Psy.D Sleep, why do people sleep at all? Why can’t we just stay awake? Somebiologist suggest that sleep provides the opportunity to conduct self-repair andpurge the body of it’s waste that has built up during the day’s activity.
Nevertheless, the body is capable of repairing itself and disposing of wastesduring waking hours, so sleep in a way really isn’t necessary for routinemaintenance (e.g., urinating, etc.). Dr. Quentin Regestein, lead sleep and sleepdisorders researcher at Harvard Medical School also believed that sleep kept ourdistant ancestors out of harms way during the night when they could not see aswell as their night roaming predators.
Sleep is regulated by a connected series of structures in the deep midlineareas, and along other way stations that extend through the central axis of thebrain, these structures relay information about things that affect sleep. In Dr.
Regestein notes, he spoke of experiments that were performed by researchers.
The researchers he spoke of would destroy specific brain structures of a labanimal and then note how the animal slept.For instances, in one lab animalthe researcher cut through the axis of the brain at one level, which wouldprevented the animal from awakening; showing that brain structures below thelevel of the cut were responsible for awakening the lab animal.
The American Sleep Disorders Association (ASDA), Association for thePsychophysiological Study of Sleep (APSS), Association of Sleep Disorder Centers(ASDC), and the American Psychiatric Association (APA) has studied sleep andsleep disorders since the early 1970’s. Out of all the sleep disorderscurrently being studied, sleep apnea has gain world wide attention, affectingover 15 million people. Apnea, derived from the Greek word “want to breath.”Sleep Apnea (cessation of air flow at the mouth for greater than 10 seconds) canreflect 1) loss of central nervous system drive to maintain ventilation, 2)mechanical upper airway obstruction, or combinations of both. The secondedition of Anesthesia and Co-Existing Disease states “Conversely, obstructiveforms of sleep apnea are due to an abnormal relaxation of the posteriorpharyngeal muscles” – there is persistence of respiratory movements, but airflowis absent due to upper airway obstruction. Study shows awakening occurs when thearterial partial pressure of carbon dioxide rise or oxygen falls. Severe apnea,which affects about 1 percent of the general adult population, often results in400-500 awakenings a night. Moreover, depending on the severity and the numberof episodes of sleep apnea, the patient’s daily life and survival can be greatlyendangered. According to the Wisconsin Sleep Cohort Study, over an eight-yearperiod, a 37 percent death rate has been reported among persons with apnea (20episodes or more per hour). The Wisconsin Sleep Cohort Study also reported sleepapnea is more likely to occur in men then women, for the male hormone,testosterone is believed to be related to sleep apnea. Admittedly, researchersbelieve a female hormone, progesterone stimulates respiration and therefore mayhelp prevent breathing problems. In the Wisconsin Sleep Cohort Study, theresearchers noted a strong link between smoking and sleep apnea. Smokers thatsmoked 40 or more cigarettes a day had the greatest risk of developing sleepapnea then patients who had never smoked. The medical community has yet to fullyunderstand the intra play of factors producing the sleep apnea syndrome.
Sleep affects psychological well-being. Because sleep apnea deprivespatients of sleep, numerous of studies have consistently shown that sleep lossaffects daytime performance, sleepiness and mood. One of the first capacitiesthat Dr. Arthur J. Speilman of the Department of Psychology in New York spoke of,is the ability to produce creative solutions to problems., and how being depriveof sleep can impair a patients functional capacity. Dr. Paul Glovinsky, Dr.
Spielman’s research colleague noted “the focus of psychology is behavior, whichat first glance might be thought to cease during sleep”. Dr. Glovinsky alsonoted “neither the mind nor the body truly cease activity during sleep. Farfrom turning off, the brain in sleep generates a variety of states , accompaniedby predictable physiological changes and typical forms of mentation.” Bystudying Drs. Speilman and Glovinsky works one can conclude, the sleeplessnessof sleep apnea or the prolonged wakefulness of creative output, the timing ofphysiological rhythms can be affected by psychological states.
In 1988 a congressional commission determined that sleep relatedproblems cost American Society 50 billion dollars a year and that 95% ofindividuals with sleep disorders were going undiagnosed. According to theAmerican Academy of Family Physician (AAFP), The standard method for diagnosingsleep apnea is nocturnal polysomnography. In order for the this test to bepreformed often requires the patient to stay overnight in a sleep laboratory,which can be quite costly. There are also less costly methods of diagnosingsleep apnea. Dr. Tivinnereim of the AAFP developed the use of a five portablepressure transducer catheters connected to a data logger that can be clipped tothe patients garment. The transducers are used to measure the intrathoracicpressure fluctuations. Case study: Ten patients with obstructive sleep apneawere recruited from a sleep clinic to undergo simultaneous evaluation with theportable transducer catheter. Pressure signals were synchronized with thepolysomnographic tracings to compare the classification of 200 events of apnea.
The portable transducer catheter detected all 200 events recorded during thenocturnal polysomnography procedure.
Because of in-depth research of sleep apnea and sleep disorders, theASDA can now safely treat sleep apnea. One method that is widely used is C-PAP(Continuous – Positive Airway. C-PAP is a mask that covers the patients facethat provides a slightly increased air pressure for easier breathing. As aresult from using the C-PAP machine, muscles lining the airway and structuressuch as the soft palate are no longer sucked into the airstream. Another methodof treating sleep apnea (a fairly new surgical procedure) calleduvulopalatopharyngoplasty. This procedure involves revision of the uvula (thetissue that hangs from the midline of the throat) and tightening up the throat’slining. Study has shown surgery to be the best route for sleep apnea patients.
Case study: A 38-year-old production supervisor was interviewed four monthspostoperative and reported that the surgery had changed his life. He was nolonger weary, and he had astonished his employers by coming up with some newbusiness innovations. He also added that he felt so energetic that he had takenon a second job. Some patients that were seen postoperative reported comparableimprovements. The biochemistry of sleep is only partially understood; yet theknowledge of sleep apnea and how it occurs intra plays a great role in treatment.
In short, being deprived up sleep because of a sleep disorder like sleep apneacan eventually lead to interruption of daily task and human survival is greatlyreduced. Many people choose to prognosis themselves as to why they are havingtrouble sleeping. Researchers urge patients with a unbalanced sleep pattern toseek professional help.
“Five billion people go through the cycle of sleep and wakefulness every day,and relatively few of them know the joy of being fully rested and fully alertall day long.” – William Dement (1988)ReferencesArthur J. Speilman, Phd.D., and Paul B. Glovinsky, Ph.D.
– Department of Psychology. The City College of New YorkPinellas Public Library Cooperative, Inc. – InfoTrac System- Largo, FloridaDrs. Robert K. Stoelting, Stephen F. Dierdorf , and Richard L. McCammon.
-Second Edition / Anesthesia and Co-Existing DiseaseJohn P. Dworetzky- Psychology / Fifth EditionDr. Quentin Regestein – lead sleep researcher, Harvard Medical School- Sleep problems and solutionsDr. Scott Mantel – Anesthesiologist- Morton Plant Hospital, Department of AnesthesiologyDr. Paul Borelli – Anesthesiologist- Morton Plant Hospital, Department of Anesthesiology Category: Philosophy
