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). The term was first coined by a physiologist named Walter Cannon in 1926. Some sleep-deprived individuals have difficulty staying awake when they stop moving (for example sitting and watching television or driving a car). With excessive alcohol use, a person might experience a complete loss of consciousness and/or difficulty remembering events that occurred during a period of intoxication (McKim & Hancock, 2013). As the dose increases, people report feeling sedated. Medical marijuana is legal in over half of the United States and in the District of Columbia (Figure 4.19). Sleep apnea is defined as a reduction or cessation of breathing during sleep. 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. THE INTERNAL STATE SCALE (ISS) Version 2 and the ChronoBook SCORING KEY AND SUMMARY Mark S. Bauer, MD . Is it absolutely essential that we sleep? Some people who have injected many times into their arms will show track marks, while other users will inject into areas between their fingers or between their toes, so as not to show obvious track marks and, like all abusers of intravenous drugs, have an increased risk for contraction of both tuberculosis and HIV. Toleranceis linked to physiological dependence, and it occurs when a person requires more and more drug to achieve effects previously experienced at lower doses. Complete the following multiple choice quiz covering chapters 1, 6, and 9. While many users snort cocaine, intravenous injection and inhalation (smoking) are also common. If you get peritoneal dialysis, peritonitis symptoms also may include: Cloudy dialysis fluid. 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). 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). For example, irritability, distractibility, and impairments in cognitive and moral judgment can occur with fewer than four hours of sleep. A womans menstrual cycle is an example of a biological rhythma recurring, cyclical pattern of bodily changes. Ethanol, which we commonly refer to as alcohol, is in a class of psychoactive drugs known as depressants (Figure 4.15). In addition, these drugs can cause feelings of anxiety, hallucinations, and paranoia (Fiorentini et al., 2011). Heavy meals may make you sleepy, but they can also lead to frequent awakenings due to gastric distress. Alertness is associated with higher body temperatures, and sleepiness with lower body temperatures. Nicotine exerts its effects through its interaction with acetylcholine receptors. Not surprisingly, insomnia treatment may take one of several different approaches. Sleep can be divided into two different general phases: REM sleep and non-REM (NREM) sleep. These drugs promote increased levels of neural activity. a. c. are influenced by peer pressure, often leading to unhealthful or unsafe behaviors. There was a significant positive correlation between the degree to which women thought about their former spouses during waking hours and the number of times their former spouses appeared as characters in their dreams (Cartwright, Agargun, Kirkby, & Friedman, 2006). For example, around one third of individuals diagnosed with narcolepsy experience vivid, dream-like hallucinations during narcoleptic attacks (Chokroverty, 2010). Another evolutionary hypothesis of sleep holds that our sleep patterns evolved as an adaptive response to predatory risks, which increase in darkness. On January 16, 1997, Scott Falater sat down to dinner with his wife and children and told them about difficulties he was experiencing on a project at work. This is known as the REM rebound, and it suggests that REM sleep is also homeostatically regulated. Theta waves still dominate the activity of the brain, but they are interrupted by brief bursts of activity known as sleep spindles (Figure 4.9). Night terrorsresult in a sense of panic in the sufferer and are often accompanied by screams and attempts to escape from the immediate environment (Mahowald & Schenck, 2000). Two theories attempt to answer this question: One theory views hypnosis as dissociation and the other theory views it as the performance of a social role. 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. Treatment. In general, these drugs are not thought to possess the same sort of abuse potential as other classes of drugs discussed in this section. During this time, there is a slowdown in both the rates of respiration and heartbeat. Homeostatic regulation of sleep is evidenced by sleep rebound following sleep deprivation. Surprisingly, sleep apnea may exacerbate cardiovascular disease (Snchez-de-la-Torre, Campos-Rodriguez, & Barb, 2012). High doses of MDMA can cause brain toxicity and death. For example, withdrawal from sedative drugs often produces unpleasant arousal and agitation. These initiatives include increasing access to treatment and recovery services, increasing access to overdose-reversal drugs like Naloxone, and implementing better public health monitoring systems (NIDA, 2019). a - a mole that looks cancerous. In the therapeutic setting, a clinician may use relaxation and suggestion in an attempt to alter the thoughts and perceptions of a patient. . Reduced urine. As discussed by Siegel (2008), a definition of sleep must also include mention of the interplay of the circadian and homeostatic mechanisms that regulate sleep. Confusion. There are now several synthetic versions of opiate drugs (correctly called opioids) that have very potent painkilling effects, and they are often abused. The first three stages of sleep are NREM sleep, while the fourth and final stage of sleep is REM sleep. This discomfort is relieved by deliberately moving the legs, which, not surprisingly, contributes to difficulty in falling or staying asleep. (credit: modification of work by Mikael Hggstrm). Research shows that the most severe effects of sleep deprivation occur when a person stays awake for more than 24 hours (Killgore & Weber, 2014; Killgore et al., 2007), or following repeated nights with fewer than four hours in bed (Wickens, Hutchins, Lauk, Seebook, 2015). In some cases, though, there may be no symptoms of inflammation at all. High doses increase agitation, paranoia, can cause hallucinations. (credit: modification of work by new 1lluminati/Flickr), Medical marijuana shops are becoming more and more common in the United States. 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. Homeostasisis the tendency to maintain a balance, or optimal level, within a biological system. One or two nights of sleep difficulty is not unusual, but if you experience anything more than that, you should seek a doctors advice. The following describe internal states of symptoms EXCEPT? In recent years, methamphetamine (meth) use has become increasingly widespread. The consequences of sleep debt include decreased levels of alertness and mental efficiency. There is quite a bit of controversy within the scientific community as to the extent to which marijuana might have medicinal benefits due to a lack of large-scale, controlled research (Bostwick, 2012). We experience different states of consciousness and different levels of awareness on a regular basis. 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). Thus we sleep in safe areas to reduce the chance of harm. These symptoms usually are opposite of the effects of the drug. Fever. 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. Like NREM sleep, REM has been implicated in various aspects of learning and memory (Wagner, Gais, & Born, 2001; Siegel, 2001). Large-scale public health campaigns by the National Institutes of Health and the National Institute of Drug Abuse have led to recent declines in the opioid crisis. Cognitive-behavioral therapyis a type of psychotherapy that focuses on cognitive processes and problem behaviors. (a) Delta waves, which are low frequency and high amplitude, characterize (b) slow-wave stage 3 and stage 4 sleep. Interestingly, individuals who have increased levels of alpha brain wave activity (more often associated with wakefulness and transition into stage 1 sleep) during stage 3 often report that they do not feel refreshed upon waking, regardless of how long they slept (Stone, Taylor, McCrae, Kalsekar, & Lichstein, 2008). Some research suggests that species that face higher predatory risks sleep fewer hours than other species (Capellini et al., 2008), while other researchers suggest there is no relationship between the amount of time a given species spends in deep sleep and its predation risk (Lesku, Roth, Amlaner, & Lima, 2006). In contrast, a person who haspsychological dependencehas an emotional, rather than physical, need for the drug and may use the drug to relieve psychological distress. It is quite possible that sleep serves no single universally adaptive function, and different species have evolved different patterns of sleep in response to their unique evolutionary pressures. These symptoms include fatigue, sluggishness, irritability, and insomnia (i.e., a consistent difficulty in falling or staying asleep for at least three nights a week over a month's time) (Roth, 2007). Given that withdrawal from a drug often involves an experience opposite to the effect of the drug, it should be no surprise that opioid withdrawal resembles a severe case of the flu. Research indicates that meditation may help reduce blood pressure, and the American Heart Association suggests that meditation might be used in conjunction with more traditional treatments as a way to manage hypertension, although there is not sufficient data for a recommendation to be made (Brook et al., 2013). This will be followed by brief descriptions of the effects of some of the more well-known drugs commonly used today. Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a rare but severe, often fatal illness in humans. Obviously, regular narcoleptic episodes could interfere with the ability to perform ones job or complete schoolwork, and in some situations, narcolepsy can result in significant harm and injury (e.g., driving a car or operating machinery or other potentially dangerous equipment). Another theory regarding why we sleep involves sleeps importance for cognitive function and memory formation (Rattenborg, Lesku, Martinez-Gonzalez, & Lima, 2007). People sleep better in cooler temperatures. Whether lark, owl, or somewhere in between, there are situations in which a persons circadian clock gets out of synchrony with the external environment. This section will present information relating to the use of various psychoactive drugs and problems associated with such use. Insudden infant death syndrome (SIDS)an infant stops breathing during sleep and dies. Heroin users often shoot the drug directly into their veins. Hypnosisis a state of extreme self-focus and attention in which minimal attention is given to external stimuli. With repeated use of many central nervous system depressants, such as alcohol, a person becomes physically dependent upon the substance and will exhibit signs of both tolerance and withdrawal. Heroin can be snorted, smoked, or injected intravenously. As you will learn when you study social roles, peoples behavior can be shaped by their expectations of how they should act in a given situation. Rather, the ISS r ecognizes mixed states and depressive symptoms during manic and hypomanic episodes. Individuals who suffer from RBD have high levels of physical activity during REM sleep, especially during disturbing dreams. This often results in sleeping problems, and it can lead to signs of depression and anxiety. In contrast,non-REM (NREM)sleep is subdivided into four stages distinguished from each other and from wakefulness by characteristic patterns of brain waves. Methamphetamineis a type of amphetamine that can be made from ingredients that are readily available (e.g., medications containing pseudoephedrine, a compound found in many over-the-counter cold and flu remedies). Research indicates that included among these possible benefits are increased capacities for creative thinking (Cai, Mednick, Harrison, Kanady, & Mednick, 2009; Wagner, Gais, Haider, Verleger, & Born, 2004), language learning (Fenn, Nusbaum, & Margoliash, 2003; Gmez, Bootzin, & Nadel, 2006), and inferential judgments (Ellenbogen, Hu, Payne, Titone, & Walker, 2007). Users experience increased energy, feelings of pleasure, and emotional warmth. This is of such concern that people who are trying to overcome addiction to these substances should only do so under medical supervision. 2. Case fatality rates have varied from 25% to 90 . The participant is guided to focus on one thing, such as the hypnotists words or a ticking watch. Signs of inflammation help healthcare providers in making a diagnosis. In the wake of the opiate epidemic, many drug cartels in Mexico are shifting from producing heroin to producing highly potent but inexpensive forms of methamphetamine. Unexplained hemorrhaging, bleeding or bruising. Insleepwalking, or somnambulism, the sleeper engages in relatively complex behaviors ranging from wandering about to driving an automobile. Asleep spindleis a rapid burst of higher frequency brain waves that may be important for learning and memory (Fogel & Smith, 2011; Poe, Walsh, & Bjorness, 2010). Stimulant users seek aeuphoric high, feelings of intense elation and pleasure, especially in those users who take the drug via intravenous injection or smoking. One complete menstrual cycle takes about 28 daysa lunar monthbut many biological cycles are much shorter. When people have difficulty getting sleep due to their work or the demands of day-to-day life, they accumulate a sleep debt. As one of their mechanisms of action, cocaine and amphetamines block the reuptake of dopamine from the synapse into the presynaptic cell. This pattern of brain wave activity resembles that of someone who is very relaxed, yet awake. The amount of sleep we get varies across the lifespan. In fact, ameta-analysis, which is a study that combines the results of many related studies, conducted within the last decade indicates that by the time we are 65 years old, we average fewer than 7 hours of sleep per day (Ohayon, Carskadon, Guilleminault, & Vitiello, 2004). The typical positive symptoms of schizophrenia , such as hallucinatory experiences or fixed delusional beliefs, tend to be very upsetting and disruptivenot a positive experience at all for you or someone you care about who is experiencing them. For example, Hobson (2009) suggests that dreaming may represent a state of protoconsciousness. Opium, Heroin, Fentanyl, Morphine, Oxycodone, Vicoden, methadone, and other prescription pain relievers, Decreased pain, pupil dilation, decreased gut motility, decreased respiratory function. Gastrointestinal symptoms including abdominal pain, diarrhea, and vomiting. Thecollective unconscious, as described byJung, is a theoretical repository of information he believed to be shared by everyone. Taking a different approach to explain hypnosis, the social-cognitive theory of hypnosis sees people in hypnotic states as performing the social role of a hypnotized person. d. both b and c. 2. We also alter our consciousness through the use of various psychoactive drugs. (a) Common paraphernalia for heroin preparation and use are shown here in a needle exchange kit. Consider a patient who believed that as a result of his sleep apnea he had three car accidents in six weeks. In this section, we will discuss each of these stages of sleep and their associated patterns of brain wave activity. The following describe internal states of symptoms EXCEPT? It is typically consumed in pill form. Nicotine is most commonly used in the form of tobacco products like cigarettes or chewing tobacco; therefore, there is a tremendous interest in developing effective smoking cessation techniques. The different stages of sleep will be identified, and sleep disorders will be described. People who suffer from insomnia might limit their use of stimulant drugs (such as caffeine) or increase their amount of physical exercise during the day. Participants were told they would not feel pain, but they could press a button if they did; while they reported not feeling pain, they did, in fact, press the button, suggesting a dissociation of consciousness while in the hypnotic state (Hilgard & Hilgard, 1994). 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). Primary signs and symptoms of Ebola often include some or several of the following: Fever. 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). A) managed care Among a variety of neurobiological evidence, John Hobson cites research on lucid dreams as an opportunity to better understand dreaming in general. However, all of their somnambulistic patients who also suffered from sleep-related breathing problems showed a marked decrease in sleepwalking when their breathing problems were effectively treated. This treatment option has proven to be effective for people suffering from mild to severe cases of sleep apnea (McDaid et al., 2009). Few people in the United States remain untouched by the recent opioid epidemic. Rotating shift work has pervasive effects on the lives and experiences of individuals engaged in that kind of work, which is clearly illustrated in stories reported in a qualitative study that researched the experiences of middle-aged nurses who worked rotating shifts (West, Boughton & Byrnes, 2009). c. deaths due to accidents have increased. 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. Freud was not the only theorist to focus on the content of dreams. Many of these drugs, and their relationships, are shown inTable 4.2. These kinds of schedules are common for individuals working in health care professions and service industries, and they are associated with persistent feelings of exhaustion and agitation that can make someone more prone to making mistakes on the job (Gold et al., 1992; Presser, 1995). Depletion of certain neurotransmitters can lead to mood dysphoria, cognitive problems, and other factors. In fact, it has been suggested that there is no reason to think that energetic demands could not be addressed with periods of rest and inactivity (Frank, 2006; Rial et al., 2007), and some research has actually found a negative correlation between energetic demands and the amount of time spent sleeping (Capellini, Barton, McNamara, Preston, & Nunn, 2008). Causes. While "internal state" or impulsivity are terms more generally discussed in psychology or neuroscience, the concept is familiar to anyone. Drug withdrawal is usually an aversive experience, and it can be a life-threatening process in individuals who have a long history of very high doses of alcohol and/or barbiturates. These episodes can last 1020 seconds or longer and often are associated with brief periods of arousal. Like many other stimulants, cocaine agonizes the dopamine neurotransmitter system by blocking the reuptake of dopamine in the neuronal synapse. (credit a: modification of work by Jim Epler; credit b: modification of work by Caleb Roenigk), video about circadian rhythms and how they affect sleep, video that gives sleep tips for college students, video about the relationship between sleep and memory, instructional video about using Buddhist meditation techniques to alleviate stress, video about the results of a brain imaging study in individuals who underwent specific mindfulness meditative techniques, https://openstax.org/books/psychology-2e/pages/1-introduction, Creative Commons Attribution 4.0 International License, Cocaine, amphetamines (including some ADHD medications such as Adderall), methamphetamines, MDMA (Ecstasy or Molly), Increased heart rate, blood pressure, body temperature. Clonazepam, an anti-anxiety medication with sedative properties, is most often used to treat RBD. Unfortunately, this is not the case; however, several hypotheses have been proposed to explain the function of sleep. A person with asleep debtdoes not get sufficient sleep on a chronic basis.

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