This feeling of a depressed mood is also accompanied by two or more additional symptoms, to include changes in appetite, insomnia or hypersomnia, low energy or fatigue, low self-esteem, feelings of hopelessness, and poor concentration or difficulty with decision making. Physiologically, the body can become addicted to opiate drugs in less than a week, including when taken as prescribed. The sleep and dreaming researcher Rosalind Cartwright, however, believes that dreams simply reflect life events that are important to the dreamer. Users experience increased energy, feelings of pleasure, and emotional warmth. One way that this happens involves traveling across multiple time zones. Common definitions of health include: a. optimal weight and endurance. Delusions. Our experiences change dramatically while we are in deep sleep and once again when we are dreaming. Night terrors apparently occur during the NREM phase of sleep (Provini, Tinuper, Bisulli, & Lagaresi, 2011). THE INTERNAL STATE SCALE (ISS) Version 2 and the ChronoBook SCORING KEY AND SUMMARY Mark S. Bauer, MD . Consider a patient who believed that as a result of his sleep apnea he had three car accidents in six weeks. By the end of this section, you will be able to: Consciousnessdescribes our awareness of internal and external stimuli. While sleep apnea is less common in thin people, anyone, regardless of their weight, who snores loudly or gasps for air while sleeping, should be checked for sleep apnea. As the dose increases, people report feeling sedated. Normal brain functioning is altered after repeated use of these drugs. Given that withdrawal from a drug often involves an experience opposite to the effect of the drug, it should be no surprise that opioid withdrawal resembles a severe case of the flu. Sleep reboundrefers to the fact that a sleep-deprived individual will fall asleep more quickly during subsequent opportunities for sleep. Other drugs, including the opioid buprenorphine, have also been used to alleviate symptoms of opiate withdrawal. This is illustrated by McCartys (2010) case study of a 50-year-old woman who sought help for the excessive sleepiness during normal waking hours that she had experienced for several years. It seems like everyone knows a friend, family member, or neighbor who has died of an overdose. The pituitary gland also secretes growth hormone, during sleep, which plays a role in physical growth and maturation as well as other metabolic processes (Bartke, Sun, & Longo, 2013). Sleep is characterized by certain patterns of activity of the brain that can be visualized using electroencephalography (EEG), and different phases of sleep can be differentiated using EEG as well. Marijuana, LSD, Peyote, mescaline, DMT, dissociative anesthetics including ketamine and PCP, Increased heart rate and blood pressure that may dissipate over time, Mild to intense perceptual changes with high variability in effects based on strain, method of ingestion, and individual differences, Understand what is meant by consciousness, Explain how circadian rhythms are involved in regulating the sleep-wake cycle, and how circadian cycles can be disrupted, Describe areas of the brain involved in sleep, Understand hormone secretions associated with sleep, Describe several theories aimed at explaining the function of sleep, Differentiate between REM and non-REM sleep, Describe the differences between the three stages of non-REM sleep, Understand the role that REM and non-REM sleep play in learning and memory, Describe the symptoms and treatments of insomnia, Recognize the symptoms of several parasomnias, Describe the symptoms and treatments for sleep apnea, Recognize risk factors associated with sudden infant death syndrome (SIDS) and steps to prevent it, Describe the symptoms and treatments for narcolepsy. While "internal state" or impulsivity are terms more generally discussed in psychology or neuroscience, the concept is familiar to anyone. During periods of sleepwalking, sleepers often have their eyes open, but they are not responsive to attempts to communicate with them. As scary as it sounds, many sleep researchers believe that homicidal sleepwalking is possible in individuals suffering from the types of sleep disorders described below (Broughton et al., 1994; Cartwright, 2004; Mahowald, Schenck, & Cramer Bornemann, 2005; Pressman, 2007). This treatment option has proven to be effective for people suffering from mild to severe cases of sleep apnea (McDaid et al., 2009). Stage 2 sleep is characterized by the appearance of both sleep spindles and K-complexes. Generally, treatment for night terrors is unnecessary unless there is some underlying medical or psychological condition that is contributing to the night terrors (Mayo Clinic, n.d.). Surprisingly, narcoleptic episodes are often triggered by states of heightened arousal or stress. Sleepis a state marked by relatively low levels of physical activity and reduced sensory awareness that is distinct from periods of rest that occur during wakefulness. Neurogenic shock is caused by damage to the central nervous system, usually a spinal cord injury. In addition, stage 1 sleep involves a marked decrease in both overall muscle tension and core body temperature. Because GABA has a quieting effect on the brain, GABA agonists also have a quieting effect; these types of drugs are often prescribed to treat both anxiety and insomnia. Therefore, it is quite likely that new medications that are developed to treat narcolepsy will be designed to target the hypocretin system. Once awakened from a narcoleptic attack, people report that they feel refreshed (Chokroverty, 2010). Natural opioids, calledopiates, are derivatives of opium, which is a naturally occurring compound found in the poppy plant. These symptoms include fatigue, sluggishness, irritability, andinsomnia(i.e., a consistent difficulty in falling or staying asleep for at least three nights a week over a months time) (Roth, 2007). We experience different states of consciousness and different levels of awareness on a regular basis. While awake, we feel alert and aware of the many important things going on around us. This disorder is associated with a number of neurodegenerative diseases such as Parkinsons disease. Therefore, it is important to make a distinction between hypnosis as an empirically based therapeutic approach versus as a form of entertainment. AK-complexis a very high amplitude pattern of brain activity that may in some cases occur in response to environmental stimuli. Humans have an endogenous opioid neurotransmitter systemthe body makes small quantities of opioid compounds that bind to opioid receptors reducing pain and producing euphoria. In 2013, the U.S. Food and Drug Administration recommended tighter controls on their medical use. The early portion of stage 1 sleep producesalpha waves, which are relatively low frequency (813Hz), high amplitude patterns of electrical activity (waves) that become synchronized (Figure 4.8). In the therapeutic setting, a clinician may use relaxation and suggestion in an attempt to alter the thoughts and perceptions of a patient. Cognitive-behavioral therapyis a type of psychotherapy that focuses on cognitive processes and problem behaviors. Individuals who do rotating shift work are also likely to experience disruptions in circadian cycles. Two sleeping children are depicted in this 1895 oil painting titled. Moreover, these impairments become more severe as the amount of sleep deprivation increases (Alhola & Polo-Kantola, 2007). This becomes a self-perpetuating cycle because increased anxiety leads to increased arousal, and higher levels of arousal make the prospect of falling asleep even more unlikely. (credit: modification of work by new 1lluminati/Flickr), Medical marijuana shops are becoming more and more common in the United States. For example, withdrawal from sedative drugs often produces unpleasant arousal and agitation. Thus, K-complexes might serve as a bridge to higher levels of arousal in response to what is going on in our environments (Halsz, 1993; Steriade & Amzica, 1998). Gastrointestinal symptoms including abdominal pain, diarrhea, and vomiting. . Jet lag is a collection of symptoms that results from the mismatch between our internal circadian cycles and our environment. . Some forms of psychotherapy, such as cognitive-behavioral therapy, can help sufferers of insomnia. This final section will consider hypnotic and meditative states as additional examples of altered states of consciousness experienced by some individuals. While hypnosis may be useful in enhancing memory or a skill, such enhancements are very modest in nature (Raz, 2011). The internal state of an object is the set of all its attributes' values. They were ALL my fault. Historically, somnambulism has been treated with a variety of pharmacotherapies ranging from benzodiazepines to antidepressants. In 2015, the National Sleep Foundation updated their sleep duration hours, to better accommodate individual differences. Increased alertness, mild euphoria, decreased appetite in low doses. MDMA (3.4-methelynedioxy-methamphetamine, commonly known as ecstasy or Molly) is a mild stimulant with perception-altering effects. (a) A typical CPAP device used in the treatment of sleep apnea is (b) affixed to the head with straps, and a mask that covers the nose and mouth. If someone stays awake for 48 consecutive hours, they could start to hallucinate. Module 4: Mood Disorders - Washington State University Ebola virus disease - World Health Organization For one, research suggests that infants should be placed on their backs when put down to sleep, and their cribs should not contain any items which pose suffocation threats, such as blankets, pillows or padded crib bumpers (cushions that cover the bars of a crib). As he went to investigate what was going on, he was met by a group of police officers who arrested him for the murder of his wife (Cartwright, 2004; CNN, 1999). In the brain, the hypothalamus, which lies above the pituitary gland, is a main center of homeostasis. (2005) found that sleepwalking was not alleviated with the use of benzodiazepines. Instead, sleep is composed of several different stages that can be differentiated from one another by the patterns of brain wave activity that occur during each stage. Repeated use of these stimulants can have significant adverse consequences. Taking a different approach to explain hypnosis, the social-cognitive theory of hypnosis sees people in hypnotic states as performing the social role of a hypnotized person. You have read that the pineal gland releases melatonin during sleep (Figure 4.6). Heroin users often shoot the drug directly into their veins. 3. Users often consume the drug every few hours across days-long binges called runs, in which the user forgoes food and sleep. To keep heroin affordable, many dealers began adding more potent synthetic opioids including fentanyl and carfentanyl to increase the effects of heroin. Peritonitis - Symptoms and causes - Mayo Clinic This can lead to people compulsively using stimulants such as cocaine and amphetamines, in part to try to reestablish the persons physical and psychological pre-use baseline. The brain waves associated with REM sleep, outlined in the red box in (a), look very similar to those seen (b) during wakefulness. Not surprisingly, insomnia treatment may take one of several different approaches. Biological rhythmsare internal rhythms of biological activity. Brainwave activity changes dramatically across the different stages of sleep. Identifying Internal States of the Brain | Technology Networks c. are influenced by peer pressure, often leading to unhealthful or unsafe behaviors. It may seem counterintuitive that stimulant medications are prescribed to treat a disorder that involves hyperactivity, but the therapeutic effect comes from increases in neurotransmitter activity within certain areas of the brain associated with impulse control. These changes in brain wave activity can be visualized using EEG and are distinguished from one another by both the frequency and amplitude of brain waves (Figure 4.7). Furthermore, these types of behaviors ultimately disrupt sleep, although affected individuals have no memories that these behaviors have occurred (Arnulf, 2012). Remarkably, Falater insisted that he had no recollection of hurting his wife in any way. In this section, we will discuss each of these stages of sleep and their associated patterns of brain wave activity. Our lives involve regular, dramatic changes in the degree to which we are aware of our surroundings and our internal states. Meditative techniques have their roots in religious practices (Figure 4.21), but their use has grown in popularity among practitioners of alternative medicine. This pattern of temperature fluctuation, which repeats every day, is one example of a circadian rhythm. Whilecaffeineis generally considered a relatively safe drug, high blood levels of caffeine can result in insomnia, agitation, muscle twitching, nausea, irregular heartbeat, and even death (Reissig, Strain, & Griffiths, 2009; Wolt, Ganetsky, & Babu, 2012). Perhaps our ancestors spent extended periods of time asleep to reduce attention to themselves from potential predators. Clonazepam, an anti-anxiety medication with sedative properties, is most often used to treat RBD. Wakefulnessis characterized by high levels of sensory awareness, thought, and behavior. Meditationis the act of focusing on a single target (such as the breath or a repeated sound) to increase awareness of the moment. Hypnosis has also been used to draw out information believed to be buried deeply in someones memory. Generally, people use caffeine to maintain increased levels of alertness and arousal. A few such benefits listed by the National Sleep Foundation (n.d.) include maintaining healthy weight, lowering stress levels, improving mood, and increasing motor coordination, as well as a number of benefits related to cognition and memory formation. This chapter will discuss states of consciousness with a particular emphasis on sleep. The clock sets itself with light information received through projections from the retina. Another evolutionary hypothesis of sleep holds that our sleep patterns evolved as an adaptive response to predatory risks, which increase in darkness. There was a significant positive correlation between the degree to which women thought about their former spouses during waking hours and the number of times their former spouses appeared as characters in their dreams (Cartwright, Agargun, Kirkby, & Friedman, 2006). Weakness and fatigue. Abnormal Motor Behavior. It was getting to the point where it was kind of scary (Henry & Rosenthal, 2013, p. 52). 2. Elements that are known to make PTSD more likely are the following: Perceived life threat Personal injury Interpersonal violence, particularly perpetrated by a caregiver Past and present vulnerability, including genetics, childhood trauma, insufficient emotional support, concurrent causes of stress Example: Childhood abuse and rape Incentral sleep apnea, disruption in signals sent from the brain that regulate breathing cause periods of interrupted breathing (White, 2005). Psychometric analysis indicates that the ISS is composed of four principle components, producing four subscales. Aside from their utility as analgesic drugs, opioid-like compounds are often found in cough suppressants, anti-nausea, and anti-diarrhea medications. Like many other stimulants, cocaine agonizes the dopamine neurotransmitter system by blocking the reuptake of dopamine in the neuronal synapse. Those who continue to have insomnia, particularly if it affects their quality of life, should seek professional treatment. While medical marijuana laws have been passed on a state-by-state basis, federal laws still classify this as an illicit substance, making conducting research on the potentially beneficial medicinal uses of marijuana problematic. This chart illustrates the circadian change in body temperature over 28 hours in a group of eight young men. . Many of these drugs act as agonists of the dopamine neurotransmitter system. It is relatively easy to wake someone from stage 1 sleep; in fact, people often report that they have not been asleep if they are awoken during stage 1 sleep. For example, Hobson (2009) suggests that dreaming may represent a state of protoconsciousness. This is known as the REM rebound, and it suggests that REM sleep is also homeostatically regulated. Rather, the ISS r ecognizes mixed states and depressive symptoms during manic and hypomanic episodes. Acetylcholine functions as a neurotransmitter in motor neurons. In addition to withdrawal, many individuals who are diagnosed with substance use disorders will also develop tolerance to these substances. Many of these processes, like much of psychological behavior, are rooted in our biology. In addition, if a pregnant woman consumes alcohol, her infant may be born with a cluster of birth defects and symptoms collectively called fetal alcohol spectrum disorder (FASD) or fetal alcohol syndrome (FAS). Avoid anything stimulating for an hour before bed. Some circadian rhythms play a role in changes in our state of consciousness. Caffeine is an adenosine antagonist, so caffeine inhibits the adenosine receptors, thus decreasing sleepiness and promoting wakefulness. Some of these approaches, such as using a bright light as shown inFigure 4.4, have been shown to alleviate some of the problems experienced by individuals suffering from jet lag or from the consequences of rotating shift work. Typically, individuals suffering from night terrors will fall back asleep again within a short time. c. deaths due to accidents have increased. Acircadian rhythmis a biological rhythm that takes place over a period of about 24 hours. Thus, opioid drugs, which mimic this endogenous painkilling mechanism, have an extremely high potential for abuse. One complete menstrual cycle takes about 28 daysa lunar monthbut many biological cycles are much shorter. Methamphetamine in its smokable form, often called crystal meth due to its resemblance to rock crystal formations, is highly addictive. In fact, ameta-analysis, which is a study that combines the results of many related studies, conducted within the last decade indicates that by the time we are 65 years old, we average fewer than 7 hours of sleep per day (Ohayon, Carskadon, Guilleminault, & Vitiello, 2004). Heroin can be snorted, smoked, or injected intravenously. In the central nervous system, it plays a role in arousal and reward mechanisms. Withdrawal from opioids includes pain, which patients often misinterpret as pain caused by the problem that led to the original prescription, and which motivates patients to continue using the drugs. Ahallucinogenis one of a class of drugs that results in profound alterations in sensory and perceptual experiences (Figure 4.18). Alan Hobson, a neuroscientist, is credited for developing activation-synthesis theory of dreaming. Generally, and for most people, our circadian cycles are aligned with the outside world. These include daydreaming, intoxication, and unconsciousness due to anesthesia. It is not uncommon for people suffering from insomnia to experience increased levels of anxiety about their inability to fall asleep. Case fatality rates have varied from 25% to 90 . As a result, many of us sleep less than 78 hours a night and accrue a sleep debt. As part of treatment, the sleeping environment is often modified to make it a safer place for those suffering from RBD (Zangini, Calandra-Buonaura, Grimaldi, & Cortelli, 2011). Ethanol, which we commonly refer to as alcohol, is in a class of psychoactive drugs known as depressants (Figure 4.15). The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission. Here are some tips to maintain healthy sleep: Aparasomniais one of a group of sleep disorders in which unwanted, disruptive motor activity and/or experiences during sleep play a role. Homeostatic regulation of sleep is evidenced by sleep rebound following sleep deprivation. Upon admission to an outpatient clinic for treatment of mood disorders, she met all of the diagnostic criteria for substance dependence and was advised to dramatically limit her caffeine intake. Loss of appetite. It is possible that even the processing of emotional information is influenced by certain aspects of sleep (Walker, 2009). For example, most people sleep during the night and are awake during the day. In some cases, users experience vivid visual hallucinations. Five cardinal signs characterize this response: pain, heat, redness, swelling, and loss of function. b. absence of signs of malfunctioning. Therefore, the abuse potential of central nervous system depressants is relatively high. There are now several synthetic versions of opiate drugs (correctly called opioids) that have very potent painkilling effects, and they are often abused. Some people might turn to over-the-counter (OTC) or prescribed sleep medications to help them sleep, but this should be done sparingly because many sleep medications result in dependence and alter the nature of the sleep cycle, and they can increase insomnia over time. describes our awareness of internal and external stimuli. In individuals diagnosed with a substance use disorder, there is a compulsive pattern of drug use that is often associated with both physical and psychological dependence. Stimulant users seek aeuphoric high, feelings of intense elation and pleasure, especially in those users who take the drug via intravenous injection or smoking. For example, body temperature fluctuates cyclically over a 24-hour period (Figure 4.2). This section will consider these questions and explore various explanations for why we sleep. High doses can induce sleep, cause motor disturbance, memory loss, decreased respiratory function, and death. Restless leg syndrome is quite common and has been associated with a number of other medical diagnoses, such as chronic kidney disease and diabetes (Mahowald & Schenck, 2000). Is it absolutely essential that we sleep? Research indicates that meditation may help reduce blood pressure, and the American Heart Association suggests that meditation might be used in conjunction with more traditional treatments as a way to manage hypertension, although there is not sufficient data for a recommendation to be made (Brook et al., 2013). There are a variety of drugs that treat restless leg syndrome: benzodiazepines, opiates, and anticonvulsants (Restless Legs Syndrome Foundation, n.d.). You have read that sleep is distinguished by low levels of physical activity and reduced sensory awareness. Mescaline and LSD are serotonin agonists, and PCP (angel dust) and ketamine (an animal anesthetic) act as antagonists of the NMDA glutamate receptor. For individuals who are especially open to the power of suggestion, hypnosis can prove to be a very effective technique, and brain imaging studies have demonstrated that hypnotic states are associated with global changes in brain functioning (Del Casale et al., 2012; Guldenmund, Vanhaudenhuyse, Boly, Laureys, & Soddu, 2012). It is much more difficult to awaken someone from sleep during stage 3 than during earlier stages. Comparative research indicates, however, that the relationship that exists between predatory risk and sleep is very complex and equivocal. Test 1: Quizes 1-4 Flashcards | Chegg.com This section will present information relating to the use of various psychoactive drugs and problems associated with such use. Heavy meals may make you sleepy, but they can also lead to frequent awakenings due to gastric distress. To prevent withdrawal, many people turned to cheaper heroin, which could be bought for $5 a dose or less. Not able to pass stool or gas. There are two types of sleep apnea: obstructive sleep apnea and central sleep apnea. (credit sleeping: modification of work by Ryan Vaarsi). The pineal and pituitary glands secrete a number of hormones during sleep. Heroin produces intense feelings of euphoria and pleasure, which are amplified when the heroin is injected intravenously. Awareness of internal stimuli includes feeling pain, hunger, thirst, sleepiness, and being aware of our thoughts and emotions. Sleep apnea is much more common in overweight people and is often associated with loud snoring. How the brain's internal states affect decision-making A) a mole that looks cancerous B) nasal congestion C) change in heart rate D) issues with breathing Which of the following American health care systems is most known for requiring a referral from a primary care doctor in order to see a specialist? Several of the nurses interviewed commented that their work schedules affected their relationships with their family. Rotating shift work has pervasive effects on the lives and experiences of individuals engaged in that kind of work, which is clearly illustrated in stories reported in a qualitative study that researched the experiences of middle-aged nurses who worked rotating shifts (West, Boughton & Byrnes, 2009). A sleep deprived individual generally will fall asleep more quickly than if she were not sleep deprived. With excessive alcohol use, a person might experience a complete loss of consciousness and/or difficulty remembering events that occurred during a period of intoxication (McKim & Hancock, 2013). The first three stages of sleep are NREM sleep, while the fourth and final stage of sleep is REM sleep. However, all of their somnambulistic patients who also suffered from sleep-related breathing problems showed a marked decrease in sleepwalking when their breathing problems were effectively treated. The three types of sleep apnea are central apnea, obstructive apnea (OSA), and a mixture of central and obstructive apnea. Melatonin release is stimulated by darkness and inhibited by light. Often, however, people wishing to learn to meditate receive some training in techniques to achieve a meditative state. Sleepwalking most often occurs during slow-wave sleep, but it can occur at any time during a sleep period in some affected individuals (Mahowald & Schenck, 2000). The suprachiasmatic nucleus (SCN) serves as the brains clock mechanism. Theta wavesare even lower frequency (47 Hz), higher amplitude brain waves than alpha waves. There is a trend that females report more somatic symptoms than males; thus, more females are diagnosed with somatic symptom disorder than males (APA, 2022). Chapter 5: Indoor Air Pollutants and Toxic Materials Which of the following is true regarding patient adherence: d - all of the above (a - the average adherence rate for taking medication to treat acute illness is about 67%, b - adherence to taking medicine . One particular aspect of the internal state is that a method applied to the object being in a defined internal state (= a specific set of all its attributes' value) will result in another, also defined (and reproducible) internal state. Feeling tired. These kinds of schedules are common for individuals working in health care professions and service industries, and they are associated with persistent feelings of exhaustion and agitation that can make someone more prone to making mistakes on the job (Gold et al., 1992; Presser, 1995). This is of such concern that people who are trying to overcome addiction to these substances should only do so under medical supervision. Sleep-wake cycles seem to be controlled by multiple brain areas acting in conjunction with one another. PDF Internal States Scale and Reference - University of Washington Drug withdrawal is usually an aversive experience, and it can be a life-threatening process in individuals who have a long history of very high doses of alcohol and/or barbiturates. Stage 3is often referred to as deep sleep or slow-wave sleep because this stage is characterized by low frequency (less than 3 Hz), high amplitudedelta waves(Figure 4.10). While there is tremendous variation in any given individuals sleep needs, the National Sleep Foundation (n.d.) cites research to estimate that newborns require the most sleep (between 12 and 18 hours a night) and that this amount declines to just 79 hours by the time we are adults. Dreams and their associated meanings vary across different cultures and periods of time. While cognitive deficits may be the most obvious, many body systems are negatively impacted by lack of sleep. Train your body to associate the bed with sleeping rather than other activities like studying, eating, or watching television shows. Jet lagis a collection of symptoms that results from the mismatch between our internal circadian cycles and our environment. What Is Inflammation? Types, Causes, Symptoms, and Treatment Vaping uses battery-powered devices, sometimes called e-cigarettes, that deliver liquid nicotine and flavorings as a vapor. Historically, heroin has been a major opioid drug of abuse (Figure 4.17). It may surprise you to know that sleep deprivation is associated with obesity, increased blood pressure, increased levels of stress hormones, and reduced immune functioning (Banks & Dinges, 2007). For example, she and her colleagues published a study in which women going through divorce were asked several times over a five-month period to report the degree to which their former spouses were on their minds.
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