When the ego reigns, our emotions cloud our thoughts, and our choices are unproductive and sometimes harmful. When we do not like who we are— which again, is true for all human beings, to varying degrees—we punish ourselves with activities that are disguised as pleasurable: excessive eating, alcohol or drug abuse, jumping between fleeting relationships or sexual partners, and endless, meaningless distractions.
Sleep in Extreme Environments: Part Two // Melanie Boling , Harvard University
Sleep in Extreme Environments: Part Two.
Sleeping in Extreme Environments
Sleeping and Thermoregulation in Extreme Environments
The behavior of humans accounts for about 90% of their thermoregulation. “Under ambient conditions, the core body temperature of 37 degrees celsius is maintained by the permanent metabolic active internal organs such as the brain, heart, liver, and gastrointestinal tract through a fine-tuned thermoregulatory system that mainly adjusts peripheral perfusions of the skin and evaporation by the sweat glands to the thermal needs of the body.” (Gunga, 2015).
Human’s core body temperature begins to decrease a few hours before sleep onset. The thermal environment is one of the most important factors that can affect human sleep. Effects of heat or cold exposure are increased wakefulness and decreased rapid eye movement (REM) sleep and slow wave (SWS) sleep. Heat exposure increases wakefulness and decreases SWS and REM sleep. Humid heat exposure further increases thermal load during sleep and affects sleep stages and thermoregulation (Okamoto-Mizuno & Mizuno, 2012). “Heat loss in hot and warm environments and under strenuous exercise, the organism depends on the evaporative pathway” (Gunga, 2015).
“Cold exposure affects cardiac autonomic response during sleep without affecting sleep stages and subjective sensations. The impact of cold exposure may be greater than that of heat exposure” (Okamoto-Mizuno & Mizuno, 2012). “In cold environments, heat loss must be reduced in order to prevent hypothermia. Thus, the body shell has to be enlarged via vasoconstriction, which allows better insulation of the core (which protects vital organs). Insulating layers prevent heat loss” (Gunga, 2015).
During non-rapid eye movement (NREM) sleep, the brain, and core temperature decrease with magnitudes irrespective of the ambient temperature (Okamoto-Mizuno & Mizuno, 2012). NREM sleep is a state with a low level of energy metabolism, cardiovascular, and thermoregulatory functions to conserve energy while feeding is reduced. Central autonomic nervous system activity regulating cardiovascular function and breathing as well as endocrine function supports this need during NREM sleep. Energy conservation and cooling of the body and brain are thought to be major functions of the tight interconnection of sleep and thermoregulation.
“Thermoregulation is a mechanism by which mammals maintain body temperature with tightly controlled self-regulation independent of external temperatures. Internal temperature regulation is a type of homeostasis and a means of preserving a stable internal temperature in order to survive” (Osilla et al., 2022). The human core body temperature consists of cranial, thoracic, and abdominal cavities. Together, their median core body temperature is about 37 degrees Celsius. The temperature of human extremities is considerably lower and ranges from about 28-36 degrees celsius (Gunga, 2015). Core body temperature is not consistent, and fluctuates throughout the day via circadian rhythm.
Our internal body temperature is regulated by the hypothalamus. The hypothalamus checks our current temperature and compares it with the normal temperature of about 37°C. “If our temperature is too low, the hypothalamus makes sure that the body generates and maintains heat. If our current body temperature is too high, heat is given off or sweat is produced to cool the skin.” (Gunga, 2015). Humans require a constant high core body temperature between 36.4- 37.4 degrees celsius.
Humans are endothermic organisms, (less dependent on external environmental temperatures) (Gunga, 2015). “Endothermic Organisms have much higher basal energy consumption - this keeps the core body temperature constant throughout a wide range of different external environmental temperatures.” (Gunga, 2015). Variations of core body temperature are only tolerated in a very small range.
The Brain and Sleep in Extreme Environments
The Preoptic Area of the Hypothalamus (POAH) serves as a critical brain region that influences thermoregulation, sleep, and energy homeostasis. The POAH is also involved in regulating parenting, and sexual behaviors, each of which is controlled by dedicated circuits (Frontiers | Role of the Preoptic Area in Sleep and Thermoregulation, 2021).
The control circuit consists of the motor system, brown adipose tissue, vasomotor activity, sweat secretion, and pilomotor activity. “A critical role of the POAH in integrating temperature information and triggering behavioral and autonomic responses through their central and peripheral downstream targets to adjust the body temperature” (Frontiers | Role of the Preoptic Area in Sleep and Thermoregulation, 2021). The POAH is where body shell and body core temperatures are compared to set-point values.
A Set-Point Value is set by means of temperature reference signals placed within the brain and body’s control circuit (Gunga, 2015). A decrease of the core body temperature below the setpoint value set by the hypothalamus leads to vasoconstriction of the skin and shell vessels (negative feedback), whereby the heat release via the body shell is reduced, piloerection of the hair (goosebumps), enlarges the insulating boundary layer above the skin and thus decreases the heat loss; and increased heat production by shivering. When the actual value, on the other hand, lies above the setpoint value, all those mechanisms that might evoke a further increase in the body temperature (motor system) are extenuated (negative feedback), and the mechanisms of heat loss are strengthened (vasodilatation in the body shell, increase of sweat secretion).
In the Hypothalamus, special neurons produce signals independent of the temperature. “When temperature and set-point value deviate from each other, various elements within the control circuit are changed by the autonomic nervous system to affect vegetative nerve fibers within the control circuit of positive and/or negative feedback” (Gunga, 2015). Different defense mechanisms for the maintenance of the core body temperature are reflexes and cannot be influenced entirely through autonomic control (Gunga, 2015).
Sensations of thermal comfort or discomfort are generated within the sensory cortex. Stimulating the internal and external cold and heat receptors via the tractus spinothalamicus and the unspecific medial thalamic regions (Gunga, 2015). “With distinct thermal discomfort, not only a stimulation of the autonomic countermeasures is initiated, but also, mediated via the cortex, changes in behavior, which leads to the selection of warmer clothing or taking shelter in a heated room in a cold environment” (Gunga, 2015).
“The hypothalamic–pituitary–adrenal (HPA) axis is the major neuroendocrine axis that regulates homeostasis in mammals” (Gjerstad et al., 2018). “Glucocorticoid hormones (GH) are synthesized and secreted from the adrenal gland in response to stress. GH has a wide range of effects as they are involved in the regulation of metabolic processes, immune system, reproduction, behavior and cognitive functions” (Gjerstad et al., 2018). “Under basal conditions, glucocorticoids are released rhythmically with both a circadian and an ultradian pattern. These rhythms are important not only for the normal function of glucocorticoid target organs but also for the HPA axis responses to stress” (Gjerstad et al., 2018). When stress activates the HPA axis the resultant increase in cortisol in order to prepare the body to cope with and recover from the stressor. This is also known as resilience (Gjerstad et al., 2018).
A principal mediator of the impact of stress on the brain and behavior is the activation of the hypothalamic-pituitary-adrenal axis, which results in widespread hormonal, neurochemical, and physiological alterations (Russo et al., 2012). Inflammatory stimuli in the brain and behavior have consistently reported evidence that inflammatory cytokines affect the basal ganglia and dopamine neurotransmission (Felger, 2017). Examination of the mechanisms by which cytokines alter the basal ganglia and dopamine function will provide insights into the mitigation of cytokine-induced behavioral changes and malaise due to an inflammatory response from HPA axis dysfunction.” (Felger, 2017). Findings have included inflammation-associated reductions in ventral striatal responses to reward, decreased dopamine and dopamine metabolites in cerebrospinal fluid, and decreased availability of striatal dopamine (Felger & Miller, 2012).
Dopamine response exhibits increased peripheral cytokines and other inflammatory markers, such as c-reactive proteins or autoimmune and/or fibromyalgia response to stressors such as exposure to extreme environments (Felger & Miller, 2012). Dysfunction of neurotransmitters and their receptors can lead to dopamine-relevant corticostriatal reward circuitry. Inflammatory stimuli on the brain and behavior have consistently reported evidence that inflammatory cytokines affect the basal ganglia and dopamine (Boling, 2021).
Neuroadaptations in the brain and their neuroendocrine output contribute to resilience. The ability to avoid behavioral changes in response to chronic stress is mediated not only by the absence of key molecular abnormalities that occur in susceptible animals/humans to impair their coping ability but also by the presence of distinct molecular adaptations that occur specifically in resilient individuals to help promote normal behavioral function (Russo et al., 2012).
Sleep plays a vital role in this regulation.
Sleep in Extreme Environments: Part Three, Countermeasures and Mitigation Techniques, Coming Soon.
References
Boling, Melanie. (2022). Melanie Noelani Boling. Imagery Beyond Borders. https://imagerybeyondborders.org
Boling, Melanie (2021). Reported results of Amazonian Entheogens for treatment of Complex-Post-Traumatic Stress Disorder (C-PTSD); Military Sexual Trauma (MST); and Traumatic Brain Injury (TBI) among U.S. Military Veterans and the benefits of application through small group indigenous shamanic ceremonies. The Amazon Rainforest: From Conservation to Climate Change-research. Harvard Summer School, August 9, 2021
Callini, C. (2015, February 24). Sleeping in Space [Text]. NASA. http://www.nasa.gov/image-feature/sleeping-in-space
Felger, J. C., & Miller, A. H. (2012). Cytokine effects on the basal ganglia and dopamine function: The subcortical source of inflammatory malaise. Frontiers in Neuroendocrinology, 33(3), 315—327. https://doi.org/10.1016/j.yfrne.2012.09.003
Felger, J. C. (2017). The Role of Dopamine in Inflammation-Associated Depression: Mechanisms and Therapeutic Implications. Current Topics in Behavioral Neurosciences, 31, 199–219. https://doi.org/10.1007/7854_2016_13
Frontiers | Role of the Preoptic Area in Sleep and Thermoregulation. (n.d.). Retrieved August 2, 2022, from https://www.frontiersin.org/articles/10.3389/fnins.2021.664781/full
Gunga, H.-C. (2015). Chapter 5—Desert and Tropical Environment. In H.-C. Gunga (Ed.), Human Physiology in Extreme Environments (pp. 161–213). Academic Press. https://doi.org/10.1016/B978-0-12-386947-0.00005-8
Gjerstad JK, Lightman SL, Spiga F. Role of glucocorticoid negative feedback in the regulation of HPA axis pulsatility. Stress. 2018 Sep;21(5):403-416. doi: 10.1080/10253890.2018.1470238. Epub 2018 May 15. PMID: 29764284; PMCID: PMC6220752.
Ingersoll, G. (n.d.). 23 Examples Of Sleep In A Combat Zone. Business Insider. Retrieved August 12, 2022, from https://www.businessinsider.com/heres-23-examples-of-sleep-in-combat-2013-3
Okamoto-Mizuno, K., & Mizuno, K. (2012). Effects of thermal environment on sleep and circadian rhythm. Journal of Physiological Anthropology, 31(1), 14. https://doi.org/10.1186/1880-6805-31-14
Osilla, E. V., Marsidi, J. L., & Sharma, S. (2022). Physiology, Temperature Regulation. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK507838/
Russo, S. J., Murrough, J. W., Han, M., Charney, D. S., & Nestler, E. J. (2012). Neurobiology of Resilience. Nature Neuroscience, 15(11), 1475–1484. https://doi.org/10.1038/nn.3234
Thermoregulation in Humans—Body Temperature Regulation at Night. (n.d.). Retrieved August 2, 2022, from https://www.sleepadvisor.org/thermoregulation/
Toenders, Y. J., Laskaris, L., Davey, C. G., Berk, M., Milaneschi, Y., Lamers, F., Penninx, B. W. J. H., & Schmaal, L. (2021). Inflammation and depression in young people: A systematic review and proposed inflammatory pathways. Molecular Psychiatry, 1–13. https://doi.org/10.1038/s41380-021-01306-8
About the author:
Melanie began attending Harvard in 2020 to complete a Graduate Certificate in Human Behavior with a specialization in Neuropsychology. Boling’s research has examined extreme environments and how they can have a potential negative impact on humans operating in the extreme environment. During her time at Harvard, she has built a mental wellness tool called a psychological field kit. Implementing these tools will allow an individual to thrive in an extreme environment while mitigating negative variables such as abnormal human behavior which can play a role in team degradation.
Hau`oli La Makuahine (Happy Mother’s Day) from Moloka’i! // Melanie Boling, Boling Expeditionary Research
To all the mamas out there who need to hear this - Hau`oli La Makuahine / Happy Mother’s Day from Moloka’i!! 🥥
Here are a few scenes from Boling Expeditionary Research conservation research trip to the island of Moloka’i, Hawai’i.
Aloha Oe from our ‘ohana to yours!
- Boling Expeditionary Research. 🏝
Is deinstitutionalization better for the seriously mentally ill, or are they better off locked safely in institutions? // Melanie Boling, Harvard University.
Is deinstitutionalization better for the seriously mentally ill, or are they better off locked safely in institutions?
In modern-day society, institutionalization could be beneficial for certain mentally ill individuals that meet specific criteria.
For example, if an individual suffers from acute psychosis that can not be treated with any form of psychopharmaceutical interventions that add to the quality of the life or cannot be treated whatsoever.
If certain mental illnesses pose an immediate danger to either the patient themself or others, these would be more specific cases in which institutionalization would be suitably warranted.
The flip side to that is the fact that in some cases, misdiagnosis does occur.
Putting a patient into an environment such as an institution could potentially exasperate the condition and cause the patient to suffer far worse than ever before.
In my professional experiences, I have observed mentally-ill combat war veterans respond positively in regards to social engagement and relatable commonalities amongst their peers who also suffered from some form of mental illness.
PTSD or Post Traumatic Stress Disorder is not synonymous with all veterans, despite the contrary being reported in the mainstream media. Some military members respond to conflict in a productive manner with little to no residual side effects after the military deployment.
However, mental illness beyond PTSD is very common in the U.S. Military. This ranges from OCD or Obsessive Compulsive Disorder to Process Addictions like Alcohol and Drug Abuse or Sexually Impulsive and Deviant Behaviors; which would all constitute a valid diagnosis in the DSM V.
Furthermore, a therapeutic environment where certain types of experiences are recreated in order to provide a dynamic that models one of the small-team environments similar to that of war; in most cases, the mentally ill veterans respond positively to the relatability and camaraderie of the overall group cohesion.
An environment fit for healing or at least a place to hold space for one another.
If certain types of alternative therapies were introduced into the regimen that institutions provide their patients, it could potentially provide an avenue for some sort of peace; even the most deranged patients could possibly benefit.
Psychosis, such as untreated schizophrenia essentially has the individual suffering around the clock.
There is no easy fix in regards to medication. In some cases, it takes years to find the right kind of cocktail to allow a patient to be somewhat coherent and at least on the low-end of what society deems functional.
Alternatively, non-invasive therapy such as the outdoors in a small group environment could potentially be a way to take the sting out of a long-term stay at a mental institution, as long as it is safe for both the individual; the staff; and the other patients.
Institutionalizing someone in this day and age simply because they suffer from anxiety; are a victim of a crime that they had no control over; or, even fall on the cluster b personality disorder spectrum would not benefit anyone.
There are enough resources available in the United States to not allow someone to fall through the cracks.
However, a solid professional support system and psychological interventions are imperative for the overall success of the patient maintaining a fulfilling path to healing.
That being said, despite the mentally ill’s willingness to seek help; and the social service workers being readily available to serve, knowing how the system works here in America, the obvious bump in the road or even potential failure lies solely on the system.
There is not a lot of follow-through in regards to state services or even private services paid for by insurance companies.
The system as a whole needs a major overhaul, and effective functional communication amongst all entities involved needs to be standardized.
In America, we fail the mentally ill simply due to human error and overall disregard for those suffering due to the stigma that is deeply ingrained in our society regarding mental illness.
As sad as it may be, it’s a fact and failure perpetuated and repeated throughout every generation.
Now is the time to step in and change the paradigm.
About the author:
Melanie began attending Harvard in 2020 to complete a Graduate Certificate in Human Behavior with a specialization in Neuropsychology. Boling’s research has examined extreme environments and how they can have a potential negative impact on humans operating in the extreme environment. During her time at Harvard, she has built a mental wellness tool called a psychological field kit. Implementing these tools will allow an individual to thrive in an extreme environment while mitigating negative variables such as abnormal human behavior which can play a role in team degradation.