Electroencephalogram (EEG)

&
Physiology of sleep
Dr Madiha Imran
 Electroencephalogram (EEG)

►Graphic record of summated electrical

activity of brain (cortical neurons)
obtained by placing electrodes on scalp
 Electroencephalogram (EEG)

►EEG waves divided into four patterns on

the basis of frequency
● Beta 14-80 Hz (low voltage)
● Alpha 8-13 Hz
● Theta 4-7 Hz
● Delta 3 Hz and less (high voltage)
 Electroencephalogram (EEG)

►Important
● Frequency relates directly with cerebral
activity
● Voltage relates directly with synchronization
of cerebral activity
● High brain activity in wakefulness leads to
asynchronous electrical activity
 Electroencephalogram (EEG)

►EEG waves
● Alpha waves
♦ Present in awake relaxed person with eyes closed
(quite wakefulness)
♦ In Resting state
♦ Frequency 8-13 Hz
♦ Amplitude 50-100 µV
♦ Disappear when eyes are opened, deep sleep
♦ Depend upon thalamocortical signals
 Electroencephalogram (EEG)

►EEG waves
● Beta waves (high frequency low voltage)
♦ Present in awake attentive person with eyes
opened (alert wakefulness)
♦ Frequency 14-80 Hz
♦ Amplitude 5-10 µV
♦ Present in REM sleep
 Alpha block

Alpha waves Beta waves

 Electroencephalogram (EEG)

►EEG waves
●Theta waves
♦ Frequency 4-7 Hz
♦ Voltage about 10 µV
♦ Normally occur in children
♦ Occurs in adults in some degenerative brain
problems, emotional stress, frustration &
disappointment
 Electroencephalogram (EEG)

►EEG waves
●Delta waves (low frequency high voltage)
♦ Frequency less than 3 Hz
♦ Voltage about 20-200 µV
♦ Occur in deep sleep (stage 4), infancy and brain
diseases
♦ Independent of thalamocortical signals
Awake eyes closed
Quiet wakefulness

Maximum alertness
high frequency, low
voltage

Children, frustration

Deep sleep
low frequency, high
voltage
 Electroencephalogram (EEG)

►Basis of EEG waves

● Thalamocortical oscillations
♦ Midline thalamic neurons
■ When hyperpolarized - sleep

pattern

■ When depolarized - awake

pattern
 Electroencephalogram (EEG)

►Clinical uses
● Diagnosis of brain diseases
♦ Brain damage (hematoma, tumor)
♦ Epilepsy (type and location)
♦ Deranged blood glucose & pH (PCO2)
● To distinguish various stages of sleep
● Legal determination of brain death
● To differentiate between different states of
consciousness
 Sleep

►State of altered consciousness from

which the person can be aroused by
sensory or other stimuli

►coma which is unconsciousness from

which the person cannot be aroused
 Sleep

►About one third of our lives we spend

sleeping
►Sleep - awake cycle
● 8 : 16 hours
►Characteristic of all the animal kingdom
 Sleep

►Sleep
● An active process not merely the absence of
wakefulness
● Brain activity & O2 consumption don’t
decrease but may rise
 Sleep

►Sleep deprivation
● May lead to impaired immune system,
cognition & memory deficits, sluggishness
of thoughts, psychosis and even death
 Sleep

►States of consciousness (in decreasing

order of alertness and responsiveness)
● Maximum alertness
● Wakefulness
● Sleep
● coma
 Sleep

►Sleep divided into 2 types on the basis of

EEG patterns
►Types
● Non-REM sleep (slow wave sleep)
● REM (Rapid eye movement) sleep
 Sleep

►Non-REM sleep (slow wave or deep sleep)

● Deep restful sleep
● No eye movements
● EEG - slow frequency high amplitude
● Four stages having different EEG pattern
● Sleeping walking and talking occur during
NREM sleep
 Sleep

►Non-REM sleep (slow wave or deep sleep)

● Pulsatile release of growth hormone and
gonadotrophic hormones
● Initial phase of sleep
● Starts with stage 1 and goes to stage 4
● From stage 4 comes back to stage 1
● One cycle completes in about 90-100 minutes
 Sleep

►Non-REM sleep (slow wave or deep sleep)

● Interrupted by REM sleep after every cycle (90-
100 min)
● Occupies about 70-80 % of total sleep time
● Vegetative functions slow down
● Decreased vascular tone & blood pressure
● Decreased heart rate & respiratory rate
● Decrease BMR
 Sleep

►Non-REM sleep (slow wave or deep sleep)

● Stage one (drowsiness)
♦ Alpha waves replaced by low voltage high frequency
(may be low) waves
♦ Lasts 1-7 minutes
● Stage two (light sleep)
♦ Frequency of waves decreases and amplitude rises
(theta waves)
♦ Appearance of ‘sleep spindles’
♦
 Sleep

►Non-REM sleep (slow wave or deep sleep)

● Stage three (moderately deep sleep)
♦ Disappearance of sleep spindles
♦ Frequency decreases further & voltage rises (theta
waves)
● Stage four (deep sleep)
♦ Delta waves appear on EEG
♦ Frequency decreases to 1-3 Hz
♦ Voltage rises further
♦
 Alpha waves Frequency

Sleep spindles

Theta waves

Delta waves

Beta waves
 REM Sleep

►REM sleep (paradoxical/desynchronized sleep)

● Occupies about 20-30 % of total sleep time
● Occurs in episodes after every 90-100 min of REM
sleep
● Each episode lasts for about 5-30 min
● If extremely sleepy, bout of REM sleep is short or
may be absent
● If more restful during day, REM sleep increases
 Sleep

►REM sleep (paradoxical/desynchronized sleep)

● Difficult to arouse than NREM sleep
● Spontaneously awake in the morning during
episode of REM sleep.
● Muscle tone is depressed, irregular muscle
movements do occur
● Heart rate and respiratory rate usually
become irregular
 Sleep

►REM sleep (paradoxical/desynchronized sleep)

● Associated with dreams and active bodily muscle
movements
● Brain is highly active : Brain metabolism, blood
flow and O2 consumption increase
● Beta waves appear on EEG (alert wakefulness)
● Important for consolidation of memory
● Essential for procedural memory
 Sleep

►Sleep cycle
● Starts from stage 1 of slow wave sleep
● Passes through all the 4 stages
● Comes back from stage 4 to 1
● Interrupted by REM sleep for 5 to 30
minutes
● Again stage 1 of slow wave sleep starts
 Theories of sleep

►Old Theory:
● Passive theory
♦ Fatigue of Reticular Activating System
►New Theory:
● Active Inhibitory process
 Sleep centers

● Raphe nuclei in pons and medulla

♦ Role of serotonin
● Sleep zone of anterior hypothalamus
♦ Suprachiasmatic nucleus
♦ Diffuse nuclei of thalamus
● Nucleus of tractus solitarius
 REM sleep center

►Activation of Gigantocellular neurons of reticular

activating system along with hypothalamic sleep

centers
A model of how
alternating activity of
brainstem and
hypothalamic neurons
may influence the
different
states of
consciousness

33
Neurohumoral Control of Brain Activity

Figure 58-3; 34
Guyton & Hall
 Theories of sleep

►Neurotransmitters of sleep:
● SPP – sleep producing peptides
♦ muramyl peptide called Sleep-promoting Factor S
♦ nona peptide called delta-sleep-inducing peptide
(DSIP)

● Serotonin
 Possible Cause of REM Sleep

►Gigantocellular acetylcholine secreting neurons in

the brain stem reticular formation

►Excitatory connections with cerebral cortex

 Physiological effects of sleep
► Little on the body itself
● decrease in sympathetic tone, muscle tone, fall in
arterial pressure
► Profound effect on the brain
►Lack of sleep can lead to altered mental states,
sluggish thought process
►Irritability
►Psychosis
►Paranoia
39
 Physiological effects of sleep

►Probably functions to balance the activity

of the various areas of the brain, to
reset/re-zero/reboot neuronal circuits

40
 Functions of sleep

1. Neural maturation
2. Facilitation of learning or memory
3. Cognition
4. Clearance of metabolic waste products generated
by neural activity in the awake brain
5. Conservation of metabolic energy
 Sleep disorders
► Insomnia
● Inability to sleep
► Narcolepsy
● Irresistible urge to sleep
● Sudden loss of muscle tone - cataplexy
● Passes straight into REM without entering NREM
● Disorder of orexin-producing neurons of
hypothalamus
► Somnambulism
● Sleep walking
 Sleep disorders
• Obstructive sleep apnoea (OSA)

• Fragmented sleep at night

• Breathing ceases for > 10 s during
frequent episodes of obstruction
of the upper airway (especially the
pharynx) due to reduction in
muscle tone

• Treatment: continuous positive

airflow pressure (CPAP)

 Sleep Paralysis

► Occurs during transition between stages of sleep and

wakefulness

► Feeling of being conscious but unable to move for few

seconds up to a few minutes

►Some people may also feel pressure or a sense of

choking
44
 Sleep Paralysis
Who are prone to sleep paralysis?

►Teenagers

►Hereditary

► Other factors

► A lack of sleep

► A sleep routine that changes

► Mental health conditions such as stress or bipolar disorder

► Sleeping on the back

► Other sleep problems such as narcolepsy or night-time leg 45cramps

Disorders of brain electrical activity

46
 Epilepsy

• Uncontrolled excessive activity of a part or

all of the central nervous system
•Grand mal Epilepsy

•Petit mal epilepsy

•Focal epilepsy

47
 Grand mal Epilepsy
•Caused by an overly excitable area of the brain
called a focus
•Causes massive activation of reverberating circuits
which reactivate themselves many times
•Spasmodic contraction of the muscles followed by
an alternating contraction and relaxation
•This is called a tonic-clonic convulsion which
causes violent jerky muscle contractions

48
 Grand mal Epilepsy

•Excessive focal activity lasts for 30 seconds to 3-4

minutes followed by CNS depression (stupor,
fatigue, sleep)
•Predisposed individuals with abnormal neuronal
circuits

49
•Petit mal epilepsy (absence seizures)

•Short periods of unconsciousness (2-3 seconds) with

twitching/ contractions of the facial muscles

•Abnormal function of thalamo-cortical system

•Characteristic electrical pattern called spike and dome

50
•Focal epilepsy

•Localized organic lesion (scar, tumor, ischemia,

congenital malformation)

•Can be confined to a single area of the brain or it can

spread to adjacent regions

51
 Depression
•Feeling of severe despondency and dejection with loss
of interest and pleasure in daily activities
•Disorder of norepinephrine secreting neurons in the
locus ceruleus and / or serotonin secreting neurons
in the raphe nucleus
•Drugs that block the uptake of these transmitters are
helpful in treating depression

52
 Manic-depressive (bipolar) disorder
•A brain disorder that causes unusual shifts in mood,
energy, activity levels…. Alternating moods of
abnormal highs (mania) and lows (depression)
•Norepinephrine and serotonin systems of brain stem
normally provide drive to the limbic system
•Increase sense of well being, happiness,
contentment, psychomotor balance --------- too much
can lead to mania 53
 Schizophrenia
•Disorder of the midbrain
mesolimbic dopaminergic
system

•Patients experience hallucinations,

hear voices, have intense fear or
paranoia

54
 Schizophrenia
Cause may be: Too much
dopamine resulting from excessive
activity of dopaminergic projections
to cortex, prefrontal cortex,
hippocampus, amygdala

Treatment: Drugs that block the

action or release of dopamine

55
 Alzheimer’s disease
•Neurodegenerative disease

•Death of brain cells causes memory loss

and cognitive decline

•Mostly a disease of elderly

•Accumulation of extracellular amyloid plaques and

intracellular neurofibrillary tangles in cerebral cortex,
hippocampus and basal ganglia

56
 Alzheimer’s disease

•Dementia may result from loss of cholinergic input to

cerebral cortex from midbrain nucleus of Meynert

•Genetic predisposition involving apolipoprotein E4 (apoE4)

•Early-onset familial Alzheimer's disease in less than 5% of

patients

57
Thank you