The physiology of arousal and sleep

Image by Gemma Correll

Learning outcomes:

By the end of this module, you should be able to:

 

  • describe how different neurotransmitters influence the sleep-wake cycle

     

  • outline the role of the locus coeruleus and reticular activating system play in sleep

     

  • explain the stages of the sleep cycle and describe key waveforms at each stage

     

  • list the key physiological components that differentiate non-rapid eye movement (NREM) sleep from rapid eye movement (REM) sleep

     

  • explain the relationship between the circadian clock and the sleep-wake cycle

     

  • describe how sleep changes across the lifespan

     

  • list the effects of hypnotic drugs on sleep.

 

Module introduction

'We spend a third of our lives doing it, Napoleon, Florence Nightingale and Margaret Thatcher got by on four hours a night, Thomas Edison claimed it was a waste of time.' (BBC Science & Nature, 2014

 

What is sleep?

 

Sleep is a natural, cyclical alteration of consciousness that is essential to our normal functioning and health. During this biorhythmic state of unconsciousness, the brain becomes less sensitive to external stimuli.

 

Why do we sleep?

 

Does it conserve energy or let the brain 'recharge'?

 

This is something of a misconception. Literature suggests that 'sleeping only reduces metabolism and energy use in humans by at most 510% overall' (Mastin, 2013a). Over an 8-hour period of sleep, this would equate to approximately 50 kCal (BBC Science & Nature, 2014).

 

Sleep is necessary for normal functioning and health. It plays a significant role in brain development and deficiency of sleep, especially long-term, can lead to serious health problems. Sleep deprivation hinders brain function, especially the regions controlling memory, planning, language and sense of time.

 

Judgement can also be affected. Research suggests that remaining awake for over 17 hours reduces cognitive psychomotor performance to the same extent as that caused by a blood alcohol concentration of 0.05%, the legal drink driving limit in the UK (Dawson & Reid, 1997).

 

Sleep deprivation impacts normal physiology, with consequences on emotional and physical health. Lack of sleep has many causes and is associated with several conditions, including: depression, anxiety, obesity, heart disease and type 2 diabetes mellitus. 

 

How is sleep different to other states of unconsciousness?

 

Sleep occurs in a predictable pattern. During the shift from wakefulness to sleep, there is a progressive decrease in neurological response to environmental, auditory and visual stimuli from the brain (Moroz et al, 2011).

 

Learning notes

We recommend that you make some notes as you work through this module.

 

The 'TrOn Notebook' facility can be accessed throughout the module (allowing you to make notes on each page), and these notes will be saved in your personal area 'My TrOn', for future reference. However, you will not be able to print these notes as one single document.

 

If you would prefer to make your notes in a separate document you may wish to download the 'learning notes' below. This downloadable Word document will allow you to keep a personalised record of your learning, which you can then save and/or print for future reference.

 

Download the learning notes document for this module 

 

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© 2018 Royal College of Psychiatrists