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SLEEP physiology

by Abeer El-Emam ass. Prof. Physiology

EEG
Its a simple ,painless neurological procedure in which the brains electrical activity is recorded as wave patterns and printed on paper or recorded in a computer .

Brain cells communicate with each other by producing tiny electrical impulses. In an EEG, this faint electrical activity is measured by putting electrodes on the scalp.
There are 4 types of EEG waves:

Types

Frequency (Hz)

Location

Appears

Alpha (Bergers wave).

8 13 Higher in amplitude of about 50uV

The parietooccipital region .

Relaxed persons with closing the eyes .

Beta

12 30 Lower in amplitude

On both sides Alert or working ,but most evident state. frontally . Active, busy or anxious thinking and active concentration.

Type

Frequency (Hz)

location

Appears

Delta

1-3/sec Its the slowest wave with a high amplitude.

Frontally in adults Posteriorly in children

In adults : in very deep sleep. In infancy.

Theta

47

Found in parietal Normal in and occipital regions children Deep relaxation

THE AROUSAL OR ALERTING RESPONSE

This is an EEG response that occurs when the subject becomes alert (e.g. on opening his eyes or when solving a problem). The synchronized alpha rhythm is replaced by rapid irregular low-voltage beta waves It represents breaking up of the synchronized neuronal alpha activity, so it is also called alpha block or desynchronization.

oHow the test is performed :-

SLEEP
Sleep is a state of physiological loss of consciousness from which a subject can be aroused by an appropriate stimuli.

sleep

slow-wave sleep
NREM

rapid eye movement sleep


REM

Non-REM SLEEP
* Characters of NREM sleep: - Breathing is slow -Blood pressure falls - decrease in basal metabolic rate -Little or no body movement -Decrease in heart rate -Decrease in the peripheral vascular tone -dreams do occur but they are not consolidated in the memory, therefore not remembered.

CLASSIFICATION
- NREM sleep has traditionally been considered to be divided into 4 stages depending on EEG pattern
- During wakefulness with closed eyes and relaxed mind the alpha waves of EEG appear. Passage from wakefulness to non-REM sleep is characterized by progressively slower frequencies and higher voltage activities in the EEG.

Stage I: Theta waves start to appear Stage II: This is characterized by sleep spindles superimposed on the theta waves. Stage III: EEG starts to show slower delta waves Stage IV: stage of deep sleep, delta waves become more prominent with low frequency and high amplitude.(If the sleeper is a sleepwalker this activity will begin in this phase, Bodily functions decline to the deepest possible state of physical rest

Rapid eye movement sleep REM sleep is a type of sleep in which the brain is quite active. However, the brain activity is not channeled in the proper direction for the person to be fully aware of his or her surroundings, and therefore the person is truly asleep. This type occurs in episodes of 5-30 minutes, which recur about every 90 minutes

Muscle tone throughout the body is exceedingly depressed, indicating strong inhibition of the spinal muscle control areas by cluster of perilocus cerulous neurons. Despite the extreme inhibition of the peripheral muscles, irregular muscle movements do occur.

Heart rate and respiratory rate usually become irregular, which is characteristic of the dream state.

There is a reduction in homeostatic mechanisms such as decrease in response of respiratory system to changes in blood CO2.

It is usually associated with active dreaming that is later remembered

The eyes show rapid eye movements and EEG shows activity similar to the waking state (beta waves with block of slow waves).

The brain is highly active in REM sleep, and overall brain metabolism may be increased as much as 20 per cent.

The person is even more difficult to arouse by sensory stimuli than during deep slow-wave sleep, and yet people usually awaken spontaneously in the morning during an episode of REM sleep.

This type of sleep is often known as "paradoxical sleep" because it is a paradox that a person can still be asleep despite the marked activity in the brain.

In a normal night of sleep, bouts of REM sleep lasting5 to 30 minutes usually appear on the average every90 minutes.

accounts for 20%25% of total sleep time in most human adults.

Sleep Cycle

the sleep cycle consists of one episode of NREM followed by REM sleep this cycle is repeated 4-6 times every night

8 hours of sleep = 4 Cycles.

Mechanism of sleep
Brain centers that initiate and control sleep wake cycles are mainly located in the brain stem and hypothalamic areas. The most important of these areas are

I. Arousal centers

Part of the RAS and descending pathwasy from cerebral cortex (midbrain reticular formation)- posterior hypothalamus- (mediated by histaminergic neurons), therefore, blockage of histaminergic outputs with antihistaminic drugs promotes sleep.

II. Sleep promoting centers Ventrolateral preoptic nucleus in anterior hypothalamus (VLPO) and Adjecent basal forebrain, these areas become active during sleep and use inhibitory neurotransmitters GABA and galanin to inhibit arousal centers

Slow wave sleep

Several centers contributs to non-REM sleep

- Raphe nucleus in pons and medulla (secret serotonin at their ending) - Meduallary synchronzing zone in reticular formation of the medulla at the level of nuclus of tractus solitarius

- anterior hypothalamus and Adjecent basal forebrain,

Raphe nucleus in pons and medulla These nuclei are a thin sheet of special neurons located in the midline. Nerve fibers from these nuclei spread locally in the brain stem reticular formation and also upward into the thalamus, hypothalamus, most areas of the limbic system, and even the neocortex of the cerebrum. In addition, fibers extend downward into the spinal cord, terminating in the posterior horns where they can inhibit incoming sensory signals, including pain, It is also known that many nerve endings of fibers from these raphe neurons secrete serotonin. When a drug that blocks the formation of serotonin is administered to an animal, the animal often cannot sleep for the next several days. Therefore, it has been assumed that serotonin is a transmitter substance associated with production of sleep.

Genesis of REM sleep


The mechanism that trigger REM sleep is is located in: - Noradrenergic neurons from locus cerulous and serotonergic raphe neurons
as well as histaminergic neurons in the posterior hypothalmus; inhibit REM on cholinergic cells and stop REM sleep.
- cholinergic neurons from pontine reticular formation have extensive upward projection activate many areas of the brain. However, this activation is channeled through different pathways from those used by RAS for activation of the brain during wakefulness.

Circadian rhythm
The suprachiasmatic nucleus (SCN) of the hypothalamus sends impulses to ventrolateral preoptic area (VLPO) of hypothalamus and provides the transition between sleep and wakefulness

Compounds affecting NREM & REM sleep Adenosine; act to promote sleep, as suggested by the stimulant action of caffeine which blocks adenosine receptors

Serotonin; can cause suppression of REM sleep


Orexin; is a neuropeptide in the anterolateral hypothalamus it stimulates wakefulness centers and its deficiency causes narcolepsy Acetyl choline; Acetylcholine is released from nerve terminals in the thalamus and cortex in highest concentrations in association with cortical activation that occurs naturally during wakefulness and REM sleep Melatonin; is a naturally occurring hormone that regulates sleepiness. Melatonin can decrease sleep latency (time between laying down and onset of sleep)