Clinical Applications

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The functions of sleep are extremely important in clinical applications. If the repair and restoration theory lacks strong scientific support, attempting to recover lost sleep time may serve no functional purpose. Indeed, most subjects expect to sleep for several hours longer than normal after staying awake for twenty-four hours, presumably because they believe sleep is required for repair and restoration of the body. In practice, however, most subjects report only four to six total hours of poor-quality sleep following such deprivation. Even after 264 hours of sleep deprivation, Randy Gardner slept for only fourteen hours and forty minutes the first evening, then resumed a normal nocturnal sleep pattern of eight hours per evening.

Knowledge of sleep stages may be especially valuable in diagnosing and treating sleep disorders, because the frequency, patterns, and symptoms of these disorders may be associated with specific stages of sleep. For example, knowledge of the muscular paralysis that accompanies REM sleep has been instrumental in diagnosing the cause of male impotence. Partial or total erections are present in about 95 percent of REM periods. Therefore, men who complain of impotence yet demonstrate normal REM erections can be diagnosed as suffering from psychologically based impotence. These patients may benefit from psychotherapy or sexual counseling. In contrast, men who do not achieve REM erections are diagnosed as suffering from organically based impotence and require hormone therapy or surgical implantations.

Nocturnal enuresis, or bed-wetting, is a stage four developmental disorder present in about four million to five million children annually in the United States. The exact cause of this disorder is undetermined, although the extreme muscular relaxation during stage four sleep likely contributes to its occurrence. To prevent nocturnal enuresis, the patient must learn to associate a full bladder with waking up. Typically, a special apparatus is placed under the child, which sounds a loud buzzer when urine contacts it. Eventually, the child will learn to associate the feeling of a full bladder with waking up in the absence of the buzzer.

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