Sleep Disorders

Sleep DisordersDr. Harim MohsinSpring Hospital

Why is sleep important?

Sleep is Essential to Our Overall Health and Well-BeingKey to our health, performance, safetyand quality of life.

Essential to our ability to perform both cognitive and physical tasks, engage fully in life and function in an effective, safe and productive way.

3Sleep is a biological requirement. All animals sleep. It is theKey to our health, productivity, safety and quality of lifeIt is an active process that energizes and restores our brain and body. In order to function and live at our best, sleep is as necessary as the water we drink, the air we breathe and the food we eat.Getting enough uninterrupted and restorativeor quality sleep throughout the night prepares you for the daytime the other 2/3s of your life. Sleep gives you the potential to thrive and makes it possible to live a full life. It becomesEssential to your ability to perform both cognitive and physical tasks at your peak, engage fully in life and function in an effective, safe and productive way

Normal SleepHumans sleep more than 25 years of their life.

Average requirement of sleep varies with age:Infants: 16-20 hrsAdolescents: 7-9 hrsAdults: 6-8 hrs

AwakeStagesThe Sleep Cycle in AdultsREMREMREMREMREM1234012345678Hours in Sleep

5Sleep occurs in stages. There are 4 stages of NREM or Non-Rapid Eye Movement sleep and one stage of REM or Rapid-Eye Movement sleep. NREM Stage 1 sleep is the onset of sleep with Stages 2, 3 and 4 becoming progressively deeper. REM sleep, also known as dream sleep, first occurs about 90 minutes after sleep onset. The eyes dart back and forth during REM sleep, thus, the name rapid eye movement sleep. Brain waves, which can be measured by an overnight sleep study, alter during each stage. Most of the deep sleep occurs in the first third of the night and most of the REM sleep is experienced in the last third of the night. All stages of sleep are important.Sleeping throughout these stages is important because this is when tissue growth and repair occur, energy is restored, and learning or memory is consolidated.

Normal Sleep and Normal Aging:Less Deep Sleep

6As we age, our brain waves change and we tend to experience less deep sleep. Less time is spent in stages 3 and 4 while there may be longer periods of stage 1 and 2 sleep. In fact, stage 1 sleep can increase as much as 8-15%. Most studies also demonstrate an overall decline in REM sleep. The change in sleep architecture that occurs is associated with the aging process, but the disruptions in sleep are likely due to the impact of medical or psychiatric conditions.

Normal Sleep and Normal Aging:Sleep Efficiency

MenWomenAgeSleep Efficiency(% Time in Bed Sleeping)Changes with age

7As a result of all of these physiological, hormonal, and environmental changes, older persons tend to sleep less efficiently. While they may be in bed 8 hours, at 55 years of age and older, both men and women may be in actual sleep for just 7 hours or less. Frequent disruptions or poor sleep robs the older person of the continuous sleep necessary to experience the deeper stages of sleep and reap their benefits.

Factors affecting SleepRegulated by internal and external factors-Internal- Emotions, homeostasis (hunger/temp), hormones, Neurotransmitters. External- Temperature, Noise, Stress etc.

Sleep Need is built up during the day.

Assessment During the past month,

1. When have you usually gone to bed? ____________________________________2. How long (in minutes) has it taken you to fall asleep each night? ____________________________________3. What time have you usually gotten up in the morning? ____________________________________4. A. How many hours of actual sleep did you get at night? ____________________________________B. How many hours were you in bed?

Assessment

Scoring

Component 1 #9 Score C1 ___________

Component 2 #2 Score (60min (3))

+ #5a Score (if sum is equal 0=0; 1-2=1; 3-4=2; 5-6=3) C2 ___________

Component 3 #4 Score (>7(0), 6-7 (1), 5-6 (2), 85%=0, 75%-84%=!, 65%-74%=2,