ALTERED STATES OF AWARENESS



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ALTERED STATES OF AWARENESS REVISION

Key Ideas

Knowledge and understanding should be relevant to the following key ideas:

• Our level of awareness is constantly changing.

• Arousal can have both beneficial and deleterious effects.

• There are many effective ways to improve coping with stress.

Areas of Learning

• Circadian rhythms; sleep deprivation and sleep needs; stages of sleep; common sleep disorders; psychological and physiological arousal; the relationship between arousal and task performance; stress and its effect on health.

• Psychological principles concerning altered states of awareness in everyday experiences and events, including shift work, and in psychological interventions, including psychological therapies for insomnia and for coping with stress.

• Application of these psychological principles to social issues (e.g. the road toll, workplace accidents, the influence of shift work on health, the influence of jet lag on sporting performance) and personal growth (e.g. improving one’s own stress management, ‘sleep hygiene’).

• Investigation designs and methods of assessing psychological responses used to study altered states of awareness.

• Ethical issues associated with research and applications in the area of altered states of awareness.

Circadian rhythms

• Circadian Rhythms:

➢ The 24 hour biological cycles found in humans and many other species Accompanied by fluctuations in temperature, hormone regulation, blood pressure, etc. The rhythmic changes that affect our mental alertness

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1. Exposure to light can reset biological clocks

2. When exposed to light receptors in the retina send direct inputs to a small structure in the hypothalamus called the SUPRA-CHIASMATIC NUCLEUS (SCN)

3. The SCN sends signals to the PINEAL GLAND which secretes MELATONIN.

4. This hormone plays a key role in adjusting biological clocks.

5. Being out of sync with circadian rhythms is one reason for JET LAG and for the unpleasant nature of rotating shift work

Sleep deprivation and sleep needs

Why do we need sleep?

Why? Still remains a challenge……

Repair and Restoration

➢ Sleep promotes physiological processes that rejuvenate the body each night.

➢ A lot of cell repair occurs during sleep.

➢ Body strengthens its immune system and eliminates waste products from the muscles during sleep

Evolutionary:-Sleep has an adaptive value

➢ Sleep evolved to conserve energy

➢ Sleep evolved as a protective mechanism to prevent people from

wandering into a hostile world where predators have the advantage

➢ Helps animals restore energy and bodily resources depleted by walking

Sleep deprivation

Sleep deprivation means going without sleep

➢ Sleep deprived people are effected in terms of their mood, cognitive tasks, decision making, attention and perceptual motor tasks.

➢ However this can change based on their motivation to perform such tasks.

➢ Night time workers are known to have fallen asleep on the job

➢ Some car accidents occur when drivers fall asleep at the wheel

➢ Industrial accidents can occur when employees are sleep deprived

• Most people cannot stay awake long enough to provide meaningful research data.

Common symptoms of sleep deprivation include:

      tiredness - microsleeps

      irritability, edginess

      inability to tolerate stress

      problems with concentration and memory

      behavioral, learning or social problems

      frequent infections

      blurred vision

     

Stages of sleep

➢ REM sleep is a relatively deep stage of sleep marked by Rapid Eye Movements, high-frequency, low-amplitude brain waves and vivid dreaming.

➢ NREM (Non-REM sleep consists of stages 1 –4

➢ Absence of rapid eye movement

➢ Relatively little dreaming

➢ Varied EEG activity

➢ The sleep cycle is usually repeated about 4 times during the course of a night

➢ The first REM period lasts only a few minutes

➢ Subsequent periods get longer, peaking at around 40-60 minutes

➢ NREM intervals tend to get shorter

➢ Young adults typically spend about:

➢ 60% of their sleep time in light sleep (stages 1 & 2),

➢ 20% IN SWS (stages 3 & 4) and

➢ 20% in REM sleep

|Stage of |EEG |EMG |EOG |Other Physiological |

|Sleep |(brain wave patterns |(muscle |(eye movements) |signs |

| | |tension) | | |

|Alert |Beta waves |active |active |Normal |

| |High frequency (13-24 cps) | | | |

| |High amplitude | | | |

|Waking |Brain activity begins to slow to |High |Active, may be |Normal, relaxed |

|(relaxed) |Alpha waves |amplitude |spiky with eye | |

| |Slower frequency 8-12 cps | |blinks | |

|Stage 1 |Only a few minutes |High |May be rolling |People will deny having |

|(drowsy) |Low amplitude, mixed frequency Theta |amplitude, | |been asleep |

| |waves |but not | |Breathing, heart rate, |

| |(4-7 cps) |distorted | |blood pressure start to |

| | |Hypnic jerks | |drop |

|Stage 2 |Theta waves continue |Medium |No eye movement |Breathing, heart rate, |

|(light |Sleep spindles (low amplitude, high |amplitude | |blood pressure, body |

|sleep) |frequency) | | |temperature continue to |

| |K-complexes (slow, high amplitude | | |drop |

| |waves) | | | |

|Stage 3 |Delta waves |Medium or low|No eye movement |Breathing, heart rate, |

|(SWS – deep|High amplitude, low frequency |amplitude, | |blood pressure, body |

|sleep) |rhythmic waves |muscles relax| |temperature continue to |

| |Delta waves make up 20% -50% of brain| | |drop |

| |waves | | | |

|Stage 4 |Delta waves are more than 50% |Relaxed |No eye movement |Lower body temp, |

|(SWS – very|Deepest stage of sleep | | |respiration is decreased|

|deep sleep)| | | |Harder to wake someone |

| | | | |If awoken, confused, |

| | | | |disoriented |

|REM sleep |Similar to stage 1. Beta and some |Low |Sharp |Pulse rate, blood |

| |alpha waves |Muscles are |intermittent eye|pressure quicken, |

| | |relaxed |movements L to R|respiration faster |

| | | |and up and down |People report dreaming |

| | | | |when woken |

Effects of age on normal sleep cycles. REM sleep (darkened area) occurs cyclically throughout the night at intervals of approximately 90 minutes in all age groups. REM sleep decreases slightly in the elderly, whereas stage 4 sleep decreases progressively with age, so that little, if any, is present in the elderly. In addition, the elderly have frequent awakenings and a notable increase in wake time after sleep onset

Common sleep disorders

Insomnia

❖ Insomnia refers to chronic problems in getting adequate sleep

❖ Difficulty in falling asleep initially

❖ Difficulty in remaining asleep

❖ Persistent early-morning awakening

❖ Insomnia is also associated with daytime fatigue, impaired functioning, reduced productivity and increased health problems

Causes

❖ Excessive anxiety and tension

❖ Emotionally problems such as depression

❖ Stress such as pressures at work

❖ Health problems such as back pain, ulcers, asthma

❖ Drugs- stimulants such as cocaine and amphetamines

Treatments

See below

Sleep Apnoea

• Sleep Apnoea involves frequent, reflexive gasping for air, that awakens a person and disrupts sleep.

• In its mild form it can lead to snoring

• If severe it can lead to obstruction of the airway and cessation of breathing

Treatments

▪ Weight loss may help reduce the condition

▪ Sleep apnoea machine CPAP pump – sufferers wear a mask and air is delivered a low pressure down the airway to help keep the airway open. No cure however symptoms can be relieved and improve day to day lives.

▪

Narcolespsy

❖ Some people suffer from an inability to stay awake

❖ Narcolepsy involves extreme daytime sleepiness and sudden uncontrollable sleep attacks

❖ No cure, but stimulant drugs reduce daytime sleepiness

Sleep walking

❖ Typically occurs in stage 3 or stage 4 of slow wave sleep

❖ Blank stares, unresponsive, seem vaguely conscious of their environment, go to the bathroom or find something to eat

❖ Usually have no memory of the event in the morning

❖ May be inherited

❖ May be due to alcohol, stress, illness, medications

❖ Can be treated using psychotherapy, hypnosis, drugs or routinely awakening before they typically sleepwalk

Nightmares

❖ Nightmares are frightening, anxiety arousing dreams

❖ Occur more often during REM sleep

❖ Persistent nightmares may reflect an emotional disturbance

❖ Significant stress in one’s life is associated with increased frequency and intensity of nightmares.

Night terrors

❖ Also called sleep terrors, common in Slow Wave Sleep

❖ Intense nightmares

❖ Mainly with children

❖ Usually sit up, appear to awaken, blood curling scream, thrash about in bed, flee to another room

❖ Is some recall if woken during nightmare

Psychological and physiological arousal

Stress:

Stress is a state of heightened arousal.

The sympathetic component of the autonomic nervous system activates the fight or flight response. It is not healthy to remain in this heightened state of arousal for long periods of time.

Physiological Aspects:

When a person become physiologically aroused the fight-or-flight response causes:

▪ Increase in respiration to supply the blood with more oxygen

▪ Heart rate increase and blood pressure increase allowing more oxygen and blood sugar to reach the muscles

▪ Blood is diverted from the skin (pale, cold and clammy skin is a sign)

▪ Temperature rises

▪ We sweat more

▪ Digestion system slows down or stops

▪ Muscles become tense

Psychological Aspects:

The fight-or-flight response also causes changes that make us more:

▪ Irritable

▪ Anxious

▪ Excitable

▪ Psychologically alert to a threat

The relationship between arousal and task performance

Research shows that there is an optimal level of arousal for an individual to achieve optimal performance in a talk.

If arousal is too low or too high then they will not achieve optimal performance.

If arousal is low, you are tired, the performance won’t be as good as it could be.

If arousal is high, you are stressed, overly anxious or worried this will prevent optimal performance.

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Stress and its effect on health.

Stress us something we all feel at some time.

Stressors can be uncommon or everyday things. They can be both negative and positive (death or marriage)

Selye showed how stressful events can negatively affect health

Alarm

Adrenaline is released during the alarm phase

Fight-or-flight response

Stress resistance Normal level of resistance

Resistance

Parasympathetic nervous system conserves energy

Physiological stress symptoms decline but remain slightly

elevated. Hormones adrenaline and cortisol are released

at elevated levels

Exhaustion

The body can no longer sustain the level of arousal. During this time the ability to repair tissue and resist infection is reduced, people become more prone to illness.

Exhaustion is the key reason why prolonged stress can lead to ill health such as headaches, influenza, depression, sore throat and backache.

Ultimately stress can have a negative effect on health because the body is less able to fight illness as resources have been diverted to deal with the stress rather than keep the body’s immune system strong.

Stress often leads to mental health issues such as anxiety or depression and can lead to undesirable behaviours such as drinking and smoking, less exercise, poor diet and poor concentration.

Psychological principles concerning altered states of awareness in everyday experiences and events, including shift work, and in psychological interventions, including psychological therapies for insomnia and for coping with stress.

Psychological Interventions

Therapies for insomnia

❖ Prescription and sedative drugs. Although they promote sleep, they reduce the time spent in SWS and REM sleep

❖ CBT treatments

Stimulus Control Therapy

Based on the assumption that where a person sleeps becomes associated with factors to do with staying awake. Many insomnia sufferers can fall asleep in the lounge, but not in bed.

Advice:

1. lie in bed only when you feel sleepy

2. don’t use bed to read, watch tv, eat or worry

3. if you lie in bed but can’t sleep – get up again

4. get up at the same time each morning

5. do not nap during the day

Coping with stress

Problem based strategies

▪ change the things that are causing stress

Emotion based strategies

▪ change the negative thoughts about the situation and the negative emotional consequences of the stress

▪ Cognitive therapy – assumes that a person’s thoughts are causing them psychological problems. Psychologists use techniques to help people change negative thoughts into more positive ways of thinking

o Rational –emotive behaviours therapy aims to maximise rational thoughts and minimise irrational thoughts. Brings the irrational thoughts to the attention of the patient and then shows a more logical and rational thought.

o Cognitive therapy – patients keep a journal of thoughts and moods and then questions the patients reasons for these.

▪ Cognitive behaviour therapy- combines cognitive therapy which involves changing thoughts, with behaviour therapy, which involves chanign behaviour.

o CBT can equip people with problem-solving strategies to better deal with stressful situations

o Patients can learn to plan how to cope with stressful situations

o Useful in treating panic attacks. A patient may be taught breathing techniques and rational analysis of the beliefs that led to the panic attack.

Application of these psychological principles to social issues (e.g. the road toll, workplace accidents, the influence of shift work on health, the influence of jet lag on sporting performance) and personal growth (e.g. improving one’s own stress management, ‘sleep hygiene’).

Jet Lag

❖ Jet lag is the temporary maladjustment that occurs when a change of time zone causes biological rhythms

to be out of step with local time.

❖ Your circadian rhythm is not synchronized with your surroundings

❖ Symptoms: fatigue, insomnia, disturbed appetite, headaches, irritability, stomach aches, difficulty in concentrating.

❖ East to West Travel

❖ Your body clock moves ahead of local time

❖ Coincides with the body’s tendency to extend the sleep-wake cycle to 25 hours

❖ Exposure to light later in the day will help delay the circadian cycle

❖ Is easier to make adjustments in this direction compared with West to East travel

❖ West to East Travel

❖ Your body clock falls behind the time of your destination

❖ Coincides with the body’s tendency to shorten the sleep-wake cycle

❖ Need to avoid light late in the day to move the body clock forward

❖ It is harder to make adjustments in this direction than it is for East to West travel

• It is easier to elongate one’s day by staying up later than to try to shorten it by going to sleep earlier

Coping Strategies

❖ If staying in destination a short time:- eat and sleep on your “home time”

❖ If staying in destination for a longer time:-

❖ Eat and sleep according to your destination time before leaving

❖ Use sunlight to reset your internal clock

Shiftwork

❖ Shift work disrupts circadian rhythms and hence the body’s sleep-wale cycle is desynchronized

❖ Changing shifts intensifies the severity of circadian rhythm disturbance

❖ People can adjust to shifts if the change is relatively permanent. The shift in circadian rhythm remains constant once the body adapts to it.

Coping strategies

❖ Rotate shifts clockwise (DAY-EVENINGS-NIGHT)

❖ Spend more time an one shift

❖ For night shift workers, sleep in a quiet dark room to foster day time sleep

❖ Avoid rotating shifts from DAY – NIGHT – EVENINGS

Fatigue and the Road Toll’

▪ Fatigue is another factor along with speed, alcohol and driver inattentiveness that increases the road toll.

▪ Fatigue basically means that someone is drowsy, more likely to fall asleep and has impaired performance such as a slower reaction time.

▪ Driver fatigue often occurs for people who are driving long distances, such as commercial truck drivers, however fatigue can also occur because of the timing of the circadian rhythm.

▪ Many people drive even though they may be sleep deprived due to inadequate sleep the night before(sleep debt), or due a sleep disorder.

Coping Strategies

▪ Prior to a long trip have 7-8 hours of uninterrupted sleep

▪ Arrange accommodation in advance

▪ Take 15 minute breaks every 2 hours and eat healthy meals

▪ Governments can put in rumble strips, provide rest areas, driver revive stations on long weekends, advertising about powernaps, resting, microsleeps etc

• A delayed circadian rhythm can lead to Delayed Sleep Phase Syndrome

Delayed Sleep Phase Syndrome (DSPS)

- when a delayed circadian rhythm interferes with one’s lifestyle (e.g. social, family, vocational/occupational)

• Note: possible to have a delayed circadian rhythm yet function quite well

• Estimated 7.5 - 38% of adolescents experience DSPS

• Delay in biological (e.g. body temperature) and psychological (sleep/alertness) circadian rhythms

• How does delayed rhythm fit with typical school hours?

• Therefore, adolescents with DSPS may be asked to function or perform at a time in their circadian rhythm when in fact they should be asleep.

• The DSPS situation is similar to the effects of sleep and fatigue due to shiftwork.

• Specifically, there are two main problems:

• adolescents working at a time not conducive to their

circadian rhythm,

• adolescents are obtaining less sleep, which builds up over

the 5-day school week.

• Treating DSPS

• Make circadian rhythms of adolescents earlier:

• First, how assess if adolescents are experiencing delayed circadian rhythm.

• objective measures (EEG, body temperature, melatonin, activity monitors)

•

• subjective measures (sleep/wake diary, reaction time tasks, stanford sleepiness scales, epworth sleepiness scale, time of day preference scale)

Improving Stress Management

1. develop problem solving strategies

2. plan ways to resolve issues

3. seek advice about how to change situations

4. avoid stressors by planning ahead

5. use the support of a friend to reduce stress levels

6. exercise is important as physically fit people do not become ill as often whtn they are stressed

7. Massage lowers stress hormones and reduces depression, pain and anxiety

8. Good nutrition and adequate sleep

9. Relaxation techniques help reduce physiological arousal. Do an activity you find calming – music, reading, cooking, writing in a journal

Sleep Hygiene

1. Stick to a consistent wake up time and bedtime every day of the week

2. have a quiet and comfortable sleep environment

3. Don’t consume caffeine within 4 hours of going to bed

4. Don’t nap during the day

5. Make a worry list – don’t take problems to bed

6. Establish a bedtime routine – tv off at 9, shower, read a book, lights off at 10pm

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Investigation designs and methods of assessing psychological responses used to study altered states of awareness.

Investigation Designs

Experimental

Providing participants with white noise and experimenting on quality of sleep

Experimenting in a sleep lab with different amounts of sleep deprivation

Quantitative Observational

Observing sleep in sleep labs

Observing road statistics and reported levels of fatigue

Observing reported levels of stress on exam performance

Qualtitative

Conducting focus groups to seek information on thoughts and experiences about sleep or stress

Measures

Sleep and fatigue:

Objective measures

▪ EEG machine measures brain activity and shows different brain waves for different stages of sleep

Subjective measures

▪ Epworth sleepiness scale – scoring estimated levels of sleepiness throughout the day on a rating scale

▪ Stanford Sleepiness scale – rating 7 statements about alertness to determine current levels of alertness

Qualitative measures

▪ Open ended questions or focus groups discussing sleepiness and the effects of fatigue

Stress and arousal

Objective measures

▪ Polygraph – measure heart rate, GSR, blood pressure, breathing rate to determine levels of stress – assumes that stress increases these measures.

Subjective measures

▪ Social Readjustment Scale – list of item such as divorce, death,. moving house, holidays, marriage, pregnancy and gives each of these items a score out of 100 for the level of stress in someone’s life.

Qualitative measures

▪ Focus groups or Delphi technique questions.

Ethical issues associated with research and applications in the area of altered states of awareness.

Same ethical issues applpy to all research conducted on stress and sleep.

It is important for researchers to be aware that people with sleep disorders or who are stressed are particular vulnerable and may not think things through thoroughly. It is important for psychologists to consider this when gaining informed consent and voluntary participation from participants.

Due to vulnerability it is important to minimize the harm and remain alert to distress of participants.

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Sleep needs at different ages

Individuals differ considerably in their natural sleep patterns. Most adults in nontropical areas are comfortable with 6.5 to 8 hours daily, taken in a single period. Children (12-16 hours) and adolescents sleep more than adults, and young adults sleep more than older ones. Normal sleep consists of four to six behaviorally and electroencephalographically (EEG) defined cycles, including periods during which the brain is active (associated with rapid eye movements, called REM sleep), preceded by four progressively deeper, quieter sleep stages graded 1 to 4 on the basis of increasingly slow EEG patterns(4). Deep sleep or slow wave sleep (SWS) (stages 3 and 4) gradually lessens with age and usually disappears in the elderly.

Common effects of sleep deprivation

      increased fatigue

      depression

      difficulty with social relationships

      decreased productivity

      breathing disorders

      heart disease

      motor vehicle accidents

Common causes of sleep deprivation include:

•       not allowing enough time for sleep

      sleep disorders

      excessive worry

      depression

      repeated awakenings from noise or trips to the

       bathroom

      anything that causes insomnia or poor quality of sleep

      medication that may interfere with sleep

      lack of exercise

Optimal levels of arousal vary according to the difficulty or complexity of the task.

Complex tasks: eg concert pianist, solving maths problems, requires a low level of arousal for optimal performance

Simple tasks: eg weightlifting, adding simple numbers, requires a high level of arousal is usually best.

Task familiarity or experience is another factor. If a task is very familiar a higher level of arousal is needed to reach optimal performance.

Alarm Resistence Exhaustion

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