By R. R. Tilleard-Cole MA BM BCh MRC Psych DPM, J. Marks MA MD FRCP FRC Path (auth.)
ISBN-10: 9401171645
ISBN-13: 9789401171649
ISBN-10: 9401171661
ISBN-13: 9789401171663
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Extra resources for The Fundamentals of Psychological Medicine
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In general terms 53 The Fundamentals of Psychological Medicine towards the end of the night, the REM periods get longer and the depth of sleep gets less. Between the third and last period of REM it may well be that the depth does not go below Stage II and rarely, if ever, does it reach Stage IV (fig. 23). REM sleep or paradoxical sleep is a phase in which it seems that cortical activity becomes very much more intense. Paradoxically, however, the subject is very much more difficult to waken. aWake 11 pfl1 fIG U RE 23 12 Illldnlqht lam 2 am 3am 4anl 5am The stages of sleep during a normal night's sleep _ REM sleep.
54 Physiology and Biochemistry of the Nervous System During the deeper stages of NREM (orthodox) sleep, the secretion of growth hormone by the anterior pituitary gland appears at its greatest. Governing not only the growing period of youth and adolescence, this hormone encourages growth in skin, liver and the blood-forming cells of the bone marrow as well as exerting an effect on carbohydrate and fat metabolism. Fig. 24 shows the activity of different parts of the brain during paradoxical sleep and compares these with the situation during wake and slow wave sleep.
Stage I is characterized by drowsiness. Stage II represents early light sleep and electroencephalographically sleep spindles are seen together with K complexes in response to meaningful stimuli (p. 59). Stage III represents a deeper phase of sleep which then merges with Stage IV the deepest sleep of all. On reaching Stage IV, this phase of deep sleep is maintained for approximately 90 minutes. At the end of this time lightening of sleep occurs back through the preceding stages to Stage 1. At this point (Emergent Stage I), rapid eye movements occur in conjugate deviation (REM).
The Fundamentals of Psychological Medicine by R. R. Tilleard-Cole MA BM BCh MRC Psych DPM, J. Marks MA MD FRCP FRC Path (auth.)
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