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.

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