M M Sleep & Chronophysiology Laboratory The Importance of Sleep and Sleep Hygiene: Practical...

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  • The Importance of Sleep and Sleep Hygiene: Practical Clues for the College StudentRoseanne Armitage, Ph.D.

    ProfessorDirector - Sleep and Chronophysiology LaboratoryUniversity of Michigan

  • Functions of SleepSWS basic sleep drive rest, recovery & homeostasisBody& blood cell work, immune system, Keep circadian rhythms entrained

    Stage 2 maintain vigilance while sleeping

    REM- Memory consolidation, development of neural connections in childhood


  • REM

  • Stage 4

  • AwakeMoveREMStg 1Stg 2Stg 3Stg 4

    SLEEP EFFICIENCY: 96.8%REM LATENCY: 94.5 minSLEEP LATENCY: 7.0 min% REM: 13.3% STAGE 1: 7.5% STAGE 2: 57.0% STAGE 3: 16.9% STAGE 4: 3.5SOS: 23:54:00TIME OF NIGHTWUT: 08:51:30HEALTHY NORMAL CONTROL

  • How much sleep do you need?Not everyone needs the same amount of sleep Natural short and long sleepers

    BUT sleeping less than 6.5 or more than 9 hours is associated with 1.7 x greater mortality & risk of disease.

  • Is it Enough Sleep?More than 40 % of adults have sleep complaints25 % 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

  • How Has Sleep Changed Historically? Estimated 8-9 hrs in early 20th Century 7-8 hrs mid 1980s-2002College Students:1980s reported 7-7.5 hrs2002 reported 6-6.9 hrsGoing to bed later is the culpritBedtime is 1-2 hrs later than it was 25 yrs ago

  • Napping30-50 % of students napNappers have delayed bedtime of >1 hr30 % naps >1.7 hrsMostly late afternoon napsSleep >1 hr less than non nappers

  • Consequences of Sleep LossPoor academic performance correlated with insomnia & poor sleep qualityAutomobile Accidents: Fatigue is a leading cause Minor medical Illness: Cold & Flu rates higher in poor sleepersCircadian dysregulation: Creating Jet Lag in the home environment

    Psychiatric Illness: Depression & Anxiety

  • Sleep & DepressionSleep 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

  • Sleep & Depression

    Worse clinical outcome and increased risk of relapse in recovering patientIncreased risk of suicideDaytime fatigue/ reduced functioningWorry about insomnia may cause further insomnia and anxiety

    If sleep problems persist into clinical remission:

  • Depression in College StudentsIncidence is 2 x greater than general populationApproximately 20 % of students

    Often goes undiagnosed and untreatedIncreasing risk of another episode

  • Sleep and Depression in College StudentsWorsening 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 durationAttending University does increase both incidence of sleep problems & depression

  • AwakeMoveREMStg 1Stg 2Stg 3Stg 4

    SLEEP EFFICIENCY: 79.2%REM LATENCY: 49.0 minSLEEP LATENCY: 6.0 min% REM: 16.9% STAGE 1: 17.0% STAGE 2: 46.0% STAGE 3: 0.0% STAGE 4: 0.0SOS: 01:04:00TIME OF NIGHTWUT: 08:51:30 DEPRESSED PATIENT

  • Sleep & Biological RhythmsUltradian 24 hrs Lunar cycleMenstrual cycle

  • Circadian Rhythms24 hr rhythms in biology, physiology, mood & performance that are entrained to the light dark cycleControlled by the SCN in the hypothalamusLight is the most potent zeitgeber

    Sleep, Cardiovascular Activity, Body Temperature, Hormones, Endocrine & Metabolic Function, Liver & Kidney Function, Gastrointestinal Activity, Immunology

  • HIGH COHERENCELOW COHERENCE10010000EPOCHSEPOCHS% Time-In-Frequency% Time-In-FrequencyC3C4.99.43

  • Coherence in Girls at High-RiskHIGH RISKNCCUTPOINT= .70>50 % of girls with extreme low values had 1st episode 3-5 yrs later

  • How Do We Improve Sleep & Depression In College Students?Education about Sleep Education about DepressionClearly identify Biological & Familial Risks Early InterventionDevelopment of Easy, Practical Guidelines for Good Sleep Hygiene

  • 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 bedtime ESPECIALLY 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

  • 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 changesGood Sleep & Biological Rhythm Hygiene

  • Schedule for Light ExposureEarly morning bright light will advance the circadian clock i.e make you sleepy earlier

    Late afternoon bright light will delay your body clock i.e make 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.

  • MSleep & Chronophysiology Laboratory