L'importanza del sonno

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M Sleep & Chronophysiology Laboratory The Importance of Sleep and Sleep Hygiene: Practical Clues for the College Student Roseanne Armitage, Ph.D. Professor Director - Sleep and Chronophysiology Laboratory University of Michigan

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  • 1.The Importance of Sleep and Sleep Hygiene: Practical Clues for the College Student Roseanne Armitage, Ph.D . Professor Director -Sleep and Chronophysiology Laboratory University of Michigan M Sleep &ChronophysiologyLaboratory

2. Functions of Sleep SWS basic sleep drive rest, recovery & homeostasis Body& blood cell work, immune system,Keep circadian rhythms entrained Stage 2 maintain vigilance while sleeping REM - Memory consolidation,development of neural connectionsin childhood M Sleep &ChronophysiologyLaboratory 3. 4. POWER SPECTRA % ZERO-CROSS % FIRST DERIVATIVE POWER *FREQUENCY BAND WIDTHS DIFFER BETWEEN LABORATORIES AMPS A/D CONVERSION BOARD RESIDENT IN COMPUTER SAMPLING RATE 128-1000Hz BETA 12-32 Hz* SIGMA 12-16 Hz ALPHA8-12 Hz THETA 4-8 Hz DELTA 0.5-4 Hz PSA or PAA RAW DATA STORAGE DIGITIZED VALUES OFF-LINE VISUAL SLEEP-STAGE SCORING 5. REM 6. Stage 4 7. A wake Move REM Stg 1 Stg 2 Stg 3 Stg 4 SLEEP EFFICIENCY:96.8% REM LATENCY:94.5 min SLEEP LATENCY:7.0 min %REM:13.3 % STAGE 1:7.5 % STAGE 2:57.0 % STAGE 3:16.9 % STAGE 4:3.5 SOS:23:54:00 TIME OF NIGHT WUT:08:51:30 HEALTHY NORMAL CONTROL 8. How much sleep do you need?

  • Not everyone needs the same amount of sleep Natural short and long sleepers
  • BUTsleeping less than 6.5 or more than 9 hours is associated with 1.7 x greater mortality & risk of disease.

M Sleep &ChronophysiologyLaboratory 9. Is it Enough Sleep?

  • More than 40 % of adults have sleep complaints
    • 25 % women & 16 % men
      • # 1 Complaint: Feeling unrested
      • # 2 Complaint: Difficulty Falling Asleep
      • Among college students 71 % had sleep complaints in 2000 compared to 24 % in 1978

M Sleep &ChronophysiologyLaboratory 10. How Has Sleep Changed Historically?

  • Estimated 8-9 hrs in early 20 thCentury
  • 7-8 hrs mid 1980s-2002
  • College Students:
      • 1980s reported 7-7.5 hrs
      • 2002reported 6-6.9 hrs
    • Going to bed later is the culprit
      • Bedtime is 1-2 hrs later
      • than it was 25 yrs ago

M Sleep &ChronophysiologyLaboratory 11. Napping

  • 30-50 % of students nap
      • Nappers have delayed bedtime of >1 hr
      • 30 % naps>1.7 hrs
      • Mostly late afternoon naps
      • Sleep >1 hr less than non nappers

M Sleep &ChronophysiologyLaboratory 12. Consequences of Sleep Loss

  • Poor academic performance correlated with insomnia & poor sleep quality
  • Automobile Accidents: Fatigue is a leading cause
  • Minor medical Illness: Cold & Flu rates higher in poor sleepers
  • Circadian dysregulation: Creating Jet Lag in the home environment
  • Psychiatric Illness:
  • Depression & Anxiety

M Sleep &ChronophysiologyLaboratory 13. Sleep & Depression

  • Sleep disturbance > 2 wks is a risk factor for the development of depression
  • Sleep abnormalities are common symptoms of depression:>80% pts
  • Often the presenting symptom: Common to notice the sleep problem first

M Sleep &ChronophysiologyLaboratory 14. Sleep & Depression

  • Worseclinical outcome and increased risk of relapse in recovering patient
  • Increased risk of suicide
  • Daytime fatigue/ reduced functioning
  • Worry about insomnia may cause
  • further insomnia and anxiety

If sleep problems persist into clinical remission: M Sleep &ChronophysiologyLaboratory 15. Depression in College Students

  • Incidence is 2 x greater than general population
    • Approximately 20 % of students
  • Often goes undiagnosed and untreated
    • Increasing risk of another episode

M Sleep &ChronophysiologyLaboratory 16. Sleep and Depression in College Students

  • Worsening of depression and sleep problems at exam time (particularly in males)
  • Minor medical problems 2-4 x more prevalent in depressed students with sleep problems >2 wks duration
  • Attending University does increase
  • both incidence of sleep problems
  • & depression

M Sleep &ChronophysiologyLaboratory 17. A wake Move REM Stg 1 Stg 2 Stg 3 Stg 4 SLEEP EFFICIENCY:79.2% REM LATENCY:49.0 min SLEEP LATENCY:6.0 min %REM:16.9 % STAGE 1:17.0 % STAGE 2:46.0 % STAGE 3:0.0 % STAGE 4:0.0 SOS:01:04:00 TIME OF NIGHT WUT:08:51:30 DEPRESSED PATIENT 18. Sleep & Biological Rhythms

  • Ultradian 24 hrs
      • Lunar cycle
      • Menstrual cycle

M Sleep &ChronophysiologyLaboratory 19. Circadian Rhythms

  • 24 hr rhythms in biology, physiology, mood & performance that are entrained to the light dark cycle
  • Controlled by the SCN in the hypothalamus
  • Light is the most potent zeitgeber
  • Sleep, Cardiovascular Activity, Body Temperature,Hormones, Endocrine & Metabolic Function,
  • Liver & Kidney Function,
  • Gastrointestinal Activity,Immunology

M Sleep &ChronophysiologyLaboratory 20. HIGH COHERENCE LOW COHERENCE 100 100 0 0 EPOCHS EPOCHS % Time-In-Frequency % Time-In-Frequency C3 C4 .99 .43 100 200 300 400 500 600 700 800 900 100 200 300 400 500 600 700 800 900 21. Coherence in Girls at High-Risk HIGH RISK NC CUTPOINT= .70 >50 % of girls with extreme low values had 1st episode 3-5 yrs later M Sleep &ChronophysiologyLaboratory 22. How Do We Improve Sleep & Depression In College Students?

  • Education about Sleep
  • Education about Depression
  • Clearly identify Biological & Familial Risks
  • Early Intervention
  • Development of Easy,
  • Practical Guidelines for
  • Good Sleep Hygiene

M Sleep &ChronophysiologyLaboratory 23. Good Sleep & Biological Rhythm Hygiene

  • Maintain regular rise &bed times every night including weekends i.e. 11:00 P.M.-6:00 A.M.ESPECIALLY FOR WOMEN
  • Very hot bath (~15 min. Duration) 1 1/2 hour before bedtimeESPECIALLY FOR SWS PROBLEMS
  • Turn down thermostat,no electric blankets Use very dark curtains or use a sleep mask
  • No napping especially in afternoon
  • or evening

M Sleep &ChronophysiologyLaboratory 24.

  • Restrict caffeine (not just coffee)1-2 cups before 10
  • a.m.
  • Warm milk 1/2 hour before bedtime
  • No food or exercise within 2 hrs of bedtime
  • Avoid time zone changes

Good Sleep & Biological Rhythm Hygiene M Sleep &ChronophysiologyLaboratory 25. Schedule for Light Exposure

  • Early morning bright light will advance the circadian clocki.emake you sleepy earlier
  • Late afternoon bright light will delay your body clocki.emake you sleepy later
  • Wear dark glasses to minimize light to retina if your body clock is already shifted
  • Avoid bright light at night, use
  • incandescent light with the
  • lowest wattage possible.

M Sleep &ChronophysiologyLaboratory 26. 27. M Sleep &Chronophysiology Laboratory