In this Chapter:

• Brain Activity during Sleep

• Sleep disorders

• How is sleep regulated?

• The Sleep-Wakefulness Cycle

Introduction

• Lack of sleep increases the risk of many health problems including:

  • Diabetes

  • Cardiovascular disease

  • Heart attacks

  • Stroke

  • Depression

  • High Blood Pressure/Hypertension

  • Obesity

  • Infections

• Sleep is made of several different stages that are accompanied by daily rhythms in hormones, body temperature, etc.

• Sleep disorders are one of the least recognized sources of disease, disability, and death

Brain Activity During Sleep

• Electroencephalography (EEG): the measurement of electrical activity in different parts of the brain and the recording of such activity as a visual trace (on paper or on an oscilloscope screen).

• One sleep cycle is approximately 90 minutes

• Each night, the brain progresses through a series of stages when brain waves slow down for 60 minutes in NREM (non-rapid eye movement) sleep

  • This is accompanied by the relaxation of muscles and eyes

  • Heart rate, Blood pressure, and body temperature fall

  • If awakened in this stage of sleep, most people only recall fragments of thought

  • NREM sleep: sleep where the eyes do not rapidly move

• Over the next half-hour, brain activity changes to REM sleep

  • REM (Rapid Eye Movement) sleep: sleep characterized by the random rapid movement of the eyes when derams also occur

  • Characterized by neocortical (in the neocortex) EEG waves similar to those when a person is awake

  • REM is accompanied by atonia

    • Atonia: paralysis of muscle

  • Dreaming occurs only in REM sleep

    • The first REM period lasts 10-15 min

• Over the course of one’s lifetime: slow-wave sleep time decreases & REM time increases

• Overall sleeping time at different life stages:

  • Infants: up to 18 hrs

  • Older adults: 6-7 hrs

    • Less time sleeping in general and in slow wave sleep specifically

Sleep Disorders

• Insomnia: the most common sleep disorder where individuals have trouble falling asleep

  • Some people have problems falling asleep, some wake up in the middle of the night and can’t fall asleep again

  • Sleeping drugs do not help because they suppress slow-wave sleep and aren’t effective in keeping people asleep

• Many common disorders disrupt deeper stages of sleep

• Excessive daytime sleepiness has many causes

  • Obstructive Sleep Apnea: airway muscles relax and close airway causing difficulty breathing

    • individual wakes up without entering deeper stages of slow-wave sleep.

    • Causes high blood pressure and increases the risk of heart attack

    • more daytime sleepiness

  • Periodic Limb Movements: intermittent jerks of the legs or arms that occur as individual enters slow wave sleep and cause arousal from sleep.

  • REM behavior disorder: occurs when muscles fail to become paralyzed during REM sleep

    • Act out dreams by getting up and moving around.

    • Can be very disruptive.

  • Both periodic limb movements and REM behavior disorder are more common in people with Parkinson’s disease.

    • Can be treated with drugs for Parkinson’s or with a benzodiazepine called clonazepam

• Narcolepsy: mechanisms controlling transitions into sleep (particularly REM sleep) don’t work.

  • Narcolepsy is caused by the loss of nerve cells in lateral hypothalamus that contain orexin/hypocretin.

    • Have sleep attacks during day (suddenly fall asleep).

    • Hypnagogic hallucination: individuals tend to enter REM sleep very quickly and enter dreaming state while partially awake

    • Cataplexy: loss of muscle tone similar to what happens in REM sleep but occurs when the individual is still awake

How is Sleep Regulated?

• Wakefulness is maintained by systems in the upper brainstem and hypothalamus

  • Neurons here use acetylcholine, norepinephrine, serotonin, glutamate to connect with the forebrain

  • Neurons in the hypothalamus use orexin and some contain histamine

  • Thalamus and basal forebrain activation by acetylcholine is very important too

    • basal means “closest to midbrain/base”

• Level of alertness can be shown in an activated low-volt EEG

• Arousing systems are less active in non-REM sleep

  • Transmission of information to the thalamus is limited

• Ventrolateral preoptic (VLPO) nucleus: area in the brain that causes suppression of arousal systems

  • VLPO nucleus neurons have the inhibitors galanin and GABA

  • Damage to the VLPO area produces irreversible insomnia

• In REM sleep, there is an internally activated brain and EEG but the external input is suppressed

  • Internal activation comes from cyclically active REM sleep generator neurons in the brainstem

• Signals from neurons cause the excitation of the forebrain

  • Leads to rapid eye movements & muscle suppression

• Forebrain excitation driving force behind dreams of REM sleep

• Motor cortex neurons fire as rapidly during REM sleep as during waking movement

  • Explains movement coinciding with dreams

• Periodic recurrence of REM sleep

  • REM sleep occurs every 90 min during sleep

  • This is caused by on-and-off switching of REM-generators (acetylcholine, glutamate) and REM-suppressors (norepinephrine, serotonin, GABA)

The Sleep-Wakefulness Cycle

• 2 determining factors for sleepiness:

  • Circadian system: Monitoring the time of day/night

  • Homeostatic system: monitoring how long the person is awake

• Circadian system is regulated by the suprachiasmatic nucleus

  • Suprachiasmatic nucleus: a small group of cells in the hypothalamus serving as the master clock

    • It expresses clock proteins that go through a biochemical cycle of approximately 24 hrs

    • This sets the pace for daily cycles of activity, sleep hormone release, etc.

• The suprachiasmatic nucleus also receives input from the retina

  • The clock can be reset by light so it is linked to the outside day-night cycle

• Also provides information to the subparaventricular nucleus → dorsomedial nucleus → VLPO and orexin neurons

  • Orexin: an excitatory signal to arousal system especially norepinephrine neurons

    • Orexin activation plays role in preventing transitions into REM sleep during the day

• Arousal mediated by orexin and activation of norepinephrine neurons in the locus coeruleus

  • Locus coeruleus: a lateral part of brain stem that has norepinephrine producing neurons that mediate arousal along with orexin

• The homeostatic system responds to longer wake periods by increasing the urge to sleep

  • The longer a person is awake, the greater the likelihood of an increase in sleep-inducing factors

• Adenosine: a very important sleep promotor

  • More adenosine means increased sleepiness

  • Adenosine release starts in the basal forebrain and spreads to the rest of the cortex

  • Increased adenosine levels slow down cellular activity and diminish arousal

  • Adenosine levels decrease during sleep

• Brain adenosine may be produced by ATP breakdown over the course of wakefulness

• Neuron activity decreases and adenosine levels decline in non-REM sleep

  • ATP levels increase during sleep