Sleep
Sleep is a state of reduced mental and physical activity in which consciousness is altered and certain sensory activity is inhibited. During sleep, there is a marked decrease in muscle activity and interactions with the surrounding environment. While sleep differs from wakefulness in terms of the ability to react to stimuli, it still involves active brain patterns, making it more reactive than a coma or disorders of consciousness.
Sleep occurs in repeating periods, during which the body alternates between two distinct modes: rapid eye movement sleep and non-REM sleep. Although REM stands for "rapid eye movement", this mode of sleep has many other aspects, including virtual paralysis of the body. Dreams are a succession of images, ideas, emotions, and sensations that usually occur involuntarily in the mind during certain stages of sleep.
During sleep, most of the body's systems are in an anabolic state, helping to restore the immune, nervous, skeletal, and muscular systems; these are vital processes that maintain mood, memory, and cognitive function, and play a large role in the function of the endocrine and immune systems. The internal circadian clock promotes sleep daily at night, when it is dark. The diverse purposes and mechanisms of sleep are the subject of substantial ongoing research. Sleep is a highly conserved behavior across animal evolution, likely going back hundreds of millions of years, and originating as a means for the brain to cleanse itself of waste products. In a major breakthrough, researchers have found that cleansing, including the removal of amyloid, may be a core purpose of sleep.
Humans may suffer from various sleep disorders, including dyssomnias, such as insomnia, hypersomnia, narcolepsy, and sleep apnea; parasomnias, such as sleepwalking and rapid eye movement sleep behavior disorder; bruxism; and circadian rhythm sleep disorders. The use of artificial light has substantially altered humanity's sleep patterns. Common sources of artificial light include outdoor lighting and the screens of digital devices such as smartphones and televisions, which emit large amounts of blue light, a form of light typically associated with daytime. This disrupts the release of the hormone melatonin needed to regulate the sleep cycle.
Physiology
The most pronounced physiological changes in sleep occur in the brain. The brain uses significantly less energy during sleep than it does when awake, especially during non-REM sleep. In areas with reduced activity, the brain restores its supply of adenosine triphosphate, the molecule used for short-term storage and transport of energy. In quiet waking, the brain is responsible for 20% of the body's energy use, thus this reduction has a noticeable effect on overall energy consumption.Sleep increases the sensory threshold. In other words, sleeping persons perceive fewer stimuli, but can generally still respond to loud noises and other salient sensory events.
During slow-wave sleep, humans secrete bursts of growth hormone. All sleep, even during the day, is associated with the secretion of prolactin.
Key physiological methods for monitoring and measuring changes during sleep include electroencephalography of brain waves, electrooculography of eye movements, and electromyography of skeletal muscle activity. Simultaneous collection of these measurements is called polysomnography, and can be performed in a specialized sleep laboratory. Sleep researchers also use simplified electrocardiography for cardiac activity and actigraphy for motor movements.
Brain waves in sleep
The electrical activity seen on an EEG represents brain waves. The amplitude of EEG waves at a particular frequency corresponds to various points in the sleep-wake cycle, such as being asleep, being awake, or falling asleep. Alpha, beta, theta, gamma, and delta waves are all seen in the different stages of sleep. Each waveform maintains a different frequency and amplitude. Alpha waves are seen when a person is in a resting state, but is still fully conscious. Their eyes may be closed and all of their body is resting and relatively still, where the body is starting to slow down. Beta waves take over alpha waves when a person is at attention, as they might be completing a task or concentrating on something. Beta waves consist of the highest of frequencies and the lowest of amplitude, and occur when a person is fully alert. Gamma waves are seen when a person is highly focused on a task or using all their concentration. Theta waves occur during the period of a person being awake, and they continue to transition into Stage 1 of sleep and in stage 2. Delta waves are seen in stages 3 and 4 of sleep when a person is in their deepest of sleep.Non-REM and REM sleep
Sleep is divided into two broad types: non-rapid eye movement sleep and rapid eye movement sleep. Non-REM and REM sleep are so different that physiologists identify them as distinct behavioral states. Non-REM sleep occurs first and after a transitional period is called slow-wave sleep or deep sleep. During this phase, body temperature and heart rate fall, and the brain uses less energy. REM sleep, also known as paradoxical sleep, represents a smaller portion of total sleep time. It is the main occasion for dreams, and is associated with desynchronized and fast brain waves, eye movements, loss of muscle tone, and suspension of homeostasis.The sleep cycle of alternate NREM and REM sleep takes an average of 90 minutes, occurring 4–6 times in a good night's sleep. The American Academy of Sleep Medicine divides NREM into three stages: N1, N2, and N3, the last of which is also called delta sleep or slow-wave sleep. The whole period normally proceeds in the order: N1 → N2 → N3 → N2 → REM. REM sleep occurs as a person returns to stage 2 or 1 from a deep sleep. There is a greater amount of deep sleep earlier in the night, while the proportion of REM sleep increases in the two cycles just before natural awakening.
Awakening
Awakening can mean the end of sleep, or simply a moment to survey the environment and readjust body position before falling back asleep. Sleepers typically awaken soon after the end of a REM phase or sometimes in the middle of REM. Internal circadian indicators, along with a successful reduction of homeostatic sleep need, typically bring about awakening and the end of the sleep cycle. Awakening involves heightened electrical activation in the brain, beginning with the thalamus and spreading throughout the cortex.On a typical night of sleep, there is not much time that is spent in the waking state. In various sleep studies that have been conducted using the electroencephalography, it has been found that females are awake for 0–1% during their nightly sleep while males are awake for 0–2% during that time. In adults, wakefulness increases, especially in later cycles. One study found 3% awake time in the first ninety-minute sleep cycle, 8% in the second, 10% in the third, 12% in the fourth, and 13–14% in the fifth. Most of this awake time occurred shortly after REM sleep.
Today, many humans wake up with an alarm clock; however, people can also reliably wake themselves up at a specific time with no need for an alarm. Many sleep quite differently on workdays versus days off, a pattern which can lead to chronic circadian desynchronization. Many people regularly look at television and other screens before going to bed, a factor which may exacerbate disruption of the circadian cycle. Scientific studies on sleep have shown that sleep stage at awakening is an important factor in amplifying sleep inertia.
Determinants of alertness after waking up include quantity/quality of the sleep, physical activity the day prior, a carbohydrate-rich breakfast, and a low blood glucose response to it.
Timing
Sleep timing is controlled by the circadian clock, sleep-wake homeostasis, and to some extent by the individual will.Circadian clock
Sleep timing depends greatly on hormonal signals from the circadian clock, or Process C, a complex neurochemical system which uses signals from an organism's environment to recreate an internal day–night rhythm. Process C counteracts the homeostatic drive for sleep during the day and augments it at night. The suprachiasmatic nucleus, a brain area directly above the optic chiasm, is presently considered the most important nexus for this process; however, secondary clock systems have been found throughout the body.An organism whose circadian clock exhibits a regular rhythm corresponding to outside signals is said to be entrained; an entrained rhythm persists even if the outside signals suddenly disappear. If an entrained human is isolated in a bunker with constant light or darkness, he or she will continue to experience rhythmic increases and decreases of body temperature and melatonin, on a period that slightly exceeds 24 hours. Scientists refer to such conditions as free-running of the circadian rhythm. Under natural conditions, light signals regularly adjust this period downward, so that it corresponds better with the exact 24 hours of an Earth day.
The circadian clock exerts constant influence on the body, affecting sinusoidal oscillation of body temperature between roughly 36.2 °C and 37.2 °C. The suprachiasmatic nucleus itself shows conspicuous oscillation activity, which intensifies during subjective day and drops to almost nothing during subjective night. The circadian pacemaker in the suprachiasmatic nucleus has a direct neural connection to the pineal gland, which releases the hormone melatonin at night. Cortisol levels typically rise throughout the night, peak in the awakening hours, and diminish during the day. Circadian prolactin secretion begins in the late afternoon, especially in women, and is subsequently augmented by sleep-induced secretion, to peak in the middle of the night. Circadian rhythm exerts some influence on the nighttime secretion of growth hormone.
The circadian rhythm influences the ideal timing of a restorative sleep episode. Sleepiness increases during the night. REM sleep occurs more during body temperature minimum within the circadian cycle, whereas slow-wave sleep can occur more independently of circadian time.
The internal circadian clock is profoundly influenced by changes in light, since these are its main clues about what time it is. Exposure to even small amounts of light during the night can suppress melatonin secretion, and increase body temperature and wakefulness. Short pulses of light, at the right moment in the circadian cycle, can significantly 'reset' the internal clock. Blue light, in particular, exerts the strongest effect, leading to concerns that use of a screen before bed may interfere with sleep.
Modern humans often find themselves desynchronized from their internal circadian clock, due to the requirements of work, long-distance travel, and the influence of universal indoor lighting. Even if they have sleep debt, or feel sleepy, people can have difficulty staying asleep at the peak of their circadian cycle. Conversely, they can have difficulty waking up in the trough of the cycle. A healthy young adult entrained to the sun will fall asleep a few hours after sunset, experience body temperature minimum at 6 a.m., and wake up a few hours after sunrise.