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The Function of Sleep and Dreams
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1 2 3 4 5 6 7 HOURS OF SLEEP
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Figure 19-3 Normal sleep cycles REM sleep (darkened areas) occurs cyclically throughout the night at intervals of approximately 90 min in all age groups REM sleep shows little variation in the different age groups, whereas stage 4 sleep decreases with age (Redrawn by permission from Kales and Kales et al)
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inhibitory neurotransmitters Single-cell recordings from the pontine reticular formation have suggested that there are two interconnected neuronal populations whose levels of activity uctuate periodically and reciprocally During wakefulness, according to this conceptualization, the activity of aminergic (inhibitory) neurons is high; because of this inhibition, the activity of the cholinergic neurons is low During NREM sleep, aminergic inhibition gradually declines and cholinergic excitation increases; REM sleep occurs when the shift is complete It is likely that these monoaminergic neuronal circuits are modulated by input from hypocretin-secreting neurons of the hypothalamus, but the details of this control system are not yet known Hypocretin, a peptide that assumes great importance in the pathophysiology of narcolepsy, is discussed further on Despite the undoubted heuristic value of Hobson s reciprocal interaction hypothesis, some of its features remain controversial Although it is generally agreed that cholinergic mechanisms selectively promote REM sleep and its components rapid eye movements, absence of activity in the antigravity muscles (ie, atonia), and desynchronized EEG the role of amines has been more dif cult to establish Thus, lesions of the locus ceruleus and raphe nuclei, which contain neurons rich in norepinephrine, do not greatly alter REM sleep Nevertheless, a considerable body of pharmacologic data suggests that a decrease in monoamines causes an increase in REM activity and vice versa Insofar as the bulk of cholinergic and aminergic neurons are found in the pedunculopontine
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This has been pondered almost endlessly by physiologists and psychiatrists Parkes has reviewed the main theories body restitution, facilitation of motor function, consolidation of learning and memory and tends to agree with the ungrammatical but unambiguous conclusion of Popper and Eccles that Sleep is a natural repeated unconsciousness that we do not even know the reason for There is no convincing proof, for example, of the popular notion that we stabilize learned material while asleep, nor can one logically entertain the notion that the function of sleep is to produce dreams, at least until the utility and meaning of dreams become known On the basis of plausibility and logic, we favor the simple notion that sleep restores strength and physical and mental energy Regarding neurophysiologic changes during dreaming, Braun and colleagues, who used positron emission tomography (PET) to study REM sleep, observed selective activation of the extrastriate visual cortices and limbic-paralimbic regions, with concomitant attenuation of activity in the primary visual cortex and frontal association areas The relation of these ndings to the nature of dreams is discussed below Based on these and similar studies, several authors have speculated that the suppression of frontal lobe activity during dreaming, at a time when visual association areas and their paralimbic connections are activated, might explain the uncritical acceptance of the bizarre visual content, the disordered temporal relationships, and the heightened emotionality that characterize dreams, as mentioned earlier This would be in keeping with Hobson s expressed view of dreams as a form of delirium (This is an interesting idea and one that we nd appealing, but it explains little, since the nature of delirium is also obscure) As an alternative that links dreams to inherent meaning for the individual, Solms has suggested that activation of frontal dopaminergic systems, the same pathways that participate in most biologic drives, implies that dreams express latent wishes and drives the classic psychoanalytical interpretation expressed by Freud in his book The Interpretation of Dreams We remain skeptical of these views
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