7. Normal Changes in
SLEEP ARCHITECTURE AS WE AGE
Delayed SLEEP ONSET
Increased WAKEFULNESS after sleep onset
Perception of LIGHTER SLEEP
Decreased SLEEP EFFICIENCY
Increased STAGE I SLEEP
Decreased SLOW WAVE SLEEP
Increased FRAGMENTATION of SLEEP
7
8. History of Sleep in America
THE AVERAGE ADULT NEEDS 8 HOURS
OF SLEEP FOR OPTIMUM HEALTH
IN 1919, THE AVERAGE AMERICAN SLEPT 9 HOURS
TODAY, WE ARE SLEEPING ON AVERAGE
LESS THAN 7 HOURS
MILLIONS TRY TO GET BY ON 4.5-5 HOURS
OF SLEEP PER NIGHT
UNFORTUNATELY,
THERE ARE SERIOUS HEALTH CONSEQUENCES
TO SLEEP DEPRIVATION!8
9. GREAT 5 Minute
YouTube Video
Explaining these Serious
Health Consequences -
https://www.youtube.com/w
atch?v=pbJxLITdt_E&feature
=player_detailpage
9
10. POOR SLEEP HYGIENE
SERIOUS MEDICAL CONSEQUENCES
ACCLERATED AGING
•Increased risk for PREMATURE ATRIAL &
VENTRICULAR CONTRACTIONS
•Increased risk for A FIB, TIA (mini-
strokes) & CVA, and MI
•Compromised IMMUNE FUNCTION
•Hightened APPETITE – Increased Ghrelin
•ENDOCRINE DYSFUNCTION
oIncreased Cortisol
oDecreased Insulin, Growth
Hormone & Thyroid Function10
13. HEALTHY HABITS of
CENTENARIANS
Don’t Smoke
Minimize Alcohol Consumption
MAINTAIN A STABLE,
HEALTHY WEIGHT
Eat Fewer Calories
Increase Fruit & Vegetable
Intake
Exercise Regularly
SLEEP WELL
Challenge Your Mind
Maintain a Positive Attitude
Learn to Manage Stress
Stay Friendly & Socially
Engaged
Have a Purpose in Life13
14. “THERE IS PLENTY OF
COMPELLING EVIDENCE
THAT SLEEP IS THE MOST IMPORTANT
PREDICTOR OF HOW LONG
WE WILL LIVE”
DR. WILLIAM DEMENT
Co-Founder, Stanford University Sleep Disorder Clinic
14
16. RESOURCES
“REINVENTING MID-LIFE:
SLEEP, AGING and OVEREATING”
PRESENTATION BY MARY O’BRIEN, MD
“7 REASONS WHY YOU NEED
8 HOURS SLEEP”
BY SARA LOVELADY, THE WELLNESS ADVISOR,
www.thewellnessadvisor.com
WebMD: http://www.webmd.com/sleep-
disorders/ss/slideshow-sleep-disorders-
overview?print=true16
Editor's Notes
The SEC Committee decided to start the New Year’s Brown Bag Lunch presentations with The Effects of Sleep Deprivation, a challenge that many of us face in this computerized, digital, smart phone, fast-paced environment we call “life” . . .
. . . and especially those of us who work remote and often say, “just a little more, just a little more – so I can get a quick start on tomorrow,”
. . . thereby cutting one of the most important corners of our medical health, that of “a good night’s sleep.” This presentation will inform you of the price we all pay when we make that decision to compromise our sleep hygiene, thereby offering you the challenge to help reinvent your mid-life in order to help you live longer.
THEREFORE, THIS PRESENTATION WILL DISCUSS
THE IMPACT OF SLEEP ON AGING, OVEREATING, AND LONGEVITY,
AS WE PROGRESS THROUGH MID-LIFE TO ACHIEVE OPTIMAL WELLNESS
Now, mid-life is a relatively new concept of the last century (as life expectancy has doubled). The years between 40 to 65 require a combination of self-awareness, healthy lifestyle, appropriate preventive health care, and responsible planning in order to enhance quality of life and longevity by reducing medical risks.
And, since evidence-based medicine has proven that every organ system is profoundly affected by sleep (or the lack thereof), understanding the changes in sleep architecture as we enter and progress through mid-life becomes crucial to good health.
THE FIRST HALF OF OUR PRESENTATION LAYS THE FOUNDATION OF
EXPLAINING SLEEP ARCHITECTURE, AND ITS EFFECT ON THE HUMAN ORGANISM
SLEEP is a complex, reversible condition coordinated by Neurons and Neurotransmitters in the Brain.
Circadian rhythms (the essence of Night and Day, darkness and light, sleep and wake) are regulated by the suprachiasmatic nucleus in the Hypothalamus (just above the Optic Chiasm, above and in-between the eyes).
This Hypothalamus is extremely sensitive to light levels, and works in conjunction with the Pineal Gland to regulate sleep/wake cycles.
The neurotransmitter GABA (gamma amniobutyrric acid), in addition to the Hormones, melatonin and galanin, along with the chemical modulator, adenosine, play important roles in sleep.
And finally, the STATE OF WAKEFULNESS is influenced by histamine, acetylcholine, serotonin, and norepinephrine.
Sleep Cycle EEG Pattern = Electrical Brain Activity Pattern of Theta Waves (or slow waves)
Whereas, WAKEFULNESS is comprised of Electrical Brain Activity of Rhythmic Alpha Waves (or rapid waves)
During sleep, most systems in an animal are in a heightened anabolic state, meaning the building of organs and tissues, accentuating the growth and rejuvenation of the immune, nervous, skeletal, and muscular systems. It’s very similar to recharging a battery, and if it's not done in a pre-arranged and sequential manner, a human will wake in a very dysfunctional state in which all organ systems are compromised to various degrees.
In humans, the average length of the first sleep cycle is approximately 90 minutes, and then 100 to 120 minutes for the second to the fifth cycles. Each stage has a distinct physiological function (therefore rejuvenative purpose) and EEG pattern (measurements of brain waves). And if this result in sleep that exhibits loss of consciousness, but does not fulfill its physiological functions, one may still feel tired after apparently sufficient sleep time, or non-recovery sleep due to poor habits that disrupt sleep architecture (for instance, consuming alcohol close to initiating sleep).
STAGE I SLEEP – Characterized by . . .
Transition from wakefulness to sleep: alpha waves fade (awake state) to low voltage theta waves (sleep state)
Theta waves predominate
Shallow sleep; fragmented sleep; easily awakened
10 minutes
STAGE II SLEEP – Characterized by . . .
Longest stage of sleep
Body temperature starts to decrease and heart rate begins to slow
Older people and those with chronic illnesses can spend the entire night in Stage II Sleep
Easily Awakened
20 minutes
STAGE III SLEEP – Characterized by . . .
Transition between light sleep and very deep sleep
Beginning of priority sleep
More difficult to awaken
Restorative sleep: many repair or regenerative processes occur in connective tissues, muscles and the immune system
30 minutes
STAGE IV SLEEP – Characterized by . . .
Critical for synthesis of growth hormone by the pituitary gland, and the production of numerous neurotransmitters necessary for life, the most prominent being . . .
ACETYLCHOLINE (plays an important role in REM sleep and arousal)
SEROTONIN (functions to promote waking while inhibiting slow-wave & REM sleep)
DOPAMINE (central to dictating the "circadian rhythm" in humans -- the series of biological processes that enables brain activity to adapt to the time of the day (that is, light and dark cycles)
NOREPINEPHRINE (also plays a role in arousal, but not in REM sleep, but rather in vigilance or attention, encouraging the human to notice unusual and important stimuli)
and there are others . . .
AKA DELTA SLEEP
30 minutes
STAGE V SLEEP – Characterized by . . .
Rapid Eye Movement (REM SLEEP), or Dream Sleep
More shallow, irregular breathing
Eyes move but muscles in the extremities are paralyzed
Blood pressure and pulse increase
Memories are consolidate
THE STAGES PROGRESS & REPEAT . . .
Sleep starts out sequentially, but then it cycles through the stages in an out-of-sequence progression. It begins in Stage I and progresses into Stages II, III, and IV.
After Stage IV, III and then II are repeated before REM (Stage V) begins.
The body usually returns to Stage II sleep after REM sleep is over.
The first cycle of REM Sleep starts about 90 minutes after falling asleep, and can last only a very short amount of time. With each cycle, REM sleep lasts longer.
DEFINITION: Difficulty with the initiation, maintenance, duration or quality of sleep that results in the impairment of daytime functioning . . .
Transient – less than a week
Short-term – lasts 1 to 4 weeks
Chronic – lasts over a month
Secondary Insomnias – of which Inadequate Sleep Hygiene is one:
Poor habits which interfere with healthy sleep architecture –
Irregular hours/shift work
Excessive stimulation from lights, noise, TV, or computers
Over scheduling, or spreading yourself too thin
Caffeine
Nicotine
Alcohol close to initiating sleep
Personal stress, or conflicts
All of these unhealthy habits, as mid-life progresses, can result in serious medical consequences, which if become chronic in nature, result in accelerated aging.
SEVERAL NIGHTS OR WEEKS OF INSOMNIA FOLLOWED BY USE OF A SLEEPING PILL CAN CAUSE:
REM Behavioral Disorder – associated with vivid, violent dreams, during which REM skeletal muscle paralysis does not happen; patients in this sleep disturbance phenomenon may injure themselves or others during disturbing dreams
Night Terrors – occur during Stage III or IV Sleep, and involve tremendous fear, screaming, or flailing
Nightmares – experienced during REM Sleep, are often intensified by fever, alcohol, exhaustion, or underlying psychological stress (be it from daily stress, depression/anxiety, or upsetting TV/movies viewed just prior to sleep)
Delayed SLEEP ONSET
Increased WAKEFULNESS
Sensitivity to LIGHTER SLEEP
Decreased SLEEP EFFICIENCY
Increased STAGE I SLEEP
Decreased SLOW WAVE SLEEP
Increased FRAGMENTATION of SLEEP
AND NOW THE SECOND HALF OF OUR PRESENTATION –
THE EFFECTS OF SLEEP DEPRIVATION
Here we come across a laundry list of
“INCRERASED”, “ELEVATION”, “REDUCED”, “COMPROMISED”, “LESS EFFECTIVE” & “IMPAIRED” CONCEQUENCES!!
(Enough to make one think twice before deciding to
deprive oneself of the rejuvenation of their immune, nervous, skeletal, and muscular systems!)
Increased risk for MI
Increased risk for ARRHYTHMIAS
Increased risk for OBESITY (and consequently, increasing the risk for METABOLIC SYNDROME)
Increased risk for ACCIDENTS & WORK-RELATED ERRORS
Increased risk for ANXIETY & DEPRESSION
Increased ADRENALINE & CORTISOL production (Cortisol acting throughout the day to assist the body in adjusting to light versus dark, day versus night, and regulating the waking process)
The circadian rhythm of cortisol secretion has a waveform pattern with the nadir (or lowest level) occurring at about midnight. Cortisol levels start to rise approximately 2-3 hours after sleep onset and continue to rise into the early morning and early waking hours. The peak in cortisol is about 9am, and as the day continues, levels decline gradually. With the onset of sleep, cortisol continues to decline until the nadir. As Cortisol increases during sleep, so does EEG frequency; short-wave sleep decreases, as does light sleep and frequent waking.
Increased GREHLIN production within the stomach (which signals the brain of an increased appetite, and time to eat)
Increased IRRITABILITY
Increased MUSCCULOSKELETAL PAIN
Elevation of BP & PULSE
Reduced levels of GROWTH HORMONE, INSULIN & LEPTIN (Leptin’s primary role being in controlling appetite)
Reduced levels of LYMPHOCYTES (thus, negatively affecting the IMMUNE SYSTEM)
Less effective response to VACCINES
Impaired JUDGEMENT, MEMORY & ATTENTION SPAN
Compromised THYROID FUNCTION (resulting in . . . Tiredness / Cold hands and feet / Poor sleep architecture / Weight gain . . . and more)
AND FURTHER DISRUPTION OF SLEEP ARCHITECTURE RESULTS FROM NAPPING, AFFECTING MEMORY RETRIEVAL:
Although chronically ill and elderly patients may feel the need to nap in the daytime, naps should be limited to 1 hour, and before 3PM in order to minimize disruptions of sleep architecture during the night (such as reducing the incentive to sleep at night, also known as reducing sleep urgency at night).
Newly acquired information in the brain is consolidated by acetylcholine into long-term memory through neural pathways in the hippocampus and medial temporal lobes of the brain. This process is facilitated by REM (dream) SLEEP. Even one night of sleep deprivation can interfere with memory retrieval or processing of recently acquired information.
Furthermore, Chronic Sleep Problems are associated with higher cortisol levels and reduced levels of brain and nerve growth factors. This contributes to volume loss in the hippocampus and medial temporal lobes – thereby exacerbating problems with memory and cognition.
Renal Disease
Asthma
(as see on these 2 slides)
Parkinson’s
Alzheimer’s
Hormone dependent CA (breast, ovarian, colon, prostate, gallbladder)
Osteoarthritis
And the Obvious:
Hypertension
Hyperglycemia
Hyperinsulinemia
Type II DM
CAD
CVA
EVIDENCED-BASED MEDICINE IS ALSO CONFIRMING THAT SLEEP DEPRIVATION
INCREASES THE RISK FOR WEIGHT GAIN AND ACCELERATED AGING:
There is scientific evidence that individuals that sleep less have lower levels of LEPTIN (a hormone that acts on the hypothalamus to suppress appetite); thereby less leptin translates into more eating.
Sleep deprived individuals also have higher GHRELIN levels (which is produced by the empty stomach to stimulate the hypothalamus to boost appetite).
Another study found that sleeping only 4 hours a night for 6 nights leads to higher post-breakfast glucose levels than occurs after adequate sleep. During sleep deprivation, INSULIN secretion is compromised, CORTISOL levels rise, and THYROID production declines – RESULTS THAT ACCELERATE AGING!
Research also demonstrates that patients who are sleep deprived mount a less effective immune response to the INFLUENZA VACCINE, and have a COMPROMISED IMMUNE SYSTEM IN GENERAL:
Thereby, a correlation between only a few hours of sleep in only one night results in a significant reduction in natural “killer cells” (or lymphocytes),
And as much as a 50% drop in lymphocytes after only 1 night of 4 hours’ sleep.
In both studies, cell counts returned to normal after a good night of recovery sleep.
MEDICINE SEEMS TO BE JUST NOW OPENING THE DOORS OF
INVESTIGATING THIS ACTIVITY CALLED “SLEEP,” THIS ACTIVITY WE SHOULD BE OPTIMALLY SPENDING
ONE-THIRD OF OUR LIFE DOING, AND THAT IS, “SLEEPING.”
AND FROM THOSE INDIVIDUALS WHO HAVE ACHIEVED LONGEVITY,
NAMELY THOSE CENTENARIANS OF 100+ YEARS OF AGE,
2 OF THE 12 HEALTHY HABITS THEY EXPOUND ARE
MAINTAINING A STABLE, HEALTHY WEIGHT,
AND SLEEPING WELL.
