Week5 - We

Managing Your Sleep

• Course Information

  • California State University, Fresno

  • Department of Public Health

  • PH90 Contemporary Health Issues

  • Instructor: Dr. Qiwei Li

Sleep Patterns Overview

• Daily Sleep Cycle

  • Homeostatic Sleep Drive vs. Circadian Drive

  • Sleep Gate: the transition to wakefulness and sleep

  • Typical sleep hours: 7 AM to 11 PM

Human Circadian Rhythm

• Key Concepts

  • Zeitgeber: Environmental cues that regulate biological clocks

  • Role of the Retinohypothalamic tract and Suprachiasmatic Nuclei in syncing sleep patterns

Effects of Light on Sleep

• Macula and the Retina

  • Blue Light: Impact on the retina and sleep disruption

  • Different types of light: Near IR, Visible Light, UVB, UVA

Age-Related Changes in Sleep

• Literature Review

  • Reference: Kryger, M. H., Roth, T., & Dement, W. C. (2016)

• Sleep Patterns Variations:

  • Younger adults vs. older adults typical hypnograms (Neubauer, 1999)

Sleep Duration Recommendations

• Age-Based Guidelines

  • Newborns (0-3 months): 14-17 hours

  • Infants (4-11 months): 12-15 hours

  • Toddlers (1-2 years): 11-14 hours

  • Preschool (3-5 years): 10-13 hours

  • School Age (6-13 years): 9-11 hours

  • Teens (14-17 years): 8-10 hours

  • Young Adults (18-25 years): 7-9 hours

  • Adults (26-64 years): 7-9 hours

  • Older Adults (65+ years): 7-8 hours

Understanding Sleep Disorders

• Types of Sleep Disorders

  • Primary Sleep Disorders:

    • Sleep apnea

    • Insomnia

  • Other conditions: Restless Legs Syndrome, Narcolepsy, and Circadian Rhythm Disorders

Obstructive Sleep Apnea (OSA)

• Definition & Symptoms

  • OSA characterized by recurrent airway obstruction during sleep

  • Symptoms: Loud snoring, witnessed apneas, daytime sleepiness, morning headache

Diagnosis of OSA

• Apnea Hypopnea Index (AHI)

  • None/Minimal: AHI < 5

  • Mild: 5 ≤ AHI < 15

  • Moderate: 15 ≤ AHI < 30

  • Severe: AHI ≥ 30

Health Consequences of OSA

• Risks Associated With OSA

  • Cognitive decline, depression, cardiovascular diseases, daytime lethargy

Sleep Assessment Methods

• Polysomnography (PSG): Gold standard for diagnosing sleep conditions

• Other assessment techniques include:

  • Sleep diaries, smartphone apps, in-home testing

  • Use of Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS)

Treatment Options for OSA

• Interventions

  • Positive Airway Pressure (PAP) therapy

  • Weight management

  • Sleep hygiene practices

  • Surgical intervention may be necessary

Insomnia

• Definition & Types

  • Symptoms include difficulty in sleep initiation and maintenance, early awakenings

  • Types: Acute, Chronic, Primary, Secondary

Prevalence and Risk Factors for Insomnia

• Demographic Variance

  • More prevalent in older adults

  • Risk factors: Medical conditions, gender, stress

Narcolepsy

• Characteristics

  • Affects 1 in 3000 individuals; characterized by involuntary daytime sleep

  • Potential genetic basis for the disorder

Restless Legs Syndrome (RLS)

• Description

  • Neurological disorder with uncomfortable leg sensations; urge to move legs

  • Treatment options: Medications, lifestyle adjustments, physical therapies

Importance of Sleep

• Biological Purposes

  • Restores physical and mental health, enhances learning, and consolidation of memories

Tips for Better Sleep

• Sleep Environment and Habits

  • Maintain a cool room, create a relaxing atmosphere, establish a routine

  • Avoid screen time and stimulants before sleep

Daytime Habits for Better Sleep

• Recommendations

  • Get natural light exposure, balanced diet, and manage physical activity

  • Regulate caffeine, nicotine, and liquid intake before bed

Managing Your Sleep

Course Information

• Institution: California State University, Fresno

• Department: Public Health

• Course: PH90 Contemporary Health Issues

• Instructor: Dr. Qiwei Li

Sleep Patterns Overview

Daily Sleep Cycle

• The human body operates on a daily sleep cycle, which is influenced by both internal biological processes and external environmental cues.

• Recognizes the homeostatic sleep drive (the body's need for sleep) versus the circadian drive (the body's internal clock).

• Sleep Gate: A physiological mechanism that dictates the transitions between wakefulness and sleep, often tied to levels of adenosine in the brain.

• Typical sleep hours are often defined as from 7 PM to 11 AM, acknowledging variations based on individual lifestyles.

Human Circadian Rhythm

Key Concepts

• Zeitgeber: These are environmental cues, such as light and temperature, that regulate the body's biological clocks, helping to synchronize sleep-wake cycles.

• The retinohypothalamic tract and the suprachiasmatic nuclei play critical roles in transporting light information from the retina to the brain, which influences sleep patterns.

Effects of Light on Sleep

• The macula and the retina are crucial components in how we perceive light and its effects on sleep.

• Blue Light: A type of light known to disrupt sleep by suppressing melatonin production, making devices like smartphones and LED lights particularly problematic in the evening.

• Different types of light:

  • Near IR: Often used for therapeutic purposes.

  • Visible Light: Essential for visual perception and regulating sleep.

  • UVB: Important for Vitamin D synthesis but can also affect sleep.

  • UVA: Less understood in the context of sleep but can still impact health.

Age-Related Changes in Sleep

Literature Review

• Reference: Kryger, M. H., Roth, T., & Dement, W. C. (2016)

• Sleep Patterns Variations:

  • Differences in typical hypnograms for younger adults versus older adults as summarized by Neubauer (1999).

Sleep Duration Recommendations

• Age-Based Guidelines:

  • Newborns (0-3 months): 14-17 hours

  • Infants (4-11 months): 12-15 hours

  • Toddlers (1-2 years): 11-14 hours

  • Preschool (3-5 years): 10-13 hours

  • School Age (6-13 years): 9-11 hours

  • Teens (14-17 years): 8-10 hours

  • Young Adults (18-25 years): 7-9 hours

  • Adults (26-64 years): 7-9 hours

  • Older Adults (65+ years): 7-8 hours

Understanding Sleep Disorders

Types of Sleep Disorders

• Primary Sleep Disorders include conditions like sleep apnea, insomnia, restless legs syndrome, narcolepsy, and circadian rhythm disorders.

• Obstructive Sleep Apnea (OSA):

  • Definition: A serious sleep disorder characterized by recurrent airway obstruction during sleep.

  • Symptoms: Include loud snoring, witnessed apneas, daytime sleepiness, and morning headaches.

Diagnosis of OSA

• Measured through the Apnea Hypopnea Index (AHI):

  • None/Minimal: AHI < 5

  • Mild: 5 ≤ AHI < 15

  • Moderate: 15 ≤ AHI < 30

  • Severe: AHI ≥ 30

Health Consequences of OSA

• Risks associated with untreated OSA:

  • Cognitive decline, depression, increased risk of cardiovascular diseases, and persistent daytime lethargy.

Sleep Assessment Methods

• Polysomnography (PSG): Considered the gold standard for diagnosing sleep disorders.

• Other assessment techniques include:

  • Sleep diaries - personal logs detailing sleep patterns.

  • Smartphone apps for sleep tracking.

  • In-home testing for sleep quality.

• The Insomnia Severity Index (ISI) and Epworth Sleepiness Scale (ESS) are tools used to evaluate sleep quality and daytime sleepiness.

Treatment Options for OSA

• Interventions include:

  • Positive Airway Pressure (PAP) therapy as a common treatment.

  • Weight management strategies to alleviate symptoms.

  • Implementation of sleep hygiene practices to improve sleep quality.

  • In some cases, surgical intervention may be necessary.

Insomnia

Definition & Types

• Insomnia is characterized by difficulty in sleep initiation and maintenance, including early awakenings.

• Types include:

  • Acute: Short-term insomnia often linked to stress or trauma.

  • Chronic: Long-lasting insomnia usually requiring clinical intervention.

  • Primary: Insomnia not attributable to other conditions.

  • Secondary: Insomnia resulting from other medical or psychiatric conditions.

Prevalence and Risk Factors for Insomnia

• Notably more prevalent among older adults.

• Common risk factors: Include various medical conditions, differences in gender, and psychological stress.

Narcolepsy

Characteristics

• Narcolepsy affects approximately 1 in 3000 individuals and is marked by episodes of involuntary daytime sleep.

• Emerging research suggests a potential genetic basis for this disorder.

Restless Legs Syndrome (RLS)

Description

• A neurological disorder characterized by uncomfortable sensations in the legs and an overwhelming urge to move them, often worsening during periods of inactivity.

• Treatment options include a range of medications, lifestyle adjustments, and physical therapies.

Importance of Sleep

Biological Purposes

• Sleep serves several biological functions, including restoring physical and mental health, enhancing learning, and facilitating memory consolidation.

Tips for Better Sleep

Sleep Environment and Habits

• Recommendations for improving sleep environment:

  • Maintain a cool bedroom temperature.

  • Create a relaxing atmosphere to promote sleep.

  • Establish a consistent bedtime routine.

  • Avoid electronic devices and stimulants (like caffeine) prior to sleep.

Daytime Habits for Better Sleep

• Recommendations:

  • Get ample natural light exposure during the day.

  • Maintain a balanced diet conducive to sleep health.

  • Manage physical activity levels to promote better sleep.

  • Limit intake of caffeine, nicotine, and liquids close to bedtime to minimize disruptions during the night.