Klinische Psychologie Bonus

Wakefulness

Non-REM Sleep Stages 1-4

REM Sleep

alpha & beta activity 

1. Low-amplitude, high-frequency EEG signal (alpha, beta, theta) 5% total sleep time

2. Higher amplitude, lower frequency (sleep spindles & K-complexes ) (K-complexes are stage specific) 20% total sleep time

Slow-Wave-Sleep (SWS), often get summoned up into one stage, 20% total sleep time

3. Appearance of first delta waves (10-50%)

4. Dominance of delta waves (>50%)

• EEG similar to stage 1: high frequency, occasional theta-activity
• High arousal threshold
• Rapid eye movements 
• Muscle atonia / muscular inhibition
• dreams
• 20-25% total sleep time

eye activity

Muscular activity

Cyclic sequence of sleep stages

• Period duration: ~ 90min
• 2 runter zu 4 hoch zu REM
• Non-REM & REM = basic Rest-Activity Cycle (BRAC)
• REM sleep increases towards end of night 
• SWS decreases towards end of the night

• Old
• Hypnotoxin -> produced during wakefulness -> fall alssep
• Reduced during sleep -> wake up

• Being awake disrupts the body‘s homeostasis
• Sleep restores body & brain
• E.g., tissue repair, energy replenishment & memory consolidation
• Pro: every animal sleeps, why make vulnerable if we dont need, however not related to physical size e.g. elephant only needs 3 hours of sleep

• Sleep as evolutionary adaptation for survival
• Helps conserve energy and avoid danger during vulnerable times (e.g., night)
• Animals who are less vulnerable sleep less e.g. elephant (contra jaguar schläft 10 h)

• Process S: Sleep Homeostasis
  • Represents sleep pressure
  • Builds up during wakefulness
  • Dissipates during sleep
• Process C: Circadian Rhythm
  • Regulated by internal body clock (Suprachiasmatic Nucleus, SCN)
  • Influences sleep timing
• Not enough sleep: rising sleep pressure

• Biological process following an approximately 24-h cycle
• Most dominant rhythm in humans
• physiological / psychological circadian rhythms

• Sleep-wake cycle
• Body temperature
• Endocrine rhythms (i.e., cortisol, melatonin)
• Food intake

• Pain sensitivity
• Reaction time
• Vigilance/Alertness
• Memory

Circadian rhythms under constant enviornmental conditions

work even without external "Zeitgeber" (e.g. light, food intake, temperature, social information)

Zeitgeber -> synchronizes -> Oscillators

Oscillators = Pacemakers = biological structures/ systems responsible for generating/ controlling rhythmis physiological processes

• Primary Oscillators -> ZNS, Nucleus Suprachiasmaticus (most important inner clock) 
• Secondary Oscillators/ Passive Pacemakers -> PNS, Synchronize soecific organ systems

central pacemaker of the circadian rhythm

rel. klein, über Chiasma Opticum, Teil des Hypothalamus

Afferents: Ganglion cells of retina, Retinohypothalamic tract

way information about light gets to it: ganglion cells of retina -> bipolar cell -> zapfen/ stäbchen -> Retinohypothalamic Tract -> SCN

1. clock protein + cycle protein bind -> clocl/cycle dimer
2. clocl/cycle dimer moves into nucleaus & binds to DNS -> Activation transcription Per- & Cry Genes
3. Per & Cry associate -> bind to Tau protein
4. Per/ Cry/ Tau complex inhibits activity of Clocl/Cycle dimers -> slowed transcription (P.S Endproduktrepression)
5. Degradation of Per/Cry/TAu complex processes starts (takes ~ 24h)

Connection to light: light triggers glutamte release from ganglion cellls -> stimulates transcription cry gene

anteriorer hypothalamus

posterior hypothalamus

reticular activating system (RAS) & reticular formation

Bremer lesion experiments: cutting between midbrain & forbrain -> inability to wake up, cutting between lower brain & spinal cord -> still noraml sleep wake rhythm

Melatonin (sleep induction & maintenance)

Acetylcholine (Maintenance of wakefulness, promotes REM sleep)

Serotonin (activating, wake promoting, REM-termination/ suppression)

Orexin (Activating, wake promoting, bloackage of REM, muscle atonia)

• Insomnia
• Hypersomnia
• Parasomnia

• Difficulty initiating sleep, maintaining sleep, or early-morning awakening
• despite adequate opportunity to sleep (DSM-5
• Leading to significant distress or impairments in functioning

• Frequency of 3 or more nights per week and duration of 3 months or longer
• NOT explained by presence of mental disorders or medical conditions
• Prevalence: most common, 10% of adult population, frequency increases with age, female/ male ratio: 2:1, low socioeconomic status increases insomnia risk

• Sleep disorder triggered by a specific stressor, which remits once the stressor is removed

• Sleep disorder as a result of increased psychophysiological arousal (i.e., heightened tension levels)

• Complaints about a sleep disorder without objective evidence of one; misperception of actual sleep ability

• Sleep disorder beginning in childhood without a recognizable cause

• Sleep disorder is the main or a very severe symptom of a mental disorder and requires separate/specific treatment

• Sleep disorder involving mostly unconscious behaviors incompatible with sleep

• Sleep disorder due to lack of or inappropriate education regarding bedtime routines

• Sleep disorder due to regular use of medications/drugs or due to withdrawal effects

• Residual category for nonspecific/organic sleep disorders
• Everything that doesn’t quite fit