Special of the week; Issue 36-70 "what is REM sleep"

NDE are the national educational radio network presents special of the week from Yale University from its series called Yale reports to sleep per chance to dream how then about what. At times dreams have been considered visions of the future signs of the devil. Communications from God. Advice from ancestors. They are the truth hidden wishes and even plain nonsense. Now scientists are interested in the sleep associated with dreams. Their status sleep has been given many names but is most widely known now as a REM sleep rapid eye movement sleep periodic lay during sleep there are bursts of rapid eye movements which look like the kind of eye movements that people make when they're awake. These movements occur every 90 to 100 minutes and each REM period lasts for about 20 minutes about 20 to 25 percent of sleep is spent in the REM state. This year reports consults Dr. Charles Fisher a clinical professor of psychiatry at the Mount Sinai School of Medicine and noted investigator of REM sleep in his laboratory. Dr. Fisher is

Dr. Howard Ruff Warg assistant professor of psychiatry at Albert Einstein College of Medicine. They are interviewed by Dr. Lorraine Sagan's assistant clinical professor of psychiatry at Yale. Dr. Fisher so called we which is often called Run flea which stands for rapid eye. Was discovered in 1953 quite accidentally it was a real case of serendipity that Western authentic like Chicago the most potent scary when something no one would ever known before. The top order of sweeping everybody every night with few exceptions is spent in a state of great we're never suspect of their plethora rhodium psychoanalysts who I was placed a lot of value on and dreams and bring me dreams were in an instant. But no one had any idea except for a

candid and hinted at the past and maybe dreaming when I know but mostly people thought things were rather fragmentary and occasional what was discovered then is that there is a sort of a third state that is called the third state of existence as well as ordinary sleep it is a special organised state of being has many important functions. Did you sleep for all the other stages of sleep by the rapid. Actually several rather simple primers of recording which grossly That is to say within a minute or two of the beginning a minute or so at the end. Inform us

about the stay but the existence of the state one measure is a measure of the electroencephalogram any one experienced in these matters can identified the IGI pattern of REM sleep quite easily and with quite a high reliability. Then there is the bursting of the rapid eye movements which come in and even prior to that you get slow rolling eye movements which build up and then just after you get the EEG change to this particular kind of pattern the eye movements begin to emerge. And many people think that the eye movements are continuous all through REM sleep. But you have to have the picture in your mind of a kind of a Morse code pattern. First a single eye movement and perhaps a cluster and then no movement at all maybe some slow rolling and then maybe 10 to 15 seconds later another burst and that's the way it goes in the 1962. It was a very

I think one of the very major discovery made by Ralph Berger. Who found the muscles underneath the chin. Some mental muscles lost their tone their tone was rather constant affair lost their tone every time his subjects went into this rapid eye movement. A low voltage fast stage. And so now we use a muscle tone as a rather important characteristic of the state so with electroencephalogram AFAIK and eye movement and muscle tone recording we have a very good way of differentiating the one station the other with a mood to be stressed is that it's a state of remarkable theological activation. When a person is in dreamy sleep these in the state of the logical activation and psychic activation which is probably as great as a person in the waking state and not just any waking state of this night person the state of referee that in the waking person in the state of

alertness like let's say a person looking at the clips of the sound. You know where you would be very in a high state of alert. Now this activation is associated with the various physiological changes that are forever if you didn't care but there are a few more. For instance. Rate and respiratory rate become both somewhat increased and more and that they become highly variable that is their weight fluctuations in changes isolations in their weight and rhythm is compared to 900 mixed sleep which we call non-REM sleep where things are much more quiet and steady so Dishan to that there is another change which is quite surprising and unique notice in the meal goes into erection

during the during REM sleep and this continues out it's also present in the neonate be present in the male from birth to extreme old age. Nice physiological activations are primary that is that they're there in the neonate they entered a probably psychic count and they're there in even the third animal so the physiology comes first later with maturation development psychological development. There is some kind of relationship with the highly complex nature is established between the dreaming and the. Physiological processes that go along with the REM state that gets into the question that I was interested in which is what is the relationship between dreaming and the real state is a very dream is confined to re-instate or you can actually get

reports or is or other mental activity. We usually thought that dreaming was pretty much the end state. There are high correlations when you awaken people during the REM state you early reports were certainly 80 percent of the records have driven me away from people in stately and initial findings were about I guess 7 percent but pretty soon other workers who use more care methods began to report much higher percentages of psychic kind during REM sleep 60 70 percent of the way were associated with some reported content now some of these report sort of bookend percent out of 9 Ransley were about his brain like it's the rendering. But most of the content out of nonbeing was different in quality.

Really he was more thoughtful I was less emotional less visual less dreamlike in general what we call more of the much more like ordinary conscious thinking than dreaming and also much more concerned with recent memory recent experience in that sort of thing but our idea now is that there is some kind of psychic content that goes beyond altering the mind never rests. But what we ordinary folk of the dream at least that 90 percent of it is associated with the REM periods. There are products of the current flowing sleep in the early part of the night which can be very much like like dreams and very hard to distinguish from ordinary dreams.

That's what sleepwalking and sleep talking during the rains associated with dreaming. Well when with me truly astounding finding this field is that most of the pathological disturbances of sleep by which I mean sleep bedwetting nightmares without sleep talking I won't call it normal because that may be a normal person talking to me. Chief symptoms disturbances of sleep which I will thought were somehow associated with brain were dream equivalence that Sandy was in for instance was a dream walking and there a real severe nightmare it was a severe anxiety dream that is remembering.

Well reports began to come Ian know that this was not the case. It's a matter of fact most bedwetting. The true nightmare by which I mean the troop airborne occurrence the night terror and fanatic terrorists something it has to really be seen to be appreciated. It isn't a very common thing. Strangely enough not many people have witnessed it but it's associated with all out panic and blood curdling screams. This type of nightmare and son emulous and bed wetting will have aroused in the early part of the night out of the stage for that's the deepest stage of non dreaming sleep the night terrorizes instantaneously out of stage 4 sleep without any preparation without any physiological indication that there is something going on it's a remarkable phenomenon which I do not yet understand. Person who suddenly let out a wild shriek.

Well if they were at home these night terrors are associated with some nebulous little spears and bounce out of bed and starts running around the house. Is that like a large percentage of naysayers are really a combination of first and then. When a person's actual nightmare he is not in the state asleep he has a waking hour for rhythm and he's in a dissociated state much more much like a hypnotic trance and he's hallucinating he's out of contact with the outside world and he is in a state of terror it's associated with autonomic discharge by which I mean increases heart rate respiratory rate heart rate will go in this is probably no other condition where you can get this kind of rapid change let's say from fifty to a hundred sixty feet in the space of 15 20 seconds.

You cannot bring your heart rate up that fast with exercise and with its need of extreme terror after a few minutes. It's sides in the person idly and I'll go right back to sleep. And maybe an hour later I have another such attack. Sound the same way. It's exactly the same condition a person gets up out of bed and walk or just sit up. But it isn't associated with care and also arises out of out of stage 4. As I said any races can further arise at any stage of sleep but mostly the highest percentage of cases arise out of stage four. Now why this is is puzzling. Now when most people call nightmares for instance REM anxiety dreams of various degrees of intensity. Well the average roaming society dream does not approach in intensity these night terrors. The autonomic changes

associate associated with them at least here in the laboratory. I rarely moderate. That is the heart rate may increase 12 to 16 beats in a minute and that's enough to wake people up in the person's report varying degrees of intensity here here. Only seeing one or two very severe brain nightmares in the laboratory obviously at home people are much more intense and probably with vocalization laboratory person will remain a dream that he is screened out but actually goes through 3 weeks but with the Stage 4 nightmare people really do Boca license a bit differently but most are what people call nightmares. I ran say so because I say it wasn't quite clear why these things occur during dreaming sweetly. The fact remains that they do and it's certainly no longer talented

group and class Elise things to get treated. No no with grinding which was first reported to be associated with RAM then it was shifted west and now most of it is said to go around doing other things like head banging and rocking during sleep. It wouldn't even go on during both. And that's hard to understand too. There are several interesting moments looking for a viewer which are associated with grossly as Dr. Fisher points out were there were as many of what we called what we thought of as a dream equivalents have fallen by the wayside as far as being associated with it the most. Hallucinatory stage of sleep REM sleep certainly physiological changes very prominent with REM sleep and the person with angina pectoris for example will have the majority of his hand John episodes at night in REM sleep.

The individual who has an active peptic ulcer will tend to probe more or hydrochloric acid during REM sleep and than any other stage of sleep and have most of his also a pain at that time. A person with hypertension will have sharp peaks of blood pressure in rapid eye movement sleep. So there are these medical physiological changes and I was wondering whether we're not very close to the time when we'll be giving someone a pill which we know there are various agents which reduce REM sleep in one way or another and whether say during a critical time like this to say the first 10 days after a Kerner cushion when one would want to rest the heart muscle and not cut down coronary flow whether we'll try to reduce room sleep. I think the time was not too far away. The capacity of various drugs to affect various stages of sleep make believe important we've recently been doing something here

which I think is interesting. I told you the severe Night terrors are associated with stage 4 sleep. Actually they are very much linked to stage four sleep in the sense that the more the longer the stretch of stage 4 sleep preceding the outbreak of a nightmare the more tense the nightmare and many other indications of the link between the two occurred to us that if we can suppress stage 4 sleep of the drug we can control the nightmares. So we had heard Bally I should say rather mild tranquilizer and very interesting growth would suppress stage for some given it now to revive. Man with severe stage 4 nightmares and we've reduced their stage for end with a practically eliminated their nightmares now I was are usually very apprehensive about doing this on certain theoretical grounds. If you take away a severe symptom like this which is alleged to protect against psychosis and alternate with psychosis that you would be doing something very risky and maybe they would get

sick. Well nothing of the sort happened but have not had the silly separate exam for a weeks and with practical elimination of their nightmares they feel much better during the day. Nobody has gotten worse or was surly septics are very safe at the borderline. Eventually paranoid individuals not only don't they they don't get worse actually reported they're better in with 5 percent as I said some of the subjects through many weeks and then and seeing that gotten worse. Also we have suppressed unless we get into the problem of what stage of sleep if any is necessary and what is it necessary for. It's been said that stage 4 sleep maybe is necessary as REM sleep. We now don't even know where the REM sleep is necessary. Probably the

function of stage 4 sleep may have some connection with physiological restitution. Since it seems to increase after sleep deprivation like a rapper found out long ago that little children who are very active have much more stage for sleep than adults and as you get older. Stage 4 sleep tends to diminish because. It may not be just because people are less active and maybe some other reason for any rate there is West. Come back to these nightmare subjects we have suppressed staged for for long periods of time. Nothing bad seems to happen to them. However let Doesn't stage Burruss an artificial division only means that on a page of the record more than 50 percent of the waves are these large delta waves which we call stage four. And we're not by any means totally eliminate delta sleep. There

are still a considerable amount of delta sleep but there is not sufficient concentration of these delta waves to be able to call the stage floor. So where is with our peers who are at functions or maybe a large margin of safety. Anyway it's perfectly clear that you can reduce stage for very markedly and nothing bad happens to these people. It's very interesting to Fischer this does lead us into the whole question of sleep deprivation and what part of sleep is necessary. Dr. Ro I don't always get good if people would go to sleep. They had quite the mental changes on disorganization could this have anything to do with particular time and sleep for totals. We we we used to worry about the deprivation of rapid eye movement sleep because early reports demonstrated that there was psychological difficulties and some physiological difficulties that occur but if under the

proper setting with the subject as comfortable as he can be in the security can be I think where the supports of working go for upwards of 12 to 18 days before there's a real kind of mental breakdowns. One thing that has to be remembered about sleep is that it's quite plastic in the sense that if you deprive a person of rapid eye movement sleep in terms of the parameters that I suggested before the eye movements muscle tone and need you weigh it. It doesn't necessarily stop at the very important perhaps primarily important brain stem functions and rapid eye movement sleep going on anyway and there's no good evidence in animals that some of the important Percy's of rapid eye movement sleep which are usually integrated with these m movements in cortical waves will and will go on during not rapid eye movement sleep if the if the state of rapid eye movement sleep is blocked on the base of the superficial symbols that are not simple so much but a superficial signs I should

say. The whole business of sleep deprivation. Stage for deprivation of REM deprivation is least in my opinion the current state of considerable confusion. The problem of deprivation you see initially we thought that since it's very hard to suppress rem you know when you credit suppress that it keeps bouncing back and when you do suppress it over night and you get a compensatory increase and remain clean the next night or for a number of nights so it looked like it was a necessary thing. Also on theoretical grounds we had the idea that I had the idea at any rate be suppressed or drown in a person get psychotic because of the alleged relationship between dreams and psychosis. Now no one has ever brought about a psychosis in humans by REM deprivation. Now recently Wired In With Esther has found that you can bring about a total suppression of REM

with certain antidepressant drugs the Mayo inhibitor inhibitors. This is just a depressed patient. And it's during the suppression of REM that the patients get better and they seem to show no ill effects of the prolonged REM suppression So that's again a very mysterious thing especially sense. Animals when rendered crab do show some profound disturbances which for some reason or other people in the field don't seem to recognize and have followed the mantras written about it extensively and if you saw Ali's animal's behavior you'd think they were crazy if humans were doing the same thing you would think they were psychotic. They can become hypersexual. They become a hyper phage that is they eat too much they also become police that the rats show increased aggressive behavior. So there's a release of right behavior. Now you could make a case where well this is

what Freud said happens in dreams that Western sexual drive found a partial outlet during dreaming. If you prevent dreaming from taking place that night you will break out in the day and there is a breakdown and there breaks and then current terms of the polymorphous perverse behavior. So all that needs to be thought about a great deal more than it has been thought about because these are the most marked disturbances of behavior that you can that you can think of. I was wondering what you what you see. You say someone has an acute psychosis someone who does have an acute disturbance is there any change in the amount to sleep the whole relationship to REM sleep or even the various stages of sleep to mental disease again as well in a state of confusion but certain things are clear.

The very first piece of work I was way back early I think 19 people da man got a group of crime excuse the premix and study their sleep. He was surprised to find this ground exclusive pranic showed a rather normal sleep cycle with a normal amount of REM sleep. And you can take it back wards get schizo premix and run them and they look pretty good. But show me where the malady which was surprising. Now the whole picture of acute psychosis is rather obscure. I've told you a bit about the pathological symptoms of sleep like nightmares. They're mostly non-REM. There is one condition with that really obvious recent sleep research as clarified and that is a narc in the skull narcolepsy narcolepsy thing. Disease syndrome where people periodically fall asleep during the day in voluntarily

and one will remain asleep for 15 minutes or so and they may do this many times during the day so they have difficulty holding a chair where they may even injure themselves. And along with the sleep they show another interesting scent symptom called cataplexy will also only lose their muscle tone and fall down in a heap. Now without going into detail of all the symptoms of narcolepsy or at least the most dominant form of narcolepsy can be explained in terms of the physiology of Brehm sleep and now at least have a way of actually the narcoleptic sleep attackers. A REM sleep attack. Now I understand not all of them Colonel complete It's a very it's a very it's a one of those low loss of muscle tone that you have last year but there are a lot of left attacks that are purely granted. Actually it's again like a lot of things in this field would

first turn out to be simple and I've gotten extremely complicated. He went anyway and I'm told it's the way you think. Yeah that's right. Almost every area has become. It reaches sort of places where everything's conflicted in there there's a half dozen varying reports about the same thing and it gets very difficult. But really great recent research is certainly thrown a lot of light on narcolepsy. He also opened up some problems can be things said to be true of almost every area doing a lot of writing a lot of things but it's revealed a lot of mysteries to them and I would change 600 700 papers a year being produced on sleep. It's really no longer sleep research. It's really you know physiology and psychology taken to the dark hours of the day the dark hours of the 24 hour cycle when we never studied ourselves or or even animals and it's a very much. So we're really now talking a great deal more about the

total psychology and total physiology and or physiology of organisms. So that's what sleep is really becoming part of of every other field and every other field is really having to include in its procedures just sleep research procedures to get a person sees going on. During sleep. Random rapid eye movement sleep where Dr. Charles Spencer clinical professor of psychiatry at the Mount Sinai School of Medicine and Dr. Helen Brown Ford assistant professor of psychiatry at Albert Einstein College of Medicine interviewed by Dr. Lorraine second assistant clinical professor of psychiatry at Yale. NPR's special of the week Thanks Yale University for the recording of this program. This is Annie are the national educational radio network.