I. Sleep Interfering Processes and Sleep Interpreting Processes (Lundh & Broman, 2000)

sleep interfering processes

sleep interpreting processes

II. Sleep Homeostat: sleep duration and intensity (Benington, 2000)

A. Sleep deprivation leads to more intense sleep

i. rise rate: rate of debt accumulation during wakefulness (a smaller rise rate will result in later sleep timing and shorter sleep)

ii. gain constant: the efficiency of SWA in dissipating sleep debt (a slower decay rate will result in later sleep timing and in longer sleep)

B. if a localized area of the brain is disproportionately stimulated during waking, the EEG delta wave power is increased in that stimulated area during subsequent non-REM sleep (Krueger, et al., 2008)

C. Sleep following deprivation is deeper (arousal thresholds are higher) and more restorative

D. High amplitude slow waves in NREM sleep are a good indicator of sleep debt.

i. High in beginning of sleep episode

ii. increases following sleep deprivation

iii. suppression in the beginning of the night leads to rebound in later part of night

E. homeostat reduces with age but age related sleep deteriorations cannot be sloely attributed to alterations in the homeostat

III. Stepanski, et al., 2000

A. 1 night of sleep deprivation

B. subjects with insomnia

i. increased daytime sleepiness after deprivation

ii. increased total sleep time on recovery night

IV. Pigeon & Perlis 2006: sleep homeostat is altered in primary insomnia

A. SWS deficiency, as measured by total SWS minutes, SWS percentage, delta power, and/or SWS latency

B. reduced daytime sleepiness as measured by MSLT despite sleep loss and complaints of fatigue

C. equivalent increases in MSLT measured sleepiness forroling sleep deprivation

D. diminished SWS response to total sleep deprivation during recovery sleep

E. CBT-I effects: restricting sleep results in increased SWS

V. Circadian Rhythm: sleep timing

A. two brain centers

i. no single system

ii. wakefulness

a) brainstem reticular formation > thalamus and posterior hypothalmus > basal forebrain

b) adenosine

iii. suprachiasmatic nuclei (SCN)

a) sleep consolidation

b) sleep stage structure

c) EEG activities

iv. zeitgebers

a) light exposure is the most powerful entrainment factor

b) phase response

B. Circadian Rhythm Sleep Disorders (Reid, Chang, & Zee, 2004)

C. Treatment Strategies (Reid & Burgess, 2005)

i. practice guidelines (Sack, et al., 2007a & b)

VI. Measuring Chronotype

A. Morningness-Eveningness Questionnaire (Horne & Ostberg, 1976)

i. 70 – 86 = definite morning type

ii. 59 – 69 (65 - 69) = moderate morning type

iii. 42 – 58 (53 - 64) = neither type

iv. 31 – 41 (47 – 52) = moderate evening type

v. 16 – 30 (16 - 46) = definite evening type

B. Composite Scale (Smith, et al., 1989)

C. Munich Chronothyp Questionnaire (Roenneberg, et al., 2003)

VII. chronotype research

A. Season of birth (Natale, Adan, & Chotal, 2002)

B. Personality (Matthews, 1988)

C. Satisfaction with life (Randler, 2008)

D. Homeostatic response (Mongrain & Dumont, 2007)

VIII. Chronotype and insomnia (Ong, Huang, & Manber, 2007)

A. evening chronotypes

i. sleep/wake irregularities

ii. greater waking distress

IX. Two Process Model Borbely, 1982)

X. Key Concepts

A. Advance the sleep phase: shifting wake up time to earlier in the morning

B. Decay rate: the efficiency of slow wave sleep to dissipate the accumulated sleep drive

C. Delay the sleep phase: shifting wake up time to later in the morning

D. Evening type: “night owl” chronotype: prefers to stay up[ later and functions best later in the day

E. Morning type: “morning lark” chronotype: prefers to arise early and functions best earlier in the day

F. MSLT: multiple sleep latency test: patient is given 5 sleep opportunities during the day and sleep latency is measured for each opportunity: a measure of daytime sleepiness

G. Rise rate: rate of sleep debt accumulation during wakefulness

H. Zeitgeber: physical and social events which entrain the circidian click; light is the primary entrainer

REFERENCES

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Matthews, G. (1988). Morningness-eveningness as a dimension of personality: Trait, state, and psychophysiological correlates. European Journal of Personality, 2, 277-293.

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