PSYCH U4 AOS1 - SLEEP AND CONSCIOUSNESS

Question 1

what is consciousness?

Answer 1

Consciousness is our awareness of objects and events (stimuli) in the external world at any given moment and our internal sensations and mental experiences at any given moment.

Question 2

why is consciousness a psychological construct?

Answer 2

Consciousness cannot be seen, and therefore is a psychological construct; a concept constructed to describe specific psychological activity or a pattern of activity that is believed to occur or exist but cannot be directly observed
Personal, subjective, selective & continuous.

Question 3

what is normal waking consciousness?

Answer 3

Normal waking consciousness: refers to the states of consciousness when we are awake and aware of our thoughts, memories, feelings and the sensations we are experiencing from the outside world. Examples include anything requiring high awareness and focus. ⅔ of our day.

Question 4

what are altered states of consciousness?

Answer 4

Any state of consciousness that is distinctly different from normal waking consciousness in terms of levels of awareness and experience. Can be naturally occurring or induced.

Naturally occurring: A normal part of our lives and occurs in the course of everyday activities (sleep or daydreaming)

Induced: Can be intentionally achieved through the use of an aid (hypnosis, drugs, alcohol, medication) or unintentionally achieved due to an accident, disease or disorder.

Question 5

what is the continuum of consciousness?

Answer 5

Focused attention - Divided attention - daydreaming - Meditation - Hypnosis - Alcohol induced state - Asleep - Anaesthetised - Coma

Question 6

what is an electroencephalograph (EEG)?

Answer 6

Involves attaching electrodes to the surface of the scalp to detect electrical activity outside the skull. Shows brain waves. The electroencephalograph is a device used to detect, amplify and record electrical activity of the brain through brainwaves.

Question 7

what is an electromyograph?

Answer 7

The electromyograph detects, amplifies and records the electrical activity of the muscles of the body by indicating changes in movement and muscle tone (tension). It shows identifiable changes in muscular activity during certain SOC.

Higher levels of muscular activity and tone generally mean more alertness and vice versa. When we are in NWC, an EMG will show a pattern of electrical activity that is moderate to high. When we enter an ASC, this pattern changes as skeletal muscles and the ability to stand upright or control voluntary movement diminishes.

Question 8

what is an electro-oculargraph? (EOG)

Answer 8

The electro-oculargraph is a device used to detect, amplify and record the activity of the muscles responsible for eye movement. It measures changes in voltage as the eyes move and rotate in their sockets. EOG readings are particularly helpful for determining if someone is awake or asleep, and if asleep, which stage of sleep they are in.

Question 9

what is measurement of speed on cognitive tests?

Answer 9

involves recording the response / reaction time to a stimulus. Time taken to perform a cognitive task.

Could use a driving simulator to create conditions where a participant needs to respond to unpredictable road stimuli in both a NWC state & an ASC state

Question 10

what is the measurement of accuracy on cognitive tasks?

Answer 10

involves the number of correct responses & incorrect responses made by the individual under study. Could also be in a driving simulator test.

Question 11

what are sleep diaries?

Answer 11

A log used to self report sleep and waking time activities over a week or more. Often used in conjunction with other measures such as an EEG or EMG to support the assessment of sleep disturbances or disorders by seeing patterns in behaviour.

Records may be kept of: The time of trying to fall asleep, the number, length and time of awakenings, how well rested the individual feels after waking, factors that may influence sleep such as alcohol, caffeine or naps

Question 12

what are advantages and disadvantages of sleep diaries?

Answer 12

Advantages: Insight into an individual’s thoughts and feelings that cannot be directly observed or measured through observational studies or physiological recording devices.

Disadvantages: Subjective as it relies on personal judgements, therefore reliant on good memory and honesty.

Question 13

what is video monitoring?

Answer 13

Video cameras are used to record externally observable physiological responses throughout a sleep episode, including behaviours when falling asleep and waking up.

Records may be kept of: Changes in posture of body position, amount of tossing and turning, sleep related breathing problems

Question 14

what are advantages and disadvantages of video monitoring?

Answer 14

Advantages: Can be used in a natural environment, can rewatch footage.
Disadvantages: Subjective as researcher has to interpret behaviour, may miss events if time delay or if they look away

Question 15

what are controlled processes?

Answer 15

Controlled processes: A controlled process involves conscious, alert awareness and mental effort in which the individual actively focuses their attention on achieving a particular goal. This requires selective attention. We require this when tasks are unfamiliar and difficult. They tend to be serial (usually can only perform 1 at a time).

Question 16

what are automatic processes?

Answer 16

An automatic process requires little conscious awareness and mental effort, minimal attention and does not interfere with the performance of other activities. One can divide their attention. Used when the task is easy or familiar and tend to be able to do two or more automatic processes at once (this is called parallel)

Question 17

what are levels of awareness?

Answer 17

Awareness relates to how conscious you are of internal and/or external events. Level of awareness is most often lowered during ASC. Total awareness requires selective attention and focus.

NWC: Generally aware of internal and and external events. A good sense of time, place and reality.

ASC: Can lower or heighten.

Question 18

what are content limitations?

Answer 18

Refers to the amount of control you have to restrict what you attend to / focus on and the type of information we hold in consciousness. In NWC content limitation is more restricted and in ASC it is less restricted (decreased)

NWC: Controlled and limited to reality, logical and organised. Prevents focusing on distressing or embarrassing thoughts.

ASC: Reduced and bizarre, illogical and disorganised. Not able to block thoughts as easily.

Question 19

what are perceptual distortions?

Answer 19

Perception (hearing, taste, sight, smell, touch and pain) can be dulled or excited in different SOC.

NWC: Sensations reflect reality and perception is clear; able to accurately process sensory info

ASC: Sensations and perceptions can be stronger or more vivid, or suppressed and blurred.  Perceptual distortions
may occur (hallucinations or delusions). eg. perceive things as being louder than they actually are

Question 20

what are cognitive distortions?

Answer 20

Cognition (thinking, memory, reasoning, learning and thoughts) can change in different SOC - in ASC they can be disrupted or distorted. This includes memory storage and recall may be more fragmented and less accurate. Thought processes may also be disorganised and less logical

NWC: Effective memory functioning - can remember events experienced in NWC. Thought processes are typically organised and logical

ASC: Reduced and bizarre, illogical and disorganised. Not
able to block thoughts easily. Less information stored and harder to retrieve. Difficulty in decision making and problem solving.

Question 21

what is emotional awareness?

Answer 21

This refers to our ability to read others emotions and control our own.

NWC: Normal range of emotions. True feelings can be hidden and emotions that are expressed are generally appropriate to the situation.

ASC: we generally have less control of emotions and their expressions.

Question 22

what is self control?

Answer 22

Self control: Refers to our ability to control & coordinate our bodies and mental processes.

NWC: Behaviour and impulses can be controlled. More control over actions (eg; walking in a straight line) and behaviour can be planned and monitored.

ASC: Inhibition is often lost and more open to suggestion. Poor
coordination and balance, and engage in risky behaviour. May
have greater self control (eg. hypnosis to stop smoking).

Question 23

what is time orientation?

Answer 23

Time orientation: Refers to our awareness of time and the ability to correctly perceive the speed at which time passes.

NWC: Clear sense of time.

ASC: May have a distorted sense of time

Question 24

what are beta brain waves?

Answer 24

Normal waking consciousness. Associated with alertness and intensive mental activity. Strong cognitive function. High-frequency (fast) and low-amplitude (small) brain waves.

Question 25

what are alpha brain waves?

Answer 25

Awake and alert but mentally and physically relaxed and internally focused. Relaxed states, eg. meditation. Medium to relatively high frequency (but slower than beta waves) with low amplitude (but a slightly larger amplitude than beta waves). - rhythmic

Question 26

what are theta brain waves?

Answer 26

Commonly produced when we are very drowsy, such as when falling asleep or just before waking, creative activities or in a deep meditative state where there is no awareness of external stimuli, early states of sleep.
Medium frequency and some high-amplitude (large) waves mixed with some low-amplitude (small) waves.

Question 27

what are delta waves?

Answer 27

Delta: Deep, dreamless sleep or unconsciousness. Low-frequency (slow) and high (large) amplitude

Question 28

what are drugs?

Answer 28

A drug is any substance that can change a person’s physical and/or mental functioning. Drugs can induce ASC & therefore changes in brain waves.

Question 29

what are stimulant drugs?

Answer 29

Stimulants are drugs that increase activity in the central nervous system and the rest of the body. They therefore have an alerting, activating effect.

Can include caffines, non-prescription medication like nicotine to illegal drugs like amphetamines or cocaine.
Possible psychological effects include increased alertness, focus, confidence, feelings of wellbeing and motivation.
Physiological changes include increased BP, HR (similar to the flight/fight response).

Question 30

what brain waves do stimulants cause?

Answer 30

there is an increase in higher frequency (faster) activity and an increase in lower amplitude activity. More specifically, there is a pattern of increased beta wave activity and decreased delta, alpha and theta activity.

Question 31

what are depressant drugs?

Answer 31

Depressants are drugs that decrease activity in the central nervous system and the rest of the body. Generally, their effects result in a state of calm, relaxation, drowsiness, sleep or anaesthesia as doses of the drug increase.

All reduce alertness, environmental awareness, responsiveness to sensory stimulation, cognitive functioning and physical activity to some extent. Loss of self-control is common. In small doses, depressants can cause a person to feel more relaxed and less inhibited.

Some depressants include opiates, benzodiazepines, valium and alcohol.

Question 32

what brain waves are caused by deppressant drugs?

Answer 32

Generally, there is an increase in lower frequency (slower) activity and higher amplitude activity. More specifically, there is a pattern of reduced beta wave activity and increased delta, alpha and theta activity

Question 33

how does 0.05 BAC affect cognition, concentration, and mood?

Answer 33

COGNITITION
As BAC increases, performance on cognitive tasks decreases.
Reaction time slows down.
Impaired decision-making and problem-solving.

CONCENTRATION
Difficulty using focused or divided attention.

MOOD
Amplified OR dulled emotional responses.
More fluctuation in moods.

Question 34

how are BAC and sleep deprivation equivalent?

Answer 34

Being awake for 17-19 hours is equivalent to a 0.05 BAC and makes you 2x more likely to have an accident.
Being awake for 24 hours is equivalent to a 0.10 BAC and makes you 7x more likely to have an accident.

Question 35

what are circadian rhythms?

Answer 35

Biological rhythm that involves changes in bodily functions or activities that occur as part of a cycle with a duration of about 24 hours (once a day). This causes us to feel more or less alert at certain points of the day.

Question 36

what does the suprachiasmatic nucleus do?

Answer 36

when our eyes detect light (artificial or natural) the suprachiasmatic nucleus (SCN) is activated and stimulates the pineal gland to release less or more melatonin into the blood.
High levels of light = less melatonin = less drowsiness/high alertness and vice versa
Less light = SCN signals the pineal gland to produce and secrete more melatonin, which will induce sleepiness.

The melatonin level in the blood stays elevated all through the night, then falls back to a low daytime level before the light of a new day. When the SCN detects light in the morning, it inhibits the release of melatonin.

When light is detected, the SCN also performs functions such as initiating an increase in body temperature and the release of stimulating hormones like cortisol to promote alertness and support other arousal activities

Question 37

what are ultradian rhythms?

Answer 37

A biological rhythm involving changes in bodily functions or activities that occur as part of a cycle shorter than 24 hours.
Eg; REM and NREM cycle (sleep cycle) which are 90 minutes. Alertness tends to follow a 90 min cycle with a period of drowsiness at the end of each cycle.

Question 38

what are similarities between REM and NREM?

Answer 38

Common characteristics: both have reversibility, perceptual disengagement and unresponsiveness. NREM sleep has a relatively inactive brain in a body that can move

Question 39

what are stages 1-4 of NREM?

Answer 39

NREM STAGE ONE
Lightest sleep, called the hypnagogic state. Physiological arousal decreases, hypnic jerk may occur. Most will say they were not asleep if woken.

NREM STAGE TWO
Moderately light sleep, 70% will say they were not asleep if woken. Around 50% of total sleep. Sleep spindles and K complexes.

NREM STAGE THREE
Moderately deep sleep and low levels of physiological arousal. Very relaxed and less responsive to the external environment.

NREM STAGE FOUR
Deepest sleep and lowest levels of physiological arousal, sleepwalking and talking may occur. Not common after the first cycle.

Question 40

what is REM sleep?

Answer 40

REM SLEEP
Physiological arousal increases comparably, dreams are common, muscle atonia, rapid eye movement, lighter sleep than NREM 3 and 4, first period lasts for around 5-10mins and last is around 1 hour. Beta like waves

Question 41

what are three differences between REM and NREM?

Answer 41

REM sleep would show higher levels of electrical activity on an EOG compared to NREM sleep.

REM sleep would show little-no electrical activity on an EMG while NREM would show bursts of electrical activity; muscle atonia vs relaxed muscles.

REM sleep would show higher levels of electrical activity on an EEG whereas NREM sleep would show lower levels.

Question 42

what is the restoration theory of sleep?

Answer 42

This theory proposes that sleep provides ‘time out’ to help us recover from depleting activities during waking time that use up the body’s physical and mental resources. Provides the body with the opportunity to recover by replenishing resources, including neurotransmitters, it allows damaged cells to be repaired, muscles to be detoxified or rid themselves of waste.

Question 43

what are strengths of the restoration theory?

Answer 43

Infants sleep 16 hours and spend a lot of time in REM as they are consolidating a lot of new memories each day;

people feeling tired before sleep but usually refreshes & more energised upon waking & people usually sleep for a longer period of time during an illness;

Growth hormone, which also promotes body repair, is secreted at a much higher rate when asleep than when awake;

Sleep deprivation in humans increases susceptibility to illness & disease as a result of a suppressed immune system - release cortisol to keep up energy.

Question 44

what are limitations of the restoration theory?

Answer 44

more active people do not necessarily sleep longer; If restoration was the only function of sleep, we would expect that a physically disabled person confined to bed would sleep less than a physically active person. This, however, is not the case.

Question 45

according to the restoration theory, what are the purposes of NREM and REM sleep?

Answer 45

NREM
Restores & repairs body - tissues repair particularly in stages 3 & 4

REM
Important part in brain development evidenced by the fact there is more REM sleep infants
Restorative role for neurons in the brain. Increased brain activity in REM sleep may also stimulate and strengthen the synapses (LTP). Assists consolidation of new memories

Question 46

what is the evolutionary theory?

Answer 46

Proposes that sleep evolved to enhance chances of survival. The amount of sleep organisms have is determined by how much time it takes them to meet their energy requirements, how easily they can hide from predators and how vulnerable they are to attack. An organism’s circadian sleep–wake cycle helps ensure its lifestyle and specific activities are synchronised with the day–night cycle of its environment and at the safest times.

Question 47

what are strengths of the evolutionary theory of sleep?

Answer 47

Strengths: Animals vulnerable to predators tend to sleep a little, and large predatory animals, which are generally not vulnerable, tend to sleep a lot;

organisms with vision suited to daylight sleep during the night and vice versa;

from an evolutionary perspective it would have been safest for humans to be tucked away in a cave at night to sleep

Question 48

what are limitations of the evolutionary theory?

Answer 48

Limitations: When animals are asleep they are more vulnerable to predators due to reduced awareness; does not explain our need for sleep & that we will eventually sleep regardless of the environmental circumstances.

Question 49

what are the characteristics of sleep in newborns/infants?

Answer 49

16 hours total

50/50 REM and NREM

Can enter REM immediately
Total sleep time of about 16 hours in first month or so (but fragmented due to feeding and nurturing)
By around 12 months, majority of sleep as a single episode in the evening daytime napping common

Question 50

what are the characteristics of sleep in children?

Answer 50

10-11 hours required

75-80% NREM, 20-25% in REM

Relatively short or immediate sleep onset, minimal awakenings
within NREM sleep, about half is stages 3 and 4 deep sleep but amount decreases markedly from about age 10

Question 51

what are the characteristics of sleep in adolescents?

Answer 51

9-10 hours required

80 NREM, 20 REM

Relatively short or immediate sleep onset, minimal awakenings
within NREM sleep,

amount of stages 3 and 4 deep sleep progressively declines and the time spent in stage 2 increases

Question 52

what are the characteristics of sleep in adults?

Answer 52

7-8 hours required

80/20 NREM AND REM

Fewer awakenings
Gradual loss of stages 3 and 4 NREM sleep with a severe reduction evident by about age 60 e.g. SWS declines at a rate of about 2% per decade

Question 53

what are the characteristics of sleep in elderly people?

Answer 53

6-7 hours required

80/20 NREM REM

Frequent awakenings, delayed sleep onset

Tendency to become sleepier in the early evening and wake earlier in the morning compared to younger adults due to forward sleep–wake cycle shift

Question 54

what are seven general trends in sleep across the life span?

Answer 54

1. As people age, total sleep time decreases
2. As people age, number of awakenings increases i.e. sleep becomes more fragmented
3. REM proportion markedly decreases from about 50% between 0–2 years, then stabilises at about 20–25% through to very old age
4. Age-related increase in NREM sleep proportion through infancy and early childhood
5. Decrease in time spent in NREM and REM that persists through to a very old age, especially from birth for REM and early childhood for NREM
6. Decrease in proportion of NREM stages 3 and 4, especially a marked decrease or disappearance in late adulthood/very old age (e.g. by age 90) i.e. less deep sleep and more light sleep
7. In later adulthood, at around 60 or so, sleep is mostly stage 2 light sleep

Question 55

what are three age related sleep changes that may be attributed to circadian rhythm changes?

Answer 55

1. Newborns and infants: sleep onset initially through REM sleep, normalising (i.e. through NREM stage 1) at around 2 or 3 months with maturation (i.e. when circadian rhythms start to exert their influence); sleep cycles and episodes gradually become less fragmented and more regular and longer during first 12 months (i.e. age/maturational changes)
2. Adolescents: tendency to have less than the required amount of total sleep time due to sleep–wake cycle shift that delays sleep onset time by 1 to 2 hours
3. Elderly: tendency to become sleepier in the early evening and wake earlier in the morning compared to younger adults due to forward sleep–wake cycle shift (i.e. advanced sleep phase syndrome possibly due to age-related deterioration in the biological clock (SCN)

Question 56

what is partial and total sleep deprivation?

Answer 56

Partial sleep deprivation involves having less sleep (either quantity or quality) than what is normally required. This may occur periodically or persistently over the short-term or long-term.

Total sleep deprivation involves not having any sleep at all over a short-term or long-term period. The person stays awake for one or more days or weeks.

Question 57

what are the physiological effects of partial sleep deprivation?

Answer 57

Trembling hands
Drooping eyelids 
Staring & inability to focus the eyes
Slurred speech 
Lack of energy 
Increased pain sensitivity 
Headaches 
Fatigue 
Impaired immune system

Question 57

what are the physiological effects of partial sleep deprivation?

Answer 57

Trembling hands
Drooping eyelids 
Staring & inability to focus the eyes
Slurred speech 
Lack of energy 
Increased pain sensitivity 
Headaches 
Fatigue 
Impaired immune system

Question 58

how does partial sleep deprivation effect affective functioning?

Answer 58

Amplified emotional responses: Emotional reactions are more intense, exaggerated and out of character.

Low emotional perception: Difficulty judging other people’s emotions and reactions, reduced empathy.

Mood changes: Irritable short tempered, loss of motivation, sadness.

Question 59

how does partial sleep deprivation impact cognitive functioning?

Answer 59

Impaired learning and memory ability
Difficulty making decisions and problem solving
Reduced attention: When sleep deprived we perform complex tasks as well as we normally would, but we perform worse than usual on simple, monotonous tasks.

Question 60

how does partial sleep deprivation effect behavioural functioning?

Answer 60

Slower speed and lower accuracy levels
Impaired regulation of risk taking behaviours
Reduced motor coordination: Particularly hand-eye coordination.
Changes in eating behaviours

Question 61

what are the effects of NREM deprivation?

Answer 61

During NREM stages 3 and 4 growth hormones are released and this assists in the growth and repair of the body (evidence for the restoration theory). A loss of NREM may prevent restoration of the body & its ability to replenish energy supplies

Question 62

what are the effects of REM deprivation?

Answer 62

Loss of motor coordination (behavioural); Poor concentration (cognitive); Poor memory (cognitive); Irritability (affective); Tendency to hallucinate . When they were allowed to sleep on the 6th night they had a lot more REM sleep - REM rebound.

Question 63

what are circadian phase disorders?

Answer 63

Sleep disorder that disrupts a person’s ability to sleep due to a mismatch between an individual’s sleep-wake cycle and the natural day-night cycle of the external environment.

Causes:
Intrinsic factors (caused by the body itself) eg; adolescent delayed sleep
Extrinsic factors (caused by the environment or external behavioural factors) eg; shift work, jet lag

Symptoms:
Difficulty falling asleep at the desired time
Difficulty maintaining sleep/frequent wakings
Chronic tiredness and can lead to affective, behavioural and cognitive changes.

Question 64

what is the sleep wake shift in adolescence?

Answer 64

Adolescents experience a phase delay in their circadian rhythms, with their sleep-wake cycle shifting later in the evening - delayed sleep onset. This can lead to a delayed sleep phase disorder, (and/or sleep onset insomnia)

Biological causes: delayed release of melatonin by 1-2 hours. 11pm rather than 9pm.
Social causes: homework, social demands, technology etc
Can lead to sleep deprived adolescents who acquire a sleep debt which is formally labelled as a delayed sleep phase disorder or circadian phase disorder.

Question 65

what are sleep wake shifts with shift work?

Answer 65

Shift workers that are scheduled to work outside of the normal waking day have a circadian rhythm that is out of sync. They must be alert at times when melatonin levels are naturally higher, and sleep when melatonin levels are naturally lower.

Effects: Quality (lesser due to distractions), quantity (approx. 2 hours less than the average worker), timing (shift in sleep wake cycle).

The sleep loss & circadian cycle disruption is the main cause of sleepiness in shift workers.
The two primary symptoms of shift work disorder are insomnia when a person is trying to sleep, and excessive sleepiness when a person needs to be awake and alert.

Question 66

what is the sleep wake shift with jet lag?

Answer 66

Jet lag is a sleep disorder due to a disturbance to the circadian sleep–wake cycle caused by rapid travel across multiple time zones. This results in a mismatch between our internal circadian biological clock and the external environment — our biological clock is out of sync with the actual time in the time zone of the new environment.

Physical - Digestive problems, a vague feeling of bodily discomfort, not feeling right called malaise, greater number of NREM stage 1 sleep during first 2 or 3 sleep episodes after arrival compared to home-based sleep.
Psychological - Excessive sleepiness, reduced daytime alertness, impaired concentration & cognitive performance.

Question 67

what are dyssomnias?

Answer 67

Dyssomnias sleep disorders that produce difficulty initiating, maintaining and/or timing sleep. Involve problems with sleep–wake cycle processes, such as difficulty falling or staying asleep, inability to prevent sleep onset, or a disruption to the timing of the circadian sleep–wake cycle. As a consequence, the person suffers from changes in the quantity (amount) or quality (restfulness) of their sleep

Eg. sleep onset insomnia, circadian phase disorders, jet lag, narcolepsy.

Question 68

what are parasomnias?

Answer 68

Parasomnias sleep disorders characterised by the occurrence of inappropriate physiological and/or psychological activity during sleep or sleep-to-wake transitions. Involve inappropriate disruptions of sleep by some abnormal sleep-related event, such as sleep walking, teeth grinding and terrifying dreams. Unlike dyssomnias, parasomnias do not involve a dysfunction in any process or mechanism that generates or times sleep.

Eg. sleep walking, sleep apnea, sleep bruxism, nightmares, sleep terrors.

Question 69

what are three differences between dyssomnias and parasomnias?

Answer 69

Dyssomnias involve a problem with sleep-wake cycle process (such as difficulty falling asleep), whilst parasomnias do not involve a dysfunction in any process or mechanism that generates or times sleep.

Dyssomnias are not usually associated with abnormal behaviour or experiences, whereas parasomnias involve disruption of sleep by an abnormal event (such as a frightening dream that awakens the sleeper)

Dyssomnias primarily produce a complaint of insomnia or excessive sleepiness, whereas parasomnias primarily produce a complaint about the unusual behaviour or experience during sleep, rather than insomnia or excessive daytime sleepiness.

Question 70

what is sleep onset insomnia?

Answer 70

Sleep-onset insomnia: a sleep disorder involving persistent difficulty falling asleep at the usual sleep time, despite having adequate time and opportunity for sleep.

Symptoms:
Regular failure to fall asleep within about 20–30 minutes after intending to go to sleep
Complaint of poor quality sleep that does not leave the individual feeling rested upon awakening (i.e. nonrestorative sleep) or a consistently reduced amount of total sleep, either of which is associated with difficulty falling asleep
The sleep difficulty occurs at least three nights a week

Question 71

how does sleep onset insomnia effect a persons sleep wake cycle?

Answer 71

Sleep onset insomnia affects the circadian sleep wake cycle as:
There is a change in the timing of sleep.
Sleep onset is much later than desired.
Sleep tends to be non-restorative.
Total sleep time is less than required/desired.
Excessive daytime sleepiness. Ie. during the waking state of the circadian cycle.
Difficulty waking up in the morning.

Question 72

what is sleep walking?

Answer 72

Sleep walking: getting up from bed and walking about or performing other behaviours while asleep. Usually occurs during NREM stages 3 and 4 when we have no muscle paralysis and can move around. It is most commonly initiated at the end of the first or second episode of slow wave sleep. Sleepwalking can also be initiated in the lighter stages of NREM sleep.

Features:
Considerable difficulty in arousing/waking during a sleepwalking episode (because of tendency to be in a deep sleep state)
Little or no awareness during an episode e.g. typically unresponsive to any attempt to communicate with them, episodes often unremembered
When awakened during an episode, sleepwalker may be confused and disoriented, not recognise family or friends usually occurs during NREM stages 3 and 4 (& not during REM)
Most sleepwalkers typically engage in activities that are of low complexity

Question 73

how does sleep walking effect a persons sleep wake cycle?

Answer 73

Most commonly initiated during NREM stages 3 or 4 so there is a loss of deep sleep
Interruption to the natural progression of sleep cycle during the disturbed sleep episode
Fragmented sleep episode due to cycle disturbance
Less than the normal number of sleep cycles if a prolonged episode
Daytime sleepiness following an episode (i.e. during the waking state of the circadian cycle).

Question 74

what is cognitive behavioural therapy?

Answer 74

CBT: a type of psychotherapy (‘talking therapy’) based on the assumption that the way people feel and behave is largely a product of the way they think; aims to identify, assess and correct faulty patterns of thinking or problem behaviours that may be affecting mental health & wellbeing

Question 75

what is the cognitive component of CBT?

Answer 75

Cognitive component: focuses on the role of cognitions (thoughts, beliefs and attitudes) in determining emotions & behaviour; aims to help a person change the way they think about situations. This includes addressing anxiety or preoccupation with sleep difficulty and learning how to control or eliminate worries and negative thoughts that prevent sleep onset.

Question 76

what is the behavioural component of CBT?

Answer 76

clinical application of learning theories and principles to treat maladaptive behaviour. Helps the individual develop good sleep habits and avoid behaviours that prevent them from sleeping well.

Question 77

what are the inappropriate cognitions and behaviours of insomnia?

Answer 77

Cognitions: Misunderstandings about the causes of their insomnia e.g. distorted beliefs and attitudes; Faulty beliefs about sleep-promoting practices; Amplifications of the consequences of insomnia or poor sleep e.g. excessive frustration, worry or anxiety about not sleeping; distorted beliefs, attitudes, apprehensions etc. about daytime impairments caused by insomnia; fear of sleeplessness.

Behaviours: Remaining in bed awake for long periods of time; Sleeping in to combat the sleep problem by getting more sleep; Daytime napping to combat their sleep problem by getting more sleep; Constant clock watching when in bed.

Question 78

how could CBT address insomnia?

Answer 78

Use therapeutic techniques to systematically assist the individual to recognise and change inappropriate or dysfunctional attitudes, beliefs and other thoughts about their sleep e.g. addressing anxiety or preoccupation with sleep difficulty, learning how to control or eliminate worries and negative thoughts that prevent sleep onset.

Question 79

what is stimulus control therapy in relation to insomnia?

Answer 79

strengthen the bed and bedroom as cues for sleep and weaken them as cues for behaviours that are incompatible with sleep, and to re-establish a consistent sleep–wake schedule e.g. apply CC and OC principles to re-establish an association between sleep and the bed and bedroom.

Question 80

what is sleep hygiene education in relation to insomnia?

Answer 80

provide information about practices that tend to improve and maintain good sleep and full daytime alertness e.g. change the individual’s basic lifestyle habits that influence sleep onset eg. checking time when trying to sleep

Question 81

what is bright light therapy?

Answer 81

Bright light therapy: a technique for treating circadian rhythm phase disorders that uses timed exposure of the eyes to light with the aim of shifting an individual’s sleep–wake cycle to a desired schedule.

Involves a timed exposure of the eyes to intense, but safe amounts of light (either natural or artificial).
Essential to use light at the right time of the day, at the right intensity for the right amount of time. This helps to resynchronise sleep-wake cycles by activating the SCN and slowing the release of melatonin.

Question 82

how could bright light therapy be used to treat circadian phase disorders?

Answer 82

exposure to bright light early in the morning when melatonin release should be inhibited, thereby causing melatonin to be secreted earlier in the evening making them sleepier earlier in the evening and resynchronising their sleep-wake cycle with the external environment. Establishing a routine and avoiding bright light from devices in the evening would help

Question 83

when should bright light therapy be used?

Answer 83

When insomnia is developing/has developed into a phase disorder
Treat sleep onset insomnia, especially when other interventions have been ineffective
To complement other interventions