hour day - The alerting signals increase across the day starting at wake time and alerting signals decrease across the night until the early morning - When the sun goes down, or there is a significant decrease in light, melatonin is secreted and this increases sleepiness so that hours later, the body is able to produce sleep - There are clocks all over our body but there is a central timekeeper in the brain at the back of hypothalamus called the superchiasmatic nuclei (SCN) - There is an intrinsic, cellular rhythm that is somewhere between 23–25 hours and the SCN attempts to entrain itself to the environment, which is 24 hours - Circadian is from the words circa and diem, which means “about a day” - When devoid of time cues, our circadian rhythm free-runs over a roughly 25-hour period (for some it may be less) - For example this participant was placed in a cave devoid of any cues as to what time it is (including light) - the rhythm runs fast an hour each day until about 24 days later - they have gone completely around the clock and started back to the original circadian time they started on the first day in the cave - This drift occurs because there is nothing in the environment to utilize for entrainment - One major way the SCN entrains is light - Light triggers the onset of melatonin (M), which is under tight control of the SCN but also exerts an effect on the SCN - For example, if you were to give M around 5 pm, the person should become sleepy earlier than usual because it would shift the rhythm a little earlier - Interestingly, the cells in our body have the same rhythmicity of our clock in them - This means that although there is a central oscillator, i.e., the SCN, that coordinates our rhythms, our cells can generate the rhythm independently because of circadian genes There are four main clock genes: 1. CLOCK, 2. BMAL1, 3. PER 4. and CRY genes - and protein synthesis within the cell keeps the 24-hour (actually a little longer than 24 hours) rhythm
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Light Entrainment
- The SCN needs zeitgebers, or cues to set the clock, and photic (light) zeitgebers work through visual pathways - The eyes have connections with the pineal gland (the place where M is released) - The pineal gland feeds back into M receptors in the SCN - Movement, or locomotor activity and other nonphotic zeitgebers have input into the clock via a serotonin (5HT) messenger - It is based on a study by Czeisler, Weitzman, Moore-Ede, Zimmerman and Knauer (1980) - After observing research participants drift around the clock without cues, they used photic (light) pulses and the participants organized their bedtimes and rise times around the light on- and offset - The SCN needs input to entrain and the input of choice is the light There are two main things to understand photic entrainment: 1. colour spectrum 2. and lux 1. Colour spectrum - There is a spectrum band and humans can see all but the infrared and ultraviolet ends of the spectrum - The most powerful stimuli for the onset of the “day” is blue spectrum light (e.g., sunlight) - The most powerful stimuli for the offset of light to signify that sleep shall ensue within the next few hours is the colour seen in a sunrise (i.e., red spectrum) - When using light therapy we use light in the blue spectrum and when we need to inhibit light, we provide goggles that block out blue spectrum - Interestingly, as we age, the same degree of light has a differing (i.e., lessened) ability to shift circadian phase in older eyes - One reason is that our eyes yellow, and Yellow + Blue = Green, thus we are not getting the full effect of the blue spectrum light - Additionally, our pupils narrow so less input gets in - Lastly, cataracts increase as we age and it weakens photic input - These may be some of the reasons that there may be lower levels of circulating melatonin in our brains as we age 2. Lux - The other factor for photic entrainment is lux - Lux is a measure of light emittance - Lux tells us how much light passes through a surface and is perceived by the eye - The greater the lux, the more powerful a zeitgeber or source of entrainment - Direct sunlight produces somewhere between 30000 lux and upwards of 100000 lux - daylight produces somewhere between 10000 and 25000 - On an overcast day, lux falls to about 1000 lux and during sunrise and sunset lux is only about 500 lux - Office lighting produces about 400 lux and televisions produce about 5 lux or less - The prescription for shifting someone’s phase is typically 6000–10000 lux; however as low as 500 lux could be useful if the person is in a controlled low light environment - Many people are concerned that their TVs or electronic devices are delaying sleep by phase delaying, however, 5 lux is not robust enough to shift in experiments - There is some evidence for possible photosensitivity (i.e., light sensitive) in teens; thus, blue light exposure at night can further delay their already-delayed phase during puberty - Thus, we suggest that teens power off devices about two hours before bed so that they do not phase delay themselves further - Downloading a program that mitigates blue light, e.g., F.lux, is another possible solution - It should be noted however that blue light is very useful for alertness so reducing blue light in your life (other than the evening hours) could be expected to have a negative impact on your sense of alertness, cognitive performance and mood
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Melatonin
- Melatonin (M) is the chemical messenger of the circadian system - M is excreted in the evening and is associated with sleep onset (light delays M release and also sleep onset) - Many people take melatonin as a sleep aid - M is typically taken as a sleep aid before bed but the effect of M is time-dependent - M administration does not improve sleep at night if endogenous melatonin is already present in the brain - M is already present before bed because it was already secreted several hours before - if M is given during the day (i.e., when M is not present because there is daylight), the brain responds by becoming sleepy a few hours later; that is, it can cause a phase advance and produce sleep earlier - This explains why M does not work for insomnia - Meta-analytic evaluations of melatonin’s hypnotic effects for insomnia are mixed or negative when M is given at night - One exception for the efficacy of M is for Delayed Sleep Phase Syndrome (DSPS) - M is taken at night but earlier than their conventional bedtime because M release is delayed in those with DSPS, so by taking it earlier than the typical release we can produce sleepiness and sleep earlier - There are a few other chemical players for the clock - The SCN receives input from eyes via the chemical glutamate, - as well as serotonergic input from the midbrain and cholinergic input from the basal forebrain and brain stem
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Chronotypes
- Chronotype refers to your dispositional tendency with regards to the clock - For example, were you closer to a morning type or an evening type? - Most people are somewhere in between, but there are plenty of people who tend more towards being a “night owl” or an “early bird” A night owl: - has a delayed circadian phase relative to most others - They sleep better with a later bedtime because they do not get sleepy until very late - They tend to have difficulty waking up in the morning because they do not have alerting signals emanating from the clock early in the morning - Because of the slow rise in body temperature throughout the morning that accompanies the delayed alerting signals from the clock, they are not at their most productive in the morning - In fact, they may be slow to awaken (i.e., they feel groggy, perhaps moody, and if they eat early in the morning, they may experience a sensitive stomach) - In contrast, by the afternoon, their alerting signals sharply rise and reach a peak in the evening, so their best work is done in the afternoon or evening - Meals are often delayed and activities are often delayed as well to this time of day in which they feel better - These processes can be influenced by behaviour; that is, you may adopt even later bedtimes because you “like” being awake at night, but the underlying process is biological - Night owls sometimes adopt an earlier schedule because they believe it is “lazy” to sleep-in or they may have morning obligations - going to bed early can take very long to fall asleep because they would not be sleepy “Early birds” or “Larks”: - have an advanced circadian phase relative to most others - They keep early rise times because they have strong alerting signals coming from the clock early in the morning and an early bed time - They feel sleepy early in the evening so they have difficulty staying up late - Because of the sharp rise in body temperature that accompanies the alerting signals from the clock, they are at their most productive in the morning and early afternoon - they tend to become sleepy in the evening, so this is not typically a productive time for them - we would expect them to fall asleep very quickly or even doze off hours before the 11 pm bedtime on the couch - We would also expect them to have early wake-ups in the morning hours because the alerting signals for the clock would occur several hours earlier than the planned 6 am wake-up time
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Circadian Rhythm Disorders
There are several circadian rhythm disorders: 1. Circadian Rhythm Sleep Disorder, Delayed Sleep Phase type 2. Circadian Rhythm Sleep Disorder, Advanced Sleep Phase type 3. Circadian Rhythm Sleep Disorder, Free-running type 4. Circadian Rhythm Sleep Disorder, Irregular Sleep–wake type 5. Circadian Rhythm Sleep Disorder, Shift Work type 6. Circadian Rhythm Sleep Disorder, Jet Lag type 1. Circadian Rhythm Sleep Disorder, Delayed Sleep Phase type - Being a night owl is not abnormal and does not mean you are disordered - It is possible, however, to have an extreme in this tendency that causes problems or distress for the person, and we would diagnose this as a circadian rhythm disorder called Delayed Sleep Phase Syndrome (DSPS) - This disorder is characterized by a chronic, stable delay in the sleep period in relation to convention or a desired sleep time and wake time (typically at least 2 to 3 am or later) - as evidenced by chronic or recurrent complaint of inability to fall asleep at desired conventional clock time together with inability to wake up at desired and socially acceptable time - If the patient is able to sleep normally and feel rested upon awakening when keeping their preferred schedule, this is suggestive of DSPS - Additionally, the DSPS should not be better explained by another sleep disorder, substances, or medication use - the delayed sleep phase person is sleepy many hours later and rises many hours later than is typical 2. Circadian Rhythm Sleep Disorder, Advanced Sleep Phase type - This disorder is characterized by a chronic, stable advance in the sleep period in relation to convention - or a desired sleep time and wake time, as evidenced by chronic or recurrent complaint of inability to stay awake until a conventional clock time together with a difficulty sleeping-in - There is no clinical cut-off for the degree of advance but it is typically about 3 hours earlier than convention (e.g., 8 pm or earlier) - Like with DSPS, we assess what happens when the patient is able to choose their preferred schedule (e.g., on weekends or holidays) and whether they can sleep normally and feel rested upon awakening when keeping their preferred schedule - The phase advance cannot be better explained by another sleep disorder, substances, or medication use 3. Circadian Rhythm Sleep Disorder, Free-running type - A free-running type of circadian rhythm disorder is one in which there is no apparent entrainment to a 24-hour light/dark cycle - This most frequently occurs in those who are blind without any light perception - In such cases, M is used to entrain them to a steady schedule - the free-running person drifts about an hour forward every day 4. Circadian Rhythm Sleep Disorder, Irregular Sleep–wake type - There is no discernible phase and the patient sleeps at differing times around the clock, often in short bursts - there are short bursts of sleep throughout the 24-hour period - This sleep disorder is poorly understood and often the consequence of other factors such as poor sleep habits - It is commonly seen among people with severe cognitive deficits such as institutionalized elderly patients with dementia 5. Circadian Rhythm Sleep Disorder, Shift Work type - Shift work disorder is slightly controversial because there is no evidence that anyone can physiologically adapt to shift work without consequences such as shortened sleep - However some people’s health and sleep difficulties can be more severe than others and cause them to seek treatment - Such individuals are labeled with a shift work circadian rhythm disorder; the treatment is to stop working shifts - The only way we can help people “adapt” to shift work is to encourage them to take naps to compensate for the sleepiness they experience - Because it is unnatural to sleep outside of your biological phase, there is no way to make a healthy adjustment - Some report that they are “unaffected” by shift work but the reality is that they are simply good at coping with the consequences, rather than being exempt from the ill-effects - Shift work is associated with cancer in many large-scale studies - One possible mechanism is that the sleep deprivation creates an inflammatory response which could increase the risk for cancer - Alternatively, shift work interferes with proper M levels and secretion and M is associated with suppressed tumour growth as well as immunomodulatory and antioncogenic properties 6. Circadian Rhythm Sleep Disorder, Jet Lag type - When people have prolonged difficulties adjusting to multiple time zone travel they may seek help to mitigate the symptoms - For example, if you had to travel frequently for work and had great difficulty entraining to local time where you travelled, you may wish to seek treatment so that you would lose less time in productivity and feeling horribly - These symptoms dissipate in a number of days for most but for some, this would be a big enough problem to warrant treatment
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Effective Treatments for Circadian Rhythm Disorders
There are three main treatment approaches for circadian rhythm disorders: 1. medications, 2. light therapy 3. and behavioural approaches such as chronotherapy 1. Meds - Pharmacological Treatments for Circadian Rhythm Disorders - Unlike insomnia, in which oral M is not effective, M can be effective for circadian rhythm disorders such as DSPS, ASPS and jet lag - However, it should be noted that there are some negative studies for M for use in jet lag - The timing and dose for M still remain somewhat poorly understood - Generally, M is given in the morning when we want to phase delay an ASPS sufferer and M is given in the early evening when we want to advance a DSPS sufferer - There are also symptom-targeted pharmacotherapy strategies that include using hypnotics to induce sleep at the desired time - stimulants to allow people to wake up at the desired, shifted time - These approaches are also readily used in shift work and jet lag type disorders 2. Light Therapy - Light therapy involves prescribing artificial light (via a light box) for a specified amount of time and time of day to shift the person’s phase - Light therapy typically uses blue spectrum light with a specified lux (typically 6000 to 10000 lux) - Light therapy is a relatively common tool, relatively effective for a variety of circadian rhythm disorders except free-running type disorders** 3. Behavioural Treatments - Chronotherapy is a treatment in which the sleep opportunity is scheduled and moved around the clock until reaching the desired time - Once the desired new time is reached, patients must rigidly keep the new schedule - The idea is that the in-bed time will entrain the clock - There is some evidence for chronotherapy but much of the evidence is derived from uncontrolled trials or case studies and it appears that relapse is fairly common - One additional strategy is to schedule naps for problems such as shift work type, in which sleep is often shortened so there is chronic sleep deprivation Gottlieb’s Chronotherapy protocol Day 1: - Check in Friday 10:30 pm - Stay awake from 10:30 pm Friday, the entire night and the entire next day - Bright light therapy administered at phase-appropriate time in early morning - Discharge from clinic at 5:30 pm on Saturday - Person escorted to their private apartment or hotel room - Recovery night sleep on Saturday night, from 6 pm until 1 am Sunday - Program staff meets and accompanies person back to clinic Day 2: - Start at 1:30 am Sunday - Stay awake from 1:30 am, the entire night and the entire day - Bright light therapy administered at phase-appropriate time in early morning - Discharge from the clinic at 7:30 pm Sunday evening - Person escorted to their private apartment or hotel room - Recovery night sleep on Sunday night, from 8 pm until 3 am on Monday - Program staff meets and accompanies person back to clinic Day 3: - Start at 3:30 am Monday - Stay awake from 3:30 am Monday, the entire night and the entire day - Bright light therapy administered at phase-appropriate time in early morning - The person is discharged from the clinic at 9:30 pm on Monday evening - This marks the end of the formal treatment process - At this time, the person is free to either return home or spend their final night of recovery sleep in their apartment on the premises or at their hotel room - The final night of recovery sleep starts at 10 pm on Monday and ends at 5 am on Tuesday - At this point, people are free to return to work or home responsibilities
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Week 7 Summary
- Cellular circadian rhythms are near 24 hours and are regulated by the suprachiasmatic nuclei (SCN). - SCN receives glutamatergic input from eyes, serotonergic input from midbrain and cholinergic input from the basal forebrain and brain stem - Light entrainment is determined by colour spectrum and lux - Chronotypes are genetic dispositions towards morningness or eveningness - Circadian rhythm disorders include: Delayed Sleep Phase type, Advanced Sleep Phase type, Free-running type, Irregular sleep–wake type, Shift work type, Jet lag type - Circadian rhythm disorders are most often treated with M, stimulants/sedatives, light therapy, or chronotherapy
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~Chapter 9~ | Modern Theories of Dreams and Dreaming
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9.1.1 Freud
- One of the most common types of dream-formation may be described as follows: a train of thoughts has been aroused by the working of the mind in the daytime - During the night this train of thoughts succeeds in finding connections with one of the unconscious tendencies present ever since his childhood in the mind of the dreamer - but ordinarily repressed and excluded from his conscious life - By the borrowed force of this unconscious help, the thoughts, the residue of the day’s work, now become active again, and emerge into consciousness in the shape of a dream - in order to understand Freud’s perspective of dreams and dreaming better, we shall begin by taking a brief look at what influenced Freud’s theories Freud's history: - Born in 1856 to Jewish parents - Freud lived and practiced medicine in Vienna during the time of the decline of the Hapsburg Empire and the reemergence of anti-Semitism, with its atmosphere of strict Victorian moral codes - Living in this Victorian society influenced Freud and his thinking and theories - Freud developed his psychological theories, including those of dreams, from his experience with his troubled patients and his own life events - In 1900, he published what many regard as his most important work, The Interpretation of Dreams In his writings, Freud emphasizes three basic aspects: 1. why dreaming occurs 2. how dreams are formed 3. from these, a method of dream interpretation - Because his approach was new and unique, Freud’s ideas were the basis for the theories of many others who followed him - these other theories also adopted much of his new terminology According to Freud, dreams have two related functions: 1. to release psychic tension from unconscious wishes 2. to keep sleep from being interrupted - Freud believed that all behaviors, including dreaming, are motivated by powerful, inner, unconscious forces - These unconscious forces are so strong that they may be too disturbing to think about openly when awake - Yet, the pressure of these unconscious forces needs to be released to keep the individual from going crazy - But there exists a censor that simply will not allow conscious awareness of these forces - However, during sleep, the mind transforms the unconscious forces into a disguised version as a dream in order to get past the censor and allowing wish fulfillment Latent (or hidden) content: - The undisguised, underlying content of the dream Freud called the Manifest content: - Its disguised version, what is remembered upon awakening, he called the Dream work: - Freud considered the transformation from latent to manifest content an important psychological process - has several components Secondary revision: - occurs when thoughts and impulses are logically transformed into a visual format, and a storyline is added through the process of dramatization * Day residue: - we may use aspects of our recent experiences to precipitate some of the images of our dreams - These images are combined with memories, including those of childhood, to become the dream during the process of secondary revision Condensation: - Two or more unconscious thoughts often merge together into a single image or event in our dreams - When this merging occurs, our sleeping brain has gone through the type of dream work called condensation Overdetermined: - many single images or events in our manifest dream may be overdetermined - that is determined by the condensation of numerous latent dream thoughts - This process can be done because much of the manifest content of dreams is symbolic, and a symbol is capable of conveying multiple meanings Displacement: - This process is a part of censorship - The censor, for the same reason, also causes poor retention of dreams - If an unconscious desire, emotion, or thought is too threatening to the dreamer, it is transformed into an insignificant component of the dream - Freud saw many neutral objects and events in his own and his patients’ dreams as displaced sexual thoughts or desires - Hence to Freud, a dream of a box and a knife was actually about a vagina and a penis in a disguised form Over his 49-year professional career, Freud used secondary revision in different ways including: 1. putting finishing touches on the dream to make it more story-like 2. revising the manifest content of the dream when retelling it to make it smoother and more logical Free association: - Because dreams are protective disguises of unacceptable unconscious/latent thoughts, dreamers themselves cannot understand them fully without the help of an analyst - Freud developed and used the dream interpretation technique of free association on the manifest content to uncover the true meaning of dreams, the latent content - He famously said that dreams are ‘‘…the royal road to knowledge of the unconscious activities of the mind.’’ - In order to accomplish this, his patients were instructed to talk freely about whatever came to mind when thinking about their dream - They were to talk without judgment, evaluation, or criticism - Freud then used the associations to trace from the manifest content back to the dream’s latent content Symbol substitution: - replacing the symbols in a manifest dream with their fixed latent equivalents - His method also relied heavily on it - Symbol substitution needs to be done by the therapist - After weeks, months, or years of analysis, the conflicts that generate dreams, which also cause waking psychological problems, would be ‘‘worked through’’ and Freud would close the case - Freudian analysis of dreams is still practiced today but is not as popular as it once was because of its heavy emphasis on sex - and childhood experience and also because of the enormous amount of time it takes - Also it relies heavily on the skill and training of the psychoanalyst - Different psychoanalysts often come to different interpretations of the same dream - Yet, we owe a big debt of gratitude to Freud for introducing the notion of a dynamic unconscious to the Western world - and for linking dreams to the psychology of waking life and starting us on the road to our current understanding of dreams Critics of Frued: - Freud has been much criticized for a variety of reasons. - His methods are said to be too ‘‘arm chair’’ with little true empirical data - His theories have been called too narrow - He has been labeled as sexist - His ideas are based too much on abnormal patients and himself rather than a good cross section of people - His notions have been called anti-religious
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9.1.2.2 Amplification
Amplification: - the main technique developed by Jung for use in dream interpretation - This technique refers to the process of elaboration on or expansion of the images and ideas present in dreams in order to reveal the messages of the dream while not drifting too far from the dream’s manifest content There are two kinds of amplification: 1. Personal amplification 2. Objective amplification 1. Personal amplification: - involves asking the dreamer to explore and describe any and all possibilities of their own associations, such as thoughts, feelings, and recollections, - being careful to not stray too far from the dream - Each image is discussed to make possible associations to the dreamer’s life - For example, perhaps there was a flowering plant in the dream - The dreamer might talk about how the plant looked, what its shape was, the color, size, and smell of the flowers - The dreamer might then talk about their view of flowers in general, how to grow them, problems with them, and what use they might have - The dreamer should also relate feelings about flowers - These associations are also discussed to determine possible explanations for dream images 2. Objective amplification: - Elements of the dream that are a part of the dreamer’s culture and the more universal collective unconscious are described by the dream analyst - To do this properly, a great deal of knowledge regarding the nature of the collective unconscious is required of the therapist Interior dialogue: - Jung also advised people to meditate on or have interior dialogue with the characters in the dream, a kind of active imagination - For it is the dreamer who knows his or her dream better than anyone else and therefore can interpret it most accurately - Some consider this process Jung’s third technique for interpreting dreams Series of dreams: - Jung also believed that interpretation requires working with more than just one dream - An analyst and dreamer working together with a series of dreams can provide the best interpretation - Dreams in a series can throw light on one another and possibly show progression of ideas or events - Jung suggested that dream analysis is not really a technique that can be learned and applied according to a certain set of rules - If specific rules are used, the individual personality gets lost too easily - The intuition, imagination, and intelligence of both the analyst and the dreamer are very important and must be freely shared - Dream interpretation should come from the dreamer with the help of the analyst - It should come from what exists in the dreamer’s psyche so that it can serve the dreamer in the best way possible Cristicism of Carl Jung: - The main criticism of Jung is that he is close to being mystical in his views and theories - Also, like Freud, his method has been called too ‘‘arm chair’’ and subjective
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9.1.3.1 Adler
History of Alder: - Alfred Adler was an Austrian psychiatrist who was a member of Freud’s inner circle until he broke away with his own ideas - The key for Adler was that people strive to achieve superiority and avoid inferiority - Also, he believed that the conscious and unconscious do not oppose one another - His ideas about dreams are consistent with these basic notions, although he did not focus on dreams as much as Freud did - his ideas are not as well developed and even contain some internal inconsistencies - To Adler, dreams focus on the dreamer’s lifestyle and relate to the dreamer’s everyday existence - Therefore, therapists can use persons’ dreams to learn of their typical beliefs, behaviors, and attitudes - Dreams attempt to solve the problems of dreamers, yet are often ineffectual because they are ‘‘self protective fantasies’’ created to defend the dreamers’ impression of superiority and self-worth - In a sense, dreams are failed adaptations to waking reality and give no real help, but interpretation of them can be helpful to see these failures that are in need of waking work - Dreams anticipate or prepare for the future, yet seldom are specific solutions for interpersonal problems carried from a dream to waking life, so in a sense, dreams fail - . Rather, a mood is carried from the dream to waking life - According to Adler, dream interpretation requires a trained therapist, but the interpretation is more of an art lacking rules other than to stay within the dreamer’s unique logic and language - Free association should be used as well as looking at the emotional context of the dream - Contrary to Jung, Adler believes there are no universal symbols in dreams
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9.1.2 Jung
- "Dreams, I maintain, are compensatory to the conscious situation of the moment." -Carl Jung 1974, p. 38 History of Carl Jung: - Carl Jung was a Swiss psychologist and close colleague of Freud for several years - He broke from Freud in 1913 when he realized his views of dreams were taking a much different direction than those of his mentor - While Freud was an excellent and very systematic writer, Jung was not - As a result, it is more difficult to comprehend and describe Jung’s theories and methods - Jung built upon Freud’s theories of dreams, expanding and adding to them - Although Jung believed that wish-fulfilling dreams did exist, he did not agree with Freud that wish-fulfillment should be the sole criterion for interpreting a dream Individuation: - A process where dreams provide a compensatory function by bringing forth unconscious perspectives to complement the waking points of view - Dreams aim at psychological self-healing designed to enhance a ‘‘balance’’ of emotional well-being - Dreams reveal, not conceal - In this way, dreams are more positive in Jung’s view than they are to Freud - To Jung, the unconscious is more comprehensive than it is to Freud Collective unconscious: - In addition to containing repressed feelings, instincts, and personal memories, it also contains aspects that are a part of every human’s unconscious - The collective unconscious is composed of archetypes = predispositions, instincts, or elements that all people have inherited from primitive humans—a kind of natural wisdom - They resemble blue prints into which the individual fills in details - They are seen in the similarities of the motives and images in the dreams, fantasies, and myths from the past and present - Archetypes form a link between the ways in which we consciously express our thoughts and a more primitive, more colorful, and a more imaginative form of expression - In a sense, archetypes are universal symbols available to everyone Several of the important archetypes include: 1. the persona: - a mask of personality, the image of ourselves that we endeavor to project to others and to ourselves 2. the shadow: - the dark, repressed aspects of personality that press for recognition - These are our traits and attitudes that we hide from ourselves and try to hide from the world - They are poorly integrated into our personalities - example, a respectable but overly puritanical young woman might have a sexually uninhibited, wild female motorcycle gang member who often appears in her dreams, chasing her and causing her problems - These aspects of the shadow need to be appropriately integrated into the rest of the person, and it is up to the unconscious to insure that they are 3. The animus and anima - The animus is the male element in the female unconscious - the anima is the female element in the male unconscious - A very masculine man may appear to have nothing feminine about him - But underneath, there are very feminine aspects that are carefully guarded and hidden in order to prevent being described as ‘‘feminine.’’ - It is because of this attempt to repress as much of this femininity as possible that the anima accumulates in the unconscious and must be brought out through dreams - Dreams may seem strange to us, not because of a censor that causes obfuscation, but because of the special symbolic language of the unconscious—images, symbols, and metaphors - But Jung also believed that dreams could provide prospective visions of the future in the sense that they may show potentials for what might be - Nevertheless, they are not absolute predictions - In contrast to Freud, Jung’s methods of dream interpretation centered on helping a ‘‘normal’’ person find its meaning - He sees dream interpretation as a joint process between the dreamer and the therapist - The most important steps are first to find the context of the dream, then amplify the dream
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9.1.2.1 Context
- The first step is for the dreamer to describe their waking life in relation to the dream. - Without this knowledge, it is impossible for the therapist to interpret a dream correctly
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9.1.3.2 French and Fromm
- Thomas French and Erika Fromm, both classically trained psychoanalysts, focused on Freud’s notion of the ego; hence, they are known as ego psychologists - The goal of ego psychology is to strengthen the ego against anxiety and better adapt to the demands of social reality - This is a waking life orientation and thus a more practical approach than that of Freud’s - To French and Fromm, every dream has a ‘‘focal conflict’’ involving a current life problem - This focal conflict is personal or interpersonal with emotional overtones - The recalled dream reveals what this conflict is and how the dreamer is trying to solve it - In longer dreams, the same conflict in the dreamer’s past is also presented to see what did and did not work - Every element in the dream is connected to the conflict in some way - Dream interpretation, according to French and Fromm, needs to be done by a trained therapist who uses ‘‘empathetic imaginations’’ from a psychoanalytic viewpoint to guide the session - However, the therapist does not simply dictate conclusions to the dreamer but also carefully checks for evidence that this empathetic imagination is correct - In the process, the therapist moves between the parts of the dream to the whole and back again - Success with the process is determined when there are no inconsistencies with parts of the interpretation and the dreamer is enthusiastic about feeling that the interpretation is insightful
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9.1.3.3 Boss
- Medard Boss was a Swiss psychiatrist who trained and worked with Jung - he came to reject the notion of the unconscious and the notion that there are special messages delivered through dreams Existential phenomenalism: - Medard Boss aligned with a philosophy called existential phenomenalism that asserts that we exist solely in relationship to people and things - This ‘‘being-in-the-world’’ occurs in the world of our dreams as well as our waking world, so we must treat our dreams as an experience rather than as containing symbols and metaphors - As such, dreams mirror our present and open future potentials and possibilities - Dream experiences are more restricted and dimmer than waking existence, but they characterize how the dreamer relates to the waking world - The key to working with dreams, for Boss, is to focus on the experience - We should strive to get the obvious meaning from the dream Explication: - Medard Boss's method was not as clearly outlined as was that of Freud and Jung, but contains the following elements: - Start by looking at what is in the dream, but also notice what is not in the dream - Then note the relationship of the dreamer to the elements of the dream and how the dreamer responds to them - Make special note of how the dreamer relates emotionally to these elements - As much as possible, one should try to relive the dream - Stay as close to the recalled dream as much as possible while exploring its details and one’s reactions to them - Try to get an ‘‘increasingly refined account’’ of it - It is necessary for the dreamer to have the guidance of a trained and knowledgeable therapist to find the ‘‘significances’’ of the dream to the dreamer’s waking life - The therapist does not need to know the client’s life history or even the predream life situation - The therapist does not offer interpretations but does comment on the dream as an existential experience and offers ‘‘helpful comments and hints’’ such as, ‘‘Is there anything similar to waking life?’’ - The dream means nothing more than what the dreamer can see revealed in it and how it points to the dreamer’s individual traits - The dream experience is the focus - For Boss, dreams can be useful in psychotherapy because they can point to constrictions in the dreamer’s personality - they can also disclose potentials for growth - They can be transforming experiences - He also emphasizes that we should pay special attention to very unusual dream phenomena
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9.1.3.4 Hall
" In short, the images of our dreams are pictures of our conceptions. We study dreams in order to find out what people think during sleep" — Calvin Hall 1966, p. 10 - Calvin Hall was a university professor of psychology prior to becoming the Director of the Dream Research Institute in Santa Cruz, California - His dream theory derives from Freud’s basic concepts but differs in its details - Hall found many of the details of Freud’s and Jung’s theories to be turgid, unscientific, and impractical - He derived his notions by applying the scientific method to the study of dreams in order to determine precisely what people dream about The following discussion is from his book, The Meaning of Dreams: - Unlike Freud and Jung, who used patients’ or clients’ dreams as the basis of their theories, Hall derived his ideas from the study of thousands of dreams collected from hundreds of ‘‘normal’’ people - Yet, it is interesting to note that in the end, he concluded that Freud was essentially correct about the nature of dreams, for Hall’s normal subjects dreamed in the same way as Freud’s disturbed patients - For example, Hall’s male subjects often revealed the Oedipal complex in their dreams, just like Freud’s male patients - The details of the content and focus may differ between patients and a non-clinical population, but the basic underlying processes are the same - To Hall, a dream is ‘‘a succession of images, predominantly visual in quality, which are experienced during sleep’’ - These images represent the ideas or conceptions of the dreamer that are typically found below the level of consciousness - He did recognize that external, sensory stimuli sometimes generate dream content, but he said that they are neither responsible for the generation of the dream nor are they typically accurately portrayed - For example, a ringing telephone may become a fire alarm in a dream - Also people, things, or events of our recent waking experience may also show up later in our dreams - For Hall, dreams are continuous with the person’s waking personality and thoughts - Hall believed that people dream only of things that are of personal importance to them but not current events, even catastrophic ones - For example, none of the hundreds of dreams he collected from many U.S. citizens shortly after the first atomic bomb was dropped on Japan contained any reference to that event - Neither do people dream about other impersonal things such as politics, economics, sports, business, or work - Rather, dreams are very personal—a letter to oneself about things that are important to the dreamer - Dreams particularly reveal what dreamers really think of themselves by getting behind their waking self-facades - In this regard, Hall pointed out that each aspect of the dreamer’s personality is often symbolized by a different character in a dream, that is, the personal subjective portrayal of others as found deep in the minds of dreamers - Yet dreamers may have more than one conception of themselves and others - Some of these conceptions may even be contradictory, since logic is not important in dreaming - These various conceptions may all manifest themselves within one dream or some in one dream and others in another dream - dreams are not generated by our impulses, rather they show our attitudes toward our impulses - When asleep, our mind is free of external controls and free to indulge in impulse gratification - The contents of dreams also reflect a person’s worldview such as whether other people are generally kind and generous versus generally nasty and aggressive - Dreams also show how dreamers view the space that they live in or how it affects them - This subjective world is never an exact replica of the ‘‘real’’ world, and two different people will certainly have two different views of the same ‘‘real’’ world - dreams show the dreamer’s conflicts and problems - Most of the information gained from dreams comes from this source - Hall defined conflicts as opposing conceptions that are constantly struggling and fighting with one another within a person - The real authentic problems, rather than the delusions and pretensions of waking life, surface in dreams - Since the dreamers create their own dreams, they determine who is in them and what things become a part of them - Furthermore, everything in a dream is there for a purpose and is important - The dream is a very creative product, but it comes out of our unawareness. - We do not consciously create our dreams - Symbols are an important aspect of dreams - Hall believed that they serve the same function in dreams that they do in waking life - He called symbols pictorial metaphors, and he emphasized that they are intended not to obscure, but to clarify - Symbols are an efficient and concise way of presenting complex and hard to understand ideas and they can often make visible things that are otherwise invisible, such as feelings - But the presence of symbols in dreams does make it more difficult to assess the meaning in dreams - there is the need for dream analysis or interpretation - Interpretation of a dream means to turn the symbols back into ideas - Since dreamers are the ones who created the dreams and chose what symbols to use, the dreamers themselves should be an important part of the interpretation process - Most interpretation should be easy, because dreams are relatively transparent - If a dream does not make sense on the face of it then the dreamer must work with its parts and symbols to get at its meanings - If that approach is not successful, then the dreamer should try free associating to each symbol - Hall believed that the dreamer is the best person to interpret their own dream since the dream is a product of the dreamer’s mind - . Anyone who is clear thinking and is willing to let go without suppressing or controlling or trying to edit can free associate - Hall also advised against reading some theory into a dream; rather, he advocated reading the meaning out of the dream - The goal of dream interpretation is to convert images into verbal ideas - Hall believed that you should not work with only a portion of a dream - A dream is ‘‘an organic whole’’ and should be analyzed that way - he recommended looking at a series of dreams rather than each dream separately - Each dream is like a chapter in a book, while each chapter may contain a lot of information - Only by reading the whole book can you understand what the author is saying - Hall believed you should consider the interpretation of one dream only as a hunch until verified by the interpretation of other dreams Spotlight or bareface dreams: - occasional occurrence of dreams whose meanings are obvious, and thus need little interpretation - If such a dream is available, use this one first, then work with other, more complex dreams in the series - Hall, like Jung, broadened the scope of Freudian dream interpretation - by emphasizing the importance of working with a series of dreams and the personal, contemporary nature of dream content - He also eliminated the need for a trained analyst to interpret dreams, believing instead that each of us is best capable of interpreting our own dreams
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Box 9.1 Dream Interpretation
- All methods of dream interpretation are based on the interpreter’s theory of dreams - Sometimes the theory is described in great detail, but in other cases, it is just loosely mentioned or implied - it should also be noted that some proponents of theories of dreaming are indifferent about dream interpretation, believe it is a waste of time, or even believe it is counterproductive - Yet, there is evidence that working with dreams can be useful in psychotherapy It is a good idea when considering a dream interpretation method to begin by asking the following questions: 1. How do the theoretical assumptions behind the method influence the interpretations? 2. What are the roles of the dreamer and the interpreter? Can both roles be played by anyone, or does the interpreter need to be highly trained? - The answers can tell a lot about how narrow or broad the method is and whether you want to invest a lot of time in it The following are six of types of methods most frequently used by experts and amateurs alike. They can be used individually but often can and are used in combination: 1. Cultural-Formula - In the Cultural-Formula method, the dreamer is told what the components of the dream mean - It is among the oldest approaches to dream interpretation and, to varying degrees, some or most of the meanings of the components may be tied to a particular culture - This method is a part of Jungian and New Age dream interpretation - The assumption is that the culture implicitly agrees on the meaning of certain objects and actions - it takes someone who has carefully studied these meanings or been schooled in them to recognize them in the dreamer’s dream or record them in a book often organized like a dictionary 2. Psychotheoretical-Formula - a trained analyst interprets the themes and images of the dream for the dreamer - The analyst uses a specific psychological theory to match particular components with interpretations - Freudian and Jungian analysis is example of this method - The ordinary person cannot do the interpretation, because it requires working knowledge of the theory and considerable experience 3. Associative - the dreamer gives associations, semantic and also emotional, to components in the dream - It was Freud who first espoused using the associations of the dreamer to help with the interpretation - Later, others believed that Freud allowed dreamers to follow a train of associations too far from the dream itself - In another example, the Dream Interview Method of Gayle Delaney asks the dreamer to describe components of the dream as if talking to someone from another planet who knows little of the planet earth. - The dreamer is to give literal definitions as well as emotional feeling about the component - Since we create our dreams based on our personal meanings and feelings to understand the meaning of the dream, it is helpful to garner these individual meanings and feelings 4. Emotion-Focusing - The emphasis of the Emotion-Focusing method is for the dreamer to assume the role of an image in the dream, be it people, animals, plants, or even inanimate objects, and act it out - The dreamer may alternate between two images as they carry on a dialog - Or in a group setting, others in the group may be asked to assume the role of some of the other images and interact with the image that the dreamer assumes - The idea here is to have the dreamer get to the often intense feelings associated with the images of the dream, and the best way to get to these feelings is to experience them - The Gestalt approach of Fritz Perls (1969) champions this method 5. Personal-Projection - involves someone other than the dreamer projecting a mixture of cultural associations, psychotheoretical associations, personal associations, and emotional responses onto the dreamers’ dream - This method has been around for eons - The method of Ullman and Zimmerman (1979) is a modern version - A small group of people discuss the dream of one other group member as if it is their own, projecting their feelings and associations onto its components - At this point, the dreamer is only to listen - Then, the dreamer tells if any of the projections help to interpret the meaning of the dream - The idea is that sometimes other people can see the meanings in our dreams that we are unable to see until they are pointed out by others 6. Phenomenological - The object of the Phenomenological approach is to get the dreamer to fully re-experience the images and feelings of the dream from an individual perspective - The dreamer is to describe in as much detail as possible precisely what happened in the dream as the dream is being re-experienced - There is no presumptuous or restrictive dream theory allowed to get in the way of experiencing the dream just as it was dreamed - Re-experiencing the dream can enlighten the dreamer about new attitudes and feelings and even new ways of being - Medard Boss is credited with championing this method - Delaney’s Dream Interview Method (1991, 1996) also loosely fits in this category; - after the dreamer defines the components of the dream, the dreamer is asked if the components remind him or her of anything from waking life Other ways of working with dreams have been suggested (Siegel 2003; Savary et al. 1984) including: - working with a partner or group - automatic writing—writing all feelings, thoughts, and associations that come to mind about the contents of the dream - assessing what message could be brought to the person’s waking life - write how two characters or other components of a dream would converse with one another - start by telling the dream in the present tense a couple of times while focusing on your feelings, body sensations, and associations - tell the dream again from different perspectives such as that of different character - try drawing the dream or make a series of drawings like a cartoon strip - make as list questions you have about the dream and its parts then choose one or two of the most central questions and answer them - select an image from the dream then let the dream come alive and focus on the symbol then describe/define as if to someone from another planet including how you feel about it - what the image is doing in this dream, and what it reminds you of - finish by reflecting on things like what new insights, possibilities, healing, or peace you have gained
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9.2.1 Activation-Synthesis
- In the late 1970s, Alan Hobson and Robert McCarley of the Department of Psychiatry at Harvard Medical School first described their influential activation-synthesis model of dreaming as an extension of their reciprocal interaction model for the control of NREM/REMS cycling and how the brain causes dreaming Activation-synthesis model - According to the activation-synthesis model, dreaming during REMS is result of the REM-ON area configuring the functioning of the brain differently by activating several forebrain systems while a few others are deactivated The activated areas include those for: - awareness, - eye movements, - instincts, - vestibular sensations (sense of body position and acceleration), - memory consolidation, - and emotions - Areas involved in the production of various motor movements and the secondary procession of sensory information are also activated - but the motor output to the muscles for body movement are blocked - Simultaneously, the areas involved in the primary reception of most sensory information are not activated, causing most of the information from the senses to be ignored - there is isolation from reality - Importantly, the site of executive control, the dorsal lateral prefrontal cortex located approximately just inside the front of your temples, is deactivated - The result of this area of the brain not being online is the unquestioned acceptance while dreaming that we are having waking experiences without any realization of their frequently illogical and unfeasible nature - the activating and activated structures are interacting and the resulting information is then synthesized into a unified, perceptual whole - The result is the experience of a dream isolated from reality but that seems real at the time with heavy emphasis on emotional and sensory content It includes much that is familiar because the areas of the forebrain that are activated are also responsible for the storage: - of your preexisting memories, - your typical emotional responses, - and your typical way of synthesizing this information - In this way, the aspects of your life and personality become part of your dreams and, thus, the contents of your dreams are very meaningful to you - This important aspect of the activationsynthesis model has frequently been ignored or missed by its critics. ** - Seligman and Yellen (1987) describe a classroom demonstration that illustrates synthesis - The instructor crumples a string of sequentially blinking, miniature, Christmas tree lights into a loose ball - The lights now appear to blink randomly - The instructor then turns on a tape of Beatles’ music - Soon most students report that the lights appear to blink in synchrony with the song - When the instructor turns the music off, the randomness of the blinking again becomes apparent to the students - This demonstration shows how a pattern is imposed on something unpatterned - We cannot help but do it, because our brain does it automatically when awake and when dreaming - When awake, our sensory information is usually very much related to our motor information and seems ‘‘normal.’ - For example, when we stroke a furry cat, we see and feel our hand moving across the fur at the same time that we sense the muscles of our arm producing the stroking movements - Also, sensory events are usually sequentially continuous when we are awake - For example, when we watch a baseball game, we see the pitcher wind up and throw, then the batter swings, next the ball is rocketing toward the left field bleachers, the batter is running the bases, and the scoreboard changes the score - In contrast, discontinuities are more common in dreams - The pitcher winds up, the batter swings, and starts to run, but is now running up an escalator at an airport in a frustrating effort to get to class - The reason for discontinuities is that when asleep, the activation of the various components is random and varies in strength - Thus, at any time, the activated components may not be so well related; yet the brain synthesizes them as best it can into a single entity - The result is often the bizarreness we perceive in our dreams - For instance, the sensory part of our brain may be activated to produce the image of a wall, while the muscle command area of the brain is sending out signals to produce walking, so we dream of walking through a wall - For similar reasons, we may experience abrupt, bizarre scene shifts - We are in a boat at one instant and in class the next - The difference between dreaming and being awake, then, is not the process of activation and synthesis, but the source of the activation—more external, and sequential, when awake, almost entirely internal and random when in REM - Originally, the activation-synthesis theory was developed to explain REMS dreaming - Later, the same mechanisms were extended to explain stage 2 dreamlike mentation that is frequent toward the end of the sleep period - This process is thought to result from an ‘‘admixture’’ of REMS and N2 sleep - The length, strength, and closeness of the REMS periods to N2 sleep without intervening N3 sleep cause some components of REMS to occur during N2 sleep in a weaker intensity insufficient to trigger REMS but sufficient to cause mentation - A colleague of Hobson at Harvard, Robert Stickgold, has updated and elaborated upon aspects of the activation-synthesis theory of dreaming - Since the original formulation of the activation-synthesis hypothesis, data from neurophysiology, cognitive neuroscience, dream recall content, and postmodern literary theory have added to the specification of the synthesis component - According to Stickgold, the bizarreness in dreams has been found to be not entirely random - Rather, there are rules that restrain the transformation of objects into other objects and determine the degree of plot continuity - Analysis of dream content shows that people tend to morph into other living things but not inanimate objects and vice versa - Furthermore, people are more likely to morph into other people than into animals, rocks into chairs than into flowers, and so forth - Also, the memories that are sequentially activated during dreaming tend to be associated, resulting in immediate plot coherence, but the memories that are non-sequentially activated during dreaming are not so associated, resulting in strange twists and turns in the plot when the dream is viewed in its entirety - The result is like a meandering social conversation that twists and turns as the most recent topic leads to the next association
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Box 9.2 Implications of the Activation-Synthesis Theory for Dream Interpretation
- Dream construction, dream experience, and dream interpretation are all worthy topics of study but are independent of each other - The construction of the dream is done from randomly stimulated elements without any intent of specific meaning or plot - While experiencing the dream, the dreamer’s mind links its parts together as best it can to form a coherent plot - During interpretation, meaning for the dreamer that can be very useful is sought from the elements and the plot - This linkage can be done because the components of the dream, and the way they are joined to form a plot, come out of the dreamers own mind and are thus meaningful to them - Thus, according to Stickgold, there is no need for dreams to have intent in order to have meaning - Experiential meaning and interpreted meaning cannot legitimately be projected backwards to infer intent
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Criticisms of the activation-synthesis theory have been many and varied as follows:
- It is too neurological or too narrowly scientific to describe what dreaming is really about - It is based on animal brain research that may not apply to a mental function in humans - Evidence suggests the instigation for dreaming occurs in the cerebral cortex, not the brainstem - There are people who have REMS and do not dream, and there are people who dream but do not have REMS - Lucid dreaming is said to disavow the notion that higher mental functions of the forebrain play only a secondary role in dreaming, for many lucid dreamers can control the dream - Objective analysis of dreams shows that only a small portion of their content is bizarre, but the activation-synthesis hypothesis only describes how bizarreness occurs; and, as mentioned earlier - Random stimulation of the forebrain that results in dreaming cannot explain the meaningfulness, focus on current concerns, and their pattern of sequencing through the night - As an update and extension of the activation-synthesis model, Hobson has developed a general model of the brain-mind called AIM - It purports to model the nature of mental processes in sleep, waking, and some abnormal states AIM stands for the three factors in the model: Activation - A is activation level of activation in the brain Input - I is relative source of input, internal versus external, to the activated areas Moment - M is the information processing mode that is related to the relative levels of various neurotransmitters at the moment - The interaction of the current level of these three factors determines the instantaneous state of the mental processes in the brain/mind whether awake, asleep, dreaming, or in an abnormal mode - Dreaming occurs when A is high, I is internal, and the M component is dominated by acetylcholine ***
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9.2.2 Solms
- A somewhat different view by Mark Solms of how the brain causes dreaming based on studies of his and other’s brain damaged patients - Like Hobson and colleagues, Solms maintains that dreams occur because of a functional reorganization of the higher portions of the brain, but the specific details of that reorganization differ - The key for Solms is the direction of information flow that results in dreaming - When awake, sensory stimuli coming primarily from external sources activate the sensory areas of the cortex that in turn activate nearby perceptual and stored memory areas of the cerebral cortex - These, in their turn, activate the limbic areas that are considered important for goalseeking, appetitive, and volitional activities, and that influence the motor output system - However, during sleep, there is a different flow of information - The functioning of the primary sensory areas in the cortex that are responsive to external stimuli is attenuated - This attenuation allows internally generated stimuli, together with the small amount of external stimuli that still gets through, to first arouse the goal-seeking, appetitive, volitional, and emotional areas of the limbic system before any sensory or memory areas become involved - Motives instigate dreams because the only thing that eliminates dreaming is damage to the area of the brain involved with motivation - The generation of abstract (symbolic) thoughts derived from past experiences follows - The result is symbolic and primarily movie-like visual-spatial hallucinations - Meanwhile, the reflective mechanisms of the dorsal lateral prefrontal cortex are not operative during sleep and thus do not distinguish these resulting hallucinations from reality and awakening - In summary, dreams are the result of ‘‘abstract thinking… converted into concrete perception’’ - Solms tentatively expresses some support for Freud’s ideas about the source of dreams; that is, dreaming is motivated by our wishes yet is the guardian of sleep - These potentially arousing wishes are channeled away from waking into the sleep perpetuating hallucinations of dreaming, since neurological patients reporting the cessation of dreaming also describe their sleep as disturbed, which Solms admits needs to be objectively verified in a sleep laboratory - Furthermore, patients who exhibit loss of inhibition and regulation following damage to, or disconnection of, deep prefrontal regions, possibly Freud’s censor, report an absence of dreaming - Solms’s theories have been criticized from a number of fronts on a number of grounds - Yet, his data and some of their implications have had a major effect on how dreaming is viewed by theorists from a number of perspectives Critiques of Solms - In particular, Hobson’s group has recognized much of Solms’s data as being important and informative but disagrees with some of the interpretations - For example, Solms describes damage to the motivational system that eliminates dreaming but, according to Hobson’s group, this is damage to much more than the motivational system - Others criticize Solms for being too neurological and not psychological enough in his theory
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9.2.3 Cognitive Dream Theories
- Cognitive dream theory approaches dreams not as brain processing of perceptual experiences, but as a type of cognition or information processing - These theories assume that dreams reprocess memories and knowledge using the same basic methods that the waking mind does - The focus is more on the process of dreaming than on the particulars of dreams’ contents, sources, or significances - Unlike neuroscience approaches, they do not reduce dreams to the activity of the brain - Unlike clinical approaches, they do not see unconscious motivation for dreaming nor hidden meanings in dreams - The interest is on how dreaming is similar to and how it differs from waking cognition - Within this framework, there are different cognitive dream theories - We will examine two of the more prominent ones
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9.2.4 Foulkes
- David Foulkes (1999), as a cognitive dream theorist, maintains that dreams are not simple perceptual phenomena but are a way of thinking - The main difference between waking cognition and dreaming is that the dreaming mind is not regulated by sensory stimulation or even self-control - It processes information that is broader in scope and less associated than when awake - Yet, as in waking, the brain attempts to provide a coherent synthesis in a narrative format of the information currently available - The result is recombinations of waking experiences, knowledge, and memory that simulate waking reality - Dreaming thus depends on the ability to access and cognitively process recent experiences, knowledge, and other memories - It is also related to language production and high-level cognitive constructive processes of the human mind - For this reason, Foulkes maintains, animals do not dream because they are not capable of such cognitive processes - Foulkes comes to his understanding from rigorous series of studies of sleep laboratory dream recall from children of various ages - He sees the ability to dream gradually developing during childhood beginning at about 5 years of age as language abilities and cognitive processes continue to develop - Although a few recalls could be obtained from children beginning at age 3, they were so short and not dream-like that Foulkes dismisses them as dreaming - He sees the ability to dream becoming well formed by age 9 but continuing to develop through age 12–13 - Although dreams are the result of the ‘‘natural powers of the mind’’ that are the same as when awake and the content of dreams is systematic, coherent, and has a specific structure, there is no intention behind dream content - However, dreams do extend the dreamer’s range of experiences and contribute to self-consciousness - They constitute a model of the waking world that is not a simple replay of the past but as something that could have happened
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9.2.5 Hunt
- Harry Hunt, a psychologist at Brock University in Canada, takes a broader approach than Foulkes - He says the study of dreaming needs to take information from a variety of sources, not just from subjects in the sleep laboratory or patients in the therapist’s office - For Hunt, dream data also comes from anthropological studies, dream journals, and those special dreams that people tend to notice and remember - In fact, he maintains, home dreams, not the ones from the lab, really tell what dreaming is all about Such data show that there are a variety of types of dreams: - Personal-mnemic dreams: containing everyday matters from the dreamer’s waking life; occur frequently; come from more grammar-oriented processes - Medical-somatic dreams: reflecting the physiology of the dreamer’s body, especially illness; - Prophetic dreams: Omens or other images of the future; - Archetypal-spiritual dreams: encounters with ethereal or supernatural forces that are especially vivid and powerful often accompanied by very strong sensations; are rare but typically intense and not likely to occur in the sleep laboratory; more image-oriented - Nightmares: terrifying and upsetting; - Lucid dreams: being conscious that one is dreaming while dreaming - Each type has its own combination of cognitive processes and perhaps different functions - Hunt also maintains that dreams are not limited to being either stories or imagery - They are both - Hunt believes that Foulkes and Freud focus only on the personal-mnemic dreams; thus, their theories are incomplete - Furthermore, some dreams are verbal propositions that are transformed into images—the theories of Freud, Foulkes, and Hobson focus on these—while other dreams start as visual-spatial images that are transformed into linguistic forms—the theory of Jung focuses on these types of dreams
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9.3.1 Hartmann
The theory of dreaming by Ernest Hartmann, a Boston psychiatrist and long-time dream researcher, has three major aspects: 1. the functional structure of the brain when dreaming 2. the emotional focus of dreams 3. and an aspect of personality related to dreaming This theory is based in part on: - recent brain research and theories - his clinical impressions working with people and their dreams - his and others’ empirical research on dreams and dreamers - For Hartmann, what is most important for understanding dreams and dreaming is what happens in the cortex, for it is there that conscious experience occurs - The functional structure of the cortex is made up of neural nets - These nets are the synaptic connections between several or several hundred neurons active at any given time - Actually, it is a network of nets - That is, there are nets scattered about the cortex, sometimes widely scattered, that are networked together at specific times for specific functions - A mental event, be it a thought, memory, or an image, is the activation of a certain configuration of the net - There are different activation patterns for different contents of the mind - Parts of the net are more tightly woven than other parts A tight weave serves specific functions such as: - grammar, - image recognition, - or detailed memory recall - A tight weave serves specific functions such as grammar, image recognition, or detailed memory recall - However, when dreaming, the network is more loosely and more broadly connected - When dreaming, neural activation tends to wander around networks and explore different connections - As a result, dreaming cognition is less linguistic, logical, and goal directed than waking cognition - there are fewer direct paths from input to output - Deduction and making lists are not as possible - When dreaming, cognition is more metaphoric, bizarre, and novel - There are always disturbances in the network of nets - These disturbances can be caused by emotions resulting from behavioral stress, trauma, and conflicts - The greater the emotion, the greater the disturbance - The disturbance (emotion) focuses the content of the dream, and the nature of the network causes the disturbance to be metaphorically pictured rather than literally pictured - This process is most clearly seen in the dreams of adults following a trauma - They may dream of being overwhelmed by a tornado, an earthquake, or some similar catastrophe Hartmann also has found that some people apparently have looser, broader networks as their typical mode of functional brain organization: - Behaviorally, he describes their personalities as having ‘‘thin boundaries.’’ - They have a rich fantasy life and have trouble telling reality from fantasy - They are daydreamers and are more open to experience - They have difficulty focusing on one thing - Their thoughts and feelings merge - Artists of various types tend to fall into this category People who have tightly woven, closely networked nets: - They focus on one thing at a time - They clearly differentiate thoughts from feelings, reality from fantasy, self from others - They have a clear and well-compartmentalized sense of self that is well defended - They think of themselves as thought people - Many businessmen fall into this category - Most people are somewhere between these extremes, with thicker boundaries for some things and thinner boundaries for others - The nature of individuals’ boundaries relates to their dreams People with thin boundaries have: - more dream recall, - their dreams have more vividness, - more interaction between characters - and are more emotional than those of people with thick boundaries - more likely to have nightmares Critic of Hartmann - parts of the theory are not well-grounded in objective research - The idea that emotions direct the focus of dreaming needs to be tested rather than form the starting place for the theory - Domhoff maintains that Hartmann does not have a reliable methodology to use in studying the place of emotions in dreams - Domhoff contends that Hartmann presents no data that systematically show that dreams change over time in adults
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9.5 Conclusion
- Some see dreams as ‘‘improvisationist’’ in that the dreamer combines whatever elements of mental activity that happen to occur - Others see dreams as a ‘‘stage play’’ in that the dreamer starts with a story and brings in the elements necessary to portray that story - Hobson and colleagues would be an example of improvisationists, while Freud and Jung are examples of stage play - Other views are that dreams are either a compromise between primitive and disruptive tendencies and more advanced mental processes, or as non-linguistic, emotional expressions on the same level as waking mental processes - Examples of the first type are Freud and Hobson and colleagues, while an example of the second is Jung - There are those who insist that we reject subjectivity and study dreams only in the laboratory, believing that method is of prime importance - In contrast are those who say we should start with the dream itself and allow the methods to follow from their nature - Not everyone agrees that dreams are meaningful - Many of my colleagues in the Sleep Research Society conclude that since the activation-synthesis theory has shown that dreams are a result of random activation by the pons of the cortex, dreams are a meaningless epiphenomenon. - Others reach the same conclusion from a psychological perspective that dreams are the result of the lawful integration of more or less, randomly activated, recent and long-term memories - Although this process results in a structured storyline, there is no communicative intent - Hence, dreams do not mean anything, and interpretation of them is meaningless
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9.3.2 Domhoff
- Psychologist G. William Domhoff (2001) of the University of California, Santa Cruz, has developed what he calls ‘‘A New Neurocognitive Theory of Dreaming.’’ - It is based on the data of Solms, brain imaging during sleep, Foulkes data and theory, and the Hall and Van de Castle method of studying dream content - Domhoff sees dreaming as a developmental, cognitive process resulting from the maturation and maintenance of a network of certain forebrain structures - Dreams are produced in accordance with a continuity principle using the present concerns of relevance to the dreamer and a repetition principle based on emotional concerns from the dreamer’s past - The brain structures involved are those described by Solms and the images of the brain during sleep - The cognitive development aspect is from Foulkes’s research showing that dreaming develops gradually during the first decade of life - Domhoff points out that this cognitive development may be the result of the maturation of the brain structures necessary for dreaming - The continuity and repetition aspects come from his findings and others using the Hall and Van de Castle scales - showing that most recalled dream content is continuous with the dreamer’s waking life - yet with considerable repetition of characters, social interactions, misfortunes, negative emotions, and themes unique to the individual dreamer - The repetitive content may emanate from the activity in the portions of the brain responsible for emotionality - The parallels between waking cognition and recalled dream content suggest that figurative thinking, using symbols and metaphors, may also be an important element of dreaming - The emphasis in dreams are concerns about self and others - Yet, recalled dreams having psychological meaning does not imply that dreaming is purposeful - Rather, he agrees with Flanagan and Foulkes that dreams are the spin-off of the evolutionary development of sleep and consciousness
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Sleeping-in on the weekend delays circadian phase and increases sleepiness the following week Amanda TAYLOR, Helen R. WRIGHT and Leon C. LACK
- Previous studies have found that delaying bedtime and waking-up time (WUT) results in a delayed circadian rhythm and a decline in subsequent mood and cognitive functioning - The present study investigated the effect of delaying only WUT for two weekend mornings on the timing of the dim light melatonin onset circadian rhythm (DLMO), as well as sleep, daytime sleepiness and fatigue - In a repeated measures design with 16 participants, the delayed weekend WUT condition (DS) was compared with a weekend in which they kept their habitual weekday WUT (HS - On average, participants in the DS condition delayed their weekend WUT by about 3 h. - When compared to the HS condition, participants in the DS condition had a significant delay in salivary DLMO of 42 min between Friday and Sunday nights - they also indicated an 8-min increased sleep onset latency on Sunday night and significantly greater daytime fatigue and sleepi- ness on Monday and Tuesday of the following week - Sleeping-in late on the weekend appears to have a subsequent cost of delaying circadian rhythm, delaying sleep on Sunday night and increased daytime sleepiness and fatigue, the so-called ‘Monday morning blues’ - Previous studies have shown us that a delay of the circadian rhythm is associated with difficulty initiating sleep at night - Difficulties experienced following a weekend sleep-in include difficulty falling asleep on Sunday night and Monday morning lethargy - thus it has been hypothesised that these experiences can be following the weekend 2-hour delay of both bedtime and WUT - the findings from the present study suggest a significant cost during the week fol- lowing the very common practice of sleeping-in late on the weekend DEPENDANT VARIABLE - The main outcome dependent variable was a delay in DLMO timing across each experi- mental weekend, which was calculated by subtracting the participants’ Friday evening DLMO from their Sunday evening DLMO
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Week 7 Activities
After reading the Taylor, Wright and Lack (2008) study, complete the following quiz to test how much you know about basic experimental methodology and the Taylor study. The independent variable (IV) in an experiment is the variable that is manipulated. In the Taylor et al. (2008) experiment, what was the IV? (IV = manipulated by experimenters) - Waking-up time The dependent variable in an experiment is the variable that is measured. Which is NOT one of the dependent variables? - Sleep quality What was the main purpose of the study? - To show that an irregular schedule has negative effects on sleep and fatigue.