In need of a 250 word response/discussion to each of the following forum posts. Agreement/disagreement/and/or continuing the discussion.
Original forum discussion/topic post is as follows:
Describe brain function during REM sleep, including a discussion of the relationship between sleep and memory. How would you use this information to assess a patient who has chronic insomnia, and has already had extensive treatment with hypnotic medications? Based on your reading and research, which theories on the biological perspectives on dreaming do you agree with and why?
Forum post response #1
There are four well defined phases of sleep: NREM 1, NREM 2, NREM 3, and the REM (Rapid Eye Movement) stage. Of note, the N stands for Non (REM) (sleep) in the first three sleep phases. The special REM sleep state characteristically happens about ninety minutes or so after one falls asleep. Because people wake up during sleep and because the sleep cycle frequently starts all over again and repeats itself, REM sleep can happen more than one time. Vivid dreams occur during REM. REM is also widely accepted to be the restorative part of the cycle. Most important, it is theorized that memory consolidation occurs during Rapid Eye Movement Sleep. During the day, it is thought that new memories are compartmentalized in the proper part of the brain, depending upon what type of memory it is. While this is not yet quite understood, scientists have also theorized (with some mice research fortifying the theory) that bits and pieces of episodic memory obtained from the prior day’s events, which were temporarily stored in the brain’s hippocampus component, are processed and transferred into the cortex during sleep, the outer layer of the cerebellum and thought to be the seat of consciousness. Newly stored long term memory thus becomes information stored in the brain seemingly indefinitely. Consequently, REM Deep Sleep is viewed as particularly valuable for memory formation.
This information is especially helpful for assessing a notional patient with chronic insomnia, who already has had extensive treatment with hypnotic medications. Insomnia refers to chronic sleeplessness. Hypnotic medications are psychoactive prescriptions, which are known to induce sleep. Other sedative-hypnotic drugs are prescribed for anxiety. Of note, this medication category is ripe for misuse and abuse by the patient. Hypnotics are also the “go to” treatment for patients suffering from insomnia. Indeed, the notional patient appears to have been using prescribed hypnotics for sleeplessness without success. Long term usage of hypnotics for insomnia carry many risks such as residual sedative results, fall downs with injury, memory impairment, depression of the respiratory processes leading to lung congestion, rebound insomnia, dependency, and death (Kramer, 2000). Special note is made of the memory impairment risk. Some studies indicate that long term use of hypnotics tends to interrupt the crucial REM sleep stage. This could mean that the physiological transfer of memories into long-term storage is thwarted through the use of hypnotics. Having the patient participate in a sleep laboratory would be helpful. It would also be helpful, if not compulsory, for the patient to be weaned off the hypnotics in favor of psychological therapy, such as behavioral. However, the clinician must be mindful of the effects of hypnotics’ withdrawal. Biological causes should also be explored, such as any medical conditions causing poor sleep; caffeine dependency; a reliance on allergy medications; environmental features; and faulty sleep patterns. A physiological psychology approach would help deal with these biological causes.
There are a variety of biological perspectives on dreaming. Some researchers state that the brain is bustling with activity during the dream state, based on brain waves. In this regard, scientists concluded that dreams help to organize and process the day’s events. Other researchers asserted dreams help process emotional trauma and address problems. Still other researchers stated that dreams promote optimal neuro-cognitive development. While I do not disagree with these theories, I must return to a question that Doctor King posed to one of my classmates in Week One. I do not believe that consciousness, mind, and physical brain are all the same entity. Most relevant, based upon my ongoing research, I personally do not believe that the physical brain creates consciousness at all; but, instead, acts more as a reducing valve, so to speak. Nor is the so-called “mind” the producer of consciousness. Consciousness is of itself and by itself. Accordingly, “sleep is of the brain, by the brain, and for the brain” (Hobson, 2005, para. 1), but not for consciousness. Instead, consciousness undergoes adjustments in conjunction with the sleep-caused changes to our brains (Hobson, 2005). Although it is widely accepted that people abandon consciousness when they fall sleep, there is other ample evidence showing this not to be the case at all. It appears that sleepers and dreamers enter a new (and potentially expanded) state of consciousness, but do not leave it. Therefore, while the “battery” (the human body) is “recharging”, our mysterious consciousness is already whirring and in flight, still investigating and learning non-localized. The fascinating hypnagogic and hypnapompic jolts experienced during “threshold” sleep states (almost like a sensation of lift off or descending), while the person is half awake and half asleep, bolsters this other scientific theory (as investigated by Tart, Monroe, Campbell, and other researchers). Some dreams are not necessarily dreams at all, but consciousness on the move. The present reductive materialistic viewpoint does not appear to properly address the dreaming phenomenon. However, this is not to say that other biological functions, as discussed above, are not also taking place simultaneously. Even so, these biological processes, such as processing the day's events and emotional trauma, seemingly take a back seat to the primary purpose of what is called dreaming. Not all dreams are dreaming.
Forum post response #2
According to this week’s lesson, the functions sleep is due to muscle fatigue and/or exhaustion and is indicative of conserving energy within the body (American Public University System [APUS], 2018). Additionally, the purpose of sleep it to regenerate the body’s cell stages through mitigating metabolism rates as well as sustaining memory function levels (a preservation process). That’s why it’s very important for children and adults to receive the proper hours of sleep per night. As a chronic insomniac, I know all too well about this topic. In 2006, I was diagnosed with insomnia and symptoms/severity exacerbated when I deployed to Afghanistan. I’ve participated in multiple sleep studies (EEGs) and have taken every sleeping medication you can think of (most don't work or my body became immune to it), in which my neurologist studied my sleep patterns and actual hours of sleep. He told me “good sleep pattern levels” are approximately 85 percent or higher. Mine was at 55 percent. My brain was very active during my bouts of sleep and he’s been trying to determine if stress, insane work schedules, or migraines are correlated to the insomnia. Next month, I’m scheduled for a second MRI to see if there’s any visual signs of brain, nerve damage, and/or possible illness that can be responsible for the longevity of my insomnia. In 2015, the first MRI revealed a small cyst on the back of my brain, but the neurologist I had, at the time, stated it was too dangerous to remove it. Now I’m separated from the military, my new neurologist will assess the size the cyst and make further recommendation on how to move forward.
REM, also known as paradoxical sleep, happens during the third and four stages of sleep, which is predicated on “heart rate, breathing, and brain wave activity” (APUS, 2018, para. 2). During such stages of sleep, the brain is dependent upon the reduction of sensory functions and can show possible signs of deep and light sleep. How I know I’m in a deep sleep is the multiple dreams I have during the week. I noticed that when I’ve had a significant amount of rest is when I had a long dream that I can remember when I woke up. If I don’t, I usually didn’t have that much sleep. Week four’s notes states that during the dreaming phase, an EEG shows irregular activity of the brain as if an individual is awake and sleep interrupts will essentially produce the rebound effect, in which onel will spend additional time in the REM phase. This usually happens to me early in the morning because I drink a substantial amount of water, especially at night. It provokes to wake up between 3:00 and 4:00am and I will be in a deep sleep for another three to four hours. Just like clockwork.
Having chronic insomnia, I cannot assess my condition any further that it has been. I know the doctors continue to look at three main factors because of what I do for a living: stress, schedule, and environment. But honestly, when those aren’t factors, I still can’t sleep. I work out at least three times a week, I have a balance diet (for the most part), I’ve managed my stress by mitigating work based on priority, and I make a point to cut off work time so I can go to bed before 11pm (sometimes). I’ve completed breathing exercises, I’ve seen treatment specialists, and carved out some leisure time just for me to just chill. I still toss and turn and must have the TV on to fall asleep. One thing I haven’t tried is hypnotic sessions. It was an option presented to me, but I don’t know if that’s something I want to do. The only thing I can assess is maybe the cyst has something to do with my insomnia and I should have those answers in a few weeks.
A sleep theory I found fascinating is called lucid dreaming. The concept of lucid dreaming is essentially that one is aware of dreaming through various factors (Busby, n.d). For example, an individual is cognizant of dreaming through realization, mid-dream, or REM, but never loses conscious awareness of the dream state. Once an individual realizes they’re in a dream state and that it’s not realistic, they can control their dreams. The possibilities of what happens within the dream of indefinite (Busby, n.d.). The false-reality of the dream and being conscious that it’s not realistic is predicated on the physiological aspect and neuroscience of dreaming.
Forum post response #3
It is actually quite ironic that when one falls asleep it is said that they are “Out like a light.” This is because when a person falls asleep, their brain does not simply turn off, it actually stays highly functioning, just in a different way than we are used to. REM, short for Rapid Eye Movement, is controlled by the subcoeruleus nucleus, which make up a small, clustered group of cells in our brain stems. The subcoeruleu nucleus help our body’s muscles to become paralyzed and our both our breathing and our heart rates to become erratic. This is also the stage in which we begin dreaming. The reason our bodies experience REM is a bit of a mystery, although researchers are still studying the neurobiology and biochemistry which take place before, during and after this phase of sleep, in the hopes of learning more about it (What Happens in the Brain During Sleep, 2018). Although scientists may not understand exactly what the point of REM is, there is a definitive link between memory loss and poor sleep. This is because when a person falls asleep, memories are transferred through brain waves from the hippocampus region of the brain to the prefrontal cortex. The prefrontal cortex is the region of the brain where long-term memories are stored. Not only can poor sleep or interrupted sleep cause memories to not be stored properly, but it can actually lead to a slow deterioration of the brain over time (Nordqvist, 2013).
There are a wide variety of hypnotic medications that are often prescribed in order to help a patient fall asleep or stay asleep. However, if I were to have a patient who suffered from chronic insomnia who experienced little to no relief with the help of a hypnotic medication, I would choose to look at what was causing the insomnia rather than the insomnia itself. Insomnia can often be the result of depression, stress, anxiety, traumatic events or even other medications a patient may be taking. If they were not taking a secondary medication that could be contributing to (or causing) the problem, that would be ruled out. However, finding out what is going on in their life that could be working as a trigger for their chronic insomnia would most likely be the key to putting an end to their problem (Hypnotics for Sleep: Side Effects, Sedatives, Addiction & Withdrawal, 2018).
One fascinating biological perspective on dreaming that I agree with is sleep paralysis. Sleep paralysis takes place when a person is undergoing REM, so their body’s muscles are paralyzed, yet their brains are firing off a multitude or rapid images for dreams. The result is for the person to mentally wake up to the point that they realize they cannot physically move, yet there are enough REM images for them to believe something is going on around them. This can be a very fearful experience for a person who does not understand what is going on. It is believed that sleep paralysis takes place when a person immediately enters the REM stage of dreaming rather than gradually building up to it at the end of a sleep cycle. Because studies on sleep paralysis can be difficult to undertake, it is believed that between 5-60% of people have experienced them, with an emphasis on people who suffer from narcolepsy (Pappas, 2013).