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