Page 202 - Cardiac Nursing

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178 PA R T I I / Physiologic and Pathologic Responses
C4 C3 C4-A1
A A2 A1 ■ Figure 8-1 Placement of elec-
trodes for (top) electroencephalogram
and (bottom) electro-oculogram and
electromyogram in polygraphic sleep
recordings. (From Rechtschaffen,
A., & Kales, A. [Eds.]. [1968].
A manual of standardized terminol-
ogy, techniques and scoring system for
E1 sleep stages of human subjects [p. 15].
E E22 2 2 2 2 2 LEFT EYE - A1
Los Angeles, CA: Brain Information
Service/Brain Research Institute,
A1 University of California, 1968.)
A A2 RIGHT EYE - A1
EMG
epoch. The eyes are relatively quiet during NREM sleep, except REM sleep there is also a complete loss of postural muscle tone
for slow rolling movements that usually occur at the beginning of caused by hyperpolarization of brainstem and spinal motorneu-
stage 1 and disappear in stage 2. Muscle tone is moderately re- rons. 18 The sleeper has an active brain in a paralyzed body, with
duced from the waking level. 12,15 only the diaphragm and extraocular muscles retaining substantial
There are two types of REM sleep. Similar to waking, tonic tone. Some suggest that the purpose of this physiological phe-
REM sleep is characterized by desynchronized brain activity—a nomenon is to prevent the enactment of dreams. REM behavior
mixed frequency, relatively low-amplitude EEG. However, in disorder, in which there is loss of this normally occurring paralysis,
A WAKEFULNESS
B STAGE 1 ■ Figure 8-2 Electroencephalogram pat-
terns in wakefulness and sleep in a young
adult. (A) Rhythmic -wave activity at 8 to
10 Hz in relaxed wakefulness with the eyes
closed. (B) Mixed-frequency, relatively
C STAGE 2 low-amplitude waves in nonrapid-eye-
movement (REM) stage 1, with a vertex
sharp wave toward the end of the tracing.
(C) K complex (arrow) and sleep spindles
(underscored ) begin in stage 2. (D,E) Pro-
D STAGE 3 gressively greater percentages of slow, high-
amplitude waves in stages 3 and 4. (F)
Mixed-frequency, relatively low-amplitude
waves in rapid-eye-movement sleep, similar
to the pattern in stage 1. (From Dement,
E STAGE 4 W., Richardson, G., Prinz, P. et al. [1985].
Changes of sleep and wakefulness with age.
In C. E. Finch, & E. L. Schneider [Eds.],
Handbook of the biology of aging, [2nd ed.,
p. 694]. New York: Van Nostrand Reinhold.)
F REM
100 V
5 sec