Circadian rhythm and Sleep. Radwan Banimustafa MD

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Transcription:

Circadian rhythm and Sleep Radwan Banimustafa MD

Homeostasis Maintenance of equilibrium by active regulation of internal states: Cardiovascular function (blood pressure, heart rate) Body temperature Food and energy regulation Fluid regulation High level (hyper-) Low level (hypo-) Sensor Brain Effector Change Feedback Correct level (set point)

Summary of homeostatic control Multiple mechanisms control homeostasis Emphasises the importance to survival Set points are not fixed Many homeostatic functions show daily rhythms Maintain levels appropriate for the level of activity Therefore efficient in energy use. Example During sleep body temperature decreases Heart rate decreases Respiration rate decreases Energy conservation

Biorhythms Many functions show natural biological rhythms Circadian rhythms (daily cycle) Body temperature, heart rate, respiration, sleep Circannual rhythms (yearly cycle) Hibernation, mating behaviour, migration Linked to: Light/dark cycle Season (day length probably critical)

Circadian rhythms Bodily functions linked to day length Light/dark cycle important determinant. How does light/dark information affect body systems? Optic tract lesion Circadian rhythm maintained, even in constant light Periodicity changed Suprachiasmatic nucleus lesion Circadian rhythm abolished No periodicity Therefore suprachiasmatic nucleus important for circadian rhythm

Suprachiasmatic nucleus (SCN) Located in hypothalamus, just above optic chiasm Cells in SCN show oscillations of activity Related to circadian rhythm Believed to form the biological clock Many functions (e.g. sleep wake cycle) are maintained in constant light or constant dark Periodicity may not be 24 hours In normal light/dark cycle SCN rhythm is phase locked to light dark

How does light information reach SCN Many non-mammalian species have photoreceptors outside the eye e.g. amphibians and reptiles pineal gland is light sensitive In mammals a direct pathway from eyes to SCN has been identified Carries light information to SCN Rods and cones do influence SCN function Light sensitive information still reached SCN in the absence of rods and cones Therefore other light receptors also present in eye.

Circadian rhythms in action: sleep Free running sleep rhythm about 25 hrs Entrainment to light dark cycle maintains a 24 hr periodicity Mediated through SCN activity Jet-lag Rapid shifts in light dark cycle Takes a few days for endogenous rhythm to re-entrain

Passive onset of sleep Bremer (1930) Surgically separated midbrain from forebrain in cats Animals remained permanently asleep Proposed that in the absence of sensory input the cortex became quiescent (i.e. sleep) Moruzzi & Magoun Electrical stimulation of the midbrain woke sleeping animals Lesions to this area caused persistent sleep Activating system in the midbrain, which activates the cortex Lack of tonic activating influence of midbrain causes cortical neurones to cease firing, and sleep to ensue Cortex + + Midbrain

Normal Sleep Normal sleep consists of 1-4 series of phases of increasing depth(non REM) and REM phases. Each phase has a characteristic EEG. There is a decrease with age in sleep length.

Characteristics of sleep Slow-wave sleep(non REM) Progressive decrease in spinal reflexes Progressive reduction in heart rate and breathing rate Reduced brain temperature and cerebral blood flow Increased hormone secretion (e.g. growth hormone) Synchronised cortical activity

Characteristics of sleep REM sleep Spinal reflexes absent Rapid eye movements behind closed eyelids Increased body temperature and cerebral blood flow Desynchronised cortical activity Dreams

Dreams REM sleep dreams : sexual, clear, sleep paralysis, connected to external stimuli easy to be recalled. Nightmares Non REM sleep dreams : No story and no recall(night terrors).

Normal night Sleep In the first cycle: * 15-20 minutes to fall a sleep. * Over the next 45 min. one descends to stage 3 & 4(Non REM) * After 45 min. after stage 4 reaches the first REM stage. (REM latency = 45 + 45 = 90 min.)

Normal sleep As the night progresses: * Each REM period gets longer. * And stage 3+4 gets shorter until they disappear. * Further into the night sleep becomes lighter and dreams become more.

Brain activity during sleep Awake Low amplitude high frequency EEG Light sleep Increasing amplitude decreasing freq. EEG Deep sleep High amplitude low frequency EEG Rapid eye movement (REM) sleep Low amplitude high frequency EEG

Sleep as an active process Electroencephalographic (EEG) recordings showed abundant neuronal activity in cortex during sleep Therefore not passive neuronal quiescence Pattern of the EEG was very different in sleep than in waking Waves of activity, indicating synchronous firing of cortical neurones Synchronising stimulus coming from sub-cortical areas Reticular formation still seen as important Several different levels of sleep Sleep is a complex combination of different aspects

Characteristics of sleep Slow-wave sleep(non REM) Progressive decrease in spinal reflexes Progressive reduction in heart rate and breathing rate Reduced brain temperature and cerebral blood flow Increased hormone secretion (e.g. growth hormone) Synchronised cortical activity REM sleep Spinal reflexes absent Rapid eye movements behind closed eyelids Increased body temperature and cerebral blood flow Desynchronised cortical activity Dreams

Neuronal circuitry controlling sleep Cortex kept awake by ascending activation from midbrain 5HT inputs inhibit midbrain activating system areas therefore promotes sleep Stimulation of area surrounding SCN induces slow wave sleep mechanism unclear: Probably involves SCN No one stimulation site can promote REM sleep but lesions to specific brainstem areas abolish REM sleep

Neurochemistry of sleep Neurotransmitters 5HT - promotes slow wave sleep inhibition of activating system Noradrenaline -? inhibition of muscle tone during REM sleep Dopamine - general arousal Acetylcholine - induces REM sleep Also sleep-promoting substances Factor S, DSIP (delta-sleep inducing peptide), melatonin Not much known about their action May modulate circadian rhythmicity rather than sleep per se

Disorders of sleep Insomnia - reduction or absence of sleep - transient or persistent Hypersomnia (narcolepsy) - excessive drowsiness and falling asleep Sleep-wake schedule disturbance - transient or persistent Partial arousal - e.g. sleep-walking, nightmares Often associated with anxiety, psychological disturbance or drug taking Little known about causes Limited capacity for pharmacological treatment of sleep disorders

Summary Homeostasis Maintenance of constant conditions e.g. hunger / satiety system Circadian rhythms Biological rhythms with 24 hour periodicity Role of SCN as circadian clock: entrainment to light/dark cycle Sleep Sleep as an active process EEGs in different stages of sleep Characteristics of slow wave sleep and REM sleep Disorders of sleep