Sleep Problems? Rest Easy


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It is estimated that one in every 15 Americans is afflicted with sleep apnea. This disorder, characterized by pauses in breathing during sleep, is bad enough in and of itself, but its effects can be debilitating on a patient’s waking life as well. Between daytime sleepiness, lack of motivation, fatigue and depression, among other life-disrupting symptoms, sleep apnea is more than a sleep disorder—it’s a life disorder. Join Samir Patel, MD, and Sheila Leggett, RRT, RPSGT, Sleep Disorders Center Manager, as they discuss this debilitating condition and how you can treat it and other sleep problems so you can rest easy.

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Sleep Problems? Rest Easy

  1. 1. Sleep Problems? Rest Easy Samir Patel MD Sleep Disorders Center at Springfield Clinic
  2. 2. Sleep
  3. 3. Why do you need sleep ? <ul><li>Restorative features of sleep lend to the hypothesis of the body needing inactive time to cleanse and reinvigorate itself. </li></ul><ul><li>Although we know the body is not completely switched off during sleep </li></ul>
  4. 4. Sleep is Active
  5. 5. Function of Sleep <ul><li>Memory restoration </li></ul><ul><li>Body reparation </li></ul><ul><li>Immune system function </li></ul><ul><li>Sleep Deprivation leads to poor concentration, poor mood and decreased performance </li></ul><ul><li>Complete lack of sleep leads to death within a few days </li></ul>
  6. 6. Sleep Mechanism <ul><li>Sleep is controlled by stopping waking mechanism of the brain and starting the sleep centers of the brain </li></ul><ul><li>Sleep is also observed to have different stages: Rapid Eye Movement Sleep Non-Rapid Eye Movement Sleep </li></ul>
  7. 7. Awake Brain Centers
  8. 8. Sleep Brain Centers
  9. 9. Sleep Stages
  10. 10. Sleep Mechanism
  11. 11. NREM Sleep
  12. 12. Cycles Of Sleep Stages In a Night
  13. 13. Sleep Disorders <ul><li>Two main symptoms: </li></ul><ul><li>1) Always Sleepy 2) Cannot Sleep </li></ul><ul><li>Sleepiness can present in many ways fatigue, poor memory, agitated, grumpy, and even hyperactive. </li></ul>
  14. 14. Sleep Disorders <ul><li>Multitude Sleep disorder diagnosis, at this time over 200 described conditions </li></ul><ul><li>At some point in time most people will suffer from some sleep problem </li></ul><ul><li>Over 20% of the general population will suffer from a chronic sleep problem </li></ul><ul><li>Development of Sleep medicine and Professionals to treat Sleep Disorders </li></ul>
  15. 15. Sleep Disorders <ul><li>Commonest Sleep problems </li></ul><ul><li>Sleep Deprivation </li></ul><ul><li>Insomnia </li></ul><ul><li>Restless Legs Syndrome </li></ul><ul><li>Obstructive Sleep Apnea </li></ul>
  16. 16. Sleep Deprivation <ul><li>How much Sleep? </li></ul><ul><li>On average most persons need 8 hours of sleep, but most are only getting 6.5 hours </li></ul><ul><li>Every persons needs are variable </li></ul><ul><li>The right amount is that which allows a person fully alert and energetic throughout the day </li></ul>
  17. 17. Sleep Deprivation <ul><li>Consequences of Sleep deprivation </li></ul><ul><li>Poor mood and depression </li></ul><ul><li>Decreased work performance </li></ul><ul><li>Motor vehicle accidents </li></ul><ul><li>Cardiovascular problems </li></ul><ul><li>Decreased immunity </li></ul><ul><li>Decreased fertility </li></ul><ul><li>Acid Reflux </li></ul>
  18. 18. Insomnia <ul><li>Most people have suffered insomnia, 10% of the population suffer from chronic insomnia </li></ul><ul><li>Commonest reason is related poor sleep hygiene </li></ul><ul><li>Chronic insomniacs typically are people that are unable to turn off their minds and are hyperaroused </li></ul>
  19. 19. Insomnia <ul><li>Better sleep habits: </li></ul><ul><li>Regular sleep routine </li></ul><ul><li>Reduce caffeine use </li></ul><ul><li>No exercise within 2 hours of sleep </li></ul><ul><li>Bedroom only for sleep , no TV/internet </li></ul><ul><li>Dark bedroom </li></ul><ul><li>Good temperature/humidity </li></ul><ul><li>Bed partner snorer, leg kicker </li></ul>
  20. 20. Insomnia <ul><li>Behavioral therapy </li></ul><ul><li>Sleep restriction </li></ul><ul><li>Clock watching </li></ul><ul><li>Come out of bedroom until sleepy </li></ul><ul><li>Wind down time </li></ul><ul><li>Review medications </li></ul><ul><li>Sedatives ? </li></ul><ul><li>May be secondary to other sleep problems or medical problems </li></ul>
  21. 21. Restless Legs Syndrome <ul><li>Disturbed sensations in legs </li></ul><ul><li>Leg movements whilst asleep </li></ul><ul><li>Need to move legs and rub legs to reduce symptoms </li></ul><ul><li>Typically occurs in the evening and night </li></ul><ul><li>May involve arms as well </li></ul><ul><li>Stops persons from falling asleep or reduces quality of sleep </li></ul>
  22. 22. Restless Legs Syndrome
  23. 23. Restless Legs Syndrome <ul><li>Treated with medications </li></ul><ul><li>May be secondary to medications </li></ul><ul><li>Associated with low iron stores in body </li></ul>
  24. 24. Restless Legs Syndrome
  25. 25. Obstructive Sleep Apnea Information Sourced from Sleep Multimedia,
  26. 26. Obstructive Sleep Apnea <ul><li>Excessive Daytime Sleepiness </li></ul><ul><li>Snoring </li></ul><ul><li>Witnessed Apneas </li></ul><ul><li>Morning Headaches </li></ul><ul><li>Dry mouth at night or on awakening </li></ul><ul><li>Wake up choking/snorting </li></ul>
  27. 27. Obstructive Sleep Apnea Information Sourced from Sleep Apnea Foundation.
  28. 28. Obstructive Sleep Apnea <ul><li>Reasons to treat </li></ul><ul><li>1) Better sleep for patient and bed partner decreases daytime sleepiness </li></ul><ul><li>2) Reduce Cardiovascular Risks associated with sleep apnea </li></ul><ul><li>Diagnosis requires sleep testing called Polysomnography </li></ul>
  29. 29. Polysomnography <ul><li>Sleep study , obtaining information from brain, chest , abdomen, legs, heart, nose and mouth. </li></ul><ul><li>Performed ideally during regular time of persons sleep in laboratory environment </li></ul><ul><li>Study is interpreted/scored in episodes of 30 seconds. </li></ul>
  30. 30. Polysomnogram
  31. 31. Polysomnogram
  32. 32. Polysomnogram
  33. 33. Obstructive Sleep Apnea
  34. 34. Obstructive Sleep Apnea <ul><li>Treatment options: 1) Weight loss </li></ul><ul><li>2) CPAP </li></ul><ul><li>3) Positional therapy </li></ul><ul><li>4) Oral appliance </li></ul><ul><li>5) Tracheotomy </li></ul>
  35. 35. CPAP
  36. 36. Sleep Evaluation <ul><li>Referral by primary physician to sleep specialist </li></ul><ul><li>History and physical exam to understand problem </li></ul><ul><li>Need for further testing or treatment </li></ul><ul><li>Testing may include sleep diaries, blood tests or polysomnogram </li></ul><ul><li>Treatments include medications, behavioral, CPAP </li></ul>
  37. 37. Treatment <ul><li>Follow up with sleep clinic after testing and treatment initiation </li></ul><ul><li>Ongoing trips back to sleep clinic to monitor condition and treatment. </li></ul><ul><li>May need further testing over time or change in patients condition </li></ul>
  38. 38. Conclusion <ul><li>Good sleep is essential for good health and mood </li></ul><ul><li>Sleep is affected by many different factors ( psychological, medical and social) </li></ul><ul><li>Long standing sleep problems demand further investigation </li></ul>
  39. 39. Good Night
  40. 40. How Do You Sleep ?