![]() Sleep patterns and duration are influenced by age. As the night progresses the amount of time spent in NREM stages 3 and 4 (see below) diminishes and the amount of time in REM sleep increases. Generally, a normal night’s sleep begins with roughly 80 minutes of NREM, followed by 10 minutes of REM. Normal sleep cycles between these two states approximately every 90 minutes, and is usually repeated between three and six times in a night. Each has a distinctly different constellation of physiological and neuro-biochemical changes. Sleep is cyclical, and can be divided into two separate phases: rapid eye movement (REM) and non rapid eye movement (NREM) sleep. In animal studies sleep deprivation leads ultimately to death. Prolonged deprivation can lead to behavioural and physiological disarray, such as impaired cognitive performance, temperature control, and immune function. Studies have demonstrated sleep’s important role in memory and learning, and one broadly held theory is that it may allow for waking memories to be consolidated. However a unifying theory as to its function is still unknown. The importance of sleep cannot be underestimated. Sleep is a global state, controlled by a series of interdependent positive and negative feedback loops, exerting control over neuronal systems that in turn control movement, arousal, autonomic functions, cognition and behaviour 1. Part two of this article will be published as a separate tutorial and will discuss dyssomnias and the associated anaesthetic implications. This article describes the normal physiology of human sleep and explores the relationship between anaesthesia and sleep. This definition however, fails to describe the active physiological, psychological and environmental processes required. It can be defined simply as a reversible disengagement from environmental and external stimuli. It is observed in all mammals and birds and Humans spend approximately one third of their lives asleep. Sleep is a fundamental physiological process, crucial to health and wellbeing. Cortisol levels are highest at about midnight.NREM sleep sees an increased heart rate.Which of the following physiological changes occur during sleep?.Ibuprofen delays the onset of deeper stages of sleep.Propofol anaesthesia can help reverse the slept debt in sleep deprived individuals.Dexmedetomidine’s actions are akin to normal sleep.Propofol induced anaesthesia creates sleep spindle activity on EEG recording.Which of the following statements regarding anaesthetic agents, analgesics and sleep are true?.The answers can be found at the end of the article. Before continuing, try to answer the following questions. ![]()
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