Studying sleep disorders is important to understanding human behavior and should be an integral part of undergraduate psychology course work.
Advancements in the field of sleep over the past century have opened a new and exciting frontier for the study of human behavior. Sleep, once thought to be an inactive process, is now known to abound with behavioral activity. Sleep is an important part of the study of psychology in that it represents an integral part of human existence and interacts with the behaviors more associated with wakefulness on many levels. Some of the more commonly known examples of this interaction include the processes of memory consolidation, stress-related sleep disturbances, sleep hygiene, and the effects of sleep deprivation on mental performance. Other examples include psychosocial factors related to sleep disorders, the phenomenon of dreaming, and the frequency of sleep disturbance across the various types of mental illness. From these examples, it would be reasonable to expect sleep to be a common topic in a psychology program.
Some of the courses offered in contemporary psychology programs do, in fact, touch upon the topic of sleep. Unfortunately, many of these lectures are only a brief component of the overall class. Students often receive their first lecture on sleep as a component of the consciousness chapter in the introductory course. Other advanced courses such as abnormal, health, physiological, developmental, and cognitive psychology may also briefly discuss the role of sleep in relation to the course’s subject matter. Despite the common occurrence of sleep as a topic in these courses, few undergraduate psychology programs offer an independent course in sleep.
Based on the observation that sleep courses are infrequent and the role of sleep in the study of behavior is important, Jacksonville State University in Alabama developed and added a course on sleep and dreaming to its undergraduate curriculum. Its creation proved a challenge in that no preset standards for a course of this nature currently exist in the field of psychology. In addition, a text for the course had to be created to provide students with a reference for learning.1
The Course
The design of this course was directed at a basic introduction to the many topics within the field. The first goal was to provide an introduction to basic terminology and concepts. The second goal was to introduce more advanced topics of interest including research and assessment techniques, biological bases, biological rhythms, sleep in the context of human development, dreaming, dyssomnias, parasomnias, and sleep disturbances associated with psychopathological conditions.
Sleep represents a heterogeneous field of which psychology is one of many components. Students enrolled in an undergraduate psychology program that offers a course in sleep will have the opportunity to explore the role of psychology as it interacts with other fields such as medicine, biology, and technology. Basic sleep concepts such as sleep hygiene, sleep deprivation, sleep debt, sleepiness, and sleep architecture provide students with an framework for understanding more advanced topics covered later in the course.
Research techniques in the field of sleep are diverse and reflect the heterogeneity of its many contributing academic and clinical disciplines. Research methodology and assessment techniques are key to allowing the student to understand the scientific methodologies being employed by sleep professionals in their quest to better comprehend the many aspects of sleep. In this course, students are introduced to objective techniques such as electroencephalography, polysomnography, the Multiple Sleep Latency Test (MSLT), and Maintenance of Wakefulness Test (MWT) as well as subjective techniques such as the Epworth Sleepiness Scale (ESS), Stanford Sleepiness Scale (SSS), and Pittsburgh Sleep Quality Index (PSQI).
Biological Bases
An introduction to the biological bases for sleep and wakefulness is important in that it provides students with a foundation for understanding the processes that influence conscious states. This section examines key neuroanatomical structures and neurophysiological processes that are vital to sleep and wakefulness as well as pharmacological agents such as caffeine, nicotine, alcohol, antidepressants, anxiolytics, sedatives, and hypnotics. In many cases, the specific neuroanatomical structures involved in sleep/wake regulatory functions are not covered in psychology courses with maybe the exception of physiological psychology.
Biological rhythms play an important role in both sleep and waking states and therefore represent another important topic to cover in this type of course. Circadian rhythms, such as the sleep/wake cycle, and ultradian rhythms, such as the rapid eye movement (REM)–non-REM (NREM) cycle, as well as the numerous other types of biological rhythms are examined in this section. Individual physiological and behavioral differences related to biological rhythms such as those associated with chronotypology are also covered. In addition, this section of the course introduces the circadian rhythm disorders as the first major category of sleep disorders.
Sleep as it relates to human development is another key topic covered in this course. It is well known that sleep changes over a person’s lifespan in many ways. This section of the course is designed to provide students with the opportunity to examine the characteristics of sleep during infancy, childhood, adolescence, and both early and late adulthood.
Dreaming
Dreaming represents a facet of human existence that often elicits a great deal of curiosity and should naturally be included in a course on sleep. Unfortunately, many nonscientific books have been published on this subject and, as a result, many myths and misconceptions have been brought into existence. To combat many of these misconceptions, this course covers the topic of dreaming from a historical, theoretical, and scientific basis. In addition, the phenomenon of dreaming is explored as a holistic experience and in terms of cognitive, affective, and perceptual components. Dreams are also examined in relation to processes of learning, memory, and emotional experiences occurring during earlier periods of wakefulness. The many theories of dreaming such as wish fulfillment, cognitive/information processing, and activation-synthesis are also explored to provide students with an historical background of the development of each theory, perspectives on the challenges that scientists face in this type of research, and an opportunity to strengthen critical thinking skills.
Sleep Disorders
Another important topic of interest is sleep disorders. This course was designed to cover the topic in two sections. The first section focuses on the dyssomnias such as sleep apnea, narcolepsy, and the various types of insomnia. The second section is centered on the parasomnias. In this portion of the course, conditions such as sleepwalking, sleep terrors, nightmares, and REM behavior disorder are examined. Each sleep disorder that is covered is explored in terms of the characteristic symptomatology, proposed etiologies, common treatments, and psychosocial impact.
Psychological Conditions
The course ends with an in-depth look at sleep disturbances in psychopathological conditions. This portion of the course covers conditions such as mood disorders, schizophrenia, anxiety disorders, substance-related disorders, and attention deficit hyperactivity disorder. Many of these disorders include some form of sleep disturbance as part of the diagnostic criteria. In each of the disorders covered in this section, the characteristics of the disturbances are explored as well as how the disturbances can interact with symptoms more associated with wakefulness.
Conclusion
A course in sleep and dreaming offers several advantages to undergraduate students enrolled in a psychology program. First, sleep represents a diversified and heterogeneous field that highlights the interaction between psychology and other disciplines such as medicine, technology, and biology. This allows students to broaden their learning experience and gain an appreciation of the role of psychology in relation to other academic and clinical disciplines. Second, knowledge of sleep leads to a better understanding of behaviors more commonly observed during wakefulness such as memory recall, mood, vigilance, and concentration. Finally, the scientific community has learned over the past century that human existence is comprised of much more than wakefulness. A course in sleep, in turn, allows students the opportunity to gain a more comprehensive knowledge of human existence.
Understanding sleep is important to understanding human behavior and should, therefore, be an integral part of undergraduate psychology coursework. As these courses are integrated into psychology programs, efforts should be made to develop standards for education. In addition, new pedagogical materials should be created to provide students with the proper resources for exploring the topic of sleep. The implementation of these programs and the development of pedagogical materials will be the responsibility of sleep professionals involved in the educational setting. There is no better time than the present to develop and implement sleep-related courses in undergraduate psychology programs throughout the world.
W. Jeff Bryson, MS, is an adjunct instructor and sleep research team coordinator in the Department of Psychology at Jacksonville State University in Jacksonville, Ala, and the assistant director of clinical services at Mountain View Hospital in Gadsden, Ala.
Reference
1. Bryson WJ. Sleep and Dreaming. Acton, Mass: Copley Custom Publishing Company. In press.
