Submitted by SerendipUpdate on Tue, 01/08/2008 - 4:26pm
Sleeping Disorders and the I-Function
As we all know, sleep is an important part of our lives. Without the proper amounts and type of sleep, fatigue and other problems can arise. Generally, we can clearly distinguish between a sleeping person and a person that is awake. With sleeping disorders, the distinction between an awake person and a sleeping person becomes more intriguing. What is the difference, how does it relate to the I-function and consciousness? Each sleeping disorder has its own unique answer to this question. It is essential to understand sleep to fully appreciate it. However, many aspects of it remain a mystery. We do have some degree of understanding of sleep. Within our sleep cycle a type of unusual sleep occurs, REM sleep. During this cycle the periods of REM sleep are interspersed with slow wave sleep in alternation. Each period of REM sleep (there are usually 4 or 5 periods a night) lasts for approximately 5 to 30 minutes. During these periods a sleep paradox occurs. An enormous amount of brain activity takes place; this is sometimes even more activity then when awake. This clearly indicates that sleep is not simply to rest our mind and not to think. So, during this period our brains are extremely active, yet there is usually no input or output. During this period, along with the random eye movement (REM), there is a complete loss of muscle tone. Essentially, at this point, the motor system is paralyzed (normally the body inhibits any movement). The autonomic nervous system also alters its behavior. The regulation of body temperature is lost and the blood pressure, heart rate, respiratory rates shows increased variability. REM sleep can be detected by measuring the electrical activity of the brain with an electroencephalogram. At this point, the EEG will show the same pattern of activity as when the brain is awake.
It is fascinating that at this point, REM sleep, where dreaming is frequent, the body shuts itself down. If, as suggested in class, the I-function is active at this stage, it is interesting that all body movement is inhibited. During other stages in which there are synchronized EEGs, and the I-function is not supposed to be present, the body does not inhibit all motor activity. This seems to imply that when the I-function is present it will control the body as it sees fit. One of the more ubiquitous parasomnias is sleep talking or somniloquy. This disorder is characterized by often nonsensical or difficult to understand verbal vocalizations during sleep. The person may carry on conversations and seem to speak as if they are awake. This is not constrained to a specific stage of sleep; it is present in REM and NREM. Regardless of the stage of sleep, this is an extremely common disorder allows talking. Frequently we talk during the day, utilize our I-function when talking and remember what was talked about. This is not the case with somniloquy.
Sleepwalking, known as somnambulism, is a very interesting disorder. The symptoms of this disorder, walking while asleep, occur during slow wave sleep, in the first third of the major sleep episode. People can vary in their symptoms, from sitting up in bed, to doing more complicated activities such as preparing a meal. In addition, there is difficulty in rousing the person from the episode and amnesia following the episode. Generally, the sleepwalker has a blank face and is unresponsive to efforts made by others to communicate with them. Sleepwalking is more common in children. It also seems as if children do not inhibit their actions as much as adults do. This poses the question Are we born with an I-function? Do children develop their I-function and because it is premature, they are more likely to sleepwalk? Could the I-function be present in these synchronized periods? Is that why adults do not sleepwalk as much as children, because their I-function inhibits the behavior? Does sleepwalking occur when the I-function is distracted and allows unattended behaviors to occur?
When sleepwalking is in its most severe form, episodes take place nightly and those that are affected are prone to physical injury. Sleep walking is not caused by a medical condition or the physiological effects of a substance. As a result of the episodes, sleepwalkers can feel embarrassed, anxiety, and confusion after learning of their sleepwalking. After an episode of sleepwalking, they do not report being conscious as they might be in a dream or in real life. However, the sleepwalker may seem to act as if they were awake.
Because overexertion and lack of sleep can trigger sleepwalking episodes, getting enough rest is suggested. Moreover, stress can result in sleepwalking. A calming ritual or relaxation exercises before bed may help. Since the person is walking around in their sleep and in the dark, removing dangerous objects and sleeping on the ground floor of the house is advised. Although, some individuals are able to navigate easily and safely through their surroundings without serious harm. Hypnosis has also been found as a helpful treatment for somnambulism. The drugs that have been found helpful include benzodiazepines, diazepam, or lorazepam. Older men are more likely to be afflicted with REM sleep behavior disorder then the general population. The newly discovered REM sleep behavior disorder (RBD), is marked by complex and violent behaviors and an unawareness of surroundings. This is unusual, not only because it occurs during sleep, but because it occurs during REM sleep. Ordinarily, this REM stage of sleep is characterized by "REM atonia", which is muscle paralysis. These older men attempt to carry out "violent moving nightmares" which are characterized by attack behaviors, locomotion (particularly running), orientating and exploring behaviors (staring, grasping, head raising, reaching, searching, etc.), and a minimal syndrome of twitching and a jerking of the limbs and body. Could RBD occur because the I-function is active and the body fails to inhibit the actions as it usually does? The mind of the person would be conscious and the I-function would be active. However, the person does not receive any of the real input from his bedroom. The person simply ignores the input and generates his own internal environment which he navigates through in his mind and in real life. The person would be just like any one who is awake except seeing, feeling, hearing, tasting, and smelling things that do not actually exist. To detect RBM, family interviews, polysomnographic monitoring, psychiatric monitoring can be used. In the people with RBM, the location of the disorder in the nervous system varied greatly. This indicates that it is not always found in the same location in the nervous system. Some people that are physically debilitated by a disorder while awake, become quite active during the night when their RBM occurs. Another way to detect RBM, is by using the electromyograph. This device detects muscle activity. If the muscles of the person are active during the period of REM atonia, then the diagnosis can be made (muscles should not be active during REM sleep).
The content of the nightmares that RBD people suffer from is highly unusual. Generally, they try to defend themselves or family members from an attacker. Rarely are they the primary aggressor, an animal or unfamiliar person ordinarily is. Moreover, the odd dream content is acted out by the dreamer while in REM sleep. Some people have sustained fractures in their ribs, digits, vertebrae, sternum, gotten bruises, lacerations, sprains, joint dislocations, cartilage tears, torn nails, rug burn, pulled hair, nose bleeds, and traumatic headaches. In addition, other people in the bed have been injured. Because of the accidents that can occur while acting out dreams, many people take desperate means to prevent injury. Some tie themselves to their beds, others use sleeping bags, pillow barricades, or padded waterbeds. Sleep can contain walking, talking, and even carrying out complicated behaviors as can be done when awake. Is the I-function present? In some cases, while asleep, the I-function is present (lucid dreaming). If it is possible to be conscious, talk and carryout behaviors while asleep, why is sleep so different from when we are awake and why is it so difficult to understand? In addition, if we can carry out all of these behaviors with out our I-function why do we have the I-function? It is interesting that the body normally inhibits any movement that is made while the person is sleeping. Is it to prevent any action without the I-function? Clearly, the I-function serves a purpose and may have a role during sleep. While sleeping the person can be conscious, have the I-function present and create a new reality that seems real to them, this seems like being awake except for the person determining the input.
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