Stages of sleep

Interruptions of Consciousness
The Stages of Sleep
Non-rapid eye movement (NREM) sleep
Paradoxical or REM Sleep
Brain Mechanisms of Wakefulness, Arousal, and Sleep
Brain Structures of Arousal and Attention
Mechanisms of the pontomesencephalon:
Mechanisms regulating the hypothalamus, thalamus, and basal forebrain:
Mechanism of the hypothalamus:
Mechanisms of the basal forebrain
Mechanisms of the locus coeruleus
Sleep and the Inhibition of Brain Activity
Brain Activity in REM Sleep
Activity increased in:
Activity decreased in:
Sleep Disorders
Insomnia
Sleep Apnea
Narcolepsy
Periodic Limb Movement Disorder
REM Behavior Disorder
Night Terrors, Sleepwalking & Sexsomnia

Interruptions of Consciousness

https://youtu.be/9PW1fwKjo-Y

Altered states of consciousness, Crash course!

Sleep is a state that the brain actively produces, characterized

by decreased activity & decreased response to stimuli.

Stages of sleep 1
 Coma is an extended period of unconsciousness caused by head trauma,
stroke, or disease, and is characterized by a low level of brain activity and little
or no response to stimuli.

⚰️ Typically, someone in a coma either dies or begins to recover within a

few weeks.

Vegetative state alternates between periods of sleep and moderate arousal,

although there is no awareness of surroundings, no purposeful, regular
breathing, and autonomic response to painful stimuli.

A minimally conscious state is one stage higher, with brief periods of

purposeful actions and a limited amount of speech comprehension.

🗓️ A vegetative or minimally conscious state can last for months or years

Brain death is a condition without brain activity or responsiveness of any kind.

The Stages of Sleep

Stages of sleep 2
 The electroencephalograph (EEG) records an average of the electrical potentials of the cells
and fibers in the brain areas nearest to each electrode on the scalp. It enables brain researchers
to monitor brain activity during sleep.

Stages of sleep 3
 A polysomnograph is a combination of EEG and eye-movement records.

Non-rapid eye movement (NREM) sleep

1. While awake, the steady series of alpha waves at a high frequency and high
amplitude are characteristic of relaxation.

2. During stage 1 sleep, irregular, jagged, low-voltage theta waves signify

decreasing brain activity, lower than while awake but higher than in other
sleep stages.

3. During stage 2 sleep, K-complexes, or sharp, hugh amplitude waves, are

associated with temporary inhibition of neuronal firing, while sleep spindles,
which are a burst of high frequency waves for at least half a second, may
represent consolidation of memory.

Stages of sleep 4
 📈 Sleep spindles result from oscillating interactions between cells in
the thalamus and the cortex. They increase after new learning and
correlate positively with improvements in certain types of memory &
nonverbal tests of IQ.

4. During slow-wave sleep, the heart rate, breathing rate, and brain activity
decrease, whereas slow, large-amplitude delta waves indicate that neuronal
activity is highly synchronized and that input to the cerebral cortex is greatly
inhibited.

Paradoxical or REM Sleep

Over the course of about 90 minutes, a sleeper goes through stages 1, 2 & slow-wave sleep
(during which intrusions can interrupt the progress) then returns to a stage called REM (rapid eye
movement sleep).

During paradoxical or REM sleep, irregular, low-voltage fast

waves indicate increased neuronal activity, alongside rapid
eye-movement and increased cortical activity.

Stages of sleep 5
 The postural muscles of the body, including those that support the head, are
more relaxed during REM than in other stages.

REM is also associated with erections and vaginal moistening.

Heart rate, blood pressure, breathing rate & facial twitches fluctuate during
REM more than in other stages.

There is also an increased probability of vivid dreams.

Brain Mechanisms of Wakefulness, Arousal,

and Sleep
Brain Structures of Arousal and Attention
Mechanisms of the pontomesencephalon:

Stages of sleep 6
 The part of the reticular formation that contributes to cortical arousal is the
pontomesencephalon, which contains axons extending into the forebrain.

receives input from many sensory systems and also generates its own
activity, varying with the circadian rhythm.

release GABA, which inhibits or interrupts behavior and promotes slow-wave

sleep

Mechanisms regulating the hypothalamus, thalamus, and basal

forebrain:

Stages of sleep 7
 Other neuronal axons release acetylcholine, glutamate, or dopamine
regulate the levels of potassium and other ions, produce a constant state of
arousal in the hypothalamus, thalamus, and basal forebrain.

🛌🏾 After the ions are in a state that supports arousal, they tend to remain at
a stable concentration, causing waking up to be faster than falling
asleep.

Mechanism of the hypothalamus:

One axon pathway from the hypothalamus releases the excitatory
neurotransmitter histamine, which enhances arousal and alertness
throughout the brain

💊 Many antihistamine drugs, often used for allergies, counteract this

transmitter and produce drowsiness.

Stages of sleep 8
 The lateral and posterior nuclei of the hypothalamus (mostly), releases a peptide
neurotransmitter called orexin.

Orexin/hypocretin enhances wakefulness & activity, but isn't necessary for

waking up, rather for staying awake, especially toward the end of the day

💊 Drugs that block orexin receptors, such as suvorexant, help people go to

sleep.

Other pathways from the lateral hypothalamus regulate cells in the basal
forebrain.

Mechanisms of the basal forebrain

Stages of sleep 9
 Thebasal forebrain is a site of convergence of sleep and thermoregulatory functions.

Some basal forebrain cells increase wakefulness and others inhibit it.

Acetylcholine stimulates the basal forebrain cells that promote wakefulness,

although those cells release other transmitters to the cortex.

Mechanisms of the locus coeruleus

Stages of sleep 10
 The Locus coeruleus, a small structure in the pons, is usually inactive, especially during sleep,
but it emits bursts of impulses in response to meaningful events, especially those that produce
emotional arousal.

Axons release norepinephrine widely throughout the cortex, increasing the

activity of the most active neurons and decreasing the activity of less active
neurons.

This leads to enhanced attention & memory to important information

Sleep and the Inhibition of Brain Activity

Stages of sleep 11
 Sleep depends partly on decreased sensory input to the
cerebral cortex, although some responsiveness remains.

This is caused by:

hyperpolarization of thalamic neurons, which decreases their readiness to

respond to stimuli & transmit info to the cortex.

📈 Spontaneously active neurons continue firing at only slightly less than

their usual rate.

increase in activity of axons that release the inhibitory neurotransmitter GABA,

which interferes with the spread of information from one neuron to another

📈 Meaningful stimuli can still awaken us at NREM sleep while intense

stimuli can awaken us at REM sleep.

Because sleep depends on GABA-mediated inhibition,

substantial inhibition in only parts of the brain is possible.

Examples:

sleepwalkers are asleep in much of the brain, but awake in the motor
cortex and a few other areas

During lucid dreaming, most of the brain is asleep, but activity around 40
Hz (cycles per second) occurs in the frontal and temporal cortex, enabling
conscious monitoring of dreams.

During REM sleep, cells in the pons and medulla send

messages that inhibit the spinal neurons that control the

Stages of sleep 12
 body’s large muscles.

Example:

Occasionally, most of the brain wakes up while the pons remains in REM
causing the experience of being temporarily paralyzed, also known as
sleep paralysis.

Brain Activity in REM Sleep

Activity increased in:
the pons, which triggers the onset of REM sleep

the limbic system, which is important for emotional responses.

parts of the parietal & temporal cortex

Activity decreased in:

the primary visual cortex

the motor cortex

the dorsolateral prefrontal cortex

Stages of sleep 13
 REM sleep is associated with a distinctive pattern of high-amplitude electrical potentials known
as PGO waves (pons-geniculate-occipital) because it is detected first in the pons, shortly shortly
followed by the lateral geniculate nucleus of the thalamus, and then in the occipital cortex.

Sleep Disorders
Insomnia

Stages of sleep 14
 Neurobiology of insomnia

Effects

sleep deprivation

impairs memory, attention, & cognition

magnifies unpleasant emotional reactions

Increases the risk of depression

Causes

Jarring stimuli like noise, uncomfortable temperatures, pain

stress

diet

certain medications

medical/neurological/psychiatric conditions

like depression, brain tumors, Parkinson's disease, narcolepsy, etc.

Stages of sleep 15
 Some cases of insomnia are related to shifts in circadian rhythms. Someone whose rhythm
is phase delayed has trouble falling asleep at the usual time, while someone whose rhythm
is phase advanced, falls asleep easily but awakens early.

Sleep Apnea

Stages of sleep 16
 One type of insomnia is sleep apnea, which is the impaired ability to breathe while sleeping.

Consequences

Sleep deprivation, which leads to impaired cognition, attention and

memory

Heightened risk of stroke, heart problems & other disorders.

Loss of neurons in multiple brain areas, which leads to deficiencies of

learning, reasoning, attention, and impulse control.

Causes

genetics

hormones

old-age deterioration of the brain mechanisms that regulate breathing

Stages of sleep 17
 obesity, especially in middle-aged men due to narrower than normal
airways

🧑🏽‍⚕️ People with sleep apnea are advised to lose weight, avoid
alcohol/tranquilizers and wear a mask that covers the nose and delivers
air under enough pressure to keep the breathing passages open, or
obtain surgery to open the breathing spaces or on the jaw bone.

Narcolepsy

Stages of sleep 18
 People with narcolepsy lack the hypothalamic cells that produce and release orexin, which is
maintains wakefulness. It may be due to an autoimmune reaction, that destroys the cells with
orexin.

Symptoms

Attacks of sleepiness during the day

Occasional cataplexy, an attack of muscle weakness while the person

remains awake, that is often triggered by strong emotions

Frequent sleep paralysis

Hypnagogic hallucinations, which are dreamlike experiences that the

person has trouble distinguishing from reality, often occurring at the onset
of sleep

Stages of sleep 19
 🧑🏽‍⚕️ Cure: Orexin itself does not readily cross the blood–brain barrier, so the
most common treatment is stimulant drugs such as methylphenidate
(Ritalin), which enhance dopamine and norepinephrine activity.

Periodic Limb Movement Disorder

Periodic limb movement disorder, characterized by repeated involuntary movement of the legs
and sometimes the arms during sleep.

REM Behavior Disorder

Stages of sleep 20
 People with REM behavior disorder move around vigorously during their REM periods, acting out
their dreams, which are often about defending themselves against attack. They often injure
themselves, others and damage property. Inadequate inhibitory transmission may be responsible
for this condition.

Night Terrors, Sleepwalking & Sexsomnia

Stages of sleep 21
 Night terrors are experiences of intense anxiety from which a person awakens screaming in
terror. They occur during NREM sleep and are more common in children than adults.

Stages of sleep 22
 Sleepwalking runs in families and occurs mostly in children. It often occurs during slow-wave
sleep and may be due to sleep deprivation or stress.

Sexsomnia occurs when sleeping people engage in sexual behavior and do not remember it
afterward.

Stages of sleep 23
 Causes

Some cases occur when someone with sleep apnea suddenly awakens
partially and confused during non-REM sleep.

Antidepressant drugs

Stages of sleep 24