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L'importanza del sonno

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L'importanza del sonno

  1. 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. 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
  4. 5. REM
  5. 6. Stage 4
  6. 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
  7. 8. How much sleep do you need? <ul><li>Not everyone needs the same amount of sleep Natural short and long sleepers </li></ul><ul><li>BUT sleeping less than 6.5 or more than 9 hours is associated with 1.7 x greater mortality & risk of disease. </li></ul>M Sleep & Chronophysiology Laboratory
  8. 9. Is it Enough Sleep? <ul><li>More than 40 % of adults have sleep complaints </li></ul><ul><ul><li>25 % women & 16 % men </li></ul></ul><ul><ul><ul><li># 1 Complaint: Feeling unrested </li></ul></ul></ul><ul><ul><ul><li># 2 Complaint: Difficulty Falling Asleep </li></ul></ul></ul><ul><ul><ul><li>Among college students 71 % had sleep complaints in 2000 compared to 24 % in 1978 </li></ul></ul></ul>M Sleep & Chronophysiology Laboratory
  9. 10. How Has Sleep Changed Historically? <ul><li>Estimated 8-9 hrs in early 20 th Century </li></ul><ul><li>7-8 hrs mid 1980s-2002 </li></ul><ul><li>College Students: </li></ul><ul><ul><ul><li>1980s reported 7-7.5 hrs </li></ul></ul></ul><ul><ul><ul><li>2002 reported 6-6.9 hrs </li></ul></ul></ul><ul><ul><li>Going to bed later is the culprit </li></ul></ul><ul><ul><ul><li>Bedtime is 1-2 hrs later </li></ul></ul></ul><ul><ul><ul><li>than it was 25 yrs ago </li></ul></ul></ul>M Sleep & Chronophysiology Laboratory
  10. 11. Napping <ul><li>30-50 % of students nap </li></ul><ul><ul><ul><li>Nappers have delayed bedtime of >1 hr </li></ul></ul></ul><ul><ul><ul><li>30 % naps >1.7 hrs </li></ul></ul></ul><ul><ul><ul><li>Mostly late afternoon naps </li></ul></ul></ul><ul><ul><ul><li>Sleep >1 hr less than non nappers </li></ul></ul></ul>M Sleep & Chronophysiology Laboratory
  11. 12. Consequences of Sleep Loss <ul><li>Poor academic performance correlated with insomnia & poor sleep quality </li></ul><ul><li>Automobile Accidents: Fatigue is a leading cause </li></ul><ul><li>Minor medical Illness: Cold & Flu rates higher in poor sleepers </li></ul><ul><li>Circadian dysregulation: Creating Jet Lag in the home environment </li></ul><ul><li>Psychiatric Illness: </li></ul><ul><li>Depression & Anxiety </li></ul>M Sleep & Chronophysiology Laboratory
  12. 13. Sleep & Depression <ul><li>Sleep disturbance > 2 wks is a risk factor for the development of depression </li></ul><ul><li>Sleep abnormalities are common symptoms of depression: >80% pts </li></ul><ul><li>Often the presenting symptom: Common to notice the sleep problem first </li></ul>M Sleep & Chronophysiology Laboratory
  13. 14. Sleep & Depression <ul><li>Worse clinical outcome and increased risk of relapse in recovering patient </li></ul><ul><li>Increased risk of suicide </li></ul><ul><li>Daytime fatigue/ reduced functioning </li></ul><ul><li>Worry about insomnia may cause </li></ul><ul><li>further insomnia and anxiety </li></ul>If sleep problems persist into clinical remission: M Sleep & Chronophysiology Laboratory
  14. 15. Depression in College Students <ul><li>Incidence is 2 x greater than general population </li></ul><ul><ul><li>Approximately 20 % of students </li></ul></ul><ul><li>Often goes undiagnosed and untreated </li></ul><ul><ul><li>Increasing risk of another episode </li></ul></ul>M Sleep & Chronophysiology Laboratory
  15. 16. Sleep and Depression in College Students <ul><li>Worsening of depression and sleep problems at exam time (particularly in males) </li></ul><ul><li>Minor medical problems 2-4 x more prevalent in depressed students with sleep problems >2 wks duration </li></ul><ul><li>Attending University does increase </li></ul><ul><li>both incidence of sleep problems </li></ul><ul><li>& depression </li></ul>M Sleep & Chronophysiology Laboratory
  16. 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
  17. 18. Sleep & Biological Rhythms <ul><li>Ultradian <24 hrs </li></ul><ul><ul><ul><li>Most common 90 min REM/NREM sleep cycle </li></ul></ul></ul><ul><ul><ul><li>Task Performance </li></ul></ul></ul><ul><li>Infradian >24 hrs </li></ul><ul><ul><ul><li>Lunar cycle </li></ul></ul></ul><ul><ul><ul><li>Menstrual cycle </li></ul></ul></ul>M Sleep & Chronophysiology Laboratory
  18. 19. Circadian Rhythms <ul><li>24 hr rhythms in biology, physiology, mood & performance that are entrained to the light dark cycle </li></ul><ul><li>Controlled by the SCN in the hypothalamus </li></ul><ul><li>Light is the most potent zeitgeber </li></ul><ul><li>Sleep, Cardiovascular Activity, Body Temperature, Hormones, Endocrine & Metabolic Function, </li></ul><ul><li>Liver & Kidney Function, </li></ul><ul><li>Gastrointestinal Activity, Immunology </li></ul>M Sleep & Chronophysiology Laboratory
  19. 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
  20. 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
  21. 22. How Do We Improve Sleep & Depression In College Students? <ul><li>Education about Sleep </li></ul><ul><li>Education about Depression </li></ul><ul><li>Clearly identify Biological & Familial Risks </li></ul><ul><li>Early Intervention </li></ul><ul><li>Development of Easy, </li></ul><ul><li>Practical Guidelines for </li></ul><ul><li>Good Sleep Hygiene </li></ul>M Sleep & Chronophysiology Laboratory
  22. 23. Good Sleep & Biological Rhythm Hygiene <ul><li>Maintain regular rise & bed times every night including weekends i.e. 11:00 P.M.-6:00 A.M. ESPECIALLY FOR WOMEN </li></ul><ul><li>Very hot bath (~15 min. Duration) 1 1/2 hour before bedtime ESPECIALLY FOR SWS PROBLEMS </li></ul><ul><li>Turn down thermostat, no electric blankets Use very dark curtains or use a sleep mask </li></ul><ul><li>No napping especially in afternoon </li></ul><ul><li>or evening </li></ul>M Sleep & Chronophysiology Laboratory
  23. 24. <ul><li>Restrict caffeine (not just coffee) 1-2 cups before 10 </li></ul><ul><li>a.m. </li></ul><ul><li>Warm milk 1/2 hour before bedtime </li></ul><ul><li>No food or exercise within 2 hrs of bedtime </li></ul><ul><li>Avoid time zone changes </li></ul>Good Sleep & Biological Rhythm Hygiene M Sleep & Chronophysiology Laboratory
  24. 25. Schedule for Light Exposure <ul><li>Early morning bright light will advance the circadian clock i.e make you sleepy earlier </li></ul><ul><li>Late afternoon bright light will delay your body clock i.e make you sleepy later </li></ul><ul><li>Wear dark glasses to minimize light to retina if your body clock is already shifted </li></ul><ul><li>Avoid bright light at night, use </li></ul><ul><li>incandescent light with the </li></ul><ul><li>lowest wattage possible. </li></ul>M Sleep & Chronophysiology Laboratory
  25. 27. M Sleep & Chronophysiology Laboratory

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