SLEEP DISORDERS

Sleep

• is a natural, periodically recurring physiological state of rest, characterized by relatively little physical and nervous activity, various levels of consciousness and lessened responsiveness to external stimuli.

• It is a universal phenomenon present in all living things and revolving around biological rhythms called CIRCADIAN RHYTHM.

• It is a biological behavioral process that recurs in approximately 24-hour cycle.

• The cyclic nature of sleep is controlled by the center located in the lower part of the brain-mesencephalic portion of the reticular formation.

Circadian Rhythm

what is the biological rhythm found in sleep?

24-hour cycle

sleep is a biological behavioral process that recurs in approximately ________

Stage I

• 5% of the person’s sleep

• Transitional stage between wakefulness and sleep

• The person is in the relax state but still somewhat aware of his surroundings.

• This stage normally lasts for few minutes.

• The person can be aroused easily.

• Involuntary muscle jerking may occur and may waken the person

Stage II

• 50% of the person’s sleep

• The person falls into a stage of sleep

• The person can be aroused with relative ease

Stage III

• deep sleep state

• The depth of sleep increases and arousal becomes increasingly difficult

Stage IV

• the person reaches the greatest depth of sleep, which is called the DELTA SLEEP

• Arousal from sleep is difficult

• Physiologic changes in the body

Physiologic changes in the body

• Slow brain waves are recorded on an electro encephalogram (EEG)

• Pulse and respiratory rates decrease

• Muscles are very relax

• Metabolism slows and the body temperature is low

Rapid Eye Movement (REM)

• Sometimes called PARADOXICAL SLEEP

• Because it seems that the person is close to wakefulness

• 20%-25% of person’s nightly sleep

• It is more difficult to wake a person at this stage’

• if they are awakened, they always report that they have been dreaming.

• unable to recall dreams

Characteristics of REM sleep

•  Eyes dart back and forth

•  Muscles- small muscle twitching, such as on the face

•  Large muscles immobility resembling paralysis

•  Respiration- irregular sometimes there is apnea

•  Pulse-rapid and irregular

•  BP- increases or fluctuates

•  Gastric secretions increase

•  Metabolism and body temperature increase

•  Brain waves- EEG tracing active

amino-acid tryptophan

acts to promote sleep by increasing the production of serotonin, which is a precursor to melatonin, the hormone that regulates sleep.

melatonin

natural hormone secreted by the pineal gland

Allergies and respiratory problems

• can make it challenging to breathe at night.

• The inability to breathe through your nose can also cause sleeping difficulties.

Nocturia or frequent urination

• may disrupt sleep by causing an individual to wake up during the night.

• Hormonal imbalances and diseases of the urinary tract may contribute to the development of this condition.

Insomnia

inability to obtain an adequate or quality of sleep

Initial insomnia

difficulty in falling asleep

Intermittent or maintenance insomnia

difficulty in staying asleep because of frequent or prolonged waking.

Terminal insomnia

early morning or premature waking

Hypersomnia

excessive sleep (daytime or night time)

Narcolepsy

sudden wave of overwhelming sleepiness (Sleep attack)

Sleep apnea

periodic cessation of breathing during sleep and interfere with sleep.

Parasomnias

clusters of waking behaviors that appear during sleep and interfere with sleep.

Somnambulism

sleep walking

Night terrors

after having slept for few hours, the child bolts upright, shakes and screams, appears pale and terrified. Attributed to CNS disorders and infections (no memory of what may have happened)

Nocturnal enuresis

involuntary voiding at night or bedwetting

Soliloquy

sleep talking

Bruxism

clenching and grinding of teeth during sleep. May erode and diminish the height of the dental crowns and may cause the teeth to become loose.

Nightmares

exceedingly vivid dreams from which the individual wakens in fear. Upon awakening has good recall of the nightmare content.

Nocturnal erections

wet dreams and experienced by adolescent males.

Polysomnography (PSG)

This is a lab sleep study that evaluates oxygen levels, body movements, and brain waves to determine how they disrupt sleep vs. home sleep study (HST) that is performed in your own and is used to diagnose sleep apnea.

Electroencephalogram (EEG)

• This is a test that assesses electrical activity in the brain and detects any potential problems associated with this activity.

• It’s part of a polysomnography.

Continuous positive airway pressure (CPAP) therapy

• is a common treatment for obstructive sleep apnea.

• uses a hose and mask or nosepiece to deliver constant and steady air pressure.