U4 AOS1 - Revision

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CONSCIOUSNESS


  1. At any given moment it includes our awareness of (4):

  2. Is classified as a:

  3. Its contents…

  4. varies along:

  5. two states of consciousness:

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54 Terms

1

CONSCIOUSNESS


  1. At any given moment it includes our awareness of (4):

  2. Is classified as a:

  3. Its contents…

  4. varies along:

  5. two states of consciousness:

  1. AWARENESS OF:

    • all objects / events in the external world

    • our sensations

    • mental experiences

    • our own existence


  1. psychological construct (cannot be directly observed / measured, but rather is inferred from other measures)

  2. it’s contents constantly change as you continually shift your focus of attention

  3. a continuum of awareness (consciousness with two distinctive extremes - total awareness / complete lack of awareness)


  4. TWO STATES OF CONSCIOUSNESS:

    • normal waking consciousness (NWC)

    • altered states of consciousness (ASC)

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NORMAL WAKING CONSCIOUSNESS (NWC)


  1. Perceptions and thoughts continue to be…

  2. We perceive the world as:

  1. perceptions and thoughts continue to be organised and clear + remain aware of our personal identity

  2. real + maintain a sense of time / place

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ALTERED STATES OF CONSCIOUSNESS (ASC)


  1. Mental processing of internal / external stimuli shows…

  2. Things that may be subject to change (4):

  3. Two types of ASC:

  1. mental processing of internal / external stimuli shows distinguishable, measurable changes

  2. SUBJECT TO CHANGE:

    • wakefulness

    • self-awareness

    • emotional awareness

    • perceptions of time, place + one’s surroundings


  3. TWO TYPES:

    • naturally occurring ASC: normal part of our lives + happen naturally without any aids (e.g. sleep / daydreaming)

    • induced ASC: intentionally brought on by the use of some kind of aid (e.g. meditation, hypnosis, alcohol, drugs) - some are unintentionally induced such as and accident of head trauma / disease

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SLEEP AS A PSYCHOLOGICAL CONSTRUCT


  1. Considered a psychological construct because:

  2. Measurements of sleep that can be objectively quantified (3):

  3. Characteristics of sleep include (4):

  1. it is a subjective experience that cannot be overtly measured

  2. MEASURED:

    • physiological changes

    • overt behaviours

    • self reports


  3. CHARACTERISTICS:

    • reduced ability to control behaviour

    • reduction in the control we have over thoughts

    • less accurate understanding of the passage of time

    • perceptual and cognitive distortions

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HYPNOGRAM


  1. Shows how…

  2. A Sleep Episode is made up of:

  3. How many sleep cycles (approx.) are there in an average adult’s sleep episode?

  1. shows how NREM and REM sleep periods alternate in a cyclical way

  2. sleep cycles: repeated cycles of REM and NREM stages

  3. 5-6 ninety minute sleep cycles

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NON-REM SLEEP


  1. Proportion of total time asleep:

  2. Which half of the night has more NREM?

  3. How many stages + distinguished by?

  4. Each successive stage is indicative of (strength of sleep):

  5. Characterised by:

  6. Each stage is dominated by (measurement):

  7. As sleep gets deeper (brain waves + physiological changes):

  1. 75-80%

  2. first half of the night

  3. three (N1, N2, N3) - distinguishable pattern of physiological activity

  4. ‘deeper’ sleep (N1 = lightest, N3 = deepest)

  5. reduction in physiological activity during transition from stage 1 to 3

  6. a particular brain wave pattern that is different from that of the other stages

  7. brain waves get slower / bigger, breathing / heart rate slows down, blood pressure drops

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NON-REM STAGE 1 (N1)


  1. Is when…

  2. Proportion of total sleep time:

  3. How ‘deep’ is sleep?

  4. Most commonly associated with (brain waves):

  5. Sometimes experience (body movement):

  6. Arousal threshold:

  7. Physiological changes (5):

  1. is when sleep begins in the first sleep cycle

  2. 4-5%

  3. relatively light sleep

  4. alpha brain waves

  5. involuntary muscle twitches (hypnic jerks)

  6. low arousal threshold - can be easily awakened

  7. PHYSIOLOGICAL CHANGES:

    • lower level of bodily arousal

    • decreased heart rate

    • decreased breathing rate

    • decreased body temperature

    • decreased muscle tension

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NON-REM STAGE 2 (N2)


  1. How much of sleep cycle does it account for?

  2. How long does it generally last for?

  3. How ‘deep’ is sleep?

  4. Transition to (brain waves):

  5. Brain waves (frequency):

  6. Arousal threshold:

  7. Continued lowering of physiological responses (6):

  1. majority of sleep cycle

  2. 10-25 minutes (lengthens with each sleep cycle)

  3. light - moderate sleep (becoming deeper)

  4. theta brain waves

  5. generally slow further - brief bursts of electrical activity (sleep spindles) typically every 3-6 seconds, signalling transition

  6. higher arousal threshold than N1 - can still be easily aroused

  7. PHYSIOLOGICAL CHANGES:

    • slower heart rate

    • slower breathing rate

    • lower muscle activity

    • lower body temperature

    • less body movements

    • lowering of bodily arousal

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NON-REM STAGE 3 (N3)


  1. Also known as:

  2. Proportion of total sleep time:

  3. How long does it generally last for?

  4. How ‘deep’ is sleep?

  5. Most commonly associated with (brain waves):

  6. Arousal threshold:

  7. When awoken people can experience:

  8. Physiological changes (5):

  1. slow wave sleep’ or ‘delta sleep

  2. 10-15%

  3. in first sleep cycle = 20-40 minutes spent in N3 - as night progresses = less time spent in N3 + may entirely disappear from our sleep cycles in later part of night

  4. deepest sleep

  5. delta brain waves - largest and slowest brain waves

  6. highest arousal threshold - can be difficult to awaken

  7. sleep inertia: mental lag / disorientation experienced when awoken from sleep

  8. PHYSIOLOGICAL CHANGES:

    • lowest heart rate levels

    • lowest breathing rate levels

    • muscles completely relaxed

    • no eye movements

    • lowest levels of bodily arousal / physiological responses

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REM SLEEP


  1. Also known as:

  2. Proportion of total time asleep:

  3. Characterised by:

  4. Brain wave pattern:

  5. Level of physiological responses:

  6. Somatic activity:

  7. Most dreaming occurs…

  8. Sleep periods (time / spacing):

  9. How deep is sleep?

  10. Arousal threshold:

  1. ‘paradoxical sleep’: sleeper appears paralysed - few outward signs of body movement

  2. 20-25%

  3. spontaneous bursts of rapid eye movement during which the eyeballs quickly move beneath closed eyelids

  4. beta brain waves - like that produced during alert wakefulness

  5. higher levels of physiological responses - more active in REM than NREM (heartbeat faster / irregular, blood pressure rises, shallower breathing, body temperature rises)

  6. low somatic activity - lowest muscle tone / tension

  7. most dreaming occurs during REM

  8. sleep periods lengthen / occur closer together as sleep episode progresses (first = about 1-5 minutes, second = about 12-15 minutes, third = about 20-25 minutes etc.)

  9. shares both light / deep sleep qualities (brain waves similar to when awake but muscle tension at its lowest)

  10. sleep arousal threshold is variable - most attributed to N2/N3

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NREM V REM DREAMS


  1. Characteristics of NREM dreams:

  2. Characteristics of REM dreams:

  1. NREM DREAMS:

    • shorter

    • less frequent

    • less structured

    • less likely to be recalled

    • less vivid


  1. REM DREAMS:

    • narrative structure

    • can consist of storylines

    • consist of more abstract shapes / colours etc.

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MEASUREMENTS OF PHYSIOLOGICAL RESPONSES TO SLEEP


  1. Most sleep takes place in:

  2. They enable + when:

  3. Objective measurements:

  4. Subjective measurements:

  1. a sleep laboratory

  2. enable researchers to obtain quantitative data on bodily processes / changes that occur as we fall asleep, during sleep + as we awaken from sleep

  3. OBJECTIVE:

    • electroencephalography (EEG)

    • electromyography (EMG)

    • electro-oculargraphy (EOG)


  4. SUBJECTIVE:

    • sleep diaries

    • video monitoring

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ELECTROENCEPHALOGRAPHY (EEG)


  1. Is used to (DARE):

  2. Describes brain waves in terms of:

  3. Difference between high / low frequency brain waves:

  4. Difference between high / low amplitude brainwaves:

  1. used to detect, amplify + record the electrical activity through electrodes manually placed at various points on the scalp

  2. frequency (number of brain waves per second) + amplitude (intensity of brain waves measured in microvolts / visually judged by size of peaks and troughs of waves from a baseline of zero activity)

  3. DIFFERENCY IN FREQUENCY:

    • high frequency brain wave activity = faster - more brain waves per unit of time

    • low frequency brain wave activity = slower - fewer brain waves per unit of time


  4. DIFFERENCE IN AMPLITUDE:

    • high amplitude brain waves = bigger peaks / troughs

    • low amplitude brain waves = smaller peaks / troughs

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BRAIN WAVES


  1. Types of brain wave patterns measured in EEG:

  2. Throughout a typical sleep episode, patterns of electrical activity tend to…

  1. BRAIN WAVE PATTERN:

    • beta pattern

    • alpha pattern

    • theta pattern

    • delta pattern


  2. patterns of electrical activity tend to follow a regular sequence

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BETA BRAIN WAVE PATTERN


  1. Associated with:

  2. Present when:

  3. State of consciousness:

  4. Frequency:

  5. Amplitude:

  1. alertness + intensive mental activity

  2. dreaming during period of REM sleep

  3. normal waking consciousness

  4. high frequency

  5. low amplitude

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ALPHA BRAIN WAVE PATTERN


  1. Associated with:

  2. State of consciousness:

  3. Frequency:

  4. Amplitude:

  1. awake / alert but mentally / physically relaxed and internally focused

  2. normal waking consciousness

  3. high / medium frequency (lower than beta)

  4. low amplitude (higher than beta)

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THETA BRAIN WAVE PATTERN


  1. Produced when:

  2. State of consciousness:

  3. Frequency:

  4. Amplitude:

  1. when very drowsy (e.g. just before falling asleep / just after waking up) + when awake and engaged in creative activities

  2. awake or asleep

  3. low frequency

  4. medium amplitude

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DELTA BRAIN WAVE PATTERN


  1. Associated with:

  2. State of consciousness:

  3. Frequency:

  4. Amplitude:

  1. deep sleep, dreamless sleep + unconsciousness

  2. unconscious / asleep

  3. low frequency

  4. high amplitude

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ELECTROMYOGRAPHY (EMG)


  1. Used to (DARE):

  2. Recordings show:

  3. Electrical activity indicates:

  4. The higher amount of electrical activity:

  1. used to detect, amplify + record the electrical activity by attaching electrodes to the skin above relevant muscles (facial / leg / torso / combo of above)

  2. strength of electrical activity occurring in the muscles

  3. changes in muscle activity (movement) + muscle tone (tension)

  4. the more alert

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ELECTRO-OCULARGRAPHY (EOG)


  1. Used to (DARE):

  2. Varieties of eye movements recorded during sleep studies (3):

  3. Value is in…

  1. used to detect, amplify + record the electrical activity in eye muscles that control eye movements

  2. EYE MOVEMENTS:

    • waking eye movements (WEMs)

    • slow eye movements (SEMs)

    • rapid eye movements (REMs)


  3. value is in clarifying the distinction between the two different types of periods of sleep (NREM / REM)

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SLEEP DIARIES


  1. Definition:

  2. Duration of recording:

  3. Data is collected through:

  4. Considered (subjective / objective):

  5. Examples of recordings (4):

  1. sleep diary: a ‘log’ used in conjunction with physiological measures to support the assessment of sleep disturbances / disorders

  2. usually one week or more

  3. self-monitoring of relevant data

  4. subjective: based on personal feelings / interpretations - often biased data

  5. EXAMPLES:

    • time trying to fall asleep

    • time sleep onset occurred

    • time of awakening in morning

    • how rested on feels

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VIDEO MONITORING


  1. Records:

  2. Location:

  1. externally observable physiological responses throughout a sleep episode (e.g. falling asleep, changes in body position, waking)

  2. can be conducted at home

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REGULATION OF SLEEP-WAKE PATTERNS BY INTERNAL BIOLOGICAL MECHANISMS


  1. Behaviour / how we feel are influenced by:

  2. Biological rhythms are linked to:

  3. Each biological rhythm is maintained / controlled by:

  4. Two types of biological rhythms:

  1. biological rhythms

  2. linked to cyclical changes in environmental cues (sunrise / sunset, day length, amount of light, passing seasons)

  3. a biological clock - genetically determined + occurs at cellular level

  4. BIOLOGICAL RHYTHMS:

    • circadian rhythm

    • ultradian rhythm

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SLEEP-WAKE CYCLE (CIRCADIAN RHYTHM)


  1. Why is the sleep-wake cycle a circadian rhythm?

  2. Sleep-wake cycle linked to:

  3. Exogenous / endogenous?

  4. Influenced by:

  5. Important property:

  6. In a ‘time-free’ environment:

  7. Following re-exposure to time cues:

  1. 24-hour cycle - made up of time spent awake / time spent asleep + involves biological changes that occur over 24-hour period (transitioning from sleep to wakefulness)

  2. SCN

  3. endogenous: internally produced, self-sustaining and persisting in the absence of exogenous cues

  4. environmental time giving cues / stimuli (exogenous) - used to keep in sync with the 24 hour day-night cycle

  5. ability to synchronise with external time cues - if there is a shift / change in external cues = sleep-wake cycle may shift

  6. sleep-wake cycle becomes ‘free-running’ and tends to be pushed forward in time

  7. cycle quickly adjusts to match the 24 hour day-night cycle of the normal environment after being ‘out-of-sync’ after isolation in a time-free environment

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ULTRADIAN RHYTHM


  1. During sleep episodes (within sleep-wake cycle) individuals experience:

  2. How many sleep cycles (average) are there during a typical sleep episode?

  1. sleep cycles: repeated approximate 90 minute periods in which individuals progress through stages of REM and NREM sleep

  2. around 5-6

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SUPRACHIASMATIC NUCLEUS (SCN)


  1. Location:

  2. Position enables:

  3. Receives info from:

  4. Receives info about:

  5. Receives internal feedback on:

  6. Sends neuronal messages to (glands + hormone):

  7. Chain reactions is suppressed when:

  1. above the optic chasm - point where optic nerves connecting eyes / brain cross

  2. enables SCN to respond to light + control production of melatonin

  3. external / internal cues - helping modulate circadian rhythm

  4. amount of incoming light from eyes - adjusts sleep-wake cycle accordingly

  5. level of melatonin in the blood to further regulate output + timing of sleep-wake cycle

  6. pineal gland - stimulating the secretion of more / less melatonin + adrenal gland - stimulating the secretion of more / less cortisol

  7. it is dark (no light detected)

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MELATONIN


  1. Effect:

  2. Released by:

  3. Peaks between:

  4. What conditions is it produced in?

  5. Effect of light:

  6. Amount of melatonin secreted:

  7. Secretion can be impeded by:

  1. induces a sense of calmness + promotes drowsiness (keeps asleep)

  2. pineal gland

  3. 2-4am - before gradually declining over night until wake in morning

  4. dark / dimly light environment

  5. inhibits release (e.g. in morning to increase alertness)

  6. varies with amount of light detected by SCN

  7. artificial lighting

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CORTISOL


  1. Responsible for (sleep-wake):

  2. Released by / when

  1. increasing alertness / maintaining heightened arousal

  2. adrenal glands in morning - promoting wakefulness

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DIFFERENCES IN THE DEMANDS FOR SLEEP ACROSS THE LIFE SPAN


3 main changes in characteristics of sleep:

  1. from birth onwards = duration of sleep decreases

  2. proportion of REM decreases from about 2 years old + remains relatively stable

  3. age related decrease in the time spent in each stage of NREM that persists through old age

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NEONATAL PERIOD (1-15 DAYS) - CHARACTERISTICS OF SLEEP


  1. Duration:

  2. Proportion of REM / NREM sleep:

  1. highest it will ever be (approx. 16 hours)

  2. 50 / 50 split

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INFANCY (3-24 MONTHS) - CHARACTERISTICS OF SLEEP


  1. Duration:

  2. Proportion of REM / NREM sleep:

  1. decreases to approx. 13.5 hours

  2. REM = 35%, NREM = 65%

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CHILDHOOD (2-14 YEARS) - CHARACTERISTICS OF SLEEP


  1. Duration:

  2. Proportion of REM / NREM sleep:

  3. Due to significant period…

  1. decrease to approx. 11 hours

  2. REM = decreases to approx. 20%, NREM = increase to approx. 80%

  3. due to significant period there are slight variations

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ADOLESCENCE (14-18 YEARS) - CHARACTERISTICS OF SLEEP


  1. Duration:

  2. Proportion of REM / NREM sleep:

  3. Sleep onset:

  1. decreases to approx. 9 hours

  2. REM = 20%, NREM = 80% (consistent)

  3. biological delayed sleep onset by 1-2 hours

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YOUNG ADULTHOOD (18-30 YEARS) - CHARACTERISTICS OF SLEEP


  1. Duration:

  2. Proportion of REM / NREM sleep:

  1. decreases to approx. 7.75 hours

  2. REM = 20%, NREM = 80% (consistent)

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MIDDLE ADULTHOOD (30-75 YEARS) - CHARACTERISTICS OF SLEEP


  1. Duration:

  2. Proportion of REM / NREM sleep:

  1. remains at approx. 7-8 hours

  2. REM = 20%, NREM = 80% (consistent)

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OLD AGE (75+ YEARS) - CHARACTERISTICS OF SLEEP


  1. Duration:

  2. Proportion of REM / NREM sleep:

  3. Tend to experience:

  1. decreases to approx. 6 hours

  2. REM = 20%, NREM = 80% (consistent)

  3. advanced sleep phase disorder (ASPD) - biological shift forward in sleep-wake cycle

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SLEEP DISTURBANCE


  1. Short-term / long-term?

  2. When is a sleep disturbance considered a sleep disorder?

  1. short-term

  2. if a sleep disturbance is persistent and regularly disrupts sleep = causing distress / impediment in important areas of everyday life during normal waking hours

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SLEEP DISORDER


  1. Short-term / long-term?

  2. Primary sleep disorder definition:

  3. Secondary sleep disorder definition:

  4. Most are associated with:

  1. long-term

  2. primary sleep disorder: persistent sleep disturbances that cannot be attributed to another condition - occurs in its own right / cannot be explained by another condition

  3. secondary sleep disorder: a sleep disturbance that is a by-product of / results from another condition - secondary to something else (underlying condition)

  4. partial sleep deprivation - occurring routinely over a prolonged period

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SLEEP DEPRIVATION


  1. Involuntary / voluntary?

  2. Types of sleep deprivation (2):

  3. How does sleep debt accumulate?

  4. Functions it effects (3):

  1. both

    • voluntary: occurs when we choose to go without sleep

    • involuntary: when an individual does not choose to go without sleep, but cannot because of other influences (e.g. jobs, working shift work, travelling across time zones)

  2. TYPES:

    • partial sleep deprivation: individual sleeps some duration within a 24 hour period (but too short / quality poor) - may occur periodically / persistently over the short-term / long-term

    • total / full sleep deprivation: individual does not sleep at all within a 24 hour period / longer


  3. amount of sleep needed to function at an optimal level - amount of sleep a person actually gets = sleep debt (does not grow to an amount that must be entirely repaid)


  4. EFFECTS:

    • affective effects (emotions)

    • behavioural effects (behaviours)

    • cognitive effects (thinking)

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AFFECTIVE FUNCTIONING


  1. Definition:

  2. More likely to be effected when lacking what kind of sleep?

  3. Examples of effects (9):

  1. affective functioning: describes the experience, regulation and expression of emotions

  2. REM sleep

  3. AFFECTIVE EFFECTS:

    • poor emotional regulation = amplified emotional responses that are out of proportion (exaggerated) compared to normal

    • irritability and moodiness

    • increase in negative emotions

    • reduced ability to cope with stress

    • difficulty judging other people’s emotions

    • reduced empathy towards others

    • impaired ability to appropriately respond to situations - might overreact to minor things / experience emotional outbursts

    • increase in aggression and impatience

    • increase in mood swings

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BEHAVIOURAL EFFECTS


  1. Definition:

  2. Examples of effects (9):

  1. behavioural effects: are changes in observable behaviour

  2. BEHAVIOURAL EFFECTS:

    • sleep inertia (sense of disorientation after waking)

    • excessive sleepiness during the day

    • increased likelihood of engaging in risk-taking behaviours

    • fatigue / lack of energy

    • slowed reaction time

    • reduced efficiency - more time to do tasks

    • reduced motor control + heightened clumsiness

    • involuntary lapses into micro sleeps - not linked to melatonin + light sleep (lacking REM sleep)

    • diminished social functioning + impaired control of behaviour

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COGNITIVE EFFECTS


  1. Definition:

  2. Examples of effects (9):

  1. cognitive effects: changes in mental processes

  2. COGNITIVE EFFECTS:

    • reduced concentration

    • impaired short-term memory - diminishes ability to actively process / mentally manipulate info (smaller capacity)

    • diminished ability to perform cognitive tasks - more monotonous tasks = more likely to make mistakes when sleep deprived

    • impaired decision making processes / problem-solving abilities

    • diminished creativity + ability to use abstract thought

    • reduced retention of info - impaired learning and memory processes

    • irrational / illogical thinking

    • more time spent analysing situations / greater likelihood of over looking important details

    • impaired visual / spatial ability

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SLEEP DEPRIVATION V BAC


  1. Significant relationship between:

  2. Effect of alcohol on functioning:

  3. BAC 0.05% =

  4. BAC 0.10% =

  5. Affective effects:

  6. Cognitive effects:

  1. relationship between fatigue due to a moderate level of sleep deprivation, legal levels of alcohol consumption + impaired performance

  2. alcohol is a depressant = slows down nervous system + decreases alertness, concentration, reflexes, decision-making

  3. BAC 0.05% = 17 hours of sleep deprivation (partial sleep deprivation)

  4. BAC 0.10% = 24 hours of sleep deprivation (full sleep deprivation)

  5. affective: sleep deprivation = more moody, irritable, sensitive (negative) - alcohol consumption = happy, excited, angry, sad (greater variability)

  6. COGNITIVE (BOTH SIMILAR):

    • slower mental processes (e.g. reduced speed in processing / understanding info)

    • decreased ability to reason / problem solve

    • greater difficulty making sense of the world

    • reduced ability to make decisions quickly / effectively

    • cognitive disorders

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CIRCADIAN RHYTHM SLEEP DISORDERS


  1. Under normal conditions, there is alignment between:

  2. Involves a problem with:

  3. May be caused by (3):

  4. Types of circadian rhythm sleep disorders (3):

  1. our internally programmed circadian sleep-wake cycle + the sleep-wake schedule we maintain

  2. the timing of sleep / wake states (cannot sleep when desired / needed / expected)


  3. CAUSED BY:

    • naturally occurring change / malfunction of biological mechanisms or processes (SCN / melatonin) regulating sleep-wake cycle

    • mismatch between sleep-wake cycle + day-night cycle of the physical environment

    • mismatch between individuals sleep-wake cycle + sleep-wake cycle required by school / work / sleep schedule


  4. CIRCADIAN RHYTHM SLEEP DISORDERS:

    • delayed sleep phase syndrome (DSPS)

    • advanced sleep phase disorder (ASPD)

    • shift work disorder

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DELAYED SLEEP PHASE SYNDROME (DSPS)


  1. Involves:

  2. Caused by (cues):

  3. Sleep onset is delayed by:

  4. Symptoms involve:

  5. When sleep allowed, quality / quantity is:

  6. Main problem of persistent DSPS:

  7. When does it tend to emerge / worsen?

  8. Effect of treatment:

  1. major sleep episode delayed in relation to desired sleep time or ‘conventional’ time (consistent)

  2. internal cues = natural tendency to sleep later / wake up later

  3. 3-4 + hours

  4. insomnia (“sleep onset insomnia”), excessive sleepiness, difficulty awakening at desired time

  5. normal for age + same cycles of REM / NREM

  6. sleep pattern desynchronises with day-night cycle / environmental time cues = mismatch between social requirements (school / work) therefore requiring waking up earlier than would otherwise occur naturally

  7. adolescence - continuing into early adulthood before normalising again in early adulthood

  8. resistant to many treatment methods

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ADVANCED SLEEP PHASE DISORDER (ASPD)


  1. Involves:

  2. Caused by (cues):

  3. Proposed reasoning for disorder:

  4. Timing of sleep episode is:

  5. Symptoms involve:

  6. When sleep allowed, quality / quantity is:

  7. Unlike DSPS individuals with ASPD have less…

  8. Effect of treatment:

  1. advancement of the major sleep episode to earlier time compared to desired / conventional sleep time

  2. internal cues

  3. may be due to age-related deterioration in biological clock (SCN) = reduction in melatonin production evident in older people / shift in melatonin to 2-4 hours earlier than normal

  4. advanced = occurs earlier

  5. persistent sleep deprivation, daytime sleepiness

  6. normal for age

  7. individuals with ASPD have less difficulty maintaining social requirements - societal norms fit more easily into sleep-wake schedules

  8. more receptive to treatment

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SHIFT WORK DISORDER


  1. Caused by (cues):

  2. Work shifts overlap with:

  3. Circadian rhythm is:

  4. Symptoms involve:

  5. When sleep allowed, quality / quantity is:

  6. Problem of shift work disorder during night:

  1. external cues: work shifts being regularly scheduled during the usual sleep period

  2. all / part of the sleep period = requiring readjustment of sleep / wake times to work times

  3. constantly shifting / adapting to environment

  4. insomnia when trying to sleep + excessive sleepiness when needing to be awake / alert

  5. poor: night shift workers report sleeping less than desired during the day (fragmented sleep), while social norms / environment continues to work at normal cycle

  6. excessive sleepiness = safety consequences on the job

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BRIGHT LIGHT THERAPY (BLT)


  1. Aim to:

  2. Light may be:

  3. Most commonly used device:

  4. 3 important variables:

  1. re-set the biological clock (SCN) + realign with desired / required sleep-wake cycle

  2. artificial / sunlight

  3. light box: self-administered, brighter than indoor lights but not sunlight, required number of session across days until body adjusts to new times

  4. 3 VARIABLES:

    • appropriate timing of exposure sessions: according to characteristics of disorder

    • intensity of light: should build gradually to avoid negative side effects

    • safe exposure / amount of time: should not look directly into light + adequate distance away

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BLT TO TREAT CIRCADIAN RHYTHM SLEEP DISORDERS


  1. Delayed Sleep Phase Syndrome (DSPS):

  2. Advanced Sleep Phase Disorder (ASPD):

  3. Shift Work Sleep Disorder:

  1. DSPS: exposure to bright light source in morning at an appropriate waking time = promoting wakefulness by externally cueing SCN to send signals for release of cortisol + melatonin release at earlier / more appropriate sleeping time

  2. ASPD: exposure to bright light source in evening when feeling sleepy = externally cueing SCN to release cortisol / promote wakefulness + signal melatonin release at later / more appropriate sleeping time, promoting sleepiness

  3. shift work sleep disorder: depends on timing of work = best timing of exposure before beginning of work shift to promote wakefulness when required to be awake / alert (promotes sleepiness later when not required to work)

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50

SLEEP HYGIENE (IMPROVING SLEEP)


  1. ‘Hygiene’ used interchangeably with:

  2. Highly effective practices in treatment of sleep disorders / establishing regular sleep-wake patterns:

  1. sleep ‘habits

  2. PRACTICES:

    • time: sleep / wake at time enabling adequate amount of sleep + consistency

    • sound: quiet space

    • light: dark space + reducing exposure to bright light close to sleep time

    • comfort

    • technology / devices: avoiding bright screen use close to sleep time

    • association with bed: avoid activities other than sleep in bed

    • food / drink consumption: avoid large meals / caffeine / alcohol before sleep time

    • exercise: exercise earlier in day not close to sleep time

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51

ADAPTATIONS TO ZEITGEBERS (IMPROVING SLEEP)


  1. Zeitgebers in external environment are used by:

  2. When using zeitgebers to change sleep schedule, adjustments are best made:

  1. used by SCN to adjust circadian rhythms to a 24-hour day

  2. gradually increasing / over time / max. difference of 1-2 hours per night (body allowed time to adjust to circadian rhythm / more sustainable)

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52

LIGHT (ZEITGEBER)


  1. Daylight:

  2. Artificial blue light:

  3. Exposure to artificial blue light through electronic devices:

  1. predominantly natural blue light - regulating SCN to cease melatonin production / promote wakefulness

  2. acts as an external cue similar to daylight - promoting wakefulness

  3. reduces / delays natural production of melatonin / decreases feelings of sleepiness

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53

TEMPERATURE (ZEITGEBER)


  1. Link between:

  2. Ideal room temperature for sleep:

  3. Extreme temperatures (very high / very low):

  1. cool room temperature + experiencing improved quantity / quality of sleep

  2. 18.3 degrees celsius

  3. result in poor sleep quantity / quality

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54

EATING / DRINKING PATTERNS (ZEITGEBER)


  1. How do eating / drinking patterns impact sleep? (3)

  2. Impact of Caffeine:

  3. Impact of Alcohol:

  4. Impact of High-sugar + High-fat Foods:

  5. Impact of Spicy foods:

  1. IMPACTS:

    • what we eat / drink

    • when we eat / drink (stimulation of digestion system)

    • how much we eat / drink


  2. caffeine: promotes wakefulness - stimulant increasing activity of NS + blocks sleep-promoting neurotransmitters

  3. alcohol: promotes drowsiness - depressant making it easier to fall asleep (but negatively impacts second half of sleep episode, where sleep disturbances are more likely to occur)

  4. hs / hf food: promotes wakefulness - body expends more energy to digest

  5. spicy food: promotes wakefulness - increasing body temperature + stimulating metabolic processes

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