Altered States of Awareness Flashcards

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1
Q

State of awareness

A

The sensations, perceptions, cognitions and emotions we experience.

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2
Q

Circadian rhythm + Examples

A

A behavioural or physiological cycle that occurs over a 24 hour period.

Example:

  • Alertness
  • Sleep/wake cycle
  • Body temperature
  • Blood pressure
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3
Q

What are circadian rhythms controlled by?

A
  • Exogenous rhythms (external)

- Endogenous rhythms (internal)

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4
Q

Exogenous rhythms

A

External cues including lifestyle and environmental factors (showering before bed, dressing each morning).

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5
Q

Endogenous rhythms

A

Biological processes which are influenced by the hypothalamus part of the brain (SCN = suprachiasmatic nucleus).

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6
Q

Suprachiasmatic nucleus (SCN)

A

Located in the hypothalamus in the brain, the suprachiasmatic nucleus acts a biological clock and controls the sleep/wake circadian rhythm.

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7
Q

How is the sleep/wake cycle controlled (SCN)?

A
  • Light entering the eyes falls on the retina and a signal is sent via the optic nerve to the SCN.
  • The SCN delivers a message to the pineal gland which secretes the hormone melatonin.
  • The release of melatonin increases when it is dark and decreases when it is light.
  • Increased melatonin makes people sleepy and inversely, reduced melatonin makes people more alert.
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8
Q

What are the needs for sleep?

A
  • Energy conservation: During sleep less energy is used and energy is conserved due to lower metabolic rate and lower temperature.
  • Repair and restoration: Sleep aids repair and restoration as cells are repaired, the immune system is strengthened and waste products from muscles are eliminated.
  • Memory consolidation: Learning is consolidated during sleep, with memories being stored logically so they are accessible later.
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9
Q

Sleep dept

A

An accumulation of the difference between the amount of sleep that a person requires to function at an optimal level and the amount they actually have.

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10
Q

Sleep deprivation

A

Occurs when we don’t have enough sleep to operate at an optimal level.

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11
Q

What are the effects of sleep deprivation?

A

Common symptoms:

  • daytime sleepiness
  • moodiness
  • slowed reaction time
  • poorer memory
  • hand tremors
  • micro sleeps

Long-term effects:

  • health problems due to reduced immune system
  • hallucinations
  • delusions
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12
Q

Microsleep + two situations when particularly dangerous

A

A brief unintended loss of attention, which often occurs when a tired person is performing a monotonous task.

  • Driving
  • Operating Machinery
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13
Q

Does sleep debt build up?

A

No sleep debt does not continue to build up. If we have 8 hours too little sleep over a long weekend, 8 hours sleep is not required to recover. Only about 3 hours extra the next night and 2 hours extra the second night would return us to normal.

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14
Q

Stages of sleep

A

During sleep a person moves up and down through 5 different stages of sleep. Each cycle is 90 minutes and 4 - 5 cycles occur per night.

  • Non-REM sleep: A collective term for stages 1 to 4 of sleep
  • REM sleep: The fifth stage of sleep which is distinguished by rapid eye movements.
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15
Q

Method of investigating sleep: Electro-Encephalographs (EEG)

A

An Electro-Encephalograph is a device which monitors the electrical activity in the brain through the use of electrodes on the scalp to measure electricity produced by neurons in the brain. The different stages of sleep produce different traces of electrical activity called brainwaves. The height of a wave is called amplitude and the number of wave cycles per second is called frequency.

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16
Q

Sleep disorders

A

Sleep problems that disrupt the normal NREM-REM sleep cycle, including the onset of sleep. Sleep disorders can cause personal distress and often interfere with an individuals normal functioning.

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17
Q

Sleep apnea (biological level)

A

A sleep disorder in which a persons breathing stops periodically for a few moments while they are asleep.

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18
Q

Problems associated with sleep apnea

A

Due to consistent waking up, person is prevented from completing full cycles of sleep and remain until the light stage. Therefore the person fails to achieve the sleep needs.

This leads to:

  • Sleep deprivation
  • High blood pressure
  • Heart problems
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19
Q

Two types of sleep apnea

A
  • Obstructive sleep apnea

- Central sleep apnea

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20
Q

Obstructive sleep apnea

A

An obstruction in the throat during sleep, due to the complete relaxation of the throats muscles causing blockage of the upper airway at the back of the tongue.

This can be a result of several factors: being overweight and drinking alcohol before sleep. It is more common in overweight men over 40.

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21
Q

Central sleep apnea

A

This type is cause by a delay in the signal from the brain to breathe.

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22
Q

Treatment for sleep apnea

A

Mild sleep apnea: behavioural changes (loosing weight and refraining from sleeping on back)

Moderate-high sleep apnea: a CPAP machine

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23
Q

C-PAP (continuous positive airway pressure)

A

A C-PAP is a machine that blows air into the nose via a nose mask, keeping the airway open and unobstructed.

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24
Q

Narcolepsy

A

A sleep disorder in which people experience irresistible and unpredictable daytime attacks of sleepiness, lasting 5 to 30 minutes. Sleep attacks commonly occur at times when people are in a heightened state of alertness.

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25
Q

Problems associated with narcolepsy

A
  • Sleep attacks
  • Loss of muscle tension
  • Hallucinations may be experienced as the person goes in to REM almost immediately.
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26
Q

Causes of narcolepsy

A

There is a genetic component in narcolepsy.

27
Q

Treatment for narcolepsy

A

There is no cure for narcolepsy.

The excessive daytime sleepiness may be reduced with stimulant drugs (caffeine, exercise, keeping busy).

28
Q

Insomnia

A

A sleeping disorder in which people suffer from a reduction in the quality and amount of sleep as they experience problems getting to sleep, staying asleep or waking up too early.

29
Q

Causes of insomnia

A
  • Psychological factors: persistent stress, excessive anxiety and tension can prevent relaxation. Stress can cause worrying, which leads to a heightened state of psychological arousal making to difficult to sleep.
  • Lifestyle factors: drinking caffeine or smoking cigarettes are stimulants which make it difficult to sleep. Working shift work can make a sleep routine difficult to establish.
  • Environmental factors: noise and light.

Illness and secondary factors can contribute to insomnia (depression, arthritis and asthma)

30
Q

Problems with insomnia

A

A person is unable to function as they wish to during the day. Symptoms include fatigue and impaired concentration.

31
Q

Treatments for insomnia

A
• Medical treatment
 - sleeping pills
• Psychological interventions 
- stimulus control therapy
- sleep restriction therapy
- cognitive behaviour therapy
- bright light therapy
32
Q

Stimulus control therapy

A

Therapy used to treat insomnia using the principles of classical conditioning in which a person learns to associate the bed only with sleeping.

33
Q

Rules of stimulus control therapy

A
  • Only go to bed when feeling sleepy
  • Do not use bed for reading, watching television, eating or worrying
  • If unable to sleep after 10 minutes, leave room and repeat step as many times till asleep.
  • Get up same time every morning regardless of how much sleep is achieved.
  • No daytime naps
34
Q

Sleep restriction therapy

A

A treatment for insomnia which invokes limiting time spent in bed because the person spends too much time in bed attempting to sleep. This works by increasing sleep dept so the person can fall asleep more easily.

35
Q

Process of sleep restriction therapy

A
  1. Person records their estimated amount of sleep time each night in a sleep diet for two weeks.
  2. Diary is used to work out average number of hours sleep per night.
  3. Person is allowed to say in bed for the average number of hours slept plus 15 mins, but the total amount is never less than 4 and a half hours.
  4. Get up same time each day.
  5. No naps allowed during day.
  6. Once a person sleeps for 75% of the time that they are allowed to spend in bed for 5 days, they are allowed to go to bed 15 mins earlier.
  7. Repeat procedure until the person can sleep for eight hours or the amount of time desired.
36
Q

Bright light therapy

A

Therapy used for insomnia and other problems associated with circadian rhythms which involves wearing glasses with LED lights. If the CR is delayed, so you cannot sleep until late at night and then wake up late, bright light therapy in the morning can correct this. If the CR is advanced, so you fall asleep early and wake up very early, bright light therapy in the evening can correct this.

37
Q

Flight or flight response

A

A reaction to the perception of danger, invoking the release of neurotransmitters to activate the body and mind for survival.

38
Q

How is the flight or flight response controlled by the sympathetic nervous system and endocrine system?

A

During the flight-or-flight response, the sympathetic nervous system and endocrine system are activated. The sympathetic nervous system prepares the body for action. The endocrine system secretes hormones into the blood; adrenaline, cortisol which are released from the adrenal glands. This stimulates physiological and psychological arousal.

39
Q

Physiological arousal

A

The flight-or-flight response causes an increase in respiration, blood pressure which allows more oxygen and blood sugar to power the muscles. Blood is diverted from the digestive tract to parts of the body needed in an emergency response and digestion slows/stops. There is an increase in sweating, which cools the skin and allows the muscles to breathe.

40
Q

Psychological arousal

A

The flight-or-flight response causes changes which make people more irritable, anxious, excitable and psychologically alert to the threat.

41
Q

YERKES-DODSON LAW

A

There is an optimal level of arousal to achieve optimal performance on a task. If arousal is too low, the person will be very relaxed with low alertness and motivation causing a poor performance. If a persons arousal is too high, the person will experience hyper-alertness and anxiety, thus causing a poor performance.

42
Q

The level of arousal that is optimal for performance depends on two factors:

A
  • the difficulty or complexity of the task

- the individual

43
Q

The complexity of the task

A
  • simple tasks required higher arousal for best performance, as simple tasks need less processing of information.
  • complex tasks require lower arousal for best performance.
  • once a complex task has been practiced and the person becomes familiar it has a higher level of optimal arousal.
44
Q

The individual

A
  • Introverts tend to prefer less stimulating environments as they can easily become over-aroused and perform badly. Therefore, introverts need lower arousal levels to perform at their best.
  • Extroverts prefer more stimulating environments and therefore need higher arousal levels to perform at their best.
45
Q

Stress

A

Stress is a physical or psychological reaction to either a positive or negative change, presenting a series of challenges in everyday life. Stress can have a negative effect on health as the cardio-vascular, respiratory and immune system are often affected.

46
Q

How does the body respond to stress?

A

Hans Selye proposed the general adaption syndrome to describe the body’s response to stress, in which three stages occur; alarm, resistance and exhaustion.

47
Q

Alarm

A

In the alarm stage the sympathetic nervous system flight or flight response is activated to combat the stress. Hormones and neurotransmitters are released to prepare for action, causing a high arousal. Initially normal resistance levels are lowed.

48
Q

Resistance

A

In the resistance phase, the body remains in elevated arousal however there is a slight decline in physiological stress responses.

49
Q

Exhaustion

A

In the exhaustion phase, the body can no longer sustain the high level of arousal. The body’s psychological and physiological reserves are depleted and more severe damage to nerves and organs can occur. The ability to resist infections and repair tissue is reduced and there is a greater risk of cardiovascular disease, arthritis, ulcers, influenza and headaches. Psychological problems can also be induced like anxiety and depression which often lead to unhealthy coping mechanisms (bad diet, smoking, poor diet).

50
Q

Types of strategies for coping with stress

A
  • problem focused: solving the problem or changing the situation that is causing the stress
  • emotion focused: managing the emotions that are associated with the stress, usually by changing the way the person thinks about and perceives the situation.
51
Q

Cognitive behaviour therapy

A

The cognitive aspect aims to change the persons thinking towards situations. The behaviour aspects aims to change the persons behaviour and help develop skills and strategies.

52
Q

Stress management strategies

A
  • problem solving
  • social support
  • exercise
  • relaxation
  • time management
  • healthy eating
  • sleep
53
Q

Shift work

A

Shift works involves trying to stay awake at night when circadian rhythms such as alertness, body temperature and melatonin are signalling sleep. It therefore involves attempting to sleep during the day when the opposite is the case. Alternating between day and night shift is difficult because the persons circadian system is not able to become synchronised with his lifestyle.

54
Q

Effects of shift work

A
  • circadian rhythm becomes desynchronised
  • irritability
  • tiredness
  • sleep disturbances
  • digestive issues
  • increased risk of accidents
  • cardiovascular and gastrointestinal disease
55
Q

How can the effects of shift work be minimised?

A
  • change shifts as infrequently as possible, which allows time for the circadian rhythm of melatonin secretion to become more synchronised to sleep.
  • use bright lights (bright light therapy) to reset biological clock in the SCN and help adjust to the new time schedule.
  • wear dark glasses/ blinds to block light to limit amount of light that can be registered by the SCN
  • melatonin supplements
  • short naps
  • caffeine
  • if changing shifts, rotate forwards rather than backwards as people can adopt to forward shift rotation more rapidly than backward rotation.
56
Q

Jet lag

A

When the suprachiasmatic nucleus recognises the time of day to be different from what external cues tell us it is. It occurs when travelling through several time zones. The body clock is eventually naturally reset to local time by exogenous and endogenous factors. This reset happens at the rate of about 1 hour per day spent in the new time zone. It is less problematic to travel west as it is easier to stay awake longer than to force yourself to go to sleep and wake up earlier.

57
Q

Sleep hygiene

A

Things in your behaviour control that can help you to have optimal sleep quality and quantity.

  • consistent bed time and wake up time
  • have pre-sleep routine (shower)
  • quiet and comfortable sleeping environment
  • avoid caffeine
  • no naps
  • not taking worries to bed
58
Q

Ethical considerations

A
  • causing harm by putting people through stressful or sleep deprivation situations
  • people with sleep disorders should be regarded as a vulnerable group and particular care should be taken of their welfare
59
Q

Body temperature circadian rhythm

A

The body temperature circadian system fluctuates about one degree centigrade each day. Generally it peaks in late afternoon and is lowest in the early hours of the morning. The drop in body temperature in the evening coincides with a drop in alertness.

60
Q

STAGE ONE

A

Body activity:
• eye movements
• breathing
• heart rate slows
• muscles relax
• blood pressure drops
• brief muscle contractions (hypnic jerks)
Brain activity:
• theta waves have a lower frequency of 4-7 cups, than the alpha waves that occurred in the relaxed state before stage 1
- Light sleep
- No difficulty, person will deny being asleep at all

61
Q

STAGE TWO

A
Body activity: 
• respiration rate declines
• heart rate declines 
• muscle tension declines 
• body temperature declines
Brain activity: 
• Theta waves continue 
• onset of sleep spindles and k-complexes 
- Light sleep 
- No difficulty waking someone as it is a light sleep
62
Q

STAGE THREE

A

Body activity:
• muscles continue to become more relaxed
Brain activity:
• delta wave commence which are high-amplitude, low frequency rhythmic brainwaves.
• delta waves make up less than 50% of brain activity
- sleep becomes more deeper
- hardest stage to wake someone. If woken person may be confused and disoriented

63
Q

STAGE FOUR

A
Body activity:
• muscles are relaxed
• a decreased rate of respiration 
• slightly lower body temperature 
Brain activity:
• delay waves make up more than 50% of brain activity 
- deepest stage of sleep 
- hardest stage to wake someone. If woken person may he confused and disoriented.
64
Q

REM STAGE

A
Body activity: 
• the eyes rapidly move left to right and up and down.
• pulse rate and blood pressure quicken
• response is faster and irregular 
• muscles relax
Brain activity:
• Brain activity is similar to that if a person who is awake
- light/deep sleep
- no difficulty waking someone
- most likely for dreams to occur