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.

CIRCADIAN RHYTHM

Sleep is a universal phenomenon present in all living things and revolving around biological rhythms called ______ _______.

24-hour cycle

Sleep is a biological behavioral process that recurs in approximately ___ cycle

mesencephalic portion of the reticular formation.

The cyclic nature of sleep is controlled by the center located in the lower part of the brain-

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 2

• 50% of the person’s sleep

• The person falls into a stage of sleep

• The person can be aroused with relative ease

Stage 3

• 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

• Slow brain waves are recorded on an

• Pulse and respiratory rates decrease

• Muscles are very relax electro encephalogram (EEG)

• Metabolism slows and the body temperature is low

Physiologic changes in the body DURING STAGE 4 NREM include: SPMM

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’

• 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

Characteristics of REM sleep ESLR PBG MB

• It allows the mind and body to recognize and regenerate in preparation for the coming day.

• Physiologically, hormone releases, cellular refreshment and other metabolic changes that occur during sleep are secondary to reduced body activity and usage.

• Psychologically, sleep may assist the person in problem solving, coping and re-energizing his powers of concentration and interest in the daily tasks.

Functions of sleep

• Age

• Physical activity

• Psychological stress

• Motivation

• Diet

• Alcohol intake

• Caffeine containing beverages

• Environmental factors

Factors that influence sleep APP MDACE

Age

the quantity, sleep cycles and sleep quality differs among persons of various ages.

Physical activi

activity and exercise influence sleep by increasing fatigue and in many instances, promoting relaxation that is followed by sleep.

Psychological stress

illness and daily situations can cause psychological stress and may disturb sleep.

Motivation

a desire to be wakeful and alert helps overcome sleepiness and sleep.

amino-acid tryptophan

acts to promote sleep

Alcohol intake

alcohol beverages, when used in moderation, seem to help induce sleep in some people.

• Allergies and respiratory problems

• Frequent urination

• Chronic Pain

• Stress and anxiety

Causes of sleep disorders: AFCS

Insomnia

inability to obtain an adequate or quality of sleep

• Initial insomnia

• Intermittent or maintenance insomnia

• Terminal insomnia

3 Types of Insomnia:

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

Multiple sleep latency test (MSLT)

This daytime napping study is used in conjunction with a PSG at night to help diagnose narcolepsy.