This document discusses sleep, what it is, how much we need, consequences of poor sleep, common sleep disorders, and tips for good sleep hygiene. Sleep is a behavioral and physiological state that alternates with waking and is regulated by circadian rhythms. Most adults need 7-8 hours per night, and short sleep is associated with negative health outcomes. Common sleep disorders include insomnia, sleep apnea, and restless leg syndrome. Maintaining a regular sleep schedule, quiet bedroom, and limiting screens before bed can promote good sleep.

1. A GOOD NIGHT’S SLEEP
Linda J. Larson-Prior
Professor
Psychiatry, Neurobiology & Dev Sci, Neurology,
Biomedical informatics
Director: Neurocognitive Dynamics Laboratory
University of Arkansas for Medical Sciences

2. Sleep is a
BEHAVIORAL
state
That normally
alternates with
waking
WHAT IS SLEEP?

3. BEHAVIORAL
OR

4. OR
BEHAVIORAL

5. OR
BEHAVIORAL

6. Sleep is a
FUNDAMENTAL
RHYTHM of the
brain
WHAT IS SLEEP?
Constrained by the day-night
circadian (one day, ~24 hr)
cycle that is present in all living
organisms

7. FUNDAMENTAL RHYTHM

8. FUNDAMENTAL RHYTHM

9. Sleep is a
PHYSIOLOGICAL
state
WHAT IS SLEEP?
Defined by changes in neural
activity, metabolism, and
system homeostasis

10. PHYSIOLOGICAL
Wake
Stage 1 (N1)
Stage 2 (N2)
Stage 3 (SWS)
Stage REM
Time (hrs)
Stage W
N1
N2
N3
Slow Wave Sleep
Stage REM
Sleep Hypnogram

11. PHYSIOLOGICAL
Growth
Hormon
e

12. HOW MUCH SLEEP DO WE NEED?
Humans sleep between 4 and 10 hours/night – there is no number of hours
that is “right” for everyone
4 8 12
No.ofpeople
• Average is ~ 8 hrs
• Data indicates that
short-sleep (<6 hrs) is
deleterious
Coop Home

13. HOW MUCH SLEEP DO WE GET?

14. If we get “enough” sleep
7-8 hours
sleep/night
We feel . . . .
And are more
likely to . . . .
WHAT ARE THE CONSEQUENCES?

15. < 6 hours of sleep
We feel. . . .
And are
more likely
to …..
BUT, if we get poor sleep
WHAT ARE THE CONSEQUENCES?

16. WHAT ARE THE CONSEQUENCES?
Source: CDC
~20% of Americans are sleepy during the day

17. WHAT ARE THE CONSEQUENCES?
SOURCE: Youngstedt and Kripke (2004)
Sleep Medicine Reviews
CI
Short and long sleep result in increased risk of death

18. WHAT ARE THE CONSEQUENCES?
Decreased
Immune System
Function
INCREASED RISK OF . . .

19. TRACKING YOUR SLEEP

20. WHAT MAKES A GOOD NIGHT’S SLEEP?
A survey (1500 participants) by the National Sleep Foundation showed :
ENVIRONMENT MATTERS
Quiet Room (74%)
Dark Room (73%)
Fresh air, clean room (63%)
76% said they get a GOOD
night’s sleep at least a few
times per week

21. WHAT MAKES A BAD NIGHT’S SLEEP?
Source: BBC Science

22. AROUSAL STATE AFFECTS SLEEP
LOW AROUSAL HIGH AROUSAL
Quiet
Dark
Cool
Calm
Loud
Light
Hot
Agitated

23. Sleep Is a 2-part RHYTHM
GOOD SLEEP requires a strong SLEEP
DRIVE (process S) and a low circadian
drive (process C)
REGULAR SCHEDULE

24. SLEEP HYGIENE
HABITS TO IMPROVE SLEEP
Maintain a consistent sleep schedule
To synchronize your internal clock and keep its rhythm

25. SLEEP HYGIENE
Design your bedroom for sleeping
Black-out curtains
No TV, phone, electronic devices

26. SLEEP HYGIENE
Avoid heavy meals
Avoid caffeine, alcohol, nicotine
4-6 hours before bedtime

27. SLEEP HYGIENE
Establish a pre-sleep routine
for “winding down”

28. SLEEP HYGIENE
Exercise Regularly, but avoid
strenuous exercise close to bedtime

29. SLEEP HYGIENE
Limit exposure to bright light at night
Reduce electronic device use close
to bedtime

30. COMMON SLEEP DISORDERS
INSOMNIA
• Difficulty falling asleep
• Difficulty staying asleep
• Non-restorative sleep
• Daytime consequences

31. INSOMNIA

32. INSOMNIA
Environment Mental
Illness
Medical
Illness
Ingested
Substances
Sleep
Disorder
Sleep
Cycle
Disorder
Poor
Sleep
Hygeine.
Bedtime
paired
with
physical,
emotional
cognitive
arousal
Anxiety
Depression
Psychosis
Pain
Dementia
Respiratory
Disease
CHF
GERD
Endocrine
Disease
Drugs
Alcohol
Caffeine
Stimulants
Heavy
Foods
Sleep
Disordered
Breathing
Restless
Leg
Syndrome
Jet Lag
Shift
Work
Cycle
Misalignment

33. INSOMNIA
Possible Mechanisms of Insomnia
Reduced homeostatic sleep drive (Process S)
Dysregulated circadian rhythm (Process C)

34. INSOMNIA
Possible Mechanisms of Insomnia

35. INSOMNIA
Start with Good Sleep Hygiene
If it lasts several weeks without respite,
SEEK HELP
Insomnia.uams@gmail.com

36. COMMON SLEEP DISORDERS
SLEEP DISORDERED BREATHING
APNEA

37. APNEA
Incidence varies by sex, age and BMI
Male Railway Workers

38. APNEA

39. APNEA

40. OBSTRUCTIVE SLEEP APNEA
Obstruction or collapse
of the upper airway
during sleep
Due to:
• Decreased muscle
activity
• Decreased
ventilatory motor
output
• Increased upper
airway resistance

41. When to Seek Help
• Snoring loudly enough to disturb others
• Frequently waking due to shortness of breath
• Excessive daytime sleepiness
• Bed partner reports cessation of breathing,
gasping or choking during the night
SLEEP APNEA

42. OBSTRUCTIVE SLEEP APNEA
• Weight Loss
• CPAP
• Dental Appliances
• Upper airway surgery

43. COMMON SLEEP DISORDERS
RESTLESS LEG SYNDROME (RLS)
A sensorimotor disorder characterized by
an urge to move the legs due to annoying
sensations that is worse with inactivity

44. RESTLESS LEG SYNDROME (RLS)
Study of 10,263 reported in Neurology 2005 (Tison et al.)
Males Females

45. RLS
RLS adversely affects sleep,
increasing restlessness and
preventing well consolidated
sleep
• Familial, often begins in childhood
• Associated with iron deficiency,
drugs, periodic leg movements of
sleep (PLMS)
• Treatable with medicines

46. RLS
First, avoid substances or foods that cause or worsen the
problem
Be sure that RLS is not secondary to another condition
such as anemia, kidney disease
Medications are prescribed to relieve symptoms occurring
>3 nights/week and can include:
• Dopaminergics (Sinemet)
• Anticonvulsants (gabapentin)
• Alpha-2 agonists (clonidine)

47. RESOURCES
Good Reads Online Resources