Sleep Problems? Rest Easy

Sleep Problems? Rest Easy Samir Patel MD Sleep Disorders Center at Springfield Clinic

Why do you need sleep ?
Restorative features of sleep lend to the hypothesis of the body needing inactive time to cleanse and reinvigorate itself.
Although we know the body is not completely switched off during sleep

Sleep is Active

Function of Sleep
Memory restoration
Body reparation
Immune system function
Sleep Deprivation leads to poor concentration, poor mood and decreased performance
Complete lack of sleep leads to death within a few days

Sleep Mechanism
Sleep is controlled by stopping waking mechanism of the brain and starting the sleep centers of the brain
Sleep is also observed to have different stages: Rapid Eye Movement Sleep Non-Rapid Eye Movement Sleep

Awake Brain Centers

Sleep Brain Centers

Sleep Stages

Sleep Mechanism

NREM Sleep

Cycles Of Sleep Stages In a Night

Sleep Disorders
Two main symptoms:
1) Always Sleepy 2) Cannot Sleep
Sleepiness can present in many ways fatigue, poor memory, agitated, grumpy, and even hyperactive.

Sleep Disorders
Multitude Sleep disorder diagnosis, at this time over 200 described conditions
At some point in time most people will suffer from some sleep problem
Over 20% of the general population will suffer from a chronic sleep problem
Development of Sleep medicine and Professionals to treat Sleep Disorders

Sleep Disorders
Commonest Sleep problems
Sleep Deprivation
Insomnia
Restless Legs Syndrome
Obstructive Sleep Apnea

Sleep Deprivation
How much Sleep?
On average most persons need 8 hours of sleep, but most are only getting 6.5 hours
Every persons needs are variable
The right amount is that which allows a person fully alert and energetic throughout the day

Sleep Deprivation
Consequences of Sleep deprivation
Poor mood and depression
Decreased work performance
Motor vehicle accidents
Cardiovascular problems
Decreased immunity
Decreased fertility
Acid Reflux

Insomnia
Most people have suffered insomnia, 10% of the population suffer from chronic insomnia
Commonest reason is related poor sleep hygiene
Chronic insomniacs typically are people that are unable to turn off their minds and are hyperaroused

Insomnia
Better sleep habits:
Regular sleep routine
Reduce caffeine use
No exercise within 2 hours of sleep
Bedroom only for sleep , no TV/internet
Dark bedroom
Good temperature/humidity
Bed partner snorer, leg kicker

Insomnia
Behavioral therapy
Sleep restriction
Clock watching
Come out of bedroom until sleepy
Wind down time
Review medications
Sedatives ?
May be secondary to other sleep problems or medical problems

Disturbed sensations in legs
Leg movements whilst asleep
Need to move legs and rub legs to reduce symptoms
Typically occurs in the evening and night
May involve arms as well
Stops persons from falling asleep or reduces quality of sleep

Treated with medications
May be secondary to medications
Associated with low iron stores in body

Obstructive Sleep Apnea Information Sourced from Sleep Multimedia, www.sleepmultimedia.com

Excessive Daytime Sleepiness
Snoring
Witnessed Apneas
Morning Headaches
Dry mouth at night or on awakening
Wake up choking/snorting

Obstructive Sleep Apnea Information Sourced from Sleep Apnea Foundation.

Reasons to treat
1) Better sleep for patient and bed partner decreases daytime sleepiness
2) Reduce Cardiovascular Risks associated with sleep apnea
Diagnosis requires sleep testing called Polysomnography

Polysomnography
Sleep study , obtaining information from brain, chest , abdomen, legs, heart, nose and mouth.
Performed ideally during regular time of persons sleep in laboratory environment
Study is interpreted/scored in episodes of 30 seconds.

Polysomnogram

Treatment options: 1) Weight loss
2) CPAP
3) Positional therapy
4) Oral appliance
5) Tracheotomy

Sleep Evaluation
Referral by primary physician to sleep specialist
History and physical exam to understand problem
Need for further testing or treatment
Testing may include sleep diaries, blood tests or polysomnogram
Treatments include medications, behavioral, CPAP

Treatment
Follow up with sleep clinic after testing and treatment initiation
Ongoing trips back to sleep clinic to monitor condition and treatment.
May need further testing over time or change in patients condition

Conclusion
Good sleep is essential for good health and mood
Sleep is affected by many different factors ( psychological, medical and social)
Long standing sleep problems demand further investigation

Good Night

How Do You Sleep ?

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Sleep Problems? Rest Easy

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