1. Sleep Disorders
Maggie Hamilton
Current Issues in the Brain
ECE 275

2. Quick Sleep Facts
• There are 5 phases of sleep: 1, 2, 3, 4, and REM, which is
when we experience dreams. We spend about 50% of our
sleep time in stage 2, 20% in REM sleep, and the other 30%
in the other stages (NINDS, 2007).
• Neurotransmitters control whether we are asleep or awake.
• Experts say if you feel drowsy during the day, you haven’t
had enough sleep.
• Most adults need 7-8 hours of sleep, teenagers about 9, and
infants require about 16 hours a day.

3. Quick Sleep Facts
• Sleep gives neurons that are used
when we are awake a chance to
shut down and repair themselves.
Without sleep those neurons
would be depleted of energy,
polluted with byproducts, and
normal cellular activities would
begin to malfunction.
• Sleeping may also help learning because it gives the brain a
chance to exercise neural connections that might deteriorate
otherwise.

4. Narcolepsy
• Narcolepsy is a chronic, neurological sleep
disorder that causes excessive sleepiness
and frequent daytime sleep attacks.
• Usually occurs in people ages 15-30.
• The exact cause is unknown but it is linked
to reduced amounts of a protein made in
the brain called hypocretin. This lack of
hypocretin could be the result of traumatic
injury, stroke, or tumors.
• Hypocretin is a peptide derived from the
hypothalamus that has been linked to
regulatory functions including sleep/wake
cycles (Peacock, 2010).

5. Narcolepsy Symptoms
• Periods of extreme drowsiness throughout the day
lasting about 15 minutes each time although it may be
longer.
• Sleep paralysis – a person cannot move as they start
falling asleep or when they wake up, may last 15 min.
This can be a frightening experience for the patient.
• Cataplexy – Sudden loss of muscle tone when awake
that makes you unable to move, most of these attacks
last less than 30 seconds and can sometimes be missed.
The head will suddenly fall forward, jaw becomes slack,
and knees buckle. In sever cases, a person may fall and
stay paralyzed for several minutes.

6. Narcolepsy Video
(Click on box to play)

7. Sleep Apnea
• Sleep disorder that occurs when a person’s breathing is
interrupted during sleep. They stop breathing repeatedly
during their sleep, sometimes hundreds of times.
• This means that the brain, and the rest of the body, may
not get enough oxygen.
• Two types:
– Obstructive Sleep Apnea (OSA), caused by blockage of the
airway, usually when the soft tissue in the back of throat
collapses during sleep.
– Central Sleep Apnea (CSA), the brain fails to signal the muscles
to breathe due to instability in the respiratory control center.

8. Sleep Apnea
• Snoring is common
• Breathing pauses can last a
few seconds to a few
minutes, typically when
normal breathing starts
again, it starts with a loud
snort or a choking sound.
• Disturbs nightly sleep
making the person
excessively sleepy during the
daytime.
*Interesting Fact*
Some very young infants
experience a kind of apnea due
to immaturity of the brain
stem.

9. Sleep Apnea:
Brain Damage
• Obstructive Sleep Apnea (OSA) impairs
vigilance and executive functioning. This is
due to the effects of sleep fragmentation from
repetitive apneas that the prefrontal cortex of
the brain experiences. The prefrontal cortex
also seems to be very sensitive to sleep
deprivation which contributes to these
impairments. (Wong, 2006).

10. Insomnia
• Insomnia is characterized by difficulty falling asleep,
staying asleep, or getting good quality sleep.
• Insomnia can be acute (short-term) or chronic (ongoing).
• It is often brought on by stress, traumatic events, anxiety or
physiological causes such as caffeine or alcohol.
• Insomnia can cause daytime sleepiness, lack of energy and
trouble learning. This lack of learning occurs with lack of
sleep because sleep gives the brain a chance to exercise
important neural connections that were made that day that
may otherwise deteriorate from lack of activity (NINDS,
2007).

12. REM Behavior Disorder
“Murder while Sleepwalking”
“In 2001 Stephen Reitz claimed to be sleepwalking when he
stabbed and beat his married girlfriend to death in their hotel
room and later walked to the police station to turn himself in.
Reitz claimed to be dreaming of attacking a male intruder in
„flashbacks‟, although he also claimed to remember nothing of
the attack. Although Reitz had no apparent motive, he did
have a history of violence and abuse. In 2004, Stephen Reitz
was convicted of first-degree murder.” (Ciccarelli, 2010).
Can watch story at:
http://www.msnbc.msn.com/id/29658353/ns/dateline_nbc-
crime_reports/t/deadly-dreams/
“In 2003, Jules Lowe of Manchester, England, attacked and killed
his 82-year old father while sleepwalking. Lowe had a history of
sleepwalking, was under great stress, and had no motive to kill his
father. Sleep expert Dr. Irshaad Ebrahim testified that tests showed
Lowe to be sleepwalking at the time of the attack. In 2005, Lowe
was acquitted.” (Ciccarelli, 2010).

13. REM Behavior Disorder
• In this rare disorder, brain mechanisms that normally inhibit
voluntary muscles fail, allowing the person to thrash around,
sleepwalk, and even act out nightmares.
• During REM sleep the electrical
activity in the brain is similar to
the electrical activity that occurs
when awake, but when in REM
sleep, one experiences muscle
paralysis. People with REM
Behavior Disorder lack this
muscle paralysis, permitting
them to act out their dramatic or
violent dreams.

14. REM Behavior Disorder
• The only sensations the person “acting out” experiences is
what is occurring in their dream. They may move around
without waking or realizing that they are dreaming.
– A 77-year old minister had been behaving violently in his sleep for 20 years,
sometimes even injuring his wife.
– A 60-year old surgeon would jump out of bed during nightmares of being
attacked by "criminals, terrorists and monsters."
– A 62-year old industrial plant manager who was a war veteran dreamt of being
attacked by enemy soldiers and fights back in his sleep, sometimes injuring
himself.
– A 57-year old retired school principal was inadvertently punching and kicking
his wife for two years during vivid nightmares of protecting himself and family
from aggressive people and snakes. (National Sleep Foundation, 2011)
*Interesting Fact*
“Cats with lesions affecting the part of the brain stem that involves the
inhibition of locomotor activity will have motor activity during REM sleep:
they will arch their backs, hiss and bare their teeth for no reason, while their
brain waves register normal REM sleep.” (National Sleep Foundation, 2011).

15. Annotated Bibliography
NINDS. (2007, May 21). Brain basics: Understanding sleep. Retrieved from
http://www.ninds.nih.gov/disorders/brain_basics/understanding_sleep.htm
-This article provided some of the basic information on sleep. It went over the different stages of sleep
and how lack of sleep and the benefits of sleep effects our brains.
*Ciccarelli, S. K., & White, J. N. (2010). Psychology. (2 ed.). Pearson College Div.
-This book covers different sleep disorders and the role the brain plays in sleep. It also provided several
stories regarding REM behavior disorder. It also had extensive information on sleep in general, not
pertaining to sleep disorders.
*Wong, K. H., Grunstein, R. R., Bartlett, D. J., & Gordon, E. (2006). Brain Function In
Obstructive Sleep Apnea:: Results from The Brain Resource International
Database. Journal Of Integrative Neuroscience, 5(1), 111-121.
-This peer reviewed article tests patients who have Obstructive Sleep Apnea (OSA). The tests examined
the effects of OSA on the brain but yielded inconsistent results. Studies did show deficits in executive
functioning which relates to the prefrontal cortex.
*Peacock, J., & Benca, R. M. (2010). Narcolepsy: Clinical features, co-morbidities & treatment. Indian
Journal Of Medical Research, 131(2), 338-349.
-This peer reviewed article talks in depth about narcolepsy, and how hypocretin is linked to patients
having this disorder.
National sleep foundation. (2011). Retrieved from http://www.sleepfoundation.org/article/sleep-
related-problems/rem-behavior-disorder-and-sleep
-REM behavior disorder was discussed in this online article. It talks about the history, causes, and some
potential treatments. It also gave some examples of how people who suffer from this disorder act
during their sleep.