The Absolute Essentials of Sleep Knowledge (Mini Book)

8/11/2019 The Absolute Essentials of Sleep Knowledge (Mini Book)

1/63

THEABSOLUTE

ESSENTIALSOFSLEEP

KNOWLEDGE

WILLIAMC. DEMENT, M.D., PH.D.

STANFORDUNIVERSITY


2/63

A Note From the Author:

"#$ %&'$ '$($)'*#$' )+,-(. /$0$' +--1( 2)*13 4#$/ ) '$($)'*#%-(5.5-/ '$6&5'$( (-,$ .$)*#5/78 5. 5( .#$/ /$*$(()'9 .- -'7)/5:$ )/; %'$(/ '$*$/. 9$)'(8 > #)0$ 2$$/ 5/*'$)(5/7+9 .'-&2+$; 29 .#$ =)5+&'$

-= (-,/-+-79 )/; (+$$% ;5(-';$'( .- )*#5$0$ ,)5/(.'$), (.).&(3 @ *-/. 5( (,)++ $/-&7# .- 2$ ?5;$+9 ;5(.'52&.$; ).

:$'- -' 0$'9 +5..+$ *-(.3 > #-%$ .#$ =-'$7-5/7 5( )/ );$6&).$ 5/.'-;&*.5-/

)/; $A%+)/).5-/3

\ 45++5), M3 D$,$/.


3/63

Contents

1 Long Night!s Journey into Day 1 "#$ &$'()(*(+) +' ,-$$.

2 Sleep Debt and Sleep Deprivation 4 /+0 "(1$2 31$ 4+56 "#$ 75-*(.-$ ,-$$. 89*$):; "$ ?9*51$!< 8+9) ,#91@ 31+5 "#$ 79


4/63

5 Snoring and Sleep Apnea 28L#$) ,)+1()B E$:+K$< ,-$$. 3.)$9

"1$9*()B ,-$$. 3.)$9

6 Narcolepsy and Other Sleep Disorders 35 ?91:+-$.


5/63

LONGNIGHTSJOURNEYINTODAY

"#$%& '()*+ '$,%-& $#$%& .$%/0' 0' +*$ .-,'$+ 1'2$%)0$/ ,'

,/+01'2(') 3$+,30%.*0/(/ ,/ +*$ /-(2$ +04,%2 /-$$. 5$)('/6 7+ +*$

303$'+ 08 /-$$.9 01% 502& (/ ('$%+ ,'2 01% $&$/ %0-- /-04-& 8%03

/(2$ +0 /(2$ 1'2$% 01% :-0/$2 $&$-(2/6 ;,+$% ,/ %,.(2 $&$ 30#$3$'+/

5$)('9 01% 3('2 $'+$%/ +*$ 2%$,3 40%-26 01%/ -,+$%9 ,/ +*$ /1' %(/$/ 0%

+*$ ,-,%3 /01'2/9 4$ ,%$ +%,'/.0%+$2 5,:? +0 4,?(') :0'/:(01/'$//6 7'2 4$ %$3$35$% ,-30/+ '0+*(')6

@-$$. (/ , 3(%,:1-01/ A01%'$& 3,2$ ,-- +*$ 30%$ $B+%,0%2(=

',%& 5& +*(/ 0'$ /(3.-$ 8,:+C D$ '$#$% ?'04 4$ ,%$ /-$$.(') 4*(-$

4$ ,%$ ,/-$$.6 E+ (/ (3.0//(5-$ +0 *,#$ :0'/:(01/9 $B.$%($'+(,- ?'04-=

$2)$ 08 '0'=2%$,3(') /-$$.6 E' ,22(+(0'9 *13,' 5$(')/ *,#$ )%$,+

2(88(:1-+& 30'(+0%(') +*$(% 04' $B,:+ F303$'+ 08 /-$$.6G E+ (/ '0+

-(?$ , .('.%(:?6 H8+$' E ,/? 3& /+12$'+/ +0 2$/:%(5$ +*$ 303$'+ 08

8,--(') ,/-$$.9 ,'2 ('#,%(,5-& +*$& :,''0+6


6/63

LONGNIGHTSJOURNEYINTODAY

Human brain wave patterns associated with stages of sleep and wakefulness. In thisfigure, alpha rhythm is mistakenly labeled drowsy. When individuals are awake and theireyes are open, alpha rhythm is suppressed and low voltage fast patterns are seen. When

the eyes are closed, prominent alpha rhythm is seen whether or not an individual issleepy. The disappearance of alpha rhythm signals the moment of sleep onset and thebeginning of NREM Stage I. In humans, NREM Stage I is roughly similar to the EEG activity

!"#$% '())* '+$,)-

./$0) ! #$% &$#'()* ! +(,-$./ 0(1'

123/-4 ! 2 '$ 34 561 ! (#67( %(&*1

'+$,) 5 ! 8 '$ 9 561 ! '7*'( %(&*1

:7*'( %(&*1

'+$,) 6 ! 34 '$ 3; 561 ! 1#**6 16*1

?#**6 ?6

1)(+$ '())* ! 3A4 '$ 4 561 ! -*#'( %(&*1 B 9C D

789 ':88; ! #$% &$#'()* ! +(,-$./ #(1' %


7/63

LONGNIGHTSJOURNEYINTODAYLONGNIGHTSJOURNEYINTODAY

!"# %#&'(')'*( *& +,##-

E 2$8('$ /-$$. (' +$%3/ 08 0'-& +40 $//$'+(,- 8$,+1%$/6


8/63

"#$ %& $'( )*+$ %,(*- %& .-%/0(12( *3%#$ +0((45 -%$'6-2 6+

7%8( 674%8$*-$ $'*- $'( $%46, %& +0((4 1(3$9 :& /( ,*- 0(*8- $% #-1(8;

+$*-1 +0((4 6-1(3$(1-(++ *-1 7*-*2( 6$5 /( ,*- 28(*$0< 6748%)( %#8

()(8


9/63

SLEEPDEBTANDTHEMORTGAGEDMIND

!"# %&'() *'( +",- %.( /,01&20( 30((2 451(678 %(91

H%-,(6)6-2 *-1 1()(0%46-2 *- %3=(,$6)( 7(*+#8( %& +0((46;-(++ /*+ 4(8'*4+ %-( %& $'( 7%+$ 674%8$*-$ *1)*-,(+ 6- +0((4 +,6(-,(9

I( 1#33(1 $'6+ %3=(,$6)( 7(*+#8( $'( /,01&20( 30((2 451(678 %(915

%8 JKA>9 >'6+ $(+$ 7(*+#8(+ $'( +4((1 %& &*006-2 *+0((4 ()(8< $/%

'%#8+ 1#86-2 $'( 1*% 76-676F( $'( 4%++630( '%88(-1%#+ 3%8(;

1%7 %& 0


10/63

/( $*006(1 $'( 6-16)61#*0 +0((4 0*$(-,< +,%8(+ &8%7 $'( -(@$ 1* +,%8(+9 :-%$'(8 /%81+5 $'( 0(++ +0((4 +#3=(,$+ 2%$5 $'( 7%8( 8*4610< $'(< &(00

*+0((4T6- 168(,$ 48%4%8$6%- $% $'( *7%#-$ %& +0((4 0%+$9 I( 8(*06F(1

/6$' 28(*$ (@,6$(7(-$ $'*$ /( ,%#01 *,,#8*$(0< 7(*+#8( * 4(8+%-D+

+0((4 0%*1 6- * /*< $'*$ /( -()(8 ,%#01 /6$' 4(8&%87*-,( $(+$+9

J< ,%00(*2#(+ *-1 : $'(- 8(-$(1 * +7*00 1%876$%8< *-1

0*#-,'(1 $'( K$*-&%81 K#77(8 K0((4 H*74 6- %81(8 $% 48%)61(

*1(?#*$( *-1 ,%7&%8$*30( &*,606$6(+ &%8 %#8 8%#-1;$'(;,0%,. +$#16(+9

E&$(8 /( 2*$'(8(1 7#,' 7%8( 1*$* /( 1(,61(1 $'*$ * +,%8( %& M $%V +62-6&6(1 *- (@$8(7( +0((4 $(-1(-,'6+ 6-,8(*+(1 1*


11/63

+0((4 1(3$ *-1 6$+ 1*-2(8%#+ (&&(,$+ *8( 1(&6-6$(0< 168(,$0< 8(0*$(1 $%

$'( $%$*0 *7%#-$ %& 0%+$ +0((49 \-$60 48%)(- %$'(8/6+(5 6$ 6+ 8(*+%-*30(

*-1 ,(8$*6-0< +*&(8 $% *++#7( $'*$ *,,#7#0*$(1 0%+$ +0((4 7#+$ 3( 4*613*,. '%#8 &%8 '%#89 >'(8(&%8(5 6& '( +$#1(-$+c 1*60< +0((4 8(?#68(7(-$

/*+ 7%8( $'*- (62'$ '%#8+ >% 48%)( $'6+ /( 161 +$#16(+ /'(8( /(



12/63

d(+46$( $'( &*,$ $'*$ W+0((4 1(3$X '*+ (-$(8(1 ,%77%- 4*8;

0*-,(5 7*-< 4(%40( 1% -%$ < #-1(8+$*-1 $'( ,%-,(4$9 E2*6- *-1

*2*6- : '(*8 4(%40( ,%740*6- $'*$ $'(< +0((4 * -62'$5 ()(- *- (@$8*'%#8 %8 +%5 *-1 +$600 &((0 =#+$ *+ $68(1 *-1 +0((4< %8 ()(- +0((46(8 $'*-

3(&%8(9 WI(005X $'(< $'6-.5 W: 7#+$ 3( +0((4< 3(,*#+( : *7 +0((46-2

$%% 7#,'9X

*'",950< %.( /59? "@ 30((2 :(;1

`(,*#+( $'( *0(8$-(++;+0((46-(++ ,%-$6-##7 6+ * ,%740(@

-,$6%- %& +0((4 1(3$ %- $'( %-( '*-1 *-1 36%0%26,*0 *0(8$6-2 *-1(-)68%-7(-$*0 +$67#0*$6%- %- $'( %$'(85 /( *8( 2(-(8*00< )(8< 3*1

=#12(+ %& %#8 +0((4 $(-1(-,


13/63

E &(/ /% )%0#-$((8+ +$*'( )%0#-$((8+ &68+$ +4(-$ U '%#8+ 6- 3(1 4(8 -62'$ &%8 %-(

/((.9 >'(- $'(< 3(2*- +4(-16-2 QR '%#8+ 6- $'( 1*8.5 6- 3(19 >'('(%7 [%$'

*-1 '6+ ,%00(*2#(+9 :- $'( (@4(867(-$ 7(-$6%-(1 3(0%/5 [%$' *-1

,8(/ $(+$(1 $'( ,%2-6$6)( 4(8&%87*-,( %& +%7( %& '6+ +#3=(,$+ /'%

'*1 +,%8(1 -(*8 F(8% %- $'( JKA>9 >'(- $'(< 8(?#68(1 $'( +#3=(,$+

$% +4(-1 QM '%#8+ 6- 3(1 &%8 +()(- ,%-+(,#$6)( -62'$+ 6- %81(8 $%

4*< %&& $'(68 1(3$+9 E&$(8/*81 $'( +#3=(,$+ /(8( 8($(+$(1 *-1 $'(687(-$*0 4(8&%87*-,( 6748%)(19 >'( 8(+#0$+ +'%/(1 * 168(,$ ,%88(0*;

$6%- 3($/((- $'( ?#*06$< %& 7(-$*0 4(8&%87*-,( *-1 $'( 0()(0 %& +0((4

1(3$9 I'*$ $'6+ 7(*-+ $% 7( 6+ $'*$ 76006%-+ %& #+ *8( 06)6-2 * 0(++

$'*- %4$67*0 06&( *-1 4(8&%876-2 *$ * 0(++ $'*- %4$67*0 0()(05 674*68(1

3< *- *7%#-$ %& +0((4 1(3$ $'*$ /( *8( -%$ ()(- */*8( /( ,*88'(

67406,*$6%-+ &%8 48%1#,$6)6$< *-1 4(8&%87*-,( 6- ()(8< *8(* %& 06&(

*-1 ()(8< ,%74%-(-$ %& +%,6($< *8( +$*22(86-29

D5150 D51&C,(< *07"."0 56) 30((2 :(;1

`#$ *00 $'%+( 6-$(8(+$(1 6- $8*&&6, +*&($< *-1 *00 $'%+( /'% /6+'

$% '*)( * 0%-2 06&( *+ /(005 7#+$ $*.( -%$(9 I'(- * ,8*+' 6+ *$$863#$(1

$% *0,%'%05 $'( 8(*0 ,#0486$5 %8 *$ 0(*+$ * ,%;,%-+468*$%85 6+ )(8< %&$(-

+0((4 1(486)*$6%-9 :- +$#16(+ $'*$ *8( ,8#,6*00< 674%8$*-$5 $'( 4%/(8

6-$(8*,$6%- 3($/((- +0((4 *-1 *0,%'%0 /*+ 8()(*0(1 3< *-%$'(8 +$#1'(- $'(68 1(28(( %& 674*68(1 *0(8$-(++

/*+ ()*0#*$(1 #$606F6-2 $'( JKA> *-1 4(8&%87*-,( $(+$+9 I'(- $'(

+#3=(,$+ /(8( 26)(- $'( 0%/ 1%+( %& *0,%'%0 *&$(8 $'( U;'%#8 +,'(1#0(5

$'(< 3(,*7( +062'$0< 7%8( 674*68(1 $'*- /'(- 26)(- 40*,(3%9 E&$(8$'( +,'(1#0( %& L -62'$+ /6$' 06$$0( +0((45 $'( (@*,$ +*7( 1%+( %& *0,%;

'%0 $'( -( $ 7%8-6-2 7*1( $'(7 +( (8(0 674*68(1 *-1 +0((4 3*8(0



15/63

QM '%#8+ %& +0((4 ()(8< -62'$ &%8 * /((. '*1 -% 16+,(8-630( (&&(,$9

:- %$'(8 /%81+5 *0,%'%0 7*< -%$ 3( * 4%$(-$ +(1*$6)( 3< 6$+(0&5 3#$ 6$

3(,%7(+ )(8< +(1*$6-2 /'(- 4*68(1 /6$' +0((4 1(3$9

>'( 67406,*$6%-+ %& $'6+ 6-$(8)(-$6%- *8( &*8;8(*,'6-29 f(%40(

*8( /(00 */*8( %& $'( 1*-2(8+ %& 186-.6-2 *-1 186)6-25 3#$ $'(< 1% -%$

.-%/ $'*$ * 0*82( +0((4 1(3$ *-1 ()(- * +7*00 *7%#-$ %& *0,%'%0 ,*-

,8(*$( * W&*$*0 &*$62#(9X f(%40( ,*- 3( =#+$ &6-( 186)6-2 *&$(8 * +6-20(

186-. %-( 1*< O/'(- $'(< '*)( 06$$0( +0((4 1(3$P5


16/63

!"#$ &'((')*+ ), -#.$+/ )0$ 1)2'#+ 3."# 2#"#()4#2 . $#&.$56

.1(- 4$#7'+# 1')()8'7.( 7()75 9) $#80(.9# +(##4'*8 .*2 :.5'*8;


17/63

THEHUMANANIMALANDTHEBIOLOGICALCLOCKTHEHUMANANIMALANDTHEBIOLOGICALCLOCK

)$2#$ 9) &'*'&'I# 93# #,,#79 ), #*"'$)**9.( +9'&0(.9')*/ 93# &)*6

5#-+ :#$# +902'#2 :3'(# 93#- :#$# &.'*9.'*#2 '* 7)*+9.*9 2'& ('839/

+)0*2 '*+0(.9')*/ 7)*+9.*9 9#&4#$.90$#/ .*2 .26('1 ,))2 .*2 :.9#$; B*.* .1+)(09#(- 0*73.*8'*8 #*"'$)**9/ 93# *)$&.( &)*5#-+ 1#3."#2

.+ ', 93#$# :#$# . +0*+#9 .*2 +0*$'+# )$ +) +)$9 ), *'839 .*2 2.-

+73#20(#;


18/63

2#7$#.+#+ 93# 9#*2#*7- 9) ,.(( .+(##4;


19/63

!77.+')*.((- +01?#79+ :#$# 7)&4(#9#(- 0*.1(# 9) ,.(( .+(##4 20$'*8

93# (.+9 9#+9;

E,9#$ 7#*90$'#+ ), .++0&'*8 93# ()*8#$ :# .$# .:.5#/ 93#+(##4'#$ :# :'(( 1#7) .*2 93# &)$# :# :'(( 9#*2 9) ,.(( .+(##4/ :#

:#$# 7)*,$)*9#2 :'93 93# +0$4$'+'*8 $#+0(9 93.9 .,9#$ JO 3)0$+ ), 1#'*8

.:.5#/ 93# +01?#79+ 3.2 . -+%.+#+(##4 9#*2#*7-; >#7.0+# :# *):

5*): 93.9 93#$# '+ . +9$)*8 #"#*'*8 4#$')2 ), 7()7562#4#*2#*9 .(#$96

'*8/ 93# #A9#*2#2 V=W< $#+0(9+ .$# *)9 )*(- 4#$,#79(- 0*2#$+9.*2.1(#/

109 93#- .(+) 4$)"'2# +9$)*8 7)*,'$&.9')* ), 93# $)(# ), 93# 1')()8'7.(

7()75 '* 93# )44)*#*964$)7#++ &)2#(;

4"+6# ;#62'.6# ,


20/63

E "#$- '&4)$9.*9 .+4#79 ), $#+#99'*8 93# 1')()8'7.( 7()75 '+

93.9 93# 7()75 7.* )*(- 1# $#+#9 .9 7#$9.'* 9'+;


21/63

THEHUMANANIMALANDTHEBIOLOGICALCLOCK

8$#.9 *#0$.( 7.1(#+ 7.$$-'*8 #(#79$)73#&'7.( +'8*.(+ ,$)& 93# #-#+ 9)

93# "'+0.( 4)$9')*+ ), 93# 1$.'*;


22/63

!"# %&'(")* + ,'"-.&/0

"#$ %$&' ()&*+ ,)%),)-. /)-$ )- 0,,&$**)-. 0-' 1&23/$4 2(

)-*24-)0 )* 5#$+#$& )+ &$0//' 32+#$&* '267 "#$ 1&23/$4 40' 3$ %$&'

*$%$&$8 +&263/$ */$$1)-. $%$&' -).#+ 5)+# 2-/' 0 %$&' *40// 0-, ()+(6/

0426-+ 2( */$$17 9& )+ 40' 3$ :6)+$ +&)%)0/8 0- #26& 050;$ )- 0 *+&0-.$

3$,&224 3$(2&$ (0//)-. 0*/$$1< 0-, -2 )-*24-)0 +#$ -$=+ -).#+7

12+3 4+)*&* 56'+7*(&738 97*"/7(+0

>/$$1 *1$?)0/)*+* /);$ +2 ,)%),$ )-*24-)0 )-+2 +52 ?0+$.2&)$*8

3'+7*(&73?0*$* /0*+)-. 2-/' 2-$ -).#+ +2 0 5$$; 2& +52< 0-, :2'"7(:

?0*$* /0*+)-. 5$$;*< 42-+#*< 2& '$0&*7 "#$*$ 0&$ 6*$(6/ ?0+$.2&)$* "' @+'.; 3" D(*&0

9-?$ )+ )* ?/$0& +#0+ *24$2-$M* )-*24-)0 )* 1$&*)*+$-+< +#0+ )*@> 0-, 3&).#+ /).#+ )- +#$ $%$-)-. (2& G>@>7 "#$

6*60/ 1&$*?&)1+)2- )* *)++)-. )- (&2-+ 2( 0 30-; 2( (/62&$*?$-+ /).#+* (2&

0 ?261/$ 2( #26&* 5)+# +#$ /).#+ ?24)-. )- 0+ 0 TUV 0-./$7

F32&' G+H"' 4+)*&* "I ,&'*(*3&73 97*"/7(+

S2& +#2*$ 5#2 #0%$ 1$&*)*+$-+ )-*24-)0 +#0+ )* -2+ ,6$ +2 3)2B/2.)?0/ ?/2?; 1&23/$4*< 0 /0&.$ 1$&?$-+0.$ 5)// ()-, +#0+ +#$)& )-*24B

-)0 )* ,6$ +2 2-$ 2( +#&$$ 1#'*)?0/ ?06*$*W&$*+/$** /$.* *'-,&24$ )* -;-2 - 3 +

INSOMNIA


25/63

)+ )* *24$5#0+ 42&$ ?2442- )- 10+)$-+* *6(($&)-. (&24 )&2- ,$()B

?)$-?'D0-$4)0 2& ;),-$' (0)/6&$ 5)+# ,)0/'*)*7

"#$ 1&$%0/$-?$ 2( YZ> )* $*+)40+$, +2 3$ )- +#$ &0-.$ 2( ]^+2 _^ 1$&?$-+7 E$ #0%$ *+6,)$, 0 1&)40&' ?0&$ 1216/0+)2- )- `2*?25'-,&24$G**2?)0+)2- $*+)40+$* +#0+ +#$&$ 0&$ 2%$& ]^ 4)//)2- *6(($&$&* )- +#$

\-)+$, >+0+$*7

97*"/7(+ O**":(+3&> #(32 ,*;:2"."?(:+.P @/"3("7+.P

+7> ,*;:2(+3'(: ,'"-.&/*

S&$:6$-+ 2& 1$&*)*+$-+ 1&23/$4* */$$1)-. 0&$ %$&' ?2442-/'

0**2?)0+$, 5)+# ,$1&$**)2- 0-, 2+#$& 1*'?#)0+&)? 1&23/$4*7 E#$-+#$*$ 1&23/$4*W1#23)0*< 0-=)$+)$*< -$6&2*$*< 0-, *2 2-W0&$ -2+

23%)26*< *12++)-. +#$ +&6$ ?06*$ 2( +#$ )-*24-)0 3$?24$* 42&$ ,)(B

()?6/+7 b$-$&0//'< +#$*$ ?0*$* 0&$ #0-,/$, 3' 1*'?#)0+&)*+*< 0/+#26.#

42*+ 1*'?#)0+&)*+* #0%$ /)++/$ $=1$&+)*$ )- */$$1 ,)*2&,$&*7 K2+ $-26.#

26+?24$ ,0+0 $=)*+ +2 )-,)?0+$ #25 (&$:6$-+/' 0- )-*24-)0 1&23/$4

?/$0&* 61 )( +#$ 6-,$&/')-. 1*'?#)0+&)? ?2-,)+)2- )* $(($?+)%$/' +&$0+$,7

Q(*"'>&'* D&R)('(7? + %.&&< 6&*3 I"' Q(+?7"*(*

9-?$ 0// 2( +#$ 0(2&$4$-+)2-$, ?06*$* 2( $%$&' -).#+ 2& (&$B

:6$-+/' &$?6&&)-. )-*24-)0 0&$ &6/$, 26+< +#$&$ *+)// $=)*+ *$%$&0/ 12*B

*)3/$ ?06*$* +#0+ ?0- 3$ ),$-+)()$, 5)+# ?$&+0)-+' 2-/' 3' 12/'*24-2B

.&01#)? +$*+)-. )- 0 */$$1 ,)*2&,$&* ?/)-)? X0/+#26.# *24$+)4$* ?0&$(6/

:6$*+)2-)-. ?0- $/)?)+ ?/6$*[7 @$* +#$ 42*+ ?2442- 2( +#$*$ )*

&' X@Z`O[< 5#)?#< 0* 4$-+)2-$,

$0&/)$&< )* %$&' (&$:6$-+/' 0**2?)0+$, 5)+# &$*+/$** /$.* *'-,&24$79??0*)2-0//'< @Z`O 2??6&* )- )*2/0+)2-7

"#$ *$?2-, ?06*$ )* :&73'+. *.&&< +


27/63

0 */$$1 *1$?)0/)*+< +#)* )* 0 %$&' )-+$&$*+)-. 0-, 1$&1/$=)-. ?2-,)+)2-

5#)?# 2??6&* )- 0326+ U 1$&?$-+ 2( )-*24-)0 ?0*$*7 A+ )* ,)0.-2*$, )-

10+)$-+* 5#2 ?241/0)- 2( 1$&*)*+$-+ )-*24-)0< 36+ 5#$- +$*+$, *#25?241/$+$/' -2&40/ */$$17 `2*+ 2( +#$*$ 1$21/$ ,2 -2+ *0' +#$' #0%$

#0, -2 */$$1 5#0+*2$%$&< 36+ +#$)& $*+)40+$ )* 0 /2+ /$** +#0- 5#0+

0?+60//' 2??6&*7 "#$ 1&23/$4 2( */$$1B*+0+$ 4)*1$&?$1+)2- ?0- *24$B

+)4$* 3$ &$*2/%$, 3' 1$&*60,)-. 1$21/$ +#0+ +#$)& */$$1 )* -2&40/ -2

40++$& 5#0+ +#$' +#)-;7

,'(/+'; 97*"/7(+*

G+ /0*+ 5$ 0&$ /$(+ 5)+# +52 ,)*+)-?+ ,)0.-2*$* +#0+ 0&$ 2(+$-

/641$, +2.$+#$& 0* I1&)40&' )-*24-)0*7J "#$ ()&*+< 0-, 3' (0& +#$

42*+ ?2442-< )*


28/63

6'&+3(7? ,'(/+'; 97*"/7(+*

"#$ 1&)40&' )-*24-)0* 0&$ 6*60//' ,)(()?6/+ +2 +&$0+7 L25$%$&4 () 5&+0 4- :$&)*+$ 5-@ :*,5 +$ )#$$% )*,5 %&4($'4) #-)$2 3*4 (4 ()

&4 #$&)4 & 45(+0 -? 45$(+ 4(:$ (' 3$06 ='0 @5$' )#$$% () ('4$++*%4$0 45()

:&'9 4(:$)2 (4 5&) #(44#$ 8*$ (' +$0*,('. )#$$% 0$346 K(,4(:) -? 45():(0'(.54 )4+&'.#$+ :&9 3$ &@&+$ 45&4 45$9 5&8$ #-)4 45$(+ $'$+.9 &'0

Snoring and Sleep Apnea

5


33/63


34/63

SNORINGANDSLEEPAPNEA

(a):Schmatic drawing illustrating normal breathing during sleep. Airway resistance

is low.

(b): Schematic drawing illustrating increased airway resistance. The airway size is

reduced, but not completely blocked. This partial blockage increases inspiratory effort

and the increased velocity of airflow causes turbulence, which, in turn, causes the softtissue to vibrate creating the noise known as snoring.

(a)

(c)

(b)

!"#$%&

&'($)"!!(*

#+*+) -+.(!/

*"0! '+)+!&

'+1!(+))/ 2)"-3&4 %''&1 +(15+/ (#-1&+*&*(#*'(1+!"1/ &00"1! +#4 !6& .(21+!("#* "0*"0! !(**%& !6+! -+%*&* *#"1(#$

(#*'(1+!"1/ &00"1! "0 )%#$*

"2*!1%-!&4 %''&1 +(15+/


35/63

W9%-%'$& >'0$F Q=W>R6 =' "30'0$#2 () @5$' 45$ 45+-&4 0-$) '-4

X*(4$ ,#-)$ $'4(+$#92 3*4 &(+ ?#-@ () +$0*,$0 )*??(,($'4#9 4- #-@$+

-F9.$' &'0 ,&*)$ &' &+-*) D5$ =W> ),-+$ +$%+$)$'4) 45$ &8$+&.$'*:3$+ -? &%'$& &'0 59%-%'$& $%()-0$) 45&4 & %&4($'4 $F%$+($',$)

0*+('. &' 5-*+ -? )#$$%6 =' =W> -? ; () 45$ #-@$+ #(:(4 ?-+ :&1('. &

,#('(, 0(&.'-)() -? )#$$% &%'$&6

=00(4(-'#92 45$ 0&'.$+ -? &%'$& )4$:) '-4 -'#9 ?+-: 5$&+4

%+-3#$:) &'0 5(.5 3#--0 %+$))*+$2 3*4 )- ?+-: 45$ (',+$0(3#$ )#$$%

0$34 45&4 &%'$& )*??$+$+) ,&++9 &+-*'0 @(45 45$: )(',$ 45$9 .$4 :-)4

'- ,-'4('*-*) )#$$% &4 '(.546 Y$-%#$ @(45 )$8$+$ &%'$& 49%(,#9 ,&++9

)- :*,5 )#$$% 0$34 45&4 45$9 ?# &)#$$% @5(#$ 0+(8('.2 $&4('.2 -+ 4G('.6 Y$-%#$ @(45 &%'$& &+$ :*,5 :-+$ #(1$#9 4- 3$ ('8-#8$0 (' &*4-

&,,(0$'4)6 "-:$ )4*0($) )*..$)4 45&4 )#$$% &%'$& 8(,4(:) 5&8$ &'

&,,(0$'4 +&4$ Z< 4(:$) 45&4 -? 45$ .$'$+ %-%*#&4(-' &'0 45$9 5&8$ '-

(0$& @59 45$9 &+$ ?#('. &)#$$% 3$5('0 45$ @5$$#6

[('#92 45$ ?&,4 45&4 )#$$% &%'$& &'0 :&+1$0 -3$)(49 -?4$'

.- 5&'0 (' 5&'0 :$&') 45&4 :&'9 -? 45$ 5$- %+-3#$:) ,&*)$0 39

&%'$& &+$ $++-'$-*)#9 &44+(3*4$0 4- 45$ %&4($'4M) @$(.546

D5$+$ () '- X*$)4(-' -3)4+*,4(8$ )#$$% &%'$& %#&9) & :&\-++-#$ (' ,&*)('. 5(.5 3#--0 %+$))*+$2 5$&+4 0()$&)$2 &'0 )4+-1$6 S$

*+.$ %$-%#$ @5- 5&8$ 5(.5 3#--0 %+$))*+$2 5$&+4 0()$&)$2 -+ ,-',$+'

&3-*4 & )4+-1$ 4- &)1 45$:)$#8$) 4@- X*$)4(-')A =: > 4(+$0 (' 45$

0&94(:$] ='0 5&8$ > 3$$' 4-#0 45&4 > )'-+$] >? 45$ &')@$+) 4- 3-45

X*$)4(-') &+$ 9$)2 ,5$,1('. ?-+ 45$ %+$)$',$ -? &%'$& () :&'0&4-+92

$8$' (? 45$ )#$$% 4$)4 () '-45('. :-+$ 45&' %*44('. & 4&%$ +$,-+0$+ '$F4

4- 45$ 3$0 &4 '(.546

D5$ %+$8$',$ -? &%'$& +()$) &) 5*:&') .$4 -#0$+2 %+-3&3#93$,&*)$ # 4())*$2 (',#*0('. 4())*$ (' 45$ &(+@&92 3$,-:$) #$)) ?(+:

&) @$ &.$6 D5$+$?-+$2 &%'$& )5-*#0 3$ -'$ -? 45$ ?(+)4 45('.) 0-,4-+)

,-')(0$+ @5$' $#0$+#9 %&4($'4) 5&8$ %+-3#$:) @(45 )#$$%('$))2 5(.5

3#--0 %+$))*+$2 -+ ,-.'(4(8$ %+-3#$:)J3*4 0-,4-+) +&+$#9 0- 45()6

4(#25)$* &/##0 10$#2

>? 45$ 3&0 '$@) &3-*4 )#$$% &%'$& () 45&4 (4 () @(0$)%+$&02#(?$G45+$&4$'('.2 &'0 *'0$+0(&.'-)$02 45$ .--0 '$@) () 45&4 (4 ,&' 3$

? # 0 ?? ( # 0 (



36/63

)#$$%2 -+ 39 $'#&+.('. 45$ &(+ %&))&.$6

6'$5)$7'7. 8'.)5)9# 1)(:23 8(#..7(# [-+ -8$+ 4@- 0$,&0$)2 ,-'4('*-*) %-)(4(8$ &(+@&9 %+$)G

)*+$ QEY=YR :&,5('$) 5&8$ 3$$' 45$ :-)4 $??$,4(8$ @&9 -? 4+$&4('.

-3)4+*,4(8$ )#$$% &%'$&6 D- *)$ 45$ :&,5('$2 & ):#2 ,-:?-+4&3#$

:&)1 () ?(44$0 -8$+ 45$ '-)$2 #$&8('. 45$ :-*45 *',-8$+$06 Y&4($'4)

:*)4 )#$$% @(45 45$(+ :-*45 ,#-)$02 )-:$4(:$) &(0$0 39 & ,5(' )4+&%2

@5(#$ 45$ :&,5('$ .$'4#9 3#-@) &(+ ('4- 45$ '-)$ &4 & %+$))*+$ )#(.54#9

5(.5$+ 45&' 45$ )*++-*'0('. &(+ %+$))*+$6

_(4$+#9 @(45(' :('*4$) -? &,5($8('. 45$ ,-++$,4 EY=Y %+$)G)*+$ 4- :&('4&(' &' -%$' &(+@&92 %&4($'4) @(45 -3)4+*,4(8$ )#$$% &%'$&

)4&+4 )#$$%('. #(1$ %$-%#$ @5- 5&8$ .-'$ @(45-*4 )#$$% ?-+ :&'9 0&9)6

[-+ 45$ ?(+)4 @$$1 -+ )- &?4$+ )4&+4('. 4- *)$ 45$ :&,5('$2 %&4($'4) @(##

)%$'0 & .+$&4 0$ -? 4(:$ (' 0$$% )#$$%6 Y&4($'4) -?4$' +$%-+4 45&4

45$+$ () & 0+&:&4(, (',+$&)$ -? 0&94(:$ $+4'$)) &'0 $'$+.9 &?4$+ \*)4

& ?$@ '(.54) -' EY=Y6

='-45$+ &%%+-&,5 4- 4+$&4('. -3)4+*,4(8$ )#$$% &%'$& () 4-

1$$% 45$ &(+@&9 -%$' 39 :-8('. 45$ #-@$+ \&@ ?-+@&+06 D5() ()&,,-:%#()5$0 39 & 8&+($49 -? 0$'4 &%%#(&',$) 45&4 &+$ (')$+4$0 ('

45$ :-*45 &4 '(.542 3*4 +$#&4(8$#9 ?$@ @$##G0$)(.'$0 )4*0($) 5&8$

3$$' 0-'$ 4- )5-@ 45&4 45$)$ &%%#(&',$) @-+1 @$##2 '-+ 5&) %&4($'4

,-:%#(&',$ 3$$' ,&+$?*##9 $8*&4$06

;97/'02/25'0"2(3$*'0/2.53

>' Z`aZ2 45$ )&:$ 9$&+ 45&4 '&) EY=Y @&) ('4+-0*,$02 &

)*+.(, %+-,$0*+$ ,#$0 *8*#-%&4-%5&+9'.-%#&)49 -+ LYYY @&)0$8$#-%$06 D5$ LYYY %+-,$0*+$ @&) @(0$#9 *)$0 *'4(# ?-##-@G*%

)4*0($) 39 )#$$% )%$,(()4) ?-*'0 45&4 (4 @&) $??$,4(8$ (' -'#9 &3-*4

Z< %$+,$'4 -? # ,&)$)6

4"# &52$


37/63

X*(?9 &) )#$$% )%$,(()4) &'0 5&8$ @-+1$0 ,-')()4$'4#9 4- 0$8$#-%

'$@ &'0 3$44$+ )*+.(, 4+$&4:$'4) ?-+ -3)4+*,4(8$ )#$$% &%'$&6 D5$(+

%+-,$0*+$) %+-8(0$ & ,*+$ -? -3)4+*,4(8$ )#$$% &%'$& (' & :&\-+(49-? ,&)$)2 &'0 @(45 +&+$ $F,$%4(-'2 # 45$(+ %&4($'4) (:%+-8$ )*3)4&'G

4(#96 D5$(+ &%%+-&,5 ,-:3('$) 45$ )4&'0&+0 LYYY @(45 ('.$'(-*)

%+-,$0*+$) 4- %*## 45$ #&+.$ 4-'.*$ :*),#$ ?-+@&+0 &'0 &@&9 ?+-:

45$ 3&,1 -? 45$ 45+-&46 D5() () &,,-:%#()5$0 39 ,*44('. -*4 & ):#

+$,4&'.#$ -? 3-'$ (' 45$ ?+-'4 -? 45$ \&@2 4- @5(,5 45$ 4-'.*$ :*),#$

() &44&,5$06 D5$9 45$' %*## 45() %($,$ -? 3-'$ -*42 +-4&4$ (4 `< 0$.+$$)2

)- (4 ,&''-4 ?# 3&,12 &'0 4+(: &'0 ?(F (4 %$+:&'$'4#96 D5() :&'$*8$+

%*##) 45$ 4-'.*$ ?-+@&+0 &'0 &00) :-+$ 45&' & ,$'4(:$4$+ 4- 45$ &(+G@&9 0(&:$4$+2 @(45-*4 &'9 8()(3#$ $F4$+' ,5&'.$)6

S5$'$8$+ &'9 )#$$% &%'$& %&4($'4 +$,$(8$) & 4+$&4:$'42

45$ $??(,&,9 -? 45() 4+$&4:$'4 :*)4 @&9) 3$ ,&+$?*##9 $8*&4$06

S$## -8$+ Z4 &%%$&+) 4- 3$ X*(4$ )*,,$))?*# ?-+ +$0*,('. )'-+('.2(:%+-8('. :(#0 ,&)$) -? )#$$% &%'$&2 &'0 (:%+-8('. )$&)-' +5('(4()

39 +$0*,('. '&) 4*+3('&4$ 4())*$6 T$,$'4 ,#('(, 4+() )5-@ 45&4 (4

)- @-+1) -' 45$ 3&)$ -? 45$ 4-'.*$2 @5(,5 () 45$ %+(:&+9 ,*#%+(4 ('

:-)4 ,&)$) -? -3)4+*,4(8$ &%'$&6

D5() &%%+-&,5 5&) '*:$+-*) &08&'4&.$) -8$+ ,-'8$'4(-'

)*+.$+96 >4 0-$) '-4 +$X*(+$ &' -%$+&4('. +--: -+ 5-)%(4(/&4(-'6 >4 ()

$&)(#9 0-'$ &) &' -*4%&4($'4 %+-,$0*+$6 D5$ 4+$&4:$'4 (4)$#? 4&1$) -'#9

& ?$@ :('*4$) &'0 () 3#--0#$)) &'0 %&('#$))6 =#45-*.5 45$+$ () )-:$

)@$##('. (::$0(&4$#9 &?4$+ 45$ %+-,$0*+$2 %-)4 4+$&4:$'4 %&(' () :*,5

#$)) )$8$+$ 45&' 45&4 ?+-: -+0('&+9 )*+.$+9 &'0 @5&4 #(44#$ %&(' 45$+$



38/63

() ,&' 3$ ,-'4+-##$0 $&)(#9 @(45 -8$+G45$G,-*'4$+ %&('1(##$+)6 U$,&*)$

45$+$ () )- #(44#$ 0(),-:?-+42 %&4($'4) &+$ @(##('. 4- ,-:$ 3&,1 ?-+ )*,G

,$))(8$ 4+$&4:$'4)6 D5$+$ )- () '- @-*'0 -' 45$ 4-'.*$ -+ )*4*+$)45&4 ,&' ,-:$ *'0-'$6



39/63


40/63

NARCOLEPSYANDOTHERSLEEPDISORDERS

@/0 /)[email protected] 0* 6*$3; M/10 -1 #) 789 1.33(? 0&3 &3-40 -)% @43-0)+

6/1,.31 *(34-03 )*46-..'? -1 %* 0&3 6/1,.31 #) 0&3 3'31; C*53$34?

0&3 6/1,.31 *2 0&3 -461 -)% .3+1 436-#) ,*6(.303.' .#6(; N2 0&3 ,-0-:(.3,0#, -00-,> (341#101? *)3 ,-) (#,> /( 0&3 $#,0#6O1 -46 -)% 1&->3 #0

.#>3 - 4-+ %*..O1? 0&3) .30 #0 2.*( @-,> 0* 0&3 (341*)O1 1#%3; 1 6-'*,,/4 -.6*10 -0 0&3 1-63 0#63 -1 3A,311#$3 1.33(#)311T @/0 0&3 %3$3.:

*(63)0 *2 ,-0-(.3A' #1 6*43 ,*66*).' %3.-'3% 05* *4 0&433 '3-41;

K,,-1#*)-..' 0&3 2#410 6-)#2310-0#*) *2 )-4,*.3(1' #1 &'()-+*+#, &-.:

./,#)-0#*)1;

+#'",-./ !"#$%&'()*

U0 (4313)0? 043-063)0 *2 ,&*#,3 2*4 )-4,*.3(1' #1 6*%-2#)#.?

V6-4>303% -1 L4*$#+#.W 5,& 3223,0#$3.' @.*,>1 1.33(#)311 -)% (4*:6*031 -.340)311; 9*%-2#)#. #1 )*0 -) -6(&30-6#)3? -)% #01 -,0#*)

%*31 )*0 [email protected] 0&-0 *2 ,*)$3)0#*)-. 10#6/.-)01? 5,& +.*@-..'

3A,#03 $-4#*/1 )34$3 ,3)0341 *2 0&3 @4-#) -)% ,-/13 - 4-)+3 *2 1#%3

3223,01 24*6 (-.(#0-0#*)1 0* -) /(130 10*6-,&; X' ,*)04-10? 6*%-2#)#.

,-/131 235 *4 )* 1#%3 3223,01; D4#,',.#, -)0#%3(4311-)01 &3.( 0* 43%/,3

,-0-(.3A'; U )35 63%#,-0#*)? Y'436 V1*%#/6 *A'@-03W &3.(1 0* ,*):

1*.#%-03 1.33( -)% 0&/1 43%/,3 %-'0#63 1.33(#)311 -)% -.1* 43%/,31

,-0-(.3,0#, -00-,>1? @/0 #0 #1 - %4/+ 0&-0 )33%1 0* @3 6*)#0*43% ,.*13.'

@' 0&3 (-0#3)0O1 1.33( 1(3,#-.#10;


41/63

9-)' *2 /1 6-' 0)> 0&-0 @3#)+ 0*.% 0&-0 */4 %43-61

5#.. ,*63 04/3 1*/)%1 #%'..#,? @/0 2*4 (3*(.3 5#0& 789 X3&-$#*4R#1*4%34? 0&-0 %43-6 #1 - )#+&06-43; D %#1*4%34 ,-) @3 43+-4%3%

-1 0&3 *((*1#03 *2 )-4,*.3(1'; N) )-4,*.3(1'? 0&3 6/1,.3 (-4-.'1#1

*2 789 1.33( #)04/%31 #)0* 5->#)+ .#23; N) 789 X3&-$#*4 R#1*4%34

V7XRW? -.. 0&3 6/1,.31 0&-0 1&*/.% @3 (-4-.'Z3% %/4#)+ 789 1.33(

-43 )*0; 789 (-4-.'1#1 ,*6(.303.' 2-#.1? -)% 0&3 @*%' -,01 */0 0&3

@4-#)O1 %43-6; N)Q/4#31 0* 0&3 %43-634 -)% 0&3 %43-634O1 1(*/13 -43

,*66*);

D&3 %#1*4%34 0'(#,-..' 104#>31 -2034 0&3 -+3 *2 [I? -.0&*/+&53 &-$3 133) (-0#3)01 -1 '*/)+ -1 )#)3 -0 B0-)2*4%; 7XR 13361 0* @3

(4*+4311#$3\ L-0#3)01 0'(#,-..' 0-.>? 05#0,&? -)% Q34> %/4#)+ %43-6#)+

2*4 '3-41 @32*43 0&3' 2/..' -,0 */0 0&3#4 789 %43-61; N0 6-' -.1* @3 -

(43,/41*4 0* )3/4*%3+3)34-0#$3 %#13-131 1/,& -1 L-4>#)1*)O1 %#13-13;

U1 53 &-$3 .3-4)3%? 0&3 %43-6#)+ @4-#) 2/),0#*)1 $34' 1#6#:

.-4.' 0* 0&3 5->#)+ @4-#)? (4*,311#)+ 0&*/+&01 -)% 13)%#)+ */0 631:

1-+31 0* 6*$3 .#6@1; S*46-..' 0&3 #)104/,0#*)1 0* 6*$3 0&3 3'31 +30

0&4*/+&? @/0 6311-+31 0* 6*$3 6/1,.31 #) 0&3 4310 *2 0&3 @*%' -43@.*,>3% @32*43 0&3' ,-) .3-$3 0&3 1(#)-. ,*4%; N) 789 @3&-$#*4 %#1:

*4%34? 0&3 6311-+31 -43 )*0 &-.03%? %/3 0* 0&3 (-0&*.*+' #) 0&3 @4-#)

1036; L3*(.3 6-' Q/10 6*$3 0&3#4 -461 -)% .3+1 #) @3% *4 0-.> #) 0&3#4

1.33(? *4 0&3' 6-' -,0/-..' +30 */0 *2 @3% -)% 4/) -4*/)%? 5#0&*/0

3$34 5->#)+ /( *4 43-.#Z#)+ 0&-0 0&3' -43 %43-6#)+;

D* 6->3 6-00341 5*413? 0&3 %43-61 0&-0 -43 -,03% */0 -43

*203) $#*.3)0 *4 24#+&03)#)+; B/,& )#+&00#63 @3&-$#*4 #1 %-)+34*/1;

]*40/)-03.'? - $34' 3223,0#$3 043-063)0 3A#101 2*4 789 @3&-$#*4 %#1:*4%34 5,& ,/40-#.1 *4 3.#6#)-031 0&3 %#1*4%34 #) -@*/0 ^ */0 *2 HI

,-131; N0 #1 ,-..3% ,.*)-Z3(-6? 04-%3 )-63 _.*)*(#);

>&''(?"&@-./ ".8 !-/5, +'##%#)

U 1.33(:%3(4#$3% ,*..3+3 2431&6-) ,.#6@1 */0 *2 @3% #) 0&3

6#%%.3 *2 0&3 )#+&0? 1#.3)0.' *(3)1 0&3 %**4 *2 %*46 4**6? -)%

5-.>1 %*5) 0&3 &-..5-'; C#1 4**66-03 5->31 /(? 1331 ? -)% -1>15&343 &3 #1 +*#)+? @/0 0&3 '*/)+ 6-) Q/10 >33(1 5-.>#)+? 1336#)+.'

)[email protected] 0* &3-4 -) 0)+ N2 4**66-03 10-)%1 #) 24*)0 *2 0&3



42/63

0&3 1.33(5-.>34 430/4)1 0* @3% -)% 2-..1 1*/)%.' -1.33(; N) 0&3 6*4):

#)+ &3 ,-))*0 43636@34 -)'0)+ -@*/0 3A,/41#*);

U 2*/4:'3-4:*.% +#4. 1#01 /( #) 0&3 6#%%.3 *2 0&3 )#+&0 -)%@3+#)1 1,43-6#)+; C34 (-43)01 4/1& #) -)% 2#)% &34 5#%3:3'3% #) 034:

4*4; D&3 (-43)01 -1> 5&-0 #1 54*)+ -)% 04' 0* 1**0&3 &34; D&3 ,.%

%*31 )*0 431(*)% 0* 0&3#4 5*4%1 -)% %*31 )*0 1336 0* 133 0&36;

B&3 >33(1 10-4#)+ -0 1*630)+? 0344#2#3%; C34 (-43)01 >33( 1-'#)+

F3 (3*(.3 5#0& 789

@3&-$#*4 %#1*4%34? (3*(.3 -22.#,03% 5#0& 1.33(5-.>#)+ -)% )#+&0

0344*41 5#.. 4#13 */0 *2 1336#)+.' %33( 1.33( -)% -,0 -1 #2 0&3' -43

-5->3T 0&3' 0'(#,-..' %* )*0 431(*)% 0* *0&34 (3*(.3 -)% &-$3 )*

636*4' *2 0&3 #),#%3)0 0&3 )3A0 %-'; c).#>3 789 @3&-$#*4 %#1*4%34?

&*53$34? (3*(.3 -43 )*0 %43-6#)+ 5&3) 0&3' 1.33(5-.> -)% -43 )*0&-$#)+ )#+&06-431 %/4#)+ )#+&0 0344*41; N) 2-,0? )3#0&34 1.33(5-.>#)+

)*4 )#+&0 0344*41 *,,/4 %/4#)+ 789 1.33(; B.33(5-.>#)+ *203) &-(:

(3)1 5&3) (3*(.3 &-$3 @3,*63 $34' 1.33( %3(4#$3%? -)% @*0& )#+&0

0344*41 -)% 1.33(5-.>#)+ -43 6*43 .#>3.' 0* *,,/4 #) 0&3 @3+#))#)+ *2

0&3 )#+&0 5&3) 1.33( %3@0 #1 10#.. +&; D&3 1.33( %3@0 5#.. )*0 43.3-13

#01 +4#( *) 0&3 @4-#)? 1* 0&3 1.33(34 )3$34 4#131 */0 *2 0&3 @./)03%

(34,3(0#*) -)% -6)31#- 0&-0 53 -.. 3A(34#3),3 0&3 2#410 235 6*63)01

-2034 5->#)+ /(; N) 04/3 1.33(5-.>#)+? 0&343 5#.. @3 1*63 (34,3(0#*)@/0 )*0 +&:.3$3. ,*+)#0#*)\ B.33(5-.>341 6-' @3 [email protected] 0* 43,*+)#Z3

- %**4 @/0 6-' )*0 @3 [email protected] 0* +30 0&3 %**4 *(3);

9*10 ,-131 *2 1.33(5-.>#)+ -)% )#+&0 0344*41 @3+#) #) 3-4.'

,.%&**%? -.0&*/+& 0&3' ,-) ,*)0#)/3 #)0* -%/.0&**%; B.33(5-.>#)+

,-) @3+#) -1 3-4.' -1 ,.%43) -43 [email protected] 0* 5-.>? @/0 #0 6*10.' *,,/41

@30533) 0&3 -+31 *2 2*/4 -)% 3#+&0? 0&3) %#1-((3-41 1(*)0-)3*/1.'

-2034 -%*.31,3),3;

D&3 @310 0&34-(' 2*4 1.33( 5-.>#)+ -)% )#+&0 0344*41 #1 0*

2*,/1 *) >33(#)+ ,.%43) 24*6 &-46; B(3->#)+ ,-.6.' -)% 43-11/4:

#)+.' 0* 0&36E3$3) 0&*/+& 0&3' %* )*0 431(*)%E1*630#631 ,-)



43/63

N2 0&3' %* 5->3? 0&3' -43 ,*)2/13% -)% /)[email protected] 0* 1-' 5&-0 5-1 1,-4:

#)+ 0&36 *4 3$3) 43636@34 0&-0 0&3' 5343 1,-43%; D&3' 5#.. (4*@-@.'

2*4+30 0&3 5&*.3 3(#1*%3 @' 6*4)#)+; ]#)-..'? - +43-0 %3-. *2 4313-4,& ,*)$#),#)+.' 1&*51 0&-0

(3*(.3 5&* &-$3 -)' *2 0&3 (-4-1*6)#-1E)#+&0 0344*41? 1.33(5-.>:

#)+? @4/A#16 V0**0& +4#)%#)+W? @3%5300#)+? -)% 0&3 .#>3E-43 )* 6*43

.#>3.' 0* &-$3 5->#)+ (1',&*.*+#,-. (4*@.361 0&-) -)'*)3 3.13;

;3% */01#%3 0&3 .-@*4-0*4' 2*4 %-0- -@*/0 0&3 3223,01 *2

1.33(#)311 -)% 1.33( %3(4#$-0#*) *) (342*46-),3 #) 43-.:5*4.% 1#0/-:

0#*)1; 3% 0* 1.33(#)311 *4 1.33(:#)%/,3% .-(131 #) -5-43)311;

U &/+3 (4*(*40#*) *2 -1136@.':.#)3 -,,#%3)01 -.1* -43 -004#@/03% 0*0&3 (*03)0 ,*6@#)-0#*) *2 1.33(#)311 -)% 6*)*0*)*/1 0-1>1; B34#*/1

322*401 0* +-/+3 0&3 2/.. #6(-,0 *2 2-0#+/3 %/3 0* 1.33( .*11 #) ,4#0#,-.

#)%/104#31 1/,& -1 -$#-0#*)? 63%#,#)3? 04/,>#)+? -)% 1((#)+ &-$3

6-%3 #0 ,.3-4 V-0 .3-10 0* 0&*13 5#0& - 2/)%-63)0-. >)*5.3%+3 *2

1.33(W 0&-0 0&3 (4*@.36 #1 5*413 -)% 6*43 (34$-1#$3 0&-) -)'*)3 &-1

&3430*2*43 1/1(3,03%;

+5' :.",%=* %C DB",-/3 '*/ ,-) 233. 3$3) 5&3) '*/ -43 ,-44'#)+ - &3-$' 1.33(

.*-%; D&-0 #1 @3,-/13 1.33( %3@0 #1 ,*/)034-,03% @' -4*/1-.E@*0&

24*6 0&3 (34#*%#, -.340#)+ 3223,01 *2 0&3 @#*.*+#,-. ,.*,> -)% 24*6

0&3 -.340#)+ 3223,01 *2 3A,#0363)0 *4 104311; d*/ ,-) 10-$3 *22 0&3

3223,01 *2 - .-4+3 1.33( %3@0 #) 0&3 1&*40 0346 @' 10-'#)+ 3)+-+3% #)

10#6/.-0#)+ -,0#$#0#31; X/0 0&3 53#+&0 *2 1.33( %3(4#$-0#*) ,-))*0 @3#+)*43% #)%32#)#03.'; 8$3)0/-..' #0 ,-0,&31 /( 5#0& '*/? /1/-..' 5&3)

. .# . & & @ % O . > % % . # #



44/63

#01 .*5310 (*#)01 %/4#)+ 0&3 3-4.' 6*4)#)+ -)% 0&3 3-4.' -2034)**);


45/63

!"#$ &'() *+,"-."/0'"12 3'-1(

"# $%&%'(%)*#+, - &%.) /0%'% 102345 6% )2 5%4.# 7) .55'%118

7)( /0% 9'264%&+ 6%*.31% . *./.1/'290% *.) 0.99%) ./ .)#/7&%: ;0%

)3&6%' 2)% 5.)(%'


46/63

FACEUPTOYOURSLEEPPROBLEMS

*7.)1 *2)/7)3% /2 422> %41%B0%'%


47/63


48/63

- .& *2)?7)*%5 /0./ &.)# 9%294% /07)> 7/ 71 )2'&.4 /2 6% /7'%5

.44 /0% /7&%: -) 2)% 2< 23' 9'7&.'# *.'% 17/%1+ /0'%%8@3.'/%'1 2< .449./7%)/1 7)/%'?7%B%5 .5&7//%5 /2 ?.'#7)( 5%('%%1 2< /'2364% 14%%97)(+

63/ )2)% 0.5 &%)/72)%5 /0% 57)2B4%5(% .623/ 14%%9 5712'5%'1 &%.)1 /0./ ?7*/7&1 2< 1%?%'%

'%1/4%11 4%(1 1#)5'2&% .'% &7157.()21%5 B7/0 ?.'7231 91#*07./'7* 5718

2'5%'1 .)5 /'%./%5 B7/0 1/'2)( /'.)@3747A%'1: E61/'3*/7?% 14%%9 .9)%.

9./7%)/1 .'% 2


49/63


50/63

N)2B B0%) .)5 02B /2 % . 9'7)/23/ 2< /0% 471/ /2

#23' .9927)/&%)/:

4#/#.'/. *6$""A C-'1"12

- *.))2/ %&90.17A% 2


51/63

/0% *47%%9 %


52/63


53/63

7)(: ;0% 2)4# B.# /2 6% 13'% /0./ #23 B744 '%&.7) .4%'/ 53'7)( . 42)(

5'7?% 71 /2 0.?% . 42B 14%%9 5%6/ .)5 /2 5'7?% 53'7)( 9%'7251 2< 9%.>.4%'/7)(:

-% 2?%' /0% 5'7?7)(+ #23 &31/

7&&%57./%4# %) )./3'.44#+ /0./ 71 %?%) 6%//%':

G"(('/. (9 @"$$

-) '%*%)/ 5%*.5%1+ B% 0.?% 6%%) .64% /2 /'.?%4 1 *.) 6% '%1%/: H1 . '%134/+ 23' *7'*.57.) '0#/0&

71 2


54/63

eU: X2)1%@3%)/4#+ (%//7)( /2 6%5 4./%' ^% B0%) *42*>85%9%)8

5%)/ .4%'/7)( 71 7) 5%*47)% /0.) /2 (2 /2 14%%9 B0%) /0% *42*>85%9%)8

5%)/ .4%'/7)( 71 1/'2)(:

6(-#(".'"1 79- !"#$'/. &'() G"( I#.

V%&%&6%' /0./ /0% &71&./*0 6%/B%%) 23' 7)/%').4 *42*>

.)5 /0% %C/%').4 ^42*.4_ *42*> 71 /0% *.31% 2< K%/ 4.(: H**2'57)(4#+ /0%

%'1


55/63

)3&6%'82)% %1 )21%)1% /2 '%1%/ #23' *42*>+ 17)*% #23 B744 2)4# 0.?% /2 '%1%/ 7/ .(.7)

B0%) #23 (2 02&%:

`%/ 31 1.#+ 2) /0% 2/0%' 0.)5+ /0./ 23' W%B P2'> /'.?%4%'1

.''7?% 7) T.'71 ./ d]SS .:&: W2B /0%7' 67242(7*.4 .4%'/7)( 71 : -< /0%# 0.?% . 42/ 2< 14%%9

5%6/+ /0%# B744 7*> 7) .'23)5 )22) 7) T.'71 ^f]SS .:&: W%B P2'>

/7&%_: "3/ &2')7)( .4%'/7)( 71 ] %C9213'%

/2 6'7(0/ 47(0/+ 7)(%1/72) 2< &%4./2)7)+ .)5 90#17*.4 .*/7?7/#: ;2 B2'>

%


56/63

9:&:_+ /0% %?%)7)( 2' $1B7)(, 107%'1 .'%'2/./%5 7) 2'5%' /2 19'%.5 /0% 3)5%17'.64% 107%)51 .)5

?.*./72)1 B0%)+ 4%/ 31 :

G3% /2 107%'1 )%?%' 6%*2&% '%.12).64# .5K31/%5 /2

.)# 17)(4% 1*0%534%: ;0% 6'.7) 71 2 9%' 107 71 K31/

42)( %)23(0 /2 6%*2&% 12&%B0./ .**47&./%5 /2 . 1*0%534%+ .)5 7/ 71

&2'% 57B71% '2/./72) 71 .).428

(231 /2 + .)2/0%' %7(0/8023' 90.1% 1077)(

3)/74 &75)7(0/ 2)4# &%.)1 1/.#7)( 39 . 47//4% 4./%' /0.) #23 )2'&.44#

B2345: "3/ &2?7)( %'1 1/.'/ B2'> K31/ .1 *42*>85%9%)5%)/ .4%'/7)( 71

5%1*%)57)( /2 7/1 B%.>%1/ 927)/ 7) /0% 5.#:

D4%%9 %C9%'/1 0.?% 42)( *2)134/%5 2) 107


57/63

%?%)7)(+ %?%)7)( /2 )7(0/+ .)5 )7(0/ /2 5.#_: ;0% /0'%%8B%%> 9%'7251

(.?% B2'>%'1 . B%%> /2 &.>% /0% .5K31/&%)/ /2 /0% )%B 1*0%534% .)5/B2 B%%>1 /2 &.7)/.7) 7/: J0%) 7/ *.&% /7&% /2 '2/./%+ 7/ B.1 /2 /0%

4./%' 107%'1 9'%


58/63

521%1 ^B07*0 102345 6% 42B%' /0.) /0% #23)( .534/ 521%_+ 12 /0%7'

42)(8/%'& 31% 71 )2 &2'% 9'264%&./7* /0.) 9'242)(%5 31% 2< 0%.'/&%57*./72)+ 2' 5.74# 7)1347) 6# 57.6%/7*1:

b4/7&./%4#+ 7&9'2?%5 &%4./2)7) 97441 .)5 2/0%' 17&74.' 5'3(1

2< /0% 1 B7/0

/0% *#*4%1 2< )7(0/ .)5 5.#: J% >)2B /0./ &%4./2)7) 9'253*/72) 7)

/0% 625# B.)%1 .1 B% .(%+ 12 &%4./2)7) '%94.*%&%)/ /0%'.9# &.#

2)% 5.# 6% .1 *2&&2) .1 %1/'2(%) '%94.*%&%)/ /0%'.9#: - .412 /07)>

/0./ B% 102345 6% 422>7)( ./ '%1/2'7)( /0% .4%'/7)( 9'2*%11%1 2< /0%

67242(7*.4 *42*>: D/7&34.)/1 &.# 9'2?75% . 1.


59/63


60/63

&0 7+, (%15$9$- 3%+< '+ (%7 +0 '#$1$ A,$1'.+%12 7+, 6.:#'

)++* (' '#(' 8(9'./,)(9 (9$( +0 7+,9 ).0$ (1 ( 8+11.@)$ #.-.%: 8)(/$ 0+9

1)$$8 89+@)$61> S(7@$ /(00$.%$ .% '#$ $H$%.%: -+$1 %+' (00$/' 7+,>T$9#(81 '#$ '$68$9(',9$ .% 7+,9 @$-9++6 -+$1 %+' 6(''$9 .% '#$

1).:#'$1'> U,' .0 7+, #(H$ %+' /+%1.-$9$- ()) '#$ 0(/'+91 '#(' 6.:#'

%$:('.H$)7 (00$/' 7+,9 1)$$82 7+, (9$ %+' (/'.%: .% (% .%0+96$- 6(%L

%$9>

V%$ +0 '#$ (@+H$ '.81 .1 '+ :$' '+ @$- '#$ 1(6$ '.6$ $H$97-(72

@,' '+ 6(*$ '#.1 .-$( 5+9* .% 7+,9 +5% ).0$2 7+, #(H$ '+ ,%-$91'(%-

5#7 9$:,)(9.'7 '$%-1 '+ 6(*$ @+'# 1)$$8 (%- 5(*$0,)%$11 6+9$

9+@,1'> V%$ +0 '#$ 9$1,)'1 +0 1,/# 9$:,)(9.'7 .1 '#(' 7+, 1'(9' 0()).%:(1)$$8 0(1'$9 (%- 5(*.%: ,8 6+9$ $(1.)7> T17/#+)+:./())7 (%- 8#71.L

+)+:./())72 7+, @$/+6$ /+%-.'.+%$- 0+9 1)$$8> ".'# ( 1$' 89$L1)$$8

9+,'.%$2 (% ,%-$91'(%-.%: +0 7+,9 %(',9() 8$9.+-1 +0 /)+/*L-$8$%-$%'

()$9'.%:2 (%- ( 89$-./'(@)$ @$-'.6$2 7+, 5.)) @$ 9$)(K$- (%- :$''.%:

-9+517 (1 7+, (889+(/# 1)$$8> W#.1 817/#+)+:./() (%- 8#71.+)+:./()

9#7'#6 .% ',9% 6(*$1 .' $(1.$9 '+ 0()) (1)$$8 (%- 1'(7 (1)$$8>

T$+8)$ 5#+ %$$- (% ()(96 /)+/* '+ 5(*$ ,8 +% '.6$ (9$

+0'$% @$.%: ?+)'$- 09+6 ( -$$8 1)$$8 @$/(,1$ '#$ @9(.% .1 %+' 9$(-7'+ 5(*$ ,8> "#+$H$9 .%H$%'$- '#$ 1%++X$ @,''+% ,%-$91'++- '#(' .'

'(*$1 ( @(99(:$ +0 5(*$L,8 /())1 '+ 9+,1$ '#$ 1$H$9$)7 1)$$8 -$89.H$->

V% '#$ +'#$9 #(%-2 .0 7+, (9$ :$''.%: $%+,:# 1)$$8 '#$ @9(.% 1#+,)-

,1,())7 5(*$ ,8 %(',9())7 (' .'1 %+96() '.6$ 5.'#+,' (% ()(96 /)+/*>

W#.1 #(88$%1 @$/(,1$ '#$ /)+/*L-$8$%-$%' ()$9'.%: 89+/$11 .%/9$(1$1

%(',9())7 .% '#$ 6+9%.%:> ".'# H$97 )+5 1)$$8 -$@' '+ +88+1$ '#.1

()$9'.%:2 5(*.%: ,8 1#+,)- %+' @$ -.00./,)' (%- 7+, 5.)) ,1,())7

(5(*$% 18+%'(%$+,1)7 (' (@+,' '#$ 1(6$ '.6$2 (%- .0 .' .1 (' (% #+,9'#(' ())+51 (-$A,('$ '.6$ '+ :$' '+ 5+9* +9 '+ @$ 1+6$5#$9$2 '#$9$ .1

%+ 89+@)$6>

./" (,""- 0123+'1)"1&

W#$ 0,%-(6$%'() 89.%/.8)$ 5.'# 9$:(9-1 '+ 7+,9 1)$$8 $%H.L

9+%6$%' .1 '#(' '#$ @$-9++6 1#+,)- @$ ( /+60+9'(@)$2 1$/,9$2 A,.$'2

(%- -(9* 8)(/$ '#(' 89+6+'$1 1)$$8 (@+H$ ()) $)1$2 '(*.%: .%'+ /+%1.-L$9('.+% 5#(' 5+9*1 @$1' 0+9 7+, .%-.H.-,())7> W#.1 6$(%1 .0 7+, 0$$)

6+1' /+60+9'(@)$ .'# ( @$-9++6 '#(' .1 /+68)$'$) %/+%'(6.%('$-


61/63

T$9#(81 '#$ 6+1' .68+9'(%' $%H.9+%6$%'() 0(/'+9 .1 %+.1$>

S+1' 1)$$8 '.81 5.)) '$)) 7+, '+ 6(*$ 1,9$ '#$ @$-9++6 .1 A,.$'>

W#$ @$-9++6 1#+,)- :$%$9())7 @$ -(9* -,9.%: 1)$$8> R)'#+,:#8$+8)$ 6(7 0$$) 6+9$ /+60+9'(@)$ 0()).%: (1)$$8 5.'# ( ).'')$ ).:#' +%2

'++ 6,/# ).:#' (' %.:#' /(% #(H$ '#$ $00$/' +0 1#.0'.%: '#$ @.+)+:./()

/)+/*>

& 6(7 @$ 59+%:2 @,' & -+ %+' @$).$H$ ( 1.%:)$ #+5L'+ @++*

(@+,' .689+H.%: 1)$$8 9$/+:%.X$1 +9 '(*$1 .%'+ (//+,%' '#(' '#$ H(1'

6(?+9.'7 +0 (-,)'1 1)$$8 5.'# 1+6$+%$E +H$9 PY 8$9/$%' +0 R6$9./(%1

-+ %+' 1)$$8 ()+%$> W#$ 89$0$9$%/$1 (%- '$%-$%/.$1 +0 ( @$-6('$ +9

9++66('$ #(H$ ( #,:$ $00$/' +% (%7+%$Z1 1)$$8> W#.1 6$(%1 '#(' ())'#$ (-H./$ (@+,' '#$ 1)$$8 $%H.9+%6$%' (%- 0.%-.%: 5#(' 9$())7 1,.'1

7+, 6,1' ()1+ 1,.' 7+,9 @$- 8(9'%$92 +9 (' )$(1' '#$9$ 6,1' @$ ( /+6L

89+6.1$>

4*3,# (,""- 5""6

W#$ 6+1' @(1./ (%- .68+9'(%' @.' +0 1)$$8 1$)0L*%+5)$-:$ .1

#+5 6,/# '+'() 1)$$8 7+, %$$- +% '#$ (H$9(:$ .% $(/# IML#+,9 8$9.+-'+ *$$8 1)$$8 )+(- (%- ()$9'%$11 .% +8'.6() @()(%/$> C$6$6@$9 '#('

?,1' (1 ( '#$96+1'(' *$$81 ( 9++6 (' ( /+%1'(%' '$68$9(',9$2 7+,9 +5%

1)$$8 #+6$+1'(' 5+9*1 '+ 6(*$ 7+, 0,)0.)) 7+,9 -(.)7 1)$$8 A,+'(> [+,

(//,6,)('$ 1)$$8 -$@' (' ( /$9'(.% 9('$ (%- #(H$ '+ 8(7 .' +00 @7 1)$$8L

.%: ( /$9'(.% (6+,%' $(/# -(7> [+, 6(7 @$ ( %(',9())7 1#+9' 1)$$8$92

%$$-.%: 0$5$9 '#(% $.:#' #+,91 ( %.:#' '+ (/#.$H$ '#.1 $A,.).@9.,62 +9

( )+%: 1)$$8$92 %$$-.%: 6+9$>

S7 0(H+9.'$ 6$'#+- +0 -$'$96.%.%: 5#$'#$9 & (6 6(.%'(.%L.%: ( 9$(1+%(@)$ 1)$$8 3-.$'< .1 '+ *$$8 '9(/* +0 67 $8.1+-$1 +0 #$(H7

$7$).-1 (%- 1'9,::).%: '+ 1'(7 (5(*$2 (%- '#$ /.9/,61'(%/$1 .% 5#./#

'#$7 '(*$ 8)(/$> & (6 %+5 1+ 1$%1.'.H$ '+ '#$1$ $H$%'1 '#(' & *%+5

$K(/')7 #+5 +0'$% '#$7 '$%- '+ #(88$%> & (6 /+%H.%/$- '#(' 6+1'

8$+8)$ -+ %+' *%+5 '#.1 (@+,' '#$61$)H$12 @,' & (6 ()1+ /+%H.%/$-

'#(' $H$97+%$ /(% )$(9%> W#$ $%/)+1$- 1)$$8 -.(97 6(7 @$ #$)80,)>


62/63

Adopt a Sleep-Smart Lifestyle

SLEEP DIARYDate_________________

Complete after awakening

Time you went to bed_________________

Time you fell asleep__________________

Time you woke up___________________

Number of times awakened during the night__________________

Amount of time awake during the night__________________

Total Nighttime Sleep_______________________________

Comments on quality of nights sleep

____________________________________________________________________________________________________________________________________________________________

Did you feel groggy after getting up in the morning? Yes___No___

If yes, for how long? __________________

Complete during and at the end of the day:

Naps:

Time fell asleep__________________

Time awoke_____________________

Total Nap Time__________________

Comments on quality of naps:

______________________________________________________________________________

Using the Stanford Sleepiness Scale below, note your alertness during the day:

1) Feeling active, vital, alert, wide awake

2) Functioning at a high level, not at peak3) Relaxed, not full alertness, responsive

4)

A little foggy, not at peak, let down5) Fogginess, losing interest, slowed down

6) Sleepiness, prefer to be lying down7) Almost in a reverie, hard to stay awake

How was your overall sleepiness/alertness today? (1-7)______

Other comments on mental and physical feelings in the day:

______________________________________________________________________________

6AM 4PM

8AM 6PM

10AM 8PM

Noon 10PM

2PM MDNT


63/63

The Absolute Essentials of Sleep Knowledge (Mini Book)

Documents

Transcript of The Absolute Essentials of Sleep Knowledge (Mini Book)