Neuroscience of Sleep Exam 4

Sleep hygiene

behaviors and environmental factors that promote "good sleep"

Sleep Hygiene Fixes

a. nighttime environment- prefer "warmer" yellow light over "cooler" white lights at night

b. limit blue light exposure near bedtime (60ish minutes)- so read a printed a book

Some examples of good sleep hygiene practices; how to promote "good sleep"?

limiting screen time near bed, not eating right before bed, doing relaxing activities before bed, not doing physical exercise too close to bed, and sleep in complete silence and dark

science behind why having a consistent bed/wake time is good

"trains' your body and mind to associate times with sleep (classical conditioning)

science behind why having a bedtime routine is good

"trains" your body and mind to associate activities with sleep (classical conditioning)

science behind why meditation/relaxation techniques are good before bed

reduces stress, relaxes the body

science behind why having bedroom environment control is good (limiting the bedroom to sleep only, not work)

leaves good associations (relaxation) to the bedroom and bad (stress) out

science behind why having a cooler bedroom is good for sleep

your body temp. needs to drop 1-2 degrees to sleep.... so having a lowered temp. in the bedroom allows the body to do this induced (and allows you to maintain the temp throughout sleep)

science behind why limiting light in the bedroom is good for sleep

light affects circadian rhythms

science behind daytime physical activity

some find it relaxing, indirect benefits (obesity)

science behind stimulant consumption

need to consider half-life (how long caffeine and nicotine stay in system)

science behind good dietary intake and its effects on sleep

need to avoid alcohol (it reduces slow wave sleep, fragments sleep), avoid large meals

science behind needing to limit late night blue light exposure

Artificial blue light mimics "day-time" signals

Blue light TRICKS the SCN into thinking that there is still natural daylight

Role of Technology

artificial light sources affects our circadian rhythm similar to sunlight: enables us to stay up later (quick effect) + impacts the signaling to the SCN (slow effect)

impacts of artificial light

affect our circadian rhythm similar to sunlight, enables us to stay up later and impacts signaling to the SCN

(Role of Technology) acuity

ability to resolve detail

cornea

outer most surface; focus/shape incoming light on retina

lens

(inside the cornea) works to focus and shape incoming light on the retina

retina

surface of the eye wall that contains photoreceptors

cones

operate in bright color (day vision), chromatic (color) sensations, better detail, fast acting receptors

rods

operates in low light (night vision), achromatic sensations (colorless), less detailed/low acuity, slow response time

fovea

location on retina with highest acuity -> "center of our visual experience"

amplitude

brightness

frequency

color

what changes in light that showcase sunlight/night coming

decrease in blue light

L cones

long length - red

M cones

medium length - green

S cones

short length - blue

issue with blue LED lights

when a house is lit with LED lights, there is never proper decrease in blue light (meaning the body does not pick up on the switch to night time)

the blue light problem

formal way of describing the issue with blue lights and how they omit blue light even after sunset

tips to minimize blue light exposure

choose yellow lights over blue lights, limit bluelight near bedtime (switch to paperback books or use nighttime setting on phone)

blindspot

the point at which the optic nerve leaves the eye, creating a "blind" spot because no receptor cells are located there

effects blue light has on sleep

reduced REM sleep, less rested and more daytime sleepiness, lag in melatonin release

sleep texting

a phenomenon in which people send texts while asleep and typically have no recollection of doing so

sleep texting suggestions

do not sleep with your phone near by, silence notifications, and wear mittens to bed

self-awakening

waking at a designated time without an alarm clock (gradual increase in blood pressure and heart rate as day starts)

forced awakening

waking to an alarm clock (intense shock in blood pressure and heart rate)

effects of snoozing your alarm

startles your heart over and over, can shorten lifespan

What are health disparities?

Preventable differences in the burden of disease, injury, violence, or opportunities.

What are health disparities directly related to?

Unequal distribution of social, political, economic, and environmental resources.

Sleep health disparities in college students

Black students reported less habitual sleep duration (compared to white, Hispanic/Latino, and Asian)

individual factors of sleep disparities

Mental health, discrimination, race and ethnicity, temperament, biological genes, immigrant/refugee status

family factors of sleep disparities

Family stress, family structure, family interactions/parenting, beliefs about sleep and health, resources, household chaos, health literacy

neighborhood and broader socio-cultural of sleep disparities

Light and noise, systemic racism, insurance coverage, neighborhood cohesion and safety, exposure to environmental toxins

Sleep Disparities - Gender Identity

Cisgender student - 12.2 % of students slept less than 5 hours of sleep

LGBT - 17.3 % of students slept less than 5 hours a day

Sleep disparities - refugee status

Sleep disturbances (insomnia and nightmares) occur with a higher prevalence among refuges

What is a potential solution based on the ecological systems model for individuals and families?

Provide proper sheets and language-based education models.

What is a potential solution based on the ecological systems model for neighborhood and broader sociocultural factors?

Implement pop-up clinics and expand government services.

are solutions to sleep disparities one size fits all

NO! each problem has their own solution

diagnosing sleep disorders

Formal evaluations require sleep studies (polysomnography) in clinic + detailed sleep log

Insomnia definition

the inability to generate an adequate amount of sleep even when you try (ie not voluntary sleep deprivation)

insomnia frequency types

acute or chronic (more than 3x per week, for at least 3 months)

insomnia prevalence

approximately 10-15% of adults... more common in older than young adults

insomnia symptoms

Difficulty falling asleep (sleep onset)

Waking up too early (sleep duration)

Not feeling refreshed after waking from sleep (self reported quality)

Difficulty staying asleep (sleep maintenance)

primary insomnia

not a symptom or side effect of another illness or medication

Secondary insomnia

a symptom or side effect of another illness or medication

insomnia causes

Genetic causes - 28-45% transmission rates from parent to child, Environmental factors (e.g. Too bright, too loud, too warm, etc.), Psychological factors (e.g., stress, anxiety)

Three-factor approach to insomnia (3-P's)

Predisposing factors (pre-existing risk factors)

Precipitating factors (triggering event)

Perpetuating factors/ priming factors (behaviors that sustain the disorder)

What is CBTI in the context of insomnia treatment?

Cognitive Behavioral Therapy for Insomnia

What percentage of patients experience relief from insomnia with CBTI?

Nearly 70-80%

What does CBTI help identify in patients with insomnia?

Irrational and faulty beliefs, such as catastrophic thinking

What does CBTI aim to highlight in patients with insomnia?

The irrationality of their beliefs

What does CBTI modify to help patients sleep better?

Previously learned associations that prevent good sleep, such as worry and anxiety

What is the role of medication in treating insomnia?

They act as a sedative (hypnotic) and do not induce natural sleep

What is a significant risk of prolonged usage of sleeping pills?

Dependency (addiction)

What are some negative side effects of sleeping pills?

Next day grogginess, daytime forgetfulness, slowed reaction times

What is the biggest negative side effect of sleeping pills?

Increased risk of mortality

What is the placebo effect's role in the effectiveness of sleeping pills?

Half of the effect is attributed to the placebo effect

Sleep apnea defintion

sleep disorder defined by disruptive breathing

What is obstructive sleep apnea?

It is caused by relaxation of throat muscles and is the most common form of sleep apnea.

What is central sleep apnea?

It occurs when the brain fails to properly signal the muscles that control breathing.

What is complex sleep apnea?

It is a combination of both obstructive and central sleep apnea.

about how many people are effected by sleep apnea

Almost a billion people effected

Symptoms of obstructive sleep apnea

Snoring, excessive daytime sleepiness, gasping or choking during sleep, dry mouth or sore throat in the morning, morning headache, witnessed pauses in breathing during sleep

sleep apnea cycle

Muscle relaxation - obstructed airway - insufficient air- gasp for air... Happens frequently and in frequently (depending on individual)

Risk factors for obstructive sleep apnea

Neck circumference

Being male

Being older

Family history

Use of alcohol, sedative or tranquilizers

Sleep apnea treatments

Continuous positive airway pressure (CPAP) machine - Air pressure is delivered through a mask

Advantage: one of the most effective treatment methods

Disadvantage: cumbersome and/or uncomfortable

Oral appliance - brings the jaw forward, thereby keeping the airway open

Lifestyle changes - Weight loss, Exercise, Avoid alcohol, sedatives, or tranquilizers, Quit smoking, Sleep on your side

Surgery (only if non of the other options work) - Tissue removal

Somnambulism defintion

sleep disorders that involve physical movement (e.g., sleep walking, sleep talking, sleep texting)

does somnambulism happen during dream (REM) sleep

NO! happens during NREM sleep (most often in first cycle of the night)

typical Somnambulism activities

engaging in routine actions (e.g., walking to the door, getting a drink of water)

who is Somnambulism most common in

children because they experience more NREM sleep

some extreme Somnambulism reports

individuals committing murder, they can not be charged though because they were unconscious

What is the estimated lifetime prevalence of somnambulism?

Around 6.9%

What is the adult prevalence of sleepwalking in the last 12 months?

1.5%

What is the childhood prevalence of sleepwalking?

5%

Somnambulism causes

Pre-disposing = (twin studies) genetic component/heritability

Precipitating/priming = arousing environment, sleep deprivation Recovery sleep (after a night of sleep deprivation) is more susceptible to sleep walking Also a effect on auditory arousal

Somnambulism

sleep disorders that involve physical movement like sleep walking, sleep talking, and sleep texting

Somnambulism treatment

Anticipatory awakenings: waking the person - 15 minutes prior to when they usually sleepwalk

Medication

Psychological/physical evaluations

Narcolepsy definition

a chronic neurological disorder that affects the brain's control over the sleep-wake cycle

How do symptoms progress sequentially?

don't typically worsen over lifetime and may partially improve but don't typically disappear either

What is the prevalence of narcolepsy in the U.S. as of 2019?

0.08% (79 per 100,000 people)

What is the prevalence of narcolepsy in the U.S. as of 2023?

0.04%

What is the typical onset age for narcolepsy?

10-20 years old

What is a primary symptom of narcolepsy?

Excessive daytime sleepiness, regardless of previous night's sleep quantity/quality

What is a common occurrence for someone with narcolepsy during activities?

Sometimes falling asleep in the middle of an activity

What is sleep paralysis in the context of narcolepsy?

Total paralysis just before falling asleep or just after waking up

What is cataplexy?

Sudden muscle weakness while awake, only present in type 1 narcolepsy

Does cataplexy involve loss of consciousness?

No, there is loss of physical control without loss of consciousness

What can trigger cataplexy?

Strong emotions

How long do episodes of cataplexy and sleep paralysis typically last?

1-2 minutes