U4 AOS1 - Revision

CONSCIOUSNESS

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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

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

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

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

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5. TWO STATES OF CONSCIOUSNESS:

   • normal waking consciousness (NWC)

   • altered states of consciousness (ASC)

NORMAL WAKING CONSCIOUSNESS (NWC)

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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

ALTERED STATES OF CONSCIOUSNESS (ASC)

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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

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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

SLEEP AS A PSYCHOLOGICAL CONSTRUCT

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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

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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

HYPNOGRAM

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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

NON-REM SLEEP

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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

NON-REM STAGE 1 (N1)

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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

NON-REM STAGE 2 (N2)

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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

NON-REM STAGE 3 (N3)

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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

REM SLEEP

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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

NREM V REM DREAMS

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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

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2. REM DREAMS:

   • narrative structure

   • can consist of storylines

   • consist of more abstract shapes / colours etc.

MEASUREMENTS OF PHYSIOLOGICAL RESPONSES TO SLEEP

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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)

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4. SUBJECTIVE:

   • sleep diaries

   • video monitoring

ELECTROENCEPHALOGRAPHY (EEG)

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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

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4. DIFFERENCE IN AMPLITUDE:

   • high amplitude brain waves = bigger peaks / troughs

   • low amplitude brain waves = smaller peaks / troughs

BRAIN WAVES

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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

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

BETA BRAIN WAVE PATTERN

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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

ALPHA BRAIN WAVE PATTERN

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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)

THETA BRAIN WAVE PATTERN

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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

DELTA BRAIN WAVE PATTERN

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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

ELECTROMYOGRAPHY (EMG)

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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

ELECTRO-OCULARGRAPHY (EOG)

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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)

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

SLEEP DIARIES

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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

VIDEO MONITORING

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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

REGULATION OF SLEEP-WAKE PATTERNS BY INTERNAL BIOLOGICAL MECHANISMS

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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

SLEEP-WAKE CYCLE (CIRCADIAN RHYTHM)

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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

ULTRADIAN RHYTHM

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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

SUPRACHIASMATIC NUCLEUS (SCN)

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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)

MELATONIN

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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

CORTISOL

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1. Responsible for (sleep-wake):

2. Released by / when

1. increasing alertness / maintaining heightened arousal

2. adrenal glands in morning - promoting wakefulness

DIFFERENCES IN THE DEMANDS FOR SLEEP ACROSS THE LIFE SPAN

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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

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

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1. Duration:

2. Proportion of REM / NREM sleep:

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

2. 50 / 50 split

INFANCY (3-24 MONTHS) - CHARACTERISTICS OF SLEEP

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1. Duration:

2. Proportion of REM / NREM sleep:

1. decreases to approx. 13.5 hours

2. REM = 35%, NREM = 65%

CHILDHOOD (2-14 YEARS) - CHARACTERISTICS OF SLEEP

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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

ADOLESCENCE (14-18 YEARS) - CHARACTERISTICS OF SLEEP

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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

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

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1. Duration:

2. Proportion of REM / NREM sleep:

1. decreases to approx. 7.75 hours

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

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

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1. Duration:

2. Proportion of REM / NREM sleep:

1. remains at approx. 7-8 hours

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

OLD AGE (75+ YEARS) - CHARACTERISTICS OF SLEEP

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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

SLEEP DISTURBANCE

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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

SLEEP DISORDER

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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

SLEEP DEPRIVATION

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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

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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)

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4. EFFECTS:

   • affective effects (emotions)

   • behavioural effects (behaviours)

   • cognitive effects (thinking)

AFFECTIVE FUNCTIONING

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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

BEHAVIOURAL EFFECTS

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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

COGNITIVE EFFECTS

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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

SLEEP DEPRIVATION V BAC

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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

CIRCADIAN RHYTHM SLEEP DISORDERS

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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)

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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

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4. CIRCADIAN RHYTHM SLEEP DISORDERS:

   • delayed sleep phase syndrome (DSPS)

   • advanced sleep phase disorder (ASPD)

   • shift work disorder

DELAYED SLEEP PHASE SYNDROME (DSPS)

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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

ADVANCED SLEEP PHASE DISORDER (ASPD)

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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

SHIFT WORK DISORDER

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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

BRIGHT LIGHT THERAPY (BLT)

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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

BLT TO TREAT CIRCADIAN RHYTHM SLEEP DISORDERS

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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)

SLEEP HYGIENE (IMPROVING SLEEP)

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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

ADAPTATIONS TO ZEITGEBERS (IMPROVING SLEEP)

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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)

LIGHT (ZEITGEBER)

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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

TEMPERATURE (ZEITGEBER)

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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

EATING / DRINKING PATTERNS (ZEITGEBER)

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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

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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