SLEEP

Dr Himalee Abeya

Phases of sleep

REM• Eye movements +• High brain activity• Recall complex

dreams more• Increase body

work• Muscles lose tone

maximally

Non – REM• No/low movements• Reduced activity• Less recall of

dreams• Less body work

• Muscle tone more

Insomnia

• Insufficient quality and quantity of sleep• Up to 50% prevalence• Common in– · females– · the middle aged– · unemployed– · separated– · lower socioeconomic class

Causes of insomnia

• Life stress

• Environment

• Physiological

• Psychiatric

• Physical illness

• Substance use

• Obstructive Sleep apnoea

Poor sleep leads to………• Daytime sleepiness• Shortened life span• Increased risk of heart and stomach

problems• Irritability, depression• Explosive outbursts and mood swings• Increased risk of accidents • Poor work and memory performance• Marital, social and employment problems

Hypersomnia

• Excessive daytime sleepiness and sleep attacks – disturbs life

• 4% of population

• Due to –

-insufficient night time sleep

-pathological sleep – Narcolepsy

– Sleep apnoea

TROUBLE SHOOTING FOR EXCESSIVE SLEEPINESS• Am I sleep deprived?

• Do I have an infection?

• Am I taking other medications now? Drinking alcohol?

• Am I eating foods that perhaps might be making me worse?

• Am I depressed or under unusual stress?

• (Women only)-where am I in my menstrual cycle?

• Am I less physically active than before?

Managing Sleep problems

• Good sleep hygiene

• Hypnotics

• Behavioral techniques

Sleep Hygiene – do’s• Go to bed at the same time each day. • Get up from bed at the same time each day. • Get regular exercise each day, preferably in the

morning. • Get regular exposure to outdoor or bright

lights, especially in the late afternoon. • Keep the temperature in your bedroom

comfortable. • Keep the bedroom quiet when sleeping. • Keep the bedroom dark enough to facilitate

sleep. • Use your bed only for sleep and sex. • Take medications as directed. • Use a relaxation exercise just before going to

sleep. Or a sleep ritual.

Sleep Hygiene – don’ts• Exercise just before going to bed. Don’t

exercise 4 hours before bed.• Engage in stimulating activity just before bed• Have caffeine in the evening (coffee, many teas,

chocolate, sodas, etc.) • Read or watch television in bed. • Use alcohol to help you sleep. • Go to bed too hungry or too full. • Take over-the-counter sleeping pills• Take daytime naps. Sleep less than one hour

before 3pm• Command yourself to go to sleep.