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  1. 1. Sleep Kieri Gibson
  2. 2. Definition of Sleep <ul><li>A natural and periodic state of rest during which ________________ of the world is suspended </li></ul>
  3. 3. Importance of Sleep <ul><li>Faster and more complete recovery from illness and injury </li></ul><ul><li>Minimizes the effects of stress </li></ul><ul><li>Increases ability to ________________ </li></ul>
  4. 4. Cont. <ul><li>Enhances ability to handle minor irritations </li></ul><ul><li>Improves _____________ </li></ul><ul><li>Enhances ability to perform tasks logically </li></ul><ul><li>Improves personal relationship </li></ul><ul><li>Increases hand-eye coordination </li></ul>
  5. 5. How much sleep is enough? <ul><li>Infants </li></ul><ul><ul><li>16-18 hrs/day </li></ul></ul><ul><li>Teenagers & Young Adults </li></ul><ul><ul><li>__ hrs/day </li></ul></ul><ul><li>Adults </li></ul><ul><ul><li>7-8 hrs/day </li></ul></ul>
  6. 6. Stages of Sleep <ul><li>Walking stage </li></ul><ul><ul><li>Body prepares for sleep </li></ul></ul><ul><ul><li>Relaxed wakefulness </li></ul></ul><ul><ul><li>Body begins to slow down </li></ul></ul><ul><ul><li>Muscles relax </li></ul></ul><ul><ul><li>________________ slows to a roll </li></ul></ul>
  7. 7. Cont. <ul><li>Non Rapid Eye Movement Stages </li></ul><ul><ul><li>Stage 1 (sleep or drowsiness) (Non-REM) </li></ul></ul><ul><ul><ul><li>50% reduction in activity between wakefulness and Stage 1 sleep </li></ul></ul></ul><ul><ul><ul><li>Person may feel he or she has not slept if aroused from this stage </li></ul></ul></ul><ul><ul><ul><li>Lasts for _____________ minutes </li></ul></ul></ul>
  8. 8. Cont. <ul><li>Stage 2 (light sleep) </li></ul><ul><ul><li>Spontaneous periods of muscle tone mixed with muscle relaxation </li></ul></ul><ul><ul><li>Heart rate slows </li></ul></ul><ul><ul><li>Body temperature ________________ </li></ul></ul><ul><ul><li>Preparation to enter deep sleep </li></ul></ul><ul><li>Stages 3 and 4 (Deep Sleep) </li></ul>
  9. 9. Cont. <ul><li>Rapid Eye Movement (deep sleep) </li></ul><ul><ul><li>Intense dreaming </li></ul></ul><ul><ul><li>Heightened cerebral activity </li></ul></ul><ul><ul><li>Paralysis in major voluntary muscles </li></ul></ul><ul><ul><li>Changes in physiological states </li></ul></ul>
  10. 10. A Good Nights Sleep <ul><li>________________ </li></ul><ul><li>Exercise </li></ul><ul><li>Avoid Caffeine, Nicotine and Alcohol </li></ul><ul><li>Relax before bed </li></ul><ul><li>Control room temperature </li></ul><ul><li>Don’t lie in bed awake </li></ul>
  11. 11. Sleep Disorders Autumn Meadows
  12. 12. Insomnia <ul><li>Difficulty falling and/or staying asleep </li></ul><ul><li>2 types </li></ul><ul><ul><li>Primary insomnia – not associated with any other health problems or conditions </li></ul></ul><ul><ul><li>Secondary insomnia – sleep problems due to a ________________ (e.g., pain, asthma, depr.) </li></ul></ul>
  13. 13. Cont. <ul><li>Causes of Insomnia </li></ul><ul><ul><li>________________ – positive or negative (e.g., job loss or moving) </li></ul></ul><ul><ul><li>Interference with sleep schedule (e.g., jet lag) </li></ul></ul><ul><ul><li>Emotional/Physical discomfort </li></ul></ul><ul><ul><li>Environment (e.g., noise, light) </li></ul></ul>
  14. 14. Cont. <ul><li>Treatment </li></ul><ul><ul><li>Acute insomnia </li></ul></ul><ul><ul><ul><li>Change sleep habits </li></ul></ul></ul><ul><ul><ul><li>Mild sleep aids </li></ul></ul></ul><ul><ul><li>________________ insomnia </li></ul></ul><ul><ul><ul><li>Treat underlying problems </li></ul></ul></ul><ul><ul><ul><li>Behavior therapy </li></ul></ul></ul>
  15. 15. Sleep Apnea <ul><li>Interrupted or discontinuous breathing during sleep </li></ul><ul><li>2 types </li></ul><ul><ul><li>Obstructive sleep apnea (OSA) – blockage of the air passage </li></ul></ul><ul><ul><li>________________ sleep apnea – brain does not signal muscles to breathe (e.g. common in stroke patients) </li></ul></ul>
  16. 16. Cont. <ul><li>Symptoms </li></ul><ul><ul><li>Dry/sore throat upon awakening </li></ul></ul><ul><ul><li>________________ </li></ul></ul><ul><ul><li>Fragmented sleep </li></ul></ul><ul><ul><li>Snoring </li></ul></ul>
  17. 17. Cont. <ul><li>Treatment </li></ul><ul><ul><li>Conservative tx </li></ul></ul><ul><ul><ul><li>_________________________ </li></ul></ul></ul><ul><ul><ul><li>Avoiding alcohol/drug use </li></ul></ul></ul><ul><ul><ul><li>Special devices (e.g. neck pillows, nose strips, dental devices) </li></ul></ul></ul>
  18. 18. Cont. <ul><li>Therapy – ________________ positive airway pressure (CPAP) </li></ul><ul><ul><ul><li>Prevents airway closure by wearing an air blower mask on face & nose </li></ul></ul></ul><ul><ul><ul><li>Apnea will come back if therapy is discontinued </li></ul></ul></ul><ul><ul><ul><li>Surgery </li></ul></ul></ul><ul><ul><ul><ul><li>Outpatient procedure </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Permanent fix to apnea </li></ul></ul></ul></ul>
  19. 19. Narcolepsy <ul><li>Neurological disorder that affects the control over sleep & wakefulness </li></ul><ul><li>Symptoms </li></ul><ul><ul><li>Excessive daytime sleeplessness </li></ul></ul><ul><ul><li>Sleep paralysis </li></ul></ul><ul><ul><li>________________ – loss of voluntary muscle control </li></ul></ul><ul><ul><li>Hallucinations </li></ul></ul>
  20. 20. Cont. <ul><li>Test for Diagnosis </li></ul><ul><ul><li>Polysomnogram (PSG) </li></ul></ul><ul><ul><ul><li>Overnight test that documents abnormalities in sleep cycle </li></ul></ul></ul><ul><ul><li>___________________________ (MSLT) </li></ul></ul><ul><ul><ul><li>Measures tendency to fall asleep </li></ul></ul></ul><ul><ul><ul><li>P.T. required to take 4-5 short naps during session </li></ul></ul></ul>
  21. 21. Cont. <ul><li>Treatment </li></ul><ul><ul><li>________________ </li></ul></ul><ul><ul><li>Drug tx – antidepressants & amphetamine-like stimulants </li></ul></ul><ul><ul><li>Avoid caffeine </li></ul></ul><ul><ul><li>Create sleep schedule </li></ul></ul>
  22. 22. Sleep Aids Amber Zabinsky
  23. 23. What is a Sleep Aid? <ul><li>Over-the-counter drugs </li></ul><ul><li>Prescription Medication </li></ul><ul><li>Non-medical supplements and therapies </li></ul>
  24. 24. Over-The-Counter Medication <ul><li>Should be used for transient or short term insomnia or in conjunction with changes in your sleep habits </li></ul><ul><li>Pay attention to your body’s physical response to them </li></ul><ul><ul><li>Discontinue use if: </li></ul></ul><ul><ul><ul><li>Drowsiness </li></ul></ul></ul><ul><ul><ul><li>Dizziness </li></ul></ul></ul><ul><ul><ul><li>Forgetfulness </li></ul></ul></ul><ul><ul><ul><li>Constipation </li></ul></ul></ul><ul><ul><ul><li>Urinary retention </li></ul></ul></ul><ul><ul><ul><li>Blurred vision </li></ul></ul></ul><ul><ul><ul><li>Dried mouth & throat </li></ul></ul></ul>
  25. 25. Most Common Ingredient in OTC Sleep Medication <ul><li>________________ </li></ul><ul><ul><li>Diphenhydramine hydrochloride </li></ul></ul><ul><ul><li>Diphenhydramine citrate </li></ul></ul><ul><ul><li>Doxylamine succinate </li></ul></ul>U.S. Food and Drug Administration
  26. 26. Most Commonly Prescribed Medications for Sleep Deprivation <ul><li>Hypnotics </li></ul><ul><ul><li>Sedatives </li></ul></ul><ul><ul><li>Minor tranquilizers </li></ul></ul><ul><ul><li>________________ drugs </li></ul></ul>
  27. 27. Prescription Sleep Medications <ul><li>Types of Sleep Aids </li></ul><ul><ul><li>Non-benzodiazepines </li></ul></ul><ul><ul><li>Benzodiazepines </li></ul></ul><ul><ul><li>Barbiturates </li></ul></ul><ul><ul><li>________________ </li></ul></ul>Shuteye. COM sanofiaventis © 2002-2005
  28. 28. Non-benzodiazepines <ul><li>Newest class of sleep meds </li></ul><ul><li>Eliminated from the body quickly (short half-life) </li></ul><ul><li>Not likely to cause daytime sleepiness </li></ul><ul><li>“Selective” </li></ul>Shuteye. COM sanofiaventis © 2002-2005
  29. 29. Benzodiazepines <ul><li>This class is both ________________ acting medicines </li></ul><ul><li>Were originally formulated to treat anxiety </li></ul>Shuteye. COM sanofiaventis © 2002-2005
  30. 30. Barbiturates <ul><li>Rarely prescribed due to risk of: </li></ul><ul><ul><li>Addiction </li></ul></ul><ul><ul><li>Abuse </li></ul></ul><ul><ul><li>_____________ </li></ul></ul>Shuteye. COM sanofiaventis © 2002-2005
  31. 31. Antidepressants <ul><li>Not approved for this purpose, but at times doctors will prescribe them to promote sleep </li></ul>
  32. 32. Non-Prescription Treatments <ul><li>________________ </li></ul><ul><ul><li>Controversial </li></ul></ul><ul><ul><li>Classified as a dietary supplement </li></ul></ul><ul><ul><li>Not undergone rigorous clinical testing that medicines do </li></ul></ul><ul><ul><li>Still widely sold as a sleep aid </li></ul></ul>
  33. 33. Herbal Sleep Aids <ul><li>Chamomile </li></ul><ul><li>Valerian root </li></ul><ul><li>Hops </li></ul><ul><li>________________ </li></ul><ul><li>Passion Flower </li></ul>
  34. 34. Cont. <ul><li>Benefits are unproven b/c lack of extensive testing </li></ul><ul><li>Generally considered safe but could be harmful under certain circumstances </li></ul><ul><ul><li>Ex: Do not use chamomile if you are pregnant or if you are taking blood thinners </li></ul></ul><ul><ul><li>Not approved by ___________ </li></ul></ul>
  35. 35. Common Side Effects (depending on prescription) <ul><li>Dizziness </li></ul><ul><li>Lightheadedness </li></ul><ul><li>Daytime ________________ </li></ul><ul><li>Diarrhea </li></ul><ul><li>Difficulty w/ coordination </li></ul>
  36. 36. Tips for better daytime habits <ul><li>Don’t take naps during the day </li></ul><ul><ul><li>Less than 30 minutes if you have to </li></ul></ul><ul><li>Limit caffeine and alcohol </li></ul><ul><li>Don’t smoke </li></ul><ul><li>Expose yourself to bright light </li></ul><ul><li> or ________________ soon after waking </li></ul><ul><li>Exercise early in the day </li></ul><ul><li>Check iron level </li></ul>Gina Kemp, MA and Robert Segal, MA © 1996 – 2005. Helpguide.org
  37. 37. Better Sleep Environment <ul><li>Make sure bed is large & comfortable </li></ul><ul><li>Make bedroom primarily a place for ________________ </li></ul><ul><li>Keep bedroom peaceful </li></ul>Gina Kemp, MA and Robert Segal, MA © 1996 – 2005. Helpguide.org
  38. 38. Cont. <ul><li>Hide your ________________ </li></ul><ul><li>Keep pre-sleep rituals </li></ul><ul><ul><li>Regular schedule </li></ul></ul><ul><ul><li>Relax before going to bed </li></ul></ul><ul><ul><li>Don’t eat too much/ little </li></ul></ul><ul><ul><li>Bedtime snacks </li></ul></ul><ul><ul><li>Jot down all worries & concerns </li></ul></ul><ul><ul><li>Go to bed when sleepy </li></ul></ul><ul><ul><li>Avoid “OTC” sleep aids </li></ul></ul>Gina Kemp, MA and Robert Segal, MA © 1996 – 2005. Helpguide.org

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