Freud made distinctions between the manifest content and the latent content of dreams. Our states of consciousness change as we move from wakefulness to sleep. This is of such concern that people who are trying to overcome addiction to these substances should only do so under medical supervision. An agonist facilitates the activity of a neurotransmitter system, and antagonists impede neurotransmitter activity. (West et al., 2009, p. 114). A womans menstrual cycle is an example of a biological rhythma recurring, cyclical pattern of bodily changes. The early portion of stage 1 sleep producesalpha waves, which are relatively low frequency (813Hz), high amplitude patterns of electrical activity (waves) that become synchronized (Figure 4.8). If you lie down to take a nap and fall asleep very easily, chances are you may have sleep debt. Often, we are not completely aware of our surroundings, even when we are fully awake. Yarmila Falaters body was found in the familys pool with 44 stab wounds. One of the nurses said, If youve had a partner who does work regular job 9 to 5 office hours . At rather low doses, alcohol use is associated with feelings of euphoria. 22. In addition, these drugs can cause feelings of anxiety, hallucinations, and paranoia (Fiorentini et al., 2011). These drugs promote increased levels of neural activity. To keep heroin affordable, many dealers began adding more potent synthetic opioids including fentanyl and carfentanyl to increase the effects of heroin. Avoid anything stimulating for an hour before bed. Melatonin is thought to be involved in the regulation of various biological rhythms and the immune system (Hardeland et al., 2006). Reduced urine. Thepineal gland, an endocrine structure located inside the brain that releases melatonin, is thought to be involved in the regulation of various biological rhythms and of the immune system during sleep (Hardeland, Pandi-Perumal, & Cardinali, 2006). Access for free athttps://openstax.org/books/psychology-2e/pages/1-introduction. It may seem counterintuitive that stimulant medications are prescribed to treat a disorder that involves hyperactivity, but the therapeutic effect comes from increases in neurotransmitter activity within certain areas of the brain associated with impulse control. During periods of sleepwalking, sleepers often have their eyes open, but they are not responsive to attempts to communicate with them. This becomes a self-perpetuating cycle because increased anxiety leads to increased arousal, and higher levels of arousal make the prospect of falling asleep even more unlikely. (a) Common paraphernalia for heroin preparation and use are shown here in a needle exchange kit. The brain waves associated with REM sleep, outlined in the red box in (a), look very similar to those seen (b) during wakefulness. Homeostasis refers to the body's need to reach and maintain a certain state of equilibrium. b. life expectancy has reached a new high. These same women were awakened during REM sleep in order to provide a detailed account of their dream content. Night terrors apparently occur during the NREM phase of sleep (Provini, Tinuper, Bisulli, & Lagaresi, 2011). While people are often unaware of their sleep apnea, they are keenly aware of some of the adverse consequences of insufficient sleep. Infants younger than 12 months appear to be at the highest risk for SIDS, and boys have a greater risk than girls. Aside from their utility as analgesic drugs, opioid-like compounds are often found in cough suppressants, anti-nausea, and anti-diarrhea medications. Rapid eye movement (REM)sleep is characterized by darting movements of the eyes under closed eyelids. While individuals suffering from sleep apnea may not be aware of these repeated disruptions in sleep, they do experience increased levels of fatigue. For instance, have you ever daydreamed while driving home from work or school without really thinking about the drive itself? describes our awareness of internal and external stimuli. In recent years, methamphetamine (meth) use has become increasingly widespread. Typically, individuals suffering from night terrors will fall back asleep again within a short time. Recommendations like these have helped to decrease the number of infant deaths from SIDS in recent years (Mitchell, 2009; Task Force on Sudden Infant Death Syndrome, 2011). Cognitive-behavioral therapyis a type of psychotherapy that focuses on cognitive processes and problem behaviors. Diarrhea. Two sleeping children are depicted in this 1895 oil painting titled. This is illustrated by McCartys (2010) case study of a 50-year-old woman who sought help for the excessive sleepiness during normal waking hours that she had experienced for several years. Devices like this are designed to provide exposure to bright light to help people maintain a regular circadian cycle. The FDAs 2013 recommendation for tighter controls on opiate prescriptions left many patients addicted to prescription drugs like OxyContin unable to obtain legitimate prescriptions. In this section, we will discuss each of these stages of sleep and their associated patterns of brain wave activity. Another evolutionary hypothesis of sleep holds that our sleep patterns evolved as an adaptive response to predatory risks, which increase in darkness. A hypnogram is a diagram of the stages of sleep as they occur during a period of sleep. (credit: modification of work by Mikael Hggstrm). Thus, K-complexes might serve as a bridge to higher levels of arousal in response to what is going on in our environments (Halsz, 1993; Steriade & Amzica, 1998). Some people also experience altered states of consciousness through meditation, hypnosis, or alcohol and other drugs. This shift in policy may be in response to the scientific communitys recommendations and/or reflect changing public opinion regarding marijuana. Elements that are known to make PTSD more likely are the following: Perceived life threat Personal injury Interpersonal violence, particularly perpetrated by a caregiver Past and present vulnerability, including genetics, childhood trauma, insufficient emotional support, concurrent causes of stress Example: Childhood abuse and rape The following describe internal states of symptoms EXCEPT? More specifically, homeostasis is the body's tendency to monitor and maintain internal states, such as temperature and blood sugar, at fairly constant and stable levels. Furthermore, these types of behaviors ultimately disrupt sleep, although affected individuals have no memories that these behaviors have occurred (Arnulf, 2012). Surprisingly, narcoleptic episodes are often triggered by states of heightened arousal or stress. These behaviors vary widely, but they can include kicking, punching, scratching, yelling, and behaving like an animal that has been frightened or attacked. Two of them I didnt even know I was involved in until afterwards (Henry & Rosenthal, 2013, p. 52). The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission. Some newer CPAP masks are smaller and cover only the nose. My sophomore college housemate got so stressed out during finals sophomore year he drank almost a whole bottle of Nyquil to try to fall asleep. Clonazepam, an anti-anxiety medication with sedative properties, is most often used to treat RBD. Humans have an endogenous opioid neurotransmitter systemthe body makes small quantities of opioid compounds that bind to opioid receptors reducing pain and producing euphoria. Like many other stimulants, cocaine agonizes the dopamine neurotransmitter system by blocking the reuptake of dopamine in the neuronal synapse. Low doses increase relaxation, decrease inhibitions. However, alternative treatment options are being explored because consistent compliance by users of CPAP devices is a problem. Insudden infant death syndrome (SIDS)an infant stops breathing during sleep and dies. Sleep regulationrefers to the brains control of switching between sleep and wakefulness as well as coordinating this cycle with the outside world. I was really sleepy and having trouble concentrating. Unlike the other sleep disorders described in this section, a person withnarcolepsycannot resist falling asleep at inopportune times. Historically, somnambulism has been treated with a variety of pharmacotherapies ranging from benzodiazepines to antidepressants. Methadone clinicshelp people who previously struggled with opioid addiction manage withdrawal symptoms through the use of methadone. Unlike Freud and Jung, Cartwrights ideas about dreaming have found empirical support. In other words, physical dependence in and of itself is of limited utility in determining whether or not someone has a substance use disorder. (credit sleeping: modification of work by Ryan Vaarsi). THE INTERNAL STATE SCALE (ISS) Version 2 and the ChronoBook SCORING KEY AND SUMMARY Mark S. Bauer, MD . In the therapeutic setting, a clinician may use relaxation and suggestion in an attempt to alter the thoughts and perceptions of a patient. These drugs share in common their ability to serve as agonists of the gamma-Aminobutyric acid (GABA) neurotransmitter system. Many of these drugs act as agonists of the dopamine neurotransmitter system. Our lives involve regular, dramatic changes in the degree to which we are aware of our surroundings and our internal states. One popular hypothesis of sleep incorporates the perspective of evolutionary psychology. This can lead to people compulsively using stimulants such as cocaine and amphetamines, in part to try to reestablish the persons physical and psychological pre-use baseline. For example, most people sleep during the night and are awake during the day. Psychometric analysis indicates that the ISS is composed of four principle components, producing four subscales. It is not uncommon for people suffering from undiagnosed or untreated sleep apnea to fear that their careers will be affected by the lack of sleep, illustrated by this statement from another patient, Im in a job where theres a premium on being mentally alert. Still, people experiencing opioid withdrawal may be given methadone to make withdrawal from the drug less difficult. According to the dissociation view, hypnosis is effectively a dissociated state of consciousness, much like our earlier example where you may drive to work, but you are only minimally aware of the process of driving because your attention is focused elsewhere. Medical marijuana is legal in over half of the United States and in the District of Columbia (Figure 4.19). Loss of appetite. If you cannot fall asleep, leave your bed and do something else until you feel tired again. These will soon, in all ordinary cases, subdue the most distressing symptoms, and effect a perfect cure in a day or two. d. both b and c. 2. D) the demographic characteristics of the person C) the severity and duration of the problem. The fifth edition of theDiagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5) is used by clinicians to diagnose individuals suffering from various psychological disorders. The following morning, he awoke to barking dogs and unfamiliar voices from downstairs. (credit a: modification of work by Todd Huffman), Psychedelic images like this are often associated with hallucinogenic compounds. Incentral sleep apnea, disruption in signals sent from the brain that regulate breathing cause periods of interrupted breathing (White, 2005). Primary signs and symptoms of Ebola often include some or several of the following: Fever. There are two types of sleep apnea: obstructive sleep apnea and central sleep apnea. One particular aspect of the internal state is that a method applied to the object being in a defined internal state (= a specific set of all its attributes' value) will result in another, also defined (and reproducible) internal state. We might also experience unconscious states of being via drug-induced anesthesia for medical purposes. The Safe to Sleep campaign educates the public about how to minimize risk factors associated with SIDS. c. This is an important factor because we can develop tolerance and experience withdrawal from any number of drugs that we do not abuse. a - a mole that looks cancerous. While sleep apnea is less common in thin people, anyone, regardless of their weight, who snores loudly or gasps for air while sleeping, should be checked for sleep apnea. A few such benefits listed by the National Sleep Foundation (n.d.) include maintaining healthy weight, lowering stress levels, improving mood, and increasing motor coordination, as well as a number of benefits related to cognition and memory formation. During this time, an individuals heart rate and respiration slow dramatically. The brain waves associated with this stage of sleep are very similar to those observed when a person is awake, as shown inFigure 4.11, and this is the period of sleep in which dreaming occurs. Getting the optimal amount of sleep has also been associated with other cognitive benefits. That includes exercise and bright light from devices. Psychology 2e by Openstax is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted. One important regulator of sleep-wake cycles is the hormonemelatonin. Users can experience physical symptoms that include nausea, elevated blood pressure, and increased heart rate. Opium, Heroin, Fentanyl, Morphine, Oxycodone, Vicoden, methadone, and other prescription pain relievers, Decreased pain, pupil dilation, decreased gut motility, decreased respiratory function. The woman used caffeine in the past to boost her mood and to provide energy, but over the course of several years, she increased her caffeine consumption to the point that she was consuming three liters of soda each day. There is a tremendous amount of variability among sufferers, both in terms of how symptoms of narcolepsy manifest and the effectiveness of currently available treatment options. These individual differences in circadian patterns of activity are known as a persons chronotype, and research demonstrates that morning larks and night owls differ with regard to sleep regulation (Taillard, Philip, Coste, Sagaspe, & Bioulac, 2003). Hypnosis in conjunction with other techniques is used for a variety of therapeutic purposes and has shown to be at least somewhat effective for pain management, treatment of depression and anxiety, smoking cessation, and weight loss (Alladin, 2012; Elkins, Johnson, & Fisher, 2012; Golden, 2012; Montgomery, Schnur, & Kravits, 2012). The different stages of sleep will be identified, and sleep disorders will be described. Body temperature rises throughout the waking day, peaking in the afternoon, and falls during sleep with the lowest point occurring during the very early morning hours. Ahallucinogenis one of a class of drugs that results in profound alterations in sensory and perceptual experiences (Figure 4.18). When he told me, I made him go see the college therapist. (a) Delta waves, which are low frequency and high amplitude, characterize (b) slow-wave stage 3 and stage 4 sleep. As mentioned earlier, one of the criteria for insomnia involves experiencing these symptoms for at least three nights a week for at least one months time (Roth, 2007). Unexplained hemorrhaging, bleeding or bruising. The heart rate slows . It is typically consumed in pill form. Insleepwalking, or somnambulism, the sleeper engages in relatively complex behaviors ranging from wandering about to driving an automobile. Natural opioids, calledopiates, are derivatives of opium, which is a naturally occurring compound found in the poppy plant. While we have discussed the negative outcomes associated with sleep deprivation, it should be pointed out that there are many benefits that are associated with adequate amounts of sleep. Although there are a number of different techniques in use, the central feature of all meditation is clearing the mind in order to achieve a state of relaxed awareness and focus (Chen et al., 2013; Lang et al., 2012). All of the following are true statements concerning the health of Americans EXCEPT: a. mortality rates from smoking have declined. This is similar to the kind of paralysis experienced by healthy individuals during REM sleep (Burgess & Scammell, 2012; Hishikawa & Shimizu, 1995; Luppi et al., 2011). However, when a stimulant drug was used in conjunction with a popular antidepressant, her condition improved dramatically. Neurogenic shock is caused by damage to the central nervous system, usually a spinal cord injury. Psychological dependence, or drug craving, is a recent addition to the diagnostic criteria for substance use disorder in DSM-5. Whilecaffeineis generally considered a relatively safe drug, high blood levels of caffeine can result in insomnia, agitation, muscle twitching, nausea, irregular heartbeat, and even death (Reissig, Strain, & Griffiths, 2009; Wolt, Ganetsky, & Babu, 2012). These sleep episodes are often associated withcataplexy, which is a lack of muscle tone or muscle weakness, and in some cases involves complete paralysis of the voluntary muscles. Although individuals suffering from night terrors appear to be awake, they generally have no memories of the events that occurred, and attempts to console them are ineffective. Medical marijuana is marijuana that is prescribed by a doctor for the treatment of a health condition. While disruptions in circadian rhythms can have negative consequences, there are things we can do to help us realign our biological clocks with the external environment. Physiologically, the body can become addicted to opiate drugs in less than a week, including when taken as prescribed. Cognitive-behavioral therapy has been demonstrated to be quite effective in treating insomnia (Savard, Simard, Ivers, & Morin, 2005; Williams, Roth, Vatthauer, & McCrae, 2013). High doses increase agitation, paranoia, can cause hallucinations. As we grow older, we sleep less. Caffeine is another stimulant drug. The pituitary gland also secretes growth hormone, during sleep, which plays a role in physical growth and maturation as well as other metabolic processes (Bartke, Sun, & Longo, 2013). Awareness of external stimuli includes experiences such as seeing the light from the sun, feeling the warmth of a room, and hearing the voice of a friend. Alertness is associated with higher body temperatures, and sleepiness with lower body temperatures. Beyond being awake or asleep, there are many other states of consciousness people experience. The term was first coined by a physiologist named Walter Cannon in 1926. It is also common for these types of drugs to cause hallucinations of body sensations (e.g., feeling as if you are a giant) and a skewed perception of the passage of time. An important difference between mood disorders and normal mood fluctuation is: A) the particular medication used to treat the problem. Comparative research indicates, however, that the relationship that exists between predatory risk and sleep is very complex and equivocal. Delusions. Many people experience disturbances in their sleep at some point in their lives. It appeared that Scott Falater had killed his wife in his sleep, or at least, that is the defense he used when he was tried for his wifes murder (Cartwright, 2004; CNN, 1999). The prevalence rates for somatic disorders are often difficult to determine; however, overall estimates of somatic symptom disorder are around 4-6%. . Why do we devote so much time to sleeping? Methamphetamine in its smokable form, often called crystal meth due to its resemblance to rock crystal formations, is highly addictive. The amount of sleep we get varies across the lifespan. Sleep-wake cycles seem to be controlled by multiple brain areas acting in conjunction with one another. These symptoms usually are opposite of the effects of the drug. Aches and pains, such as severe headache and muscle and joint pain. This section will consider these questions and explore various explanations for why we sleep. If someone stays awake for 48 consecutive hours, they could start to hallucinate. Consider a patient who believed that as a result of his sleep apnea he had three car accidents in six weeks. Sleep apnea is much more common in overweight people and is often associated with loud snoring. A person with asleep debtdoes not get sufficient sleep on a chronic basis. This often results in sleeping problems, and it can lead to signs of depression and anxiety. Weakness and fatigue. While "internal state" or impulsivity are terms more generally discussed in psychology or neuroscience, the concept is familiar to anyone. While there are variations, there are four parts that appear consistent in bringing people into the state of suggestibility associated with hypnosis (National Research Council, 1994). Nicotine is highly addictive, and the use of tobacco products is associated with increased risks of heart disease, stroke, and a variety of cancers. Early versions of this theory proposed that dreams were not the meaning-filled representations of angst proposed by Freud and others, but were rather the result of our brain attempting to make sense of (synthesize) the neural activity (activation) that was happening during REM sleep. Marijuana, LSD, Peyote, mescaline, DMT, dissociative anesthetics including ketamine and PCP, Increased heart rate and blood pressure that may dissipate over time, Mild to intense perceptual changes with high variability in effects based on strain, method of ingestion, and individual differences, Understand what is meant by consciousness, Explain how circadian rhythms are involved in regulating the sleep-wake cycle, and how circadian cycles can be disrupted, Describe areas of the brain involved in sleep, Understand hormone secretions associated with sleep, Describe several theories aimed at explaining the function of sleep, Differentiate between REM and non-REM sleep, Describe the differences between the three stages of non-REM sleep, Understand the role that REM and non-REM sleep play in learning and memory, Describe the symptoms and treatments of insomnia, Recognize the symptoms of several parasomnias, Describe the symptoms and treatments for sleep apnea, Recognize risk factors associated with sudden infant death syndrome (SIDS) and steps to prevent it, Describe the symptoms and treatments for narcolepsy. As mentioned earlier, REM sleep is marked by rapid movements of the eyes. The freebase version of cocaine, known as crack, is a potent, smokable version of the drug. Few people in the United States remain untouched by the recent opioid epidemic. Other depressants include barbiturates and benzodiazepines. (credit: Laurie Avocado). As scary as it sounds, many sleep researchers believe that homicidal sleepwalking is possible in individuals suffering from the types of sleep disorders described below (Broughton et al., 1994; Cartwright, 2004; Mahowald, Schenck, & Cramer Bornemann, 2005; Pressman, 2007). Parasomnias can occur in either REM or NREM phases of sleep. Acetylcholine functions as a neurotransmitter in motor neurons. Repeated use of these stimulants can have significant adverse consequences. Table 4.1shows the new recommendations, which describe sleep durations that are recommended, may be appropriate, and not recommended. It is administered alone or in conjunction with doses of melatonin (the hormone secreted by the pineal gland). Manifest contentis the actual content, or storyline, of a dream. Sleep apnea is defined as a reduction or cessation of breathing during sleep. Generally, and for most people, our circadian cycles are aligned with the outside world. For example, body temperature fluctuates cyclically over a 24-hour period (Figure 4.2). Which of the following was an advance in science and medicine in the18th and 19th centuries? NCEH provides leadership to promote health and quality of life by preventing or controlling those diseases, birth defects, or disabilities resulting from interaction between people and the environment. It may surprise you to know that sleep deprivation is associated with obesity, increased blood pressure, increased levels of stress hormones, and reduced immune functioning (Banks & Dinges, 2007). The hypnogram below (Figure 4.12) shows a persons passage through the stages of sleep. LINK TO LEARNING: To learn more about some of the most commonly abused prescription and street drugs, check out the, LINK TO LEARNING: Feeling stressed? Increased alertness, mild euphoria, decreased appetite in low doses. Many individuals diagnosed with sleep apnea first seek treatment because their sleeping partners indicate that they snore loudly and/or stop breathing for extended periods of time while sleeping (Henry & Rosenthal, 2013). Biological rhythmsare internal rhythms of biological activity. Latent content, on the other hand, refers to the hidden meaning of a dream. Causes. Remarkably, Falater insisted that he had no recollection of hurting his wife in any way. These episodes can last 1020 seconds or longer and often are associated with brief periods of arousal. Pain relief, euphoria, sleepiness. We might even describe consciousness as a continuum that ranges from full awareness to a deep sleep. While caffeine may have some indirect effects on dopamine neurotransmission, its primary mechanism of action involves antagonizing adenosine activity (Porkka-Heiskanen, 2011). There may also be differences in both brain structure and function in infants that die from SIDS (Berkowitz, 2012; Mage & Donner, 2006; Thach, 2005). While we all experience altered states of consciousness in the form of sleep on a regular basis, some people use drugs and other substances that result in altered states of consciousness as well. C) the severity and duration of the problem. Heavy meals may make you sleepy, but they can also lead to frequent awakenings due to gastric distress. Which of the following is true regarding patient adherence: d - all of the above (a - the average adherence rate for taking medication to treat acute illness is about 67%, b - adherence to taking medicine . In addition, these individuals may wake up several times during the night only to find that they have difficulty getting back to sleep. Despite recent changes in laws designed to make obtaining pseudoephedrine more difficult, methamphetamine continues to be an easily accessible and relatively inexpensive drug option (Shukla, Crump, & Chrisco, 2012). The participant is guided to focus on one thing, such as the hypnotists words or a ticking watch. Avoid alcohol, cigarettes, caffeine, and heavy meals before bed. It is possible that even the processing of emotional information is influenced by certain aspects of sleep (Walker, 2009). Social programs like Medicare: a - offer health coverage for the older adults 24. While many users snort cocaine, intravenous injection and inhalation (smoking) are also common.
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