Santa Fe, New MexicoJuly 29- August 2, 2013
Sleep: An analysis of    this entity and its     influence on the     development of  mankind in areas ofreligion, medicin...
Sleep and Yesterday?Dream and Yesterday?  (Show of hands)
“Yesterday” - Sir Paul                 McCartneyhttp://www.youtube.com/watch?v=Ms65JQTBCcQ
Dr. Indal M. SeudealAreas of practice  Internal medicine  Pulmonary medicine  Critical care medicine  Emergency room medic...
OutlineHistorical perspective of   Parasomniassleep                          REM behavior disorder                        ...
Historical Perspectives        of Sleep
800-600 B.C., Homer’s                  Odyssey                                               Epic Greek poem              ...
350 B.C., Aristotle            “Sleep is…a seizure of the            primary sense organ…”            Seat of consciousnes...
~1490, Leonardo da                          Vinci                                               Polyphasic sleep: daVinci ...
1598, William              ShakespeareHenry IV (1598): obstructive sleepapnea, Cheyne-Stokes respirationHamlet: “To be, or...
1737-1798, Luigi Galvani                                               Italian physician                                  ...
1769-1821, Napoleon                      Bonaparte                 Sleep prescription                 Sleep habits: possib...
1903, First sleeping pill                                               Barbital (Veronal)                                ...
1916, The hypothalamus                and sleep                Constantin von Economo                studied patients with...
1935, Biological clock                                               German biologist Erwin                               ...
1953, Discovery of REM                   sleephttp://healthysleep.med.harvard.edu/healthy/matters/history
http://healthysleep.med.harvard.edu/healthy/matters/history
1997, Mammalian clock                  genes                                               Joseph Takahashi               ...
2003, Sleep and                               memory             Sleep: important role in             learning and memory ...
“Yesterday” - Sir Paul                 McCartneyhttp://www.youtube.com/watch?v=Ms65JQTBCcQ
Sleep and Religious       Views      Christianity          Buddhism             Islam           Hinduism            Judaism
Christianity              The term sleep is used symbolically in different senses in              the Bible              •...
Christianity              •      To portray the utter and final punishment of a wicked power                     •     Pro...
Christianity                     • Sleep can suggest the notion of being unprepared to                       meet the Lord...
Christianity                     • Sometimes sleep implies the future resurrection of the                       human body...
BuddhismBuddha Gautama   Insight into cause of   suffering and steps   necessary to eliminate it   Sat under the bodhi tre...
BuddhismDalai Lama: “Sleep is the best meditation” (People Magazine, 1979)AH: So you go to bed at 8:30 at night and you wa...
Buddhism
IslamIslam  Emerged as a religion in the 7th century  2 sources of Islamic jurisprudence (the Quran and  Hadith)  Allah re...
IslamTypes of sleep:1.       Sinah: slumber or dozing off for a very short period     •         “No slumber (Sinah) can se...
IslamTypes of sleep:4. Hojoo: sleep at night  •   “They used to sleep but little by night (Hojoo). And in the      hours b...
IslamProphet Muhammad  Encouraged not to be involved in any activity after Isha  prayer (darkness prayer)     “One should ...
IslamThe Quran indicates some resemblance between sleep anddeathThe Quran uses Wafat to describe death   “It is Allah Who ...
HinduismHindu architecture: Vaastu ShastraThe world is a manifestation of the body of God:more precisely, the world IS the...
HinduismAlignment of energiesThe head of the bed is directed towards south, east, or west, butnever northA person’s body i...
JudaismJudaism views the gift of sleep as a Godly blessingMaimonides, the great doctor, lists in his halachicwork, Mishna ...
Judaism: Analysis of sleep in the context ofJudaism by Rabbi Nissan D. Dubov (Director of     Chabad Lubavitch in Wimbledo...
Judaism: Analysis of sleep in the context ofJudaism by Rabbi Nissan D. Dubov (Director of     Chabad Lubavitch in Wimbledo...
Judaism: Analysis of sleep in the context ofJudaism by Rabbi Nissan D. Dubov (Director of     Chabad Lubavitch in Wimbledo...
Judaism: Analysis of sleep in the context ofJudaism by Rabbi Nissan D. Dubov (Director of     Chabad Lubavitch in Wimbledo...
“Yesterday” - Sir Paul                 McCartneyhttp://www.youtube.com/watch?v=Ms65JQTBCcQ
Current Concepts of       Sleep
Current Concepts of      Sleep: Sleep stages                      4-5 cycles/night      Stage        1             Every 9...
Current Concepts of    Sleep: Sleep   Architecture     25%    5%                       Stage 1   5% sleep                 ...
Current Concepts of            SleepStage 1   Light sleep   Slowing of heart rate and   respiration   Brain waves: slowing...
Current Concepts of            SleepStage 2   Slower brain activity   Further decrease in heart   rate and respiration   F...
Current Concepts of            SleepStage 3   Slow wave sleep   Change in brain waves to   large slow delta waves   Contin...
Current Concepts of              SleepStage REM  Rapid eye movement sleep  Brain waves are similar to that of awake  Large...
Current Concepts of              Sleep        Take home pearls1. 3 STATES OF EXISTENCE   a) Wake   b) Non REM sleep (stage...
Parasomnias
ParasomniasA category of sleep disorders that involve abnormaland unnaturalmovements, behaviors, emotions, perception, and...
Parasomnia: REM    Behavior DisorderThe normal loss of muscle tone during sleep is absentin REM behavior disorderThe patie...
Parasomnia: REM                    Behavior Disorderhttp://www.youtube.com/watch?v=z2BgjH_CtIA
Parasomnia: REM                    Behavior Disorderhttp://www.youtube.com/watch?v=IEgvw1Z-0co
Parasomnia: REM                   Behavior Disorderhttp://www.youtube.com/watch?v=rFXYRQ9xPUA
Parasomnia: REM                   Behavior Disorderhttp://www.youtube.com/watch?v=rFXYRQ9xPUA
Parasomnia: Night                 terrors/nightmares           Arise from stage 3 sleep and REM sleephttp://www.youtube.co...
Parasomnia:                                  Catathrenia            Loud annoying sleep groanhttp://www.youtube.com/watch?...
Parasomnia:                              Sleepwalkinghttp://www.youtube.com/watch?v=mlQRiGSy1o4
Parasomnia: Sleep    swimming
Parasomnia: Sleep                        swimminghttp://bodyodd.nbcnews.com/_news/2012/08/28/13511255-swimming-in-her-slee...
Parasomnia: Sudden unexplained   nocturnal death syndrome Affects primarily young Hmong men from Laos (median age 33) and ...
Parasomnia: Sudden unexplained          nocturnal death syndromehttp://www.youtube.com/watch?v=eNAG4PGKj0c
Parasomnia: Sleep sex    (sexsomnia)An NREM parasomniaEngage in sexual activity while sleeping (have no memory of actions ...
Sleep Crime             Crimes committed in sleep including homicidal somnambulism             Steven Steinberg case:     ...
Sleep Crime             Scott Falater case:                    1997, Phoenix, AZ: murdered wife by stabbing her 44 times  ...
Parasomnia: Narcolepsy Intrusion of sleep state into wake state Tetrad:    Excessive daytime sleepiness    Sleep paralysis...
Parasomnia: Narcolepsyhttp://www.youtube.com/watch?v=59evkMq_QcM
Parasomnia: Narcolepsyhttp://www.youtube.com/watch?v=HOkckq9pfoE
“Yesterday” - Sir Paul                 McCartneyhttp://www.youtube.com/watch?v=Ms65JQTBCcQ
Brilliant Dreams
Mary Shelleys Frankenstein   Inspired By a Dream 1816, Lake Geneva, Switzerland at Lord Byron’s villa Stormy weather, reti...
Dream leads to Nobel       PrizeOtto Loewi (1873-1961), German physiologistNobel prize (medicine, 1936): work on chemicalt...
Abraham Lincoln dreamtof his own assassination President Abraham Lincoln recounted the following dream just a few days pri...
Abraham Lincoln dreamtof his own assassination “Before me was a catafalque, on which rested a corpse wrapped in funeral ve...
Kekulé dreams of molecules  and benzene structure Friedrich August Kekulé von Stradonitz Discovered tetravalent nature of ...
Kekulé dreams of molecules  and benzene structure Another dream helped him discover the benzene molecule (circular structu...
Madame C.J. Walker – From  Dream to Millionaire Madame C.J. Walker (1867-1919), first female American self-made millionair...
The Sewing MachineElias Howe, 1845Had idea of a machine with a needle which wouldgo through a piece of cloth: couldn’t fig...
Jack Nicklaus Finds a New  Golf Swing in a DreamJack Nicklaus, 1964: having a bad slump(high 70s)“Wednesday night I had a ...
Srinivasa Ramanujan –    Mathematical Genius and            DreamerInspiration and insight for his work many times cameto ...
Dreams and the King of       HorrorNovelist Stephen King describes how dreams affect his writings in an interview with UKr...
Paul McCartney finds“Yesterday” in a dream1965 filming Help!, McCartney staying in a smallattic room of his family’s house...
“Yesterday” - Sir Paul                 McCartneyhttp://www.youtube.com/watch?v=Ms65JQTBCcQ
Conclusions                                         Evolutio                                                              ...
Conclusions            Final thoughts                 Sleep: one third of your existence                 “Make it worth it...
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Sleep: An analysis of this entity and its influence on the development of mankind in areas of religion, medicine, science, arts, and literature

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Sleep: An analysis of this entity and its influence on the development of mankind in areas of religion, medicine, science, arts, and literature

  1. 1. Santa Fe, New MexicoJuly 29- August 2, 2013
  2. 2. Sleep: An analysis of this entity and its influence on the development of mankind in areas ofreligion, medicine, scien ce, arts, and literature
  3. 3. Sleep and Yesterday?Dream and Yesterday? (Show of hands)
  4. 4. “Yesterday” - Sir Paul McCartneyhttp://www.youtube.com/watch?v=Ms65JQTBCcQ
  5. 5. Dr. Indal M. SeudealAreas of practice Internal medicine Pulmonary medicine Critical care medicine Emergency room medicine Sleep medicine ABIM Board certified sleep specialist
  6. 6. OutlineHistorical perspective of Parasomniassleep REM behavior disorder Night terrors/nightmaresSleep and religious views Catathenia Christianity Sleepwalking Buddhism Sleep swimming Islam Sudden unexplained Hinduism nocturnal death syndrome Judaism Sleep sex Sleep crimesCurrent concepts Narcolepsy Architecture of sleep States of sleep Brilliant dreams
  7. 7. Historical Perspectives of Sleep
  8. 8. 800-600 B.C., Homer’s Odyssey Epic Greek poem “In his first sleep, call up your hardiest cheer.” Segmented sleep 2 shifts awake/2 shifts sleep per 24 hourshttp://healthysleep.med.harvard.edu/healthy/matters/history
  9. 9. 350 B.C., Aristotle “Sleep is…a seizure of the primary sense organ…” Seat of consciousness: heart Sleep onset – warm gastric vapors (digestion)http://healthysleep.med.harvard.edu/healthy/matters/history
  10. 10. ~1490, Leonardo da Vinci Polyphasic sleep: daVinci sleep (15 mins./2 hours) Anatomical paintings explain complexity of human nervous systemhttp://healthysleep.med.harvard.edu/healthy/matters/history
  11. 11. 1598, William ShakespeareHenry IV (1598): obstructive sleepapnea, Cheyne-Stokes respirationHamlet: “To be, or not to be, that is thequestion:
Whether tis nobler in themind to suffer
The slings and arrows ofoutrageous fortune,
Or to take armsagainst a sea of troubles
And byopposing end them. To die—tosleep,
No more; and by a sleep to saywe end
The heart-ache and thethousand natural shocks
That flesh isheir to: tis a consummation
Devoutlyto be wishd. To die, to sleep;
Tosleep, perchance to dream—ay, theresthe rub:
For in that sleep of death whatdreams may come,
When we haveshuffled off this mortal coil,
Must giveus pause—theres the respect
Thatmakes calamity of so long life.” http://healthysleep.med.harvard.edu/healthy/ matters/history
  12. 12. 1737-1798, Luigi Galvani Italian physician Discovers natural electrical activity in nervous system and muscles This discovery led to measurement of brain activity during sleephttp://healthysleep.med.harvard.edu/healthy/matters/history
  13. 13. 1769-1821, Napoleon Bonaparte Sleep prescription Sleep habits: possible obstructive sleep apneahttp://healthysleep.med.harvard.edu/healthy/matters/history
  14. 14. 1903, First sleeping pill Barbital (Veronal) German chemists Emil Fischer and Joseph von Meringhttp://healthysleep.med.harvard.edu/healthy/matters/history
  15. 15. 1916, The hypothalamus and sleep Constantin von Economo studied patients with viral encephalitis Discovered sleep and wake regions of the brain (hypothalamus)http://healthysleep.med.harvard.edu/healthy/matters/history
  16. 16. 1935, Biological clock German biologist Erwin Bunning describes the biological clock Worked with common green bean plants Conclusion: circadian rhythms are inheritedhttp://healthysleep.med.harvard.edu/healthy/matters/history
  17. 17. 1953, Discovery of REM sleephttp://healthysleep.med.harvard.edu/healthy/matters/history
  18. 18. http://healthysleep.med.harvard.edu/healthy/matters/history
  19. 19. 1997, Mammalian clock genes Joseph Takahashi (Northwestern University) Identify and clone mammalian circadian gene (Clock gene)http://healthysleep.med.harvard.edu/healthy/matters/history
  20. 20. 2003, Sleep and memory Sleep: important role in learning and memory consolidationhttp://healthysleep.med.harvard.edu/healthy/matters/history
  21. 21. “Yesterday” - Sir Paul McCartneyhttp://www.youtube.com/watch?v=Ms65JQTBCcQ
  22. 22. Sleep and Religious Views Christianity Buddhism Islam Hinduism Judaism
  23. 23. Christianity The term sleep is used symbolically in different senses in the Bible • To stress certain truths about God • “He will not allow your foot to slip; he who keeps you will not slumber. Behold, he who keeps Israel will neither slumber nor sleep” (Psalms 121:3-4) • Sometimes sleep is used as the equivalent of being lazy • “Do not give sleep to your eyes, nor slumber to your eyelids… How long will you like down, O sluggard? When will you arise from your sleep? A little sleep, a little slumber, a little folding of the hands to rest. And your poverty will come in like a vagabond, and your need like an armed man.” (Proverbs 6:4-11)Christian Courier Publications. ISSN 1559:2235
  24. 24. Christianity • To portray the utter and final punishment of a wicked power • Prophet Jeremiah foretold the complete destruction of the evil Babylonian regime: • “… Babylon shall become heaps, a dwelling-place for jackals, an astonishment, and a hissing, without inhabitant… When they are heated, I will make their feast, and I will make them drunken, that they may rejoice, and sleep a perpetual sleep, and not wake, saith Jehovah” (Jeremiah 51: 37-39) • Sometimes spiritual lethargy is represented as sleep • Paul wrote: • “And this, knowing the season, that already it is time for you to awake out of sleep: for now is salvation nearer to us than when we first believed” (Romans 13:11) • “Awake, you who are sleeping, and arise from the dead, and Christ shall shine on you” (Ephesians 5:14)Christian Courier Publications. ISSN 1559:2235
  25. 25. Christianity • Sleep can suggest the notion of being unprepared to meet the Lord • Jesus warned: • “Watch therefore: for you do not know when the lord of the house is coming…lest he come suddenly and find you sleeping” (Mark 13:35-56) • Commonly used as a designation for death in both Old and New Testement • David petitioned the Creator: • “Consider and answer me, O Jehovah my God: Lighten my eyes, lest I sleep the sleep of death” (Psalms 13:3)Christian Courier Publications. ISSN 1559:2235
  26. 26. Christianity • Sometimes sleep implies the future resurrection of the human body • “But now Christ is risen from the dead, and has become the firstfruits of those who have fallen asleep.” (1 Corinthians 15:30)Christian Courier Publications. ISSN 1559:2235
  27. 27. BuddhismBuddha Gautama Insight into cause of suffering and steps necessary to eliminate it Sat under the bodhi tree, where he vowed never to arise until he found the truth 49 days of meditation at age 35 Attained enlightenment Bodhi tree
  28. 28. BuddhismDalai Lama: “Sleep is the best meditation” (People Magazine, 1979)AH: So you go to bed at 8:30 at night and you wake up at 3:30. You clearly put a lot ofemphasis on sleep, which we love, because at The Huffington Post we have dedicatedsections on sleep. So what’s the secret of sound sleep, and why is it so important?HHDL: For me, very important. The other day, in Delhi, of course my car alwaysprovided by government. This one driver, one new driver come, then I ask him, “Howmany hours you sleep?” He says, “Four hours.” Then I told him, “Four hours notadequate. So you must sleep six hours.” Then next day, I met, “How many hours?”Then he told me, “Six hours.” So I believe, you see, sleep, complete restful, and also Ithink important is daytime your mind calm, relaxed. Then dream, during night, it’ssleep, also then, happy dream. Too much anxiety in daytime, then even in dream, somekind of nightmare, or these things happen. So, and anyway, for me, sleep, sound sleepusually eight hours, sometimes, last night, nine hours. Very sound sleep. And thenalso, when I handed over all my political responsibility to a … person, politicalleadership, formally, that night, very unusual sound sleep.
  29. 29. Buddhism
  30. 30. IslamIslam Emerged as a religion in the 7th century 2 sources of Islamic jurisprudence (the Quran and Hadith) Allah revealed the Quran to the prophet Muhammad through the angel Gabriel from 610-632 C.E. (verse 17.106)
  31. 31. IslamTypes of sleep:1. Sinah: slumber or dozing off for a very short period • “No slumber (Sinah) can seize Him nor sleep” (verse 2.255) • May correspond to stage 1 sleep2. Nu’ass: short nap • “Remember when He covered you with a slumber (Nu’ass) as a security from him” (verse 8.11) • May correspond to stage 1/stage 2 sleep3. Ruqood: sleep for long period • “And you would have thought them awake, whereas they were asleep (Ruqood) (verse 18.18)
  32. 32. IslamTypes of sleep:4. Hojoo: sleep at night • “They used to sleep but little by night (Hojoo). And in the hours before dawn, they were (found) asking (Allah) for forgiveness” (verse 51. 17-18)5. Subaat: disconnection from the surrounding environment during sleep • “And we made your sleep (Subaat) as the thing for rest” (verse 78.9)
  33. 33. IslamProphet Muhammad Encouraged not to be involved in any activity after Isha prayer (darkness prayer) “One should not sleep before night prayer, nor have discussions after it” (SB 574) Encouraged to wake up for Fajr prayer (which is about 1 hour before sunrise) Sleep on the right side and avoid lying on the stomach “Whenever you go to bed, perform ablution like that for the prayer, and lie on your right side” (SM 2710) The Prophet told a man who was lying on his stomach, “Allah and his Prophet dislike this position”
  34. 34. IslamThe Quran indicates some resemblance between sleep anddeathThe Quran uses Wafat to describe death “It is Allah Who takes away the souls (Wafat) at the time of their death, and those that die not during their sleep. He keeps those (souls) for which He has ordained death and sends the rest for a term appointed. Verily, in this are signs for people who think deeply” (verse 39.42) “It is He Who takes your souls (Wafat) by night (when you are sleep), and has knowledge of all that you have done by day, then He raises (wakes) you up again that a term appointed (your life period) be fulfilled, then (in the end) to Him will be your return. Then He will inform you of that which you used to do” (verse 6.60)
  35. 35. HinduismHindu architecture: Vaastu ShastraThe world is a manifestation of the body of God:more precisely, the world IS the body of GodA temple compared to the large universe is aconstructed miniature version (microcosm) of thegreater universe (macrocosm)
  36. 36. HinduismAlignment of energiesThe head of the bed is directed towards south, east, or west, butnever northA person’s body is a tiny magnet (with north and south poles)One’s head is the north poleThe universe is also a magnet with north and south poles (polaristhe north star is the north pole of the universe)2 like poles will repel each otherConclusion: sleep will be better when the head is placed away fromthe north
  37. 37. JudaismJudaism views the gift of sleep as a Godly blessingMaimonides, the great doctor, lists in his halachicwork, Mishna Torah, his recommendation for 8 hoursof sleep per nightShabat was given the blessing of being the day ofrest and leisureSleeping on Shabat afternoon has become a time-honored Jewish custom
  38. 38. Judaism: Analysis of sleep in the context ofJudaism by Rabbi Nissan D. Dubov (Director of Chabad Lubavitch in Wimbledon, UK) Sleep is good for digestion Soul searching prior to sleep / “let go of baggage before sleep onset” / recite prayer Your body belongs to God and is given to you as a deposit Pray at time of awakening While sleeping, soul is elevated to an upper level of consciousness and draws life from the higher world
  39. 39. Judaism: Analysis of sleep in the context ofJudaism by Rabbi Nissan D. Dubov (Director of Chabad Lubavitch in Wimbledon, UK) 0:09:30-0:11:20 Soul searching prior to sleep / “let go of baggage before sleep onset” / recite prayer
  40. 40. Judaism: Analysis of sleep in the context ofJudaism by Rabbi Nissan D. Dubov (Director of Chabad Lubavitch in Wimbledon, UK) 28:30-29:45 Pray at time of awakening*
  41. 41. Judaism: Analysis of sleep in the context ofJudaism by Rabbi Nissan D. Dubov (Director of Chabad Lubavitch in Wimbledon, UK) 51:10-51:36 While sleeping, soul is elevated to an upper level of consciousness and draws life from the higher world
  42. 42. “Yesterday” - Sir Paul McCartneyhttp://www.youtube.com/watch?v=Ms65JQTBCcQ
  43. 43. Current Concepts of Sleep
  44. 44. Current Concepts of Sleep: Sleep stages 4-5 cycles/night Stage 1 Every 90-110 minutes Stage 3: slow wave Stage sleep (SWS)REM 2 REM: rapid eye movement sleep (predominant in last Stage 1/3 of sleep time) 3
  45. 45. Current Concepts of Sleep: Sleep Architecture 25% 5% Stage 1 5% sleep 45% Stage 2 45% sleep Stage 3 20% sleep REM 20%
  46. 46. Current Concepts of SleepStage 1 Light sleep Slowing of heart rate and respiration Brain waves: slowing of brain activity Decreased muscle tonus
  47. 47. Current Concepts of SleepStage 2 Slower brain activity Further decrease in heart rate and respiration Further decrease in muscle tonus
  48. 48. Current Concepts of SleepStage 3 Slow wave sleep Change in brain waves to large slow delta waves Continued decrease in heart rate and respiration Continued decrease in muscle tonus
  49. 49. Current Concepts of SleepStage REM Rapid eye movement sleep Brain waves are similar to that of awake Large fluctuations in heart rate and respiration Almost complete paralysis
  50. 50. Current Concepts of Sleep Take home pearls1. 3 STATES OF EXISTENCE a) Wake b) Non REM sleep (stages 1, 2, and 3) c) REM sleep2. REM SLEEP IS SIMILARPHYSIOLOGICALLY TO THE WAKE STATE
  51. 51. Parasomnias
  52. 52. ParasomniasA category of sleep disorders that involve abnormaland unnaturalmovements, behaviors, emotions, perception, anddreams that occur while fallingasleep, sleeping, between sleep stages, or duringarousal from sleep
  53. 53. Parasomnia: REM Behavior DisorderThe normal loss of muscle tone during sleep is absentin REM behavior disorderThe patient is able to act out his/her dreams withmovements, vocalizations, etc.Can be very disturbing to the patient and familymembersCan lead to serious physical injury to self and others
  54. 54. Parasomnia: REM Behavior Disorderhttp://www.youtube.com/watch?v=z2BgjH_CtIA
  55. 55. Parasomnia: REM Behavior Disorderhttp://www.youtube.com/watch?v=IEgvw1Z-0co
  56. 56. Parasomnia: REM Behavior Disorderhttp://www.youtube.com/watch?v=rFXYRQ9xPUA
  57. 57. Parasomnia: REM Behavior Disorderhttp://www.youtube.com/watch?v=rFXYRQ9xPUA
  58. 58. Parasomnia: Night terrors/nightmares Arise from stage 3 sleep and REM sleephttp://www.youtube.com/watch?v=UQXJWzLjzLk
  59. 59. Parasomnia: Catathrenia Loud annoying sleep groanhttp://www.youtube.com/watch?v=9aT8vll4fBE
  60. 60. Parasomnia: Sleepwalkinghttp://www.youtube.com/watch?v=mlQRiGSy1o4
  61. 61. Parasomnia: Sleep swimming
  62. 62. Parasomnia: Sleep swimminghttp://bodyodd.nbcnews.com/_news/2012/08/28/13511255-swimming-in-her-sleep-how-the-idaho-woman-did-it?lite
  63. 63. Parasomnia: Sudden unexplained nocturnal death syndrome Affects primarily young Hmong men from Laos (median age 33) and northeastern Thailand (where the population are mainly of Laotian descent) Brugada syndrome Mutation of SCN5A on chromosome 3p21 Characterized by ventricular fibrillation and death during sleep
  64. 64. Parasomnia: Sudden unexplained nocturnal death syndromehttp://www.youtube.com/watch?v=eNAG4PGKj0c
  65. 65. Parasomnia: Sleep sex (sexsomnia)An NREM parasomniaEngage in sexual activity while sleeping (have no memory of actions onceawake)Cause: unknown (may be a genetic component)Males account for 2/3 of casesEffects: Anger Confusion Denial FearTreatment: combination of medication, therapy, and lifestyle changes
  66. 66. Sleep Crime Crimes committed in sleep including homicidal somnambulism Steven Steinberg case: 1981, Scottsdale, AZ: murdered wife by stabbing her 26 times Claimed crime committed during sleepwalking He walked away a free man Kenneth Parks case: 1987, Toronto, Canada: Drove 23 km to mother-in-law’s home and stabbed her to death Drove to police station to report crime Verdict: not guilty“Can sleepwalking be a murderdefense?”, LawrenceMartin, M.D., FACP, FCCP
  67. 67. Sleep Crime Scott Falater case: 1997, Phoenix, AZ: murdered wife by stabbing her 44 times and holding her head under water in the swimming pool Claimed he was sleepwalking at the time of the murder Verdict: guilty of First Degree Murder; life imprisonment without parole Burgess case: 1996, Queensland, Australia: hit woman on the head with a bottle and tried to strangle her Claimed sleepwalking Verdict: not guilty“Can sleepwalking be a murder defense?”,Lawrence Martin, M.D., FACP, FCCP
  68. 68. Parasomnia: Narcolepsy Intrusion of sleep state into wake state Tetrad: Excessive daytime sleepiness Sleep paralysis Hallucinations At sleep onset (hypnogogic) At sleep offset (hypnopompic) Cataplexy
  69. 69. Parasomnia: Narcolepsyhttp://www.youtube.com/watch?v=59evkMq_QcM
  70. 70. Parasomnia: Narcolepsyhttp://www.youtube.com/watch?v=HOkckq9pfoE
  71. 71. “Yesterday” - Sir Paul McCartneyhttp://www.youtube.com/watch?v=Ms65JQTBCcQ
  72. 72. Brilliant Dreams
  73. 73. Mary Shelleys Frankenstein Inspired By a Dream 1816, Lake Geneva, Switzerland at Lord Byron’s villa Stormy weather, retired indoors, went to bed. “On the morrow I announced that I had thought of a story. I began that day with the words, ‘It was on a dreary night of November’”
  74. 74. Dream leads to Nobel PrizeOtto Loewi (1873-1961), German physiologistNobel prize (medicine, 1936): work on chemicaltransmission of nerve impulseCame up with the idea of chemical transmission, 190317 years later, dreamt again of chemical transmission“I got up immediately, went to the laboratory, andperformed a single experiment on a frog’s heartaccording to the nocturnal design.”
  75. 75. Abraham Lincoln dreamtof his own assassination President Abraham Lincoln recounted the following dream just a few days prior to his assassination: “About ten days ago, I retired very late. …I soon began to dream. There seemed to be a death-like stillness about me. Then I heard subdued sobs. …” “I thought I left my bed and wondered downstairs. … I went from room to room: no living person was in sight, … I arrived at the East Room”
  76. 76. Abraham Lincoln dreamtof his own assassination “Before me was a catafalque, on which rested a corpse wrapped in funeral vestments” “’Who is dead in the White House’? I demanded of one of the soldiers ‘The President’ was his answer; ‘he was killed by an assassin!’ Then came a loud burst of grief from the crowd, which awoke me from my dream”
  77. 77. Kekulé dreams of molecules and benzene structure Friedrich August Kekulé von Stradonitz Discovered tetravalent nature of carbon and the Structural Theory “I fell into a reverie, and lo, the atoms were gamboling before my eyes!” “I had never been able to discern the nature of their motion.” “I saw how, frequently, two smaller atoms united to form a pair; how a larger one embraced the two smaller ones” “The cry of the conductor: ‘Clapham Road’, awakened me from my dreaming”
  78. 78. Kekulé dreams of molecules and benzene structure Another dream helped him discover the benzene molecule (circular structure) “I was sitting on my textbook… I turned my chair to the fire and dozed.” “Again the atoms were gamboling before my eyes.” “long rows of atoms sometimes more closely fitted together all twining and twisting in snake-like motion. … One of the snakes had seized hold of its own tail, and the form whirled mockingly before my eyes.”
  79. 79. Madame C.J. Walker – From Dream to Millionaire Madame C.J. Walker (1867-1919), first female American self-made millionaire Founded successful African-American cosmetic company Suffered from scalp infection (caused her to lose most of her hair in 1890s) Dreamt “A big black man appeared to me and told me what to mix up in my hair. Some of the remedy was grown in Africa, but I sent for it, mixed it, put it on my scalp, and in a few weeks my hair was coming in faster than it had ever fallen out.”
  80. 80. The Sewing MachineElias Howe, 1845Had idea of a machine with a needle which wouldgo through a piece of cloth: couldn’t figure outexactly how it would workHis dream: he was taken prisoner by a group ofnatives; they were dancing around him withspears.As he saw them move around him, he noticed thattheir spears all had holes near their tipsBy locating a hole at the tip of the needle, thethread could be caught after it went through cloththus making his machine operable
  81. 81. Jack Nicklaus Finds a New Golf Swing in a DreamJack Nicklaus, 1964: having a bad slump(high 70s)“Wednesday night I had a dream and it wasabout my golf swing.”“I was hitting them pretty good in thedream and realized I wasn’t holding the clubthe way I’ve been holding it lately”“So when I came to the course yesterdaymorning I tried it the way I did in my dreamand it worked. I shot a sixty-eight yesterdayand a sixty-five today.”
  82. 82. Srinivasa Ramanujan – Mathematical Genius and DreamerInspiration and insight for his work many times cameto him in his dreamsHindu goddess, Namakkal, would appear and presentmathematical formulae which he would verify afterwaking
  83. 83. Dreams and the King of HorrorNovelist Stephen King describes how dreams affect his writings in an interview with UKreporter Stan Nicholls:Nicholls: "If the inspiration for Misery didnt come from a real-life incident, where did itcome from?"King: "Like the ideas for some of my other novels, that came to me in a dream. In fact, ithappened when I was on Concord, flying over here, to Browns. I fell asleep on theplane, and dreamt about a woman who held a writer prisoner and killed him, skinnedhim, fed the remains to her pig and bound his novel in human skin. His skin, the writers skin.I said to myself, I have to write this story. Of course, the plot changed quite a bit in thetelling. But I wrote the first forty or fifty pages right on the landing here, between the groundfloor and the first floor of the hotel.""Another time, when I got road-blocked in my novel It, I had a dream about leeches insidediscarded refrigerators. I immediately woke up and thought, That is where this is supposedto go. Dreams are just another part of life. To me, its like seeing something on the street youcan use in your fiction. You take it and plug it right in. Writers are scavengers by nature."Nicholls comments: "This could explain the line in Bag of Bones that goes, 
Perhaps in dreamseveryone is a novelist."
  84. 84. Paul McCartney finds“Yesterday” in a dream1965 filming Help!, McCartney staying in a smallattic room of his family’s house on WimpoleStreetDream: “I woke up with a lovely tune in my head.I thought, Thats great, I wonder what that is?There was an upright piano next to me, to theright of the bed by the window. I got out of bed,sat at the piano, found G, found F sharp minor7th -- and that leads you through then to B to Eminor, and finally back to E. It all leads forwardlogically. I liked the melody a lot, but because Iddreamed it, I couldnt believe Id written it. Ithought, No, Ive never written anything like thisbefore. But I had the tune, which was the mostmagic thing!"
  85. 85. “Yesterday” - Sir Paul McCartneyhttp://www.youtube.com/watch?v=Ms65JQTBCcQ
  86. 86. Conclusions Evolutio n Living Beings Sleep CONCEPTS: Early / Religious / Scientific What ifs???• Unihemispheric sleep (dolphins and seals, Canadian geese)• Plants (Mimosa pudica)• Mark 14:32-42
  87. 87. Conclusions Final thoughts Sleep: one third of your existence “Make it worth it!”http://www.youtube.com/watch?v=uNkaeUr3-HU

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