Sleep DisturbancesBy: Gabi, Jessica, Jewel, Nathan, Krystian

Sleep Disturbances• also called sleep disorders, is the disorder of sleep

patterns in a person or animal. sleep disorders/ disturbances can be anything from the grinding of teeth(Bruxism) to the inability to fall asleep regularly, (insomnia). Sleep disturbances affect about 10 percent of adult Americans . Most sleep disturbances and disorders are self created

Sleepwalking/Talking• Sleepwalkers arise during deep sleep, consists of stage non-

rapid eye movement. when the sleepwalkers arise they are in a state of low consciousness; In this state activities can range from walking, talking and going to the bathroom or to hazardous activities such as driving, violent gestures or cooking. most cases of sleepwalking consist of repetitive, simple actions, with the subject having no memories of the actions performed while sleepwalking. Sleepwalking occurs mostly in children Causes and treatments: Some factors that may cause sleepwalking include lack of sleep, an irregular sleep schedule , illness, some medications and stress. There are no specific treatments for sleep walking, in most cases it can be sleepwalking can be stopped by improving sleep conditions and schedules

Sleep Apnea • Sleep apnea a disorder that has characteristics that cause

pauses in breathing or infrequent shallow breathing. Many people with sleep apnea do not realize that they have the disorder, as it is undetectable in blood test and requires multiple routine office checkups. People with sleep apnea show signs of excessive sleepiness and fatigue during the daytime because when the patient stops breathing they often go from deep sleep to light sleep many times a night. Causes and treatments: Factors include having a small upper airway, large tongues and tonsils, smoking and being overweight. If the sleep apnea is caused by factors such as smoking or being overweight, you can lose weight or quit smoking. you can also get a “Continuous positive airway pressure device” or CPAP, which is a mask that fits over the nose and mouth and keeps airways open by gently blowing air.

Insomnia• Insomnia is a sleep disruption/disorder which causes people to

have the inability to fall asleep, or stay asleep at desired times. The condition can be short term(below 3 weeks) or long term (longer than 3 weeks); Long term insomnia can lead to depression, increased risk at heart disease, memory loss and many other problems. People with insomnia often don't feel refreshed when they wake up, they often feel fatigue throughout the day Causes and treatments: some factors include extreme stress, emotional disorders, traumatic life experiences, frequent traveling, certain medical conditions and changes in lifestyle and work hours. treatments include therapy can be used if the cause of insomnia is psychological, Training your sleep routine and schedule. Medication can also be used to treat insomnia. common drugs are benzodiazepines and hypnotics, but these drugs can easily be abused and should only be used short term.

Narcolepsy• Narcolepsy is a chronic neurological disorder that affects the part of

the brain that regulates sleep. Narcolepsy causes sudden sleep episodes and/or excessive daytime sleepiness; Cataplexy is one of the most common symptoms, it causes the individual to suddenly lose control of muscles, and it is normally triggered by strong emotions, for example laughing. Narcolepsy is very dangerous as it can put victims in very unsafe predicaments; sudden sleep or Cataplexy can happen when an individual is performing activities that require the patients full attention. Causes and treatments: Scientist do not exactly know what causes Narcolepsy, researchers have suggested that there is a genetic role in the disorder. There are no cures for narcolepsy yet, but there are many treatments to help with the symptoms of narcolepsy. Stimulants such as modafinil are used to promote alertness and wakefulness .Sodium oxybate (Xyrem) is used if a patient has severe cataplexy issues; Sodium oxybate is also known as GHB or the "date rape drug", but is safe if used responsibly to help promote sleeping which would help with day time sleepiness.

Is it a Sleeping Disorder?• Do you…• feel irritable or sleepy during the day? • have difficulty staying awake when sitting still,

watching television or reading? • fall asleep or feel very tired while driving? • have difficulty concentrating? • often get told by others that you look tired? • react slowly? • have trouble controlling your emotions? • feel like you have to take a nap almost every day? • require caffeinated beverages to keep yourself going?

What Causes Sleeping Disturbances?• Sleep problems can be cause by many different

factors• The body’s natural cycle of sleeping/waking is

disrupted or exaggerated• Physical disturbances (pain from ulcers)• Medical Issues (asthma)• Psychiatric disorders (depression, anxiety)• Environmental issues (alcohol use)

How to Prevent Sleep Disturbances?• Try to sleep/get up the same time everyday• Try not to take naps during the day• Exercise regularly, but not too close to your

bedtime (can make it hard to fall asleep)• Don’t eat heavy meals late in the day• If you are worrying about things, try to avoid

focusing on those• If you can’t fall asleep – get up/read/ or do

something not over stimulating until you feel sleepy

People who have studied the issue

Sleep Walking• A group of researchers from Stanford University, studied

sleep walking by doing a test. This was led by a researcher named Maurice Ohayon. They found out that sleepwalking is far more common in children than it is in adults. However, it was still pretty common in adults so the main study they wanted to do was to find out whether medical conditions provoked sleep walking or was it vice versa. These medical conditions include clinical depression, alcoholism, and obsessive-compulsive disorder.

• Another neurologist named Gayatri Devi did a cross-sectional study that assessed the prevalence of nocturnal walking. He found out that it is better to leave a person who is sleep walking alone as long as they are safe. Or, if possible guide them toward their bed but do not wake them.

Sleep Talking• A group of researchers from the Sleep Foundation

help people with their sleeping disturbances. One of them is sleep talking. They study this disturbance and have found out that it could be caused by many things such as medical conditions, sleep deprivation, or it could simply run in the family. When people sleep talk it is either about nothing in particular or it could relate to past experiences.

Sleep Apnea• A neurologist and sleep disorder specialist named

James Weintraub has studied sleep apnea. This is when you tend to snore loudly during the night, and have periods where you stop breathing. He figured out that sleep apnea can cause medical problems such as hypertension and it was most common in middle-aged men. However, even though this is a serious sleeping disorder, he found it could be successfully treated. Nasal CPAP (continuous positive air pressure) & medication such as tricyclic antidepressants are helpful.

Insomnia•  • Sleep insomnia is when you have problems with falling asleep or staying

asleep. A psychiatry professor at University of California at San Francisco did some research on sleep insomnia and her along with other researchers did an experiment about it. They took a large sample of veterans and came to the conclusion that veterans with sleep disorders were 30% more likely to suffer dementia than those without any disturbances. 

• Another researcher named Alan Douglass studied sleep insomnia and found that it is usually associated with depression, anxiety, or bipolar spectrum disorders. He has a clinic that treats insomnia. He does research about REM (rapid eye movement) sleep and creates tests that predict treatment response in patients that suffer this problem.

• There is also a group of psychiatrists that have studied sleep insomnia and have found out that it is treatable. There are medications for this, however they found out that the medications do not work for very long. A good way to get rid of sleep insomnia is to go through psychological treatments. These include cognitive therapy, stimulus control, sleep restriction, and progressive muscle relaxation.

Experiments/case studies that have been conducted

A Month With No Artificial Light: • A family decided to go the whole month of February without

using artificial lights (TV, electric lights, and computer) to see how these lights affect our sleeping patterns and schedule. They chose February because it was the month with the shortest days and longest nights. Within the first week of the experiment they noticed they were going to sleep much earlier from their usual which was midnight. They had random spouts of joy throughout the day and they began to dream more vividly and could remember them better. There day started earlier and felt well rested. The downside to this experiment was they were less productive as it was difficult to work at night without being able to see clearly. In conclusion artificial light disrupts our circadian rhythms, prevents the production of melatonin, increases the risk of certain cancers including breast cancer and prostate cancer, and can generally wreak havoc with our health.

Social Disturbances Case Study: • Two groups of six, one with patients diagnosed

with sleepwalking and other diagnosed with night terrors were to take three questionnaires; Eysench personality quiz, the hostility and direction quiz, and the Crown Crisp experimental index. The goal of this study was to find some personality and psychoneurotic characteristics of adults with sleep walking and night terrors. The results showed both groups scored high on the Crown Crisp quiz but the sleepwalkers scored higher on the Eysench personality quiz while the night terror group scored higher on the hostility and direction quiz. The conclusion was the physiological and psychological factors of the patients possibly reflected different scored the two groups had.

Prevalence of Issue

How common is sleep walking• Studies show that 1/3 adults at some point in their

life are affected with sleepwalking• General Population – 1%-15% • Some triggers – sleep deprivation, sedative

agents (alcohol), certain medications, febrile illnesses

• Common in adulthood, usually not associated with significant underlying psychiatric/psychological problems

How common is Insomnia• Affects people at any stage in life• Affects up to 10-15 out of 100 adults• More common in women and older people (usually

over 60)• About 20/100 children are affected• People who have emotional stress, history of

mental health disorders, work late night shifts, travel through different times zone are at a higher chance being affected

How common is Narcolepsy• National Institute of Neurological Disorders and

Stroke estimates 1/2000 people are affected• Some countries its lower (Israel) 1/500,000

affected• Some countries its higher (Japan) 1/600 people

affected • The American Sleep Association estimates 125,00

to 200,000 Americans are affected• Fewer than 50,000 are properly diagnosed

How common is Sleep Apnea• Obstructive Sleep Apnea:• 1/5 American adults have mild OSA (approx 40 million

people)• One-third of 40 million have moderate/severe sleep apnea• Men are 2-3 times more likely to have it• Its more common in women when they reach menopause• OSA is linked to body weight in many people• An overweight person is more likely to develop OSA• People can develop OSA at any age

• Central Sleep Apnea• Most commonly found in people with heart failure• 40%-60% people with heart failure have central sleep apnea

Scholarly Article

Medical Author: John Mersch, MD, FAAP Sleepwalking • Causes: Genetic factors; occur more in identical twins, 10 times

more likely to happen as a first-degree relative Environmental factors; Sleep deprivation, chaotic sleep schedules, fever, stress, alcohol intoxication Drugs; sedative/hypnotics (drugs that promote sleep), neuroleptics (drugs used to treat psychosis), small tranquilizers (drugs that produce a calming effect), stimulants (drugs that increase activity), and antihistamines (drugs used to treat symptoms of allergy) Physiologic factors; length and depth of slow wave sleep ( greater in young children), pregnancy and menstruation Medical conditions; Fever, Gastro esophageal reflux (food or liquid regurgitating from the stomach into the esophagus), Nighttime asthma , Obstructive sleep apnea (breathing stops temporarily while sleeping)

• Prevention; Limit stress, Avoid alcohol intake, Avoid sleep deprivation

Medical Author: Siamak N. Nabili, MD, MPH Insomnia • Causes include; Jet lag, Changes in shift work,

unpleasant noise, Uncomfortable room temperature (too hot or too cold), Stressful situations in life (studying for an exam, loss of a loved one, divorce), Withdrawal from drugs or alcohol, Uncontrolled physical symptoms (such as pain, fever, nasal congestion, cough, diarrhea)

• Prevention; relax, Control your environment, have a bedtime routine, Avoid large meals, avoid napping

Medical Author: Siamak N. Nabili, MD, MPH Sleep apnea• Sleep apnea is divided into two groups; primary

(no underlying cause) and secondary (consequence of another condition). Causes of central sleep apnea include: strokes, heart failure, certain medications, some congenital abnormalities, or high altitude.

• Prevention; may be limited, behavioral approaches such as weight loss, smoking cessation, regular exercise, avoidance of excessive alcohol intake and drug use, and proper sleep hygiene

References• http://sleepfoundation.org/sleep-disorders-problems/abnormal-sleep-

behaviors/sleepwalking

• http://www.helpguide.org/articles/sleep/sleep-disorders-and-sleeping-problems.htm

• http://www.webmd.com/sleep-disorders/sleep-disorders-causes • http://www.webmd.com/sleep-disorders/preventing-sleep-problems • http://www.webmd.com/sleep-disorders/how-common-is-insomnia • http://en.wikipedia.org/wiki/Insomnia • http://

answers.webmd.com/answers/1176108/how-common-is-narcolepsy • http://www.apneos.com/whogets.html • http://www.emedicinehealth.com/sleepwalking/page2_em.htm• http://www.emedicinehealth.com/insomnia/page2_em.htm#insomnia

_causes

• http://www.emedicinehealth.com/obstructive_and_central_sleep_apnea/page2_em.htm#sleep_apnea_causes

• http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1662124/ • http://jdmoyer.com/2010/03/04/sleep-experiment-a-month-with-no-a

rtificial-light/

References• http://www.helpguide.org

http://www.healthline.com/health/insomnia http://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea/

• http://sleepfoundation.org/sleep-disorders-problems/sleep-apnea http://sleepfoundation.org/sleep-disorders-problems/abnormal-sleep-behaviors/sleepwalking http://www.helpguide.org/articles/sleep/narcolepsy.htm

• http://www.smithsonianmag.com/science-nature/the-science-of-sleepwalking-97626685/

• http://sleepfoundation.org/sleep-disorders-problems/sleep-talking

• http://www.headache-help.org/sleep-disorders-and-headache

• http://www.washingtonpost.com/national/health-science/sleep-disorders-may-raise-risk-of-alzheimers-new-research-shows/2014/07/13/acce3d9e-0a09-11e4-a0dd-f2b22a257353_story.html

• http://www.imhr.ca/research/sleep-disorders-e.cfm• http://www.rcpsych.ac.uk/mentalhealthinfoforall/proble

ms/sleepproblems/sleepingwell.aspx