The Importance of Sleep and Sleep Hygiene - University of Michigan

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					 The Importance of Sleep and Sleep
  Hygiene: Practical Clues for the
         College Student

         Roseanne Armitage, Ph.D.

                     Professor
Director - Sleep and Chronophysiology Laboratory
              University of Michigan


                                                   Sleep &
                                           M   Chronophysiology
                                                  Laboratory
          Functions of Sleep
  SWS – basic sleep drive – rest, recovery &
                homeostasis
   Body& blood cell work, immune system,
      Keep circadian rhythms entrained

  Stage 2 – maintain vigilance while sleeping

REM- Memory consolidation,
 development of neural connections
 in childhood                             M
                                                  Sleep &
                                              Chronophysiology
                                                 Laboratory
               RAW DATA
                STORAGE




                                                DIGITIZED VALUES
AMPS

                                                     PSA or PAA


                                                               % ZERO-CROSS
                                                POWER
            A/D CONVERSION                                   % FIRST DERIVATIVE
                                               SPECTRA
                                                                   POWER
            BOARD RESIDENT
             IN COMPUTER
              SAMPLING RATE
                128-1000Hz

                                                    BETA       12-32 Hz*
                                                    SIGMA      12-16 Hz
                                                    ALPHA       8-12 Hz
                                                    THETA        4-8 Hz
       OFF-LINE VISUAL SLEEP-STAGE                  DELTA      0.5-4 Hz
                 SCORING



                                     *FREQUENCY BAND WIDTHS DIFFER BETWEEN LABORATORIES
REM
Stage 4
    HEALTHY NORMAL CONTROL

Awak
e
Move
REM
Stg 1
Stg 2
Stg 3
Stg 4
        SOS: 23:54:00   TIME OF NIGHT   WUT:
                                        08:51:30

                                 % REM:            13.3
        SLEEP EFFICIENCY: 96.8% % STAGE 1:          7.5
        REM LATENCY:    94.5 min % STAGE 2:        57.0
        SLEEP LATENCY: 7.0 min % STAGE 3:          16.9
                                 % STAGE 4:         3.5
  How much sleep do you need?
• Not everyone needs the same amount
  of sleep Natural short and long
  sleepers

• BUT sleeping less than 6.5 or more
  than 9 hours is associated with 1.7 x
  greater mortality & risk of disease.

                                                  Sleep &
                                          M   Chronophysiology
                                                 Laboratory
            Is it Enough Sleep?
 More than 40 % of adults have sleep
  complaints
   25 % women & 16 % men
      # 1 Complaint: Feeling unrested
      # 2 Complaint: Difficulty Falling Asleep


     Among college students 71 % had sleep
      complaints in 2000 compared to 24 % in
      1978


                                                          Sleep &
                                                  M   Chronophysiology
                                                         Laboratory
 How Has Sleep Changed Historically?

 Estimated 8-9 hrs in early 20th Century
 7-8 hrs mid 1980s-2002
 College Students:
      1980s reported 7-7.5 hrs
      2002 reported 6-6.9 hrs
   Going to bed later is the culprit
      Bedtime is 1-2 hrs later
       than it was 25 yrs ago

                                                    Sleep &
                                            M   Chronophysiology
                                                   Laboratory
                   Napping

 30-50 % of students nap
      Nappers have delayed bedtime of >1 hr
      30 % naps >1.7 hrs
      Mostly late afternoon naps
      Sleep >1 hr less than non nappers




                                                       Sleep &
                                               M   Chronophysiology
                                                      Laboratory
    Consequences of Sleep Loss
 Poor academic performance correlated with
  insomnia & poor sleep quality
 Automobile Accidents: Fatigue is a leading cause
 Minor medical Illness: Cold & Flu rates higher in
  poor sleepers
 Circadian dysregulation: Creating Jet Lag in the
  home environment

 Psychiatric Illness:
  Depression & Anxiety

                                                      Sleep &
                                              M   Chronophysiology
                                                     Laboratory
             Sleep & Depression

   Sleep disturbance > 2 wks is a risk factor for
    the development of depression

   Sleep abnormalities are common symptoms of
    depression: >80% pts

   Often the presenting symptom: Common to
    notice the sleep problem first


                                                    Sleep &
                                            M   Chronophysiology
                                                   Laboratory
          Sleep & Depression
    If sleep problems persist into
     clinical remission:
   Worse clinical outcome and increased
    risk of relapse in recovering patient
   Increased risk of suicide
   Daytime fatigue/ reduced functioning
   Worry about insomnia may cause
    further insomnia and anxiety

                                                    Sleep &
                                            M   Chronophysiology
                                                   Laboratory
Depression in College Students

 Incidence is 2 x greater than general
  population
   Approximately 20 % of students


 Often goes undiagnosed and untreated
   Increasing risk of another episode


                                                  Sleep &
                                          M   Chronophysiology
                                                 Laboratory
   Sleep and Depression in College
              Students
 Worsening of depression and sleep problems at
  exam time (particularly in males)
 Minor medical problems 2-4 x more prevalent
  in depressed students with sleep problems >2
  wks duration
 Attending University does increase
both incidence of sleep problems
 & depression
                                                 Sleep &
                                         M   Chronophysiology
                                                Laboratory
          DEPRESSED PATIENT


Awake
Move
REM
Stg 1
Stg 2
Stg 3
Stg 4
        SOS: 01:04:00   TIME OF NIGHT   WUT: 08:51:30

                                   % REM:          16.9
SLEEP EFFICIENCY: 79.2%
                                   % STAGE 1:      17.0
REM LATENCY:    49.0 min
                                   % STAGE 2:      46.0
SLEEP LATENCY: 6.0 min
                                   % STAGE 3:       0.0
                                   % STAGE 4:       0.0
 Sleep & Biological Rhythms

 Ultradian <24 hrs
      Most common 90 min REM/NREM sleep cycle
      Task Performance
 Infradian >24 hrs
      Lunar cycle
      Menstrual cycle




                                                  Sleep &
                                          M   Chronophysiology
                                                 Laboratory
             Circadian Rhythms
 24 hr rhythms in biology, physiology, mood &
  performance that are entrained to the light dark
  cycle
 Controlled by the SCN in the hypothalamus
 Light is the most potent zeitgeber

 Sleep, Cardiovascular Activity, Body Temperature,
  Hormones, Endocrine & Metabolic Function,
  Liver & Kidney Function,
  Gastrointestinal Activity, Immunology

                                                             Sleep &
                                                     M   Chronophysiology
                                                            Laboratory
                                                            0




0
                                                                                      100




                             100




HS
       % Time-In-Frequency                                      % Time-In-Frequency




EPOC
                                                   EPOCHS
                                                   100
 100

                                                   200
 200
                                                   300
 300

                                                   400
 400
                                                   500
 500
                                                                                      .99




                             .43

                                                   600
 600
                                                   700
 700

                                                   800
 800
                                                                                            HIGH COHERENCE




                                   LOW COHERENCE




                                                   900
 900
                                                                        C4
                                                                              C3
Coherence in Girls at High-Risk
 1


0.8


0.6   CUTPOINT= .70


0.4


0.2

                 HIGH RISK             NC

>50 % of girls with extreme low
values had 1st episode 3-5 yrs later        M
                                                    Sleep &
                                                Chronophysiology
                                                   Laboratory
     How Do We Improve Sleep &
    Depression In College Students?

   Education about Sleep
   Education about Depression
   Clearly identify Biological & Familial Risks
   Early Intervention
   Development of Easy,
    Practical Guidelines for
    Good Sleep Hygiene
                                                  Sleep &
                                          M   Chronophysiology
                                                 Laboratory
    Good Sleep & Biological Rhythm
               Hygiene
 Maintain regular rise & bed times every night
  including weekends i.e. 11:00 P.M.-6:00 A.M.
  ESPECIALLY FOR WOMEN

 Very hot bath (~15 min. Duration) 1 1/2 hour before
  bedtime ESPECIALLY FOR SWS PROBLEMS

 Turn down thermostat, no electric blankets Use very
  dark curtains or use a sleep mask

 No napping especially in afternoon
  or evening                                              Sleep &
                                                  M   Chronophysiology
                                                         Laboratory
Good Sleep & Biological Rhythm Hygiene

Restrict caffeine (not just coffee) 1-2 cups before 10
 a.m.

Warm milk 1/2 hour before bedtime

No food or exercise within 2 hrs of bedtime

Avoid time zone changes


                                                        Sleep &
                                                M   Chronophysiology
                                                       Laboratory
      Schedule for Light Exposure
• Early morning bright light will advance the circadian
  clock i.e make you sleepy earlier

• Late afternoon bright light will delay your body clock
  i.e make you sleepy later

• Wear dark glasses to minimize light to retina if your
  body clock is already shifted

• Avoid bright light at night, use
  incandescent light with the
  lowest wattage possible.                        M
                                                          Sleep &
                                                      Chronophysiology
                                                         Laboratory
        Sleep &
M   Chronophysiology
       Laboratory

				
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posted:7/28/2011
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