Sleep, stress and dependence Flashcards
What are the impacts of loss of sleep?
Decreased attention span
More irritability
More interpersonal conflict
Increased absenteeism due to illness
Reduced productivity Workplace errors Disasters Falling asleep behind the wheel Increased clinical error
What are the long term impacts of insufficient sleep?
Depression Cancer Heart disease Diabetes Relationship between poor sleep and mortality
What is the the sleep homeostat?
The set of processes that tracks the intensity of our wakefullness to then alter the intensity of our sleep
Which molecule is involved in sleep homeostasis?
Adenosine
What happens to the levels of adenosine during wake periods?
Increases
What does caffeine do to adenosine?
Prevents the absorption of adenosine to promote wakefullness
What rhytmn controls the timing of biological processes?
Circadian rhytmn
What is the main biological time giver?
Light
Which cells are responsible for sending these signals?
Photosensitive retinal ganglion cells
What is a zeitgeber?
Any input that gives the circadian system a time cue
When does melatonin peak?
2-4am
Ganglion cells transmit the signal to which nucleus at the thalamus, in terms of sleep?
Suprachiasmatic nuclei
What method is used to measure electrical activity in the brain?
EEG
What EMG measures what?
Measures muscle tone
What does an EOG measure?
Eye movement
What does a PSG measure?
Brain, muscle tone, breathing and eye
What are the four stages of sleep?
Non-REM stages 1-3
3 being the deepest part of sleep
REM
How many stages of non-REM sleep are there?
3
Which stage of sleep is the deepest?
Stage 3 Non-REM
What is stage 1 REM sleep?
Transition from wake to sleep
Easily awakened
May experience sudden dreaming
What is stage 2 REM sleep?
Brain begins to suppress outside stimuli
Ambient noise or stimuli won’t wake up
If we;re deprived of this stage, our memories are impaired the following day
What is stage 3 sleep?
Deep sleep or slow-wave sleep has a key role to play in learning - FIRST HALF OF THE NIGHT
Out heart rate and blood pressure and muscle activity are much lower relative to wake
Night terrors
Sleep walking and talking
Being woken here will make you feel drowsy and grumpy
What is REM sleep?
Stage 4 - REM sleep
Brain consumes more energy here than during wakefulness
The eyes move around in a very distinctive and rhythmic way
Body is paralysed because REM sleep is associated with vivid dreaming and this prevents us from acting out
our dreams
Increases in heart rate, blood pressure and temperature
Being woken in this stage will make you feel confused or emotional - also unable to move your body for a few
minutes
MOST REM SLEEP IS IN THE SECOND HALF OF THE NIGHT
What is REM sleep important for?
Emotional memory consolidation
Emotional control
Learning complex skills
How can the stages of REM from a PSG be visualsied?
Hypnogram
What effect does alcohol have on sleep?
Fragmented sleep
What is rebound sleep?
After long periods of wakefulnness or sleep deprivation, we see more deep sleep
Which gender is more likely to be affected by sleep disorders?
Women
What term describes a new sleep disorder?
Orthosomnia
What are the impacts of stress?
Increased heart rate/palpitations Headache Shortness of breath Stomach upset Fatigue Mood disturbance Worry Focus-lessness Isolation
What are the physical signs of stress?
If female, changes to period Little energy Unexplaiend aches and pains Gaining/losing weight Sleeping problems
What are the psychological signs of stress?
Not motivation or interested in things Constantly feeling low or sad Having no little or no energy Having suicidal thoughts low self-esteem Feeling hopeless or helpless
What are the social signs of stress?
Difficulty coping and mistakes at work
Having difficulties in your home and family life
Disregarding Hobbies and interests
Avoiding hanging out with friends and not feeling up to meeting them
Which hormone is associated with stress?
Cortisol
What is burnout?
Stressis a normal and sometimes healthy component to life
Stress makes us work harder and achieve our goals
A syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed
What term refers to high levels and chronic exposure to stress?
Burnout
What are the three dimensions of burnout?
Feelings of energy depletion or exhaustion
Increased mental distance - negativism and cynicism
reduced professional efficacy
What is the stress-diathesis model?
Disorder or behaviour trait is the result of an interaction between genetic predisposition vulnerability and stress
What is binge drinking?
Drinking more than 8 units in one sitting for males and 6 units for females
What is alcohol abuse?
Habitual excessive use of alcohol such that drinking alcohol has caused problems in other areas of life
What is chronic alcohol dependence?
When somebody drinks excessively leading to growing problems in their life but continues to drink even after their alcohol consumption begins to affect them physically
What are the psychological factors that lead to alcohol misuse?
High stress
Anxiety
Depression
What are the social risk factors that lead to alcohol misuse?
Culture Religion family Work influence Starting collect or a new job Peer pressure
What are the environmental risk factors that lead to alcohol misuse?
Income/financial pressure
Proximity to alcohol retail stores
What is an alcohol unit?
10ml or 8g of ethanol
What is a type 1 binge drinker?
Use alcohol to regain control of life and calm down
De-stress
What is a re-bounding drinker?
Are driven by a need to keep in touch with people who are close to them.
Alcohol is the ‘shared connector’ that unifies and gets them on the same level.
They often forget the time and the amount they are consuming.
What are macho drinkers?
Often feeling under-valued, disempowered and frustrated in important areas in their life.
They are mostly men of all ages who want to stand out from the crowd.
Drinking is driven by a constant need to assert their masculinity and status.
What is a conformist drinker?
Are driven by the need to belong and seek a structure to their lives.
They are typically men aged 45 to 59 in clerical or manual jobs and believe that going to the pub every night
is what ‘men do’
What are border dependent drinkers?
Men who effectively live in the pub which, for them, is a home from home.
They visit it during the day and the evening, on weekdays and at weekends, drinking fast and often.
What are depressed drinkers?
May be of any age, gender or socioeconomic group.
Their life is in a state of crisis e.g. recently bereaved or divorced and so crave comfort, safety, and security.
Alcohol is a comforter and a form of self-medication used to help them cope.
What are hedonistic drinkers?
Crave stimulation and want to abandon control, use alcohol to release inhibitions.
They are often divorced people with grown-up children, who want to stand out from the crowd.
What are boredom drinkres?
Consume alcohol to pass the time, seeking stimulation to relieve the monotony of life.
Alcohol helps them to feel comforted and secure.
Typically, single mums or recent divorcees with a restricted social life.
What are community drinkers?
Are motivated by the need to belong. Drinking provides a sense of safety and security but also gives their lives meaning. They are usually lower-middle-class men and women who drink in large friendship groups.
What are the features of acute alcohol intoxication?
Disturbed level of consciousness
Impaired cognition
Disturbed perception
Alterations to affect or behaviour
At 1-2 units what does alcohol do to the body?
vasodilation
increased heart rate
feeling sociable and talkative
At 4-6 units what does alcohol do to the body?
impaired decision making
impaired reaction timed
impaired coordination
At 8-9 units what does alcohol do to the body?
further increases in reaction time
speech disturbance
visual changes
At 10-12 units what does alcohol do to the body?
coordination highly impaired
drowsy
increased urination
GI symptoms
Which pathway does dopamine associate with?
Mesolimbic pathway
What happens to dopamine release in a patient with substance abuse?
Blunted
In individuals with reduce dopamine function, what is the likely affect?
Predisposed to addiction
What is the role performed by endorphins?
Addiction
Role in pleasure and inhibition of pain
