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THE IMPORTANCE OF SLEEP
MARCH 3‐10 NATIONAL SLEEP AWARENESS WEEK
Sophia L. Dollar, MPHWellness Coordinator, WSU
Welcome! Today’s Outline:
Introduction
I. Public Health Problem
II. The Sleep CycleI. NREM & REM CycleII. The Right Mix
III. InsomniaI. Causes and EffectsII. Affecting your WorkIII. Vicious Cycle
IV. Chronic Disease Linked to Insufficient SleepI. Immune SystemII. DiabetesIII. Cardiovascular DiseaseIV. ObesityV. Depression
V. Good Sleep Hygiene: 12 Tips to Better Sleep
VI. Guided Relaxation
I. Public Health Problem
Sufficient sleep is increasingly being recognized as an essential aspect of health promotion and chronic disease prevention in the public health community.
Sufficient sleep is not a luxury—it is a necessity and should be thought of as a “vital sign” of good health.
Just as important as DIET and EXERCISE
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How much do we need?
(National Sleep Foundation, 2010)
Check the chart for your family members, too.
There is no “Magic Number”
Different age groups need different amounts
However…
Sleep needs are individual
I need 8.5 hours
I need 7 hours
There is no “Magic Number”
Basal Sleep Need‐what you regularly need or get
Sleep Debt‐ your bank of sleep lost Unresolved sleep dept interacts with your Basal Sleep Need
Can be “paid off”
**Note: sleep may become more fragile in older people, but the NEED does not decrease with age
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II. The Sleep Cycle
Sleep is an active physiological process
All major organs and regulatory systems continue to function
Processes of vital health and well‐being take place during sleep
2 types of sleep: non‐rapid eye movement and rapid eye movement
Non‐Rem aka “NREM”
Non‐rapid Eye Movement
4 Stages
Stage 4: Difficult to be awakened
Slow Wave Sleep
Rapid Eye Movement aka “REM”
Rapid Eye Movement
Intense brain activity
Breathing becomes more rapid, irregular
Eyes move rapidly and limb muscles become
temporarily paralyzed
Heart rate increases and BP rises
Dreams occur here
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The Right Mix
REM and NREM alternate throughout the night – predictable pattern
Complete cycle consist of NREM and REM cycles that alternate every 90‐110 minutes and is repeated 4‐6 times per night
4 cycles x 90 mins = 360 mins = 6 hours MINIMUM!
III. What is Insomnia?
Insomnia: characterized by an inability to initiate or maintain sleep Waking too early
Not being able to get back to sleep
30‐60% of Americans suffer from poor sleep quality falling asleep on the job
absenteeism
marital problems
CAR ACCIDENTS – similar to being intoxicated
(National Sleep Foundation)
Causes of Insomnia
Causes Lack of exercise
Shift work
Frequent urination
Chronic pain
Medications
Menopause
Sleep apnea
Jet lag
Cell phone use
STRESS!!! At least 50% of all insomnia is stress related
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Effects of Insomnia
Effects Depressed Immune System
Lapse of Attention
Slow Thinking
Irritability
Poor Memory
Poor Judgment
Anxiety & Depression
Increase in Accidents
Decrease in Work Productivity
Insomnia = Affects Hormones
Cortisol‐ the “good” stress hormone Dips at bed time and increases throughout the night
Promote wakefulness, increase near the end of a complete sleep cycle
Promote alertness in morning
Growth hormones
Reproduction hormones
Leptin‐ regulates metabolism
Insomnia = Affects Work
Presenteeism – working hard or hardly working?
Lack of Focus
Mistakes & Accidents
Interpersonal Difficulties
Poor Attitude
Inspection Failure Rate
Absenteeism
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Effects of Insomnia –Vicious Cycle
The more tired you are, the more caffeine you’ll consume to stay awake during the day; but the more caffeine you consume, the harder it’ll be to fall asleep at night.
IV. Chronic Disease
Insufficient sleep has been linked to chronic diseases Immune System
Cardiovascular disease
High Blood Pressure
Obesity
Diabetes
Depression
Sleep Boosts Your Immune System
No wonder we’re sleepy when we’re sick!
Cytokines
Chemicals our immune systems use to fight infections
Powerful sleep‐inducers
Body’s natural way to conserve energy to build your immune system
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Diabetes
Sleep debt accumulated over a matter of days can impair sugar metabolism and disrupt hormone levels
Ability to process blood glucose declines
Prompts your body to make more insulin
Cardiovascular Disease
Sleep Apnea‐ characterized by episodes of interrupted breathing during sleep
the brain has to awaken the individual in order for breathing to start again
High prevalence of sleep apnea among people with cardiovascular problems Related to fat build up or loss of muscle tone
Air cannot flow through the wind pipe
High Blood Pressure
Study at University of Chicago followed 578 adults over 5 years
Ages 33‐45; African Americans and Whites
Measured blood pressure during periods of rest and activity
Those who slept less were 37 percent are more likely to develop high blood pressure over time and that risk grew with each additional hour of lost sleep.
(Knutson et. al, 2009)
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Obesity
Sleepiness can create a larger appetite
Leptin levels fall Leptin – hormone regulating metabolism Promoting appetite increase ‐ carb cravings Feeling the hunger and sleepiness can get confused
due to hormone levels falling from sleepiness
Psychological manifestations of fatigue, sleep and hunger are similar. Thus, when you’re feeling sleepy you might feel like you need to head for the fridge instead of bed.
Obesity
Growth Hormones
Secreted during sleep
Regulate muscle mass
Young men studied: having less growth hormone (due to sleep deprivation) as men get older increases the tendency toward becoming overweight and having a paunch in middle age
The more tired, the more caffeine you’ll go for‐Creating a vicious cycle
Caffeine drinks are usually replete with sugar or artificial sugar and not much else.
Replace caffeine with a healthy snack
Fruit, granola bar, nuts
Caffeine & Obesity
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Depression
A common and serious medical condition that can feel overwhelming and interfere with your ability to function
Common characteristics include: Poor appetite or overeating
Insomnia or hypersomnia
Low energy or fatigue
Low self‐esteem
Poor concentration or difficulty making decisions
Feelings of hopelessness
(American Psychiatric Association, 2000 DSM‐IV‐TR)
Depression
Depression may cause sleep problems and sleep problems may cause or contribute to depressive disorders
An inability to sleep that lasts over a long period of time is also an important clue that someone may be depressed
Sidenote: This info is relevant for every family member.
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V. Good Sleep Hygiene
12 ways to increase your sleepAdapted from: Brian Luke Seaward, Ph.D., Paramount Wellness
Institute
1. Keep a regular sleep cycle
Establish a regular, relaxing Bedtime Routine
Avoid exposure to bright light before bedtime
Go to bed and wake up at the same time each day
2. Create an ideal sleep ambiance
Quiet
Clean
Dark
Relaxing
Comfortable temperature
Not too hot or cold
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Which room would you sleep better in?
3. Get out and exercise
Flush out the stress hormones
Stress is related to at least 50% of insomnia cases
4. Decrease your caffeine consumption
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5. Learn to meditate
6. Move the TV out of the bedroom
The more gadgets and distractions, the less your brain will get into sleep‐mode
vs.
7. Stop using your cell phone after 6 p.m.
It will take longer to wind down at the end of the night if your brain is occupied with conversations and text messages
Make yourself unavailable‐ it willfeel refreshing to have uninterrupted “ME ‐TIME”
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8. Avoid alcohol and nicotine
Nicotine is a stimulant, therefore falling asleep is hindered by withdrawal symptoms
Although alcohol is thought of as a sedative, it disrupts sleep and causes nighttime awakenings
9. Clear your late night mind
Reading, candles, soothing music, warm bath
10. Avoid eating before bed
Heavy meals can make you feel groggy and can make it hard to settle down.
Some meals also provoke heartburn, which worsens falling asleep and discomfort during the night.
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11. Avoid naps during the day
If you can’t rest for 10 minutes without falling asleep, you’re probably sleep deprived
12. Keep your bed for sleeping
Refrain from:
TV
Music
Reading
Computers
Other “gadgets”
For more info…
http://www.sleepfoundation.org/
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VI. Relaxation Time
Take this time to simply listen & relax
References American Psychiatric Association, 2000
Centers for Disease Control and Prevention (cdc.gov, 2010)
National Sleep Foundation (sleepfoundation.org, 2010)
World Health Organization (who.int, 2010)
Brian Luke Seaward, Ph.D., Paramount Wellness Institute
Sleep‐Wake Cycle: Its Physiology and Impact on Health, 2006. National Sleep Foundation (sleepfoundation.org)
Knutson, K. L., PhD;VanCauter, E., PhD; Rathouz, P. J., PhD; Yan, L. L., PhD; Hulley, S. B., MD, MPH; Liu, K., PhD; Lauderdale, D. S., PhD. Association Between Sleep and Blood Pressure in Mid Life. Arch Intern Med. 2009; 169(11):1055‐1061
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