The four stages of non-rapid eye movement (NREM) are linked with different brain activities and physiologies. Stage 1 is the start of the sleep cycle and is a slightly light phase of sleep. Stage 1 can be argued as a transition time between wakefulness and sleep. In this stage, the brain releases the maximum amplitude of theta waves which are slower brain waves than others. This time of sleep only lasts for a short period between five to ten minutes. If an individual is awakened at this phase, one may argue that they were still awake.
Stage 2 is the second phase of sleep and takes at least 20 minutes. During this period, a person has minimal awareness of the personal environment, body temperature reduces, and breathing and heart rates become normal. The brain starts to realize rapid and rhythmic brain waves, which are referred to as sleep spindles. According to Breedlove and Watson (2018), individuals spend about half of their overall sleep in this stage. Stage 3 involves muscle relaxing, blood pressure and breathing rate decrease, and deep sleep occurs. This stage is usually categorized into phases 3 and 4. Deep and slow brain waves are referred to as delta and occur during stage 3. This phase is also known as delta sleep. At this stage, individuals become less responsive. Noises and activities in the surrounding may fail to develop a response. It also acts as a transitional time between light and deep sleep. Kelly et al. (2018) argue that bedwetting takes place in this stage (Shokri-Kojori et al., 2018). Sleepwalking is also likely to happen. Clinicians identify all these stages by utilizing polysomnography, the combination of electroencephalography, electrocardiography, electrooculography, and electromyography to determine sleep cycles and wakefulness.
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Description of REM Sleep
Rapid eye movement (REM0 is the stage in which neuron activity in the brain is relaxed during wakefulness. It is the lightest type of sleep, and individuals awakened during REM primarily are alert and refresh. This stage is mainly shorter during the first phases of sleep as the person moves from deep and slow-wave sleep. A long time of REM sleep only occurs during the last hours of sleep, especially in the morning for most individuals. Therefore, it can be cut off if a person does not get sufficient sleep. REM sleep involves numerous activities in the brain region's visual, psychological, motor, and autobiographical memory.
REM and NREM's main difference is that the formers are among the deepest forms of sleep, while NREM is that the sleep varies or is lightest to the deepest. NREM sleep utilizes significant minimal energy and constitutes about 75% to 80% of the total period spent in sleep. REM uses more energy and comprises the remaining 20% to 25% of the total time taken on sleep (Walker & Van der Helm, 2009). REM dreams are long, clear, and detailed thoughts and images. NREM sleep is a dream-free period.
A person's sleep comprises four phases: wakefulness, light sleep, deep sleep, and REM sleep. Awake time is the period taken in bed before and after falling asleep. A person will experience brief awakenings. During light sleep, a person's muscles will relax, respiration reduces, heart rate drop, body temperature decreases, and sleep start to transition between cycles. During deep sleep, the blood pressure reduces, the body enhances muscle development and repair, waking up becomes challenging because the brain releases slow brain waves. During REM sleep, respiration increases, heart rate rises, dreams occur, and the body becomes immobile to stop a person from acting to dreams. These cycles do not progress in order. Sleep starts in phase I and transitions into phases 2 and 3. After phase 3 sleep, sleep 2 sleep is repeated before a person enters REM sleep. Once the REM sleep is over, the body mainly returns to stage 2 sleep. Sleep sequences in these phases occur about three or five times throughout the night.
Impact of Sleep Deprivation
The immediate impact of sleep deprivation is that it affects the central nervous system. The region is the vital information pathway of the body. Sleep is essential to maintain body function. Chronic insomnia affects how the body usually sends and processes information. Sleep deprivation leaves the brain exhausted, so it cannot perform its activities optimally. A person will find it hard to concentrate or to learn new information. The signals of the body distribution will be delayed, reducing the coordination and increasing risks. It also affects a person's mental state and emotional condition, whereas an individual will experience mood swings, compromised decision-making, and creativity (Cronin-Golomb, 2016). Other psychological risks include anxiety, depression, paranoia, suicidal thoughts, and impulsive behaviors.
Effectiveness of Sleep Hygiene
Sleep hygiene implies habits that assist a person get uninterrupted sleep. Common sleep issues such as insomnia are due to bad habits. Common habits are making a bedroom setting comfortable which free of disruptions, following strict bed routines, and creating healthy behaviors during the day that contributed to excellent sleep hygiene. Sleep hygiene is effective because it has been proven to promote mental and physical health, enhance production and general quality of life. Studies have found that developing good habits such as creating an excellent sleep environment makes a person sleep faster. Engaging in physical exercise also enhances sleep quantity and quality. However, sleep hygiene does not treat chronic insomnia or issues sleeping, which last for three months or more (Sie, 2010). It only addresses the perpetuating variables that maintain insomnia over time but not sufficient to realize meaningful improvements. The aspect alone is not effective in treating problems related to sleep deprivation.
Sleeping Pills
Sleeping pills assist a person in falling asleep but do not enable one to sleep a natural cycle. They bind with the GABA neurotransmitter in the brain leading to drowsiness or sedation. This medication acts by working on brain receptors to slow down the nervous system (Chung & Youn, 2017). Others are utilized for inducing sleep, while others are utilized for staying asleep.
Sleep Disorders
The NREM sleeping disorders, primarily sleepwalking, occurs when regular physiological systems are active at an inappropriate period. These commands are usually suppressed due to neurological mechanisms. Sometimes the suppression may not be completed due to genetic or environmental variables, physical immaturity, or activities that usually occur during wakefulness during sleep. During sleepwalking, people do numerous activities such as sleeping on the bed, cleaning, or driving a vehicle. When such people are awakening, they feel confused or unaware of the action that took place. Sleepwalking mainly emerges in childhood because kids devote more time to the deepest stage of sleep. Bodily activities also occur during the NREM cycle of deep sleep, which transition to the dreaming condition of REM sleep.
Regarding its neurological basis, during normal sleep, the chemical receptor GABA acts as an inhibitor that prevents the brain's motorized mechanism activity. During childhood, neurons that produce GABA are still evolving and have not entered developed a system of networks to maintain movement beneath control. This mechanism makes a person have inadequate GABA quantities, which leaves motor neurons to command the body to become mobile during sleep. In some, this inhibitory mechanism may still be infantile or be rendered less efficient due to environmental variables (Xie et al., 2013). Sleepwalking can sometimes transition into adulthood. Studies have demonstrated that sleepwalking is linked with sleep deprivation, fever, stress, drug intakes such as stimulant, hypnotic, sedatives, hypnotics, and antipsychotics.
Medical treatment for sleepwalking is essential when underlying healthcare problems cause it. Some medical issues include obstructive sleep apnea, restless legal syndrome, periodic leg movement, or gastroesophageal reflux. The clinicians diagnose sleepwalking by reviewing healthcare history and its signs. The first step is carrying out a physical example to identify any underlying issues that may be confused with sleepwalking, such as panic attacks or nightie seizures. Another step is the nocturnal sleep study which refers to polysomnography. Physicians may propose overnight study in a sleep laboratory (Stallman et al., 2018). Sensors will be placed in the body to record and evaluate brain waves, oxygen levels in the blood, heart rate and breathing, and leg movements.
The common medications of sleepwalking are Trazodone, Estazolam, and Clonazepam. They assist a patient fall asleep faster, stay asleep for an extended period, and reduce how often a person wakes during sleep to be good night rests. These drugs belong to a class of medicines called benzodiazepines. They act on a person's brain to produce calming impact (Beil, 2018). Utilizing these medications usually take a minimal short period, such as one to two weeks or less. The medicines used orally, and the dosage is based on healthcare condition and response to treatment.
Clinicians recommend some tips to stop sleepwalking. To minimize risks, a patient is advised to get enough sleep, limiting stress, and avoiding any form of stimulation before bedtime. When a person is sleepwalking, one should keep a safe sleep setting free of dangerous sharp objects, lock the doors and windows, and placing an alarm bell on the bedroom doors. Relaxation methods such as anticipatory awakening and mental imagery are preferred medical options for long-term treatments of individuals with a sleepwalking disorder. These techniques are where a person is awakening every 10 to 25 minutes before the usual sleepwalking period and making them stay awake through the period during which episodes usually emerge.
References
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