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YourHealthTodayChapter4.pptx4: Sleep
Your Health Today, 6th edition
©McGraw-Hill Education. All rights reserved. Authorized only for instructor use in the classroom. No reproduction or further distribution permitted without the prior written consent of McGraw-Hill Education.
Sleep
Circadian rhythm: internal daily 24-hour cycle of waking and sleeping
Most adults need about 8–9 hours of sleep each night
A typical college student sleeps only 6–7 hours a night on week nights
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Sleep and Your Health
Sleep is a period of rest and recovery from the demands of wakefulness
It can be described as a state of unconsciousness or partial consciousness from which a person can be roused by stimulation
We spend about a third of our lives sleeping
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Health Effects of Sleep
Sleep is strongly associated with overall health and quality of life
Restoration and growth take place during the deepest stages of sleep
Natural immune system moderators increase during sleep and promote resistance to viral infections
A lack of sleep can lead to a breakdown in the body’s health-promoting processes
Short sleep: less than 7 hours; increases risk of negative health outcomes
Long sleep: 10 hours or more; has not been found to have negative health consequences
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Health Effects of Sleep (2)
Sleep deprivation and other sleep disorders are associated with serious physical and mental health conditions
Slowed reaction time
High blood pressure, heart disease, stroke
Suppressed immune system
Overweight and obesity
Breast cancer
Diabetes
Dementia, Alzheimer’s, multiple sclerosis, Parkinson’s disease
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Sleep Deprivation
Sleep deprivation is the lack of sufficient time asleep, a condition that impairs physical, emotional, and cognitive functioning
Effects all domains of functioning
Emotional effects, including heightened irritability and difficulty handling stress
Reduced motivation
Reaction time, coordination, and judgment
Memory impairments
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Sleep Deprivation (2)
Chronic sleep deprivation damages brain cells and impairs debris removal, accelerating brain aging
Sleep debt is the difference between the amount of sleep attained and the amount of sleep needed to maintain alert wakefulness during the daytime, when the amount attained is less than the amount needed
Can’t be made up for with extra sleep on weekends
May disrupt sleep structure
Prescription stimulants are not a healthy solution
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What Makes You Sleep?
Circadian rhythms are maintained by the suprachiasmic nuclei (SCN) in the brain
Internal “biological clock” that controls body temperature and levels of alertness and activity
SCN signal the release of hormones, including signaling the pineal gland to release melatonin, which increases relaxation and sleepiness, and the pituitary gland to release growth hormone during sleep to help repair damaged tissues
External environmental cues such as light are also important
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The Structure of Sleep
The brain cycles into two main states of sleep:
Non-rapid eye movement (NREM)
Rapid eye movement (REM)
NREM sleep:
Stage 1: relaxed, half-awake sleep
Stage 2: brain activity slows and movement stops
Stages 3 and 4:
Blood pressure drops
Heart rate slows
Blood supply to brain minimized
Stage 4 is referred to as deep sleep
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The Structure of Sleep (2)
REM sleep:
Brain activity becomes more like being awake
Dreams are most likely to occur in this stage
REM sleep paralysis: periods of no muscle tone and immobility
Appears to give the brain the opportunity to “file” ideas and thoughts into memory
Creative and novel ideas may be more likely to flourish
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The Structure of Sleep (3)
Insufficient REM sleep may impair memory and the ability to learn new skills
REM rebound effect: when long sleep is possible after inadequate sleep for several nights, you will have longer and more frequent REM sleep
Demonstrates importance of REM sleep to the brain
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Sleep Cycles
After the first REM period, you cycle back and forth between REM and NREM stages
Repeats about every 90 to 110 minutes until waking
Children and adolescents experience large quantities of “deep sleep”
As people get older, high-quality, deep sleep becomes more elusive
Structure is essentially the same for men and women
Women have more slow-wave sleep (NREM stages 3 and 4) and experience more insomnia
©McGraw-Hill Education.
Figure 4.3 One night’s sleep cycles.
After your first REM period, you cycle back and forth between REM and NREM sleep stages. Typically, you experience four or five sleep cycles each night. After the second cycle, however, you spend little or no time in NREM stages 3 and 4 and most of your time in NREM stage 2 and REM sleep. After each successive cycle, the time spent in REM sleep doubles, lasting from 10 to 60 minutes at a time.
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Insomnia
Insomnia: difficulty falling or staying asleep
Can be caused by stress, anxiety, medical problems, poor sleep environment, noisy or restless partners, and schedule changes
Distress over inability to fall asleep also contributes
Improved sleep habits and exercise have been shown to improve sleep quality for chronic insomnia
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Sleep Apnea
Sleep apnea: periods of nonbreathing during sleep
Almost 40% of U.S. population may have some form of sleep apnea
Some 80–90% of cases are undiagnosed
Central sleep apnea: brain fails to regulate the diaphragm and other breathing mechanisms correctly (rare)
Obstructive sleep apnea: upper airway is obstructed during sleep
Person is typically unaware of the typical pattern of snoring and gasping
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Figure 4.4 Obstructive sleep apnea.
(a) Normally, the airway is open during sleep. (b) When the muscles of the soft palate, tongue, and uvula relax, they narrow the airway and cause snoring. (c) If these structures collapse on the back wall of the airway, they close the airway, preventing breathing. The efforts of the diaphragm and chest cause the blocked airway to become even more tightly sealed. For breathing to resume, the sleeper must rouse enough to cause tension in the tongue, which opens the airway.
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Sleep Apnea (2)
Obstructive sleep apnea is potentially dangerous, even fatal
Associated with high blood pressure and increased risk of heart disease and stroke
If not severe, sleep apnea can be addressed by behavioral strategies
More severe cases are often treated with a continuous positive airway pressure (CPAP) machine
Through a mask, pressurized air is gently blown into the patient’s nose
©McGraw-Hill Education.
Sleepwalking Disorder
Sleepwalking disorder: a person rises out of an apparently deep sleep and acts as if awake
Episodes typically last less than 10 minutes
Most sufferers have no family history of the disorder
May be brought on by excessive sleep deprivation, fatigue, stress, illness, excessive alcohol, and use of sedatives
©McGraw-Hill Education.
Sleep-Related Eating Disorder and Night Eating Syndrome
Sleep-related eating disorder (SRED): a person rises from bed during the night and eats and drinks while asleep
About three-quarters with this disorder are female
The person has no memory of the episode (or multiple episodes), and does not experience indigestion or feelings of fullness
Night eating syndrome: a person eats excessively during the night while awake
Repeatedly awakens during the night to eat, then eats very little during the day
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Evaluating Your Sleep
Take the sleep latency test
Sleep latency: amount of time it takes a person to fall asleep
Check for symptoms of a sleep disorder
Look at behavior change strategies
If referred to a sleep clinic or lab, you may be asked to monitor your sleeping habits at home, or you may be evaluated in a lab
Multiple Sleep Latency Test: administered as an index of daytime sleepiness, usually repeated five times during the day in a sleep clinic
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Getting a Good Night’s Sleep
Most people experience disordered sleep at some point, experiencing the symptoms of sleep disorders but less frequently and less severely
Ways to ensure healthy sleep patterns include moderating technology use and adopting other sleep-friendly habits and behaviors
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Taking a Break from Technology
Artificial blue light from computers, televisions, and phones blocks the production of melatonin, the hormone that induces sleep
If possible, turn off electronic devices at least 2 hours before going to sleep
Alternately, dim brightness levels or adjust light sources from blues to reds
Answering texts and calls interrupts sleep architecture and can also lead to awkward and embarrassing communications
©McGraw-Hill Education.
Establishing Good Sleep Habits
Maintain a regular sleep schedule
Be smart about napping
Create a sleep-friendly environment
Avoid eating too close to bedtime
Avoid caffeine, nicotine, and alcohol
Get regular exercise but not close to bedtime
Manage stress and establish relaxing bedtime rituals
Consider your bed partner
©McGraw-Hill Education.
Creating a Sleep-Friendly Environment
Your bedroom should be comfortable, secure, quiet, cool, and dark, giving special consideration to the following:
Choice of mattress and pillow
Clean sheets
Quiet
Temperature
Air quality
Body position
Chronic pain
©McGraw-Hill Education.
Using Sleep Aids and Sleep Apps
Frequently prescribed sleep medications induce sleep but suppress both deep sleep and REM sleep
Daytime side effects include decreased memory and intellectual functioning
Many OTC medicines contain antihistamines
Can cause dehydration, agitation, constipation
Rebound insomnia can occur, worse than before medication was taken
A variety of smartphone apps can be calming and help induce sleep, or will track your sleep quality
©McGraw-Hill Education.
Using Sleep Aids and Sleep Apps (2)
Many complementary and alternative products aim to address sleep problems
Herbal products, most commonly valerian
Can interact with other medication and drugs
Dietary supplements, especially melatonin
Aromatherapy, using certain scented oils
Relaxation drinks, or anti-energy drinks
Because of the potential for adverse affects, it is important to consult with your health provider
©McGraw-Hill Education.
In Review
How does sleep affect your health?
What makes you sleep?
What is the structure of sleep?
What are common sleep disorders?
How can you enhance the quality of your sleep?
©McGraw-Hill Education. All rights reserved. Authorized only for instructor use in the classroom. No reproduction or further distribution permitted without the prior written consent of McGraw-Hill Education.
