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L'importanza del sonno
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L'importanza del sonno

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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 & Chronophysiology Laboratory
  • 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 connections in childhood M Sleep & Chronophysiology Laboratory
  • 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 ALPHA 8-12 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
    • BUT sleeping less than 6.5 or more than 9 hours is associated with 1.7 x greater mortality & risk of disease.
    M Sleep & Chronophysiology Laboratory
  • 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 & Chronophysiology Laboratory
  • 10. How Has Sleep Changed Historically?
    • Estimated 8-9 hrs in early 20 th Century
    • 7-8 hrs mid 1980s-2002
    • College Students:
        • 1980s reported 7-7.5 hrs
        • 2002 reported 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 & Chronophysiology Laboratory
  • 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 & Chronophysiology Laboratory
  • 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 & Chronophysiology Laboratory
  • 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 & Chronophysiology Laboratory
  • 14. Sleep & Depression
    • Worse clinical 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 & Chronophysiology Laboratory
  • 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 & Chronophysiology Laboratory
  • 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 & Chronophysiology Laboratory
  • 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
        • Most common 90 min REM/NREM sleep cycle
        • Task Performance
    • Infradian >24 hrs
        • Lunar cycle
        • Menstrual cycle
    M Sleep & Chronophysiology Laboratory
  • 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 & Chronophysiology Laboratory
  • 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 & Chronophysiology Laboratory
  • 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 & Chronophysiology Laboratory
  • 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 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
    M Sleep & Chronophysiology Laboratory
  • 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 & Chronophysiology Laboratory
  • 25. Schedule for Light Exposure
    • Early 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.
    M Sleep & Chronophysiology Laboratory
  • 26.  
  • 27. M Sleep & Chronophysiology Laboratory