Sleep is essential to our overall health and well-being. It is key to our ability to perform cognitive and physical tasks, engage fully in life, and function productively and safely. The average sleep requirement varies by age, from 16-20 hours for infants to 6-8 hours for adults. There are two main types of sleep disorders - dyssomnias which affect sleep amount, timing or quality, and parasomnias which involve abnormal physical or experiential events during sleep. Sleep disorders can be treated through lifestyle modifications, behavioral therapies, medication, and treating any underlying medical conditions. Maintaining good sleep hygiene is important for promoting healthy sleep.

2. Why is sleep important?

3. Sleep is Essential to Our Overall
Health and Well-Being
0 Key to our health, performance, safety
and quality of life.
0 Essential to our ability to perform both
cognitive and physical tasks, engage fully in life and
function in an effective, safe and productive way.

4. Normal Sleep
NREM
75 to 80%
4 stages
Decrease in
HR/BP/Muscle tone
Awake
REM
20-25%
Dreaming
0 Humans sleep more than
25 years of their life.
0 Average requirement of
sleep varies with age:
0 Infants: 16-20 hrs
0 Adolescents: 7-9 hrs
0 Adults: 6-8 hrs

5. Awake
Stages
The Sleep Cycle in Adults
REM
REM
REM
REM
REM
1
2
3
4
0 1 2 3 4 5 6 7 8
Hours in Sleep

6. Normal Sleep and Normal Aging:
Less Deep Sleep

7. Normal Sleep and Normal Aging:
Sleep Efficiency
Men
Women Age
SleepEfficiency
(%TimeinBedSleeping)
Changes with age

8. Factors affecting Sleep
0 Regulated by internal and external
factors-
0 Internal- Emotions, homeostasis
(hunger/temp), hormones,
Neurotransmitters.
0 External- Temperature, Noise, Stress
etc.
0 Sleep Need is built up during the day.

9. Assessment
0 During the past month,
0 1. When have you usually gone to bed?
____________________________________
0 2. How long (in minutes) has it taken you to fall asleep each
night? ____________________________________
0 3. What time have you usually gotten up in the morning?
____________________________________
0 4. A. How many hours of actual sleep did you get at night?
____________________________________
0 B. How many hours were you in bed?

10. Assessment

11. Scoring
0 Component 1 #9 Score C1
___________
0 Component 2 #2 Score (<15min
(0), 16-30min (1), 31-60 min (2),
>60min (3))
0 + #5a Score (if sum is equal 0=0;
1-2=1; 3-4=2; 5-6=3) C2
___________
0 Component 3 #4 Score (>7(0),
6-7 (1), 5-6 (2), <5 (3) C3
___________
0 Component 4 (total # of hours
asleep) / (total # of hours in
bed) x 100
>85%=0, 75%-84%=!, 65%-
74%=2, <65%=3 C4 ___________
0 Component 5 # sum of scores
5b to 5j (0=0; 1-9=1; 10-18=2;
19-27=3) C5 ___________
0 Component 6 #6 Score C6
___________
0 Component 7 #7 Score + #8
score (0=0; 1-2=1; 3-4=2; 5-6=3)
C7 ___________
A total score of “5” or greater is indicative of poor sleep quality. It is
suggested that you discuss your sleep habits with a healthcare provider

12. Classifications of Sleep
Disorders
0 Dyssomnias
0 Disorders that produce
complaints of insomnia or
excessive sleepiness.
0 The problem is with the
amount (quantity), timing
or quality of sleep.
0Parasomnias
0 Disorders that intrude
into or occur during
sleep but the quality,
quantity, and timing of
the sleep are
essentially normal.

13. Types of Sleep disorders
Insomnia - too little sleep
Characteristics
0Difficulty initiating or
maintaining sleep
0Persists for 1 month
or longer

15. Effects of insomnia
0 Reduced productivity,
0 Increased absenteeism,
0 Accidents,
0 Hospitalization & increased medical costs.
0 Depression
0 Increased alcohol consumption
0 Weight gain
0 Forgetfulness- Poor concentration
0 Hormonal Imbalance
0 Aging of skin
0 Headaches

18. Circadian Rhythm Disorders
0Definition:
0Malfunctioning of the
biological clock within the
conventional environment

19. Types of sleep disorders
0 Primary Hypersomnia:
Sleeping too much, as well as
being drowsy at times when
patient should be alert.
Characteristics
0Excessive sleepiness
0Persists for 1 month or
longer.

20. Narcolepsy

21. Narcolepsy
Narcolepsy (Sleeping at the wrong time)
0 Sleep intrudes into wakefulness, causing clients to fall
asleep almost instantly
0 Sleep is brief but refreshing
0 May also have sleep paralysis, sudden loss of strength,
and hallucinations as fall asleep or awaken.

22. Parasomnias
0 The parasomnias are undesirable physical or
experiential events that accompany sleep.

23. Sleepwalking
Characteristics:
(1) Rising from bed during
sleep and walking about.
(2) Usually occurs early in
the night.
(3) On awakening, the
person has amnesia for episode

24. Other Parasomnias
Sleep-talking Sleep-Paralysis
Nightmare
disorder
Sleep-terror RLS Bruxism

25. Sleep disorders (secondary)
• General
medical
conditions
DM/Asthma/Heart
disease
• Substance
induced sleep
disorders
Alcohol,
Benzodiazepines,
Cannabis.
• Sleep disorders
due to
developmental
disorders.
MR, Autism.

26. Treatment of sleep disorders
0 Address the specific cause (e.g.
physical cause)
0 Treat the Medical or psychiatric
conditions.
0 Non-Pharmacological:
 Life style modification- Behavioral
treatments
 Sleep Hygiene
 Cognitive behavioral Therapy
 Sleep Restriction Therapy
.

27. Treatment of Sleep disorders
Pharmacological
0 Benzodiazepine use- follow up
0 Dependence – Misuse
0 Not more than 2 week usage.
0 Alternative sleeping aids
0 Z drugs, anti-histamines, anti-depressants

28. Psychotherapy for Sleep Disorders
Ms. Anam Bashir
Ms. Sobia Ahmed

29. 5 Areas to explore
Looking at these 5 areas in your life will help you identify any sleep problems
and may lead to getting a better night’s sleep.
Environment
2.
. Exercise
Thoughts
0 Behaviours
0 Diet

30. • Cut down on caffeine
• Don’t go to bed hungry
• Avoid moderate to heavy alcohol use in the late evening
• Avoid excessive liquids in the evening
Sleep Hygiene

31. Sleep Hygiene
Avoid smoking before bed or during the night
Make sure bedroom is quiet (except perhaps for some
white noise), very dark, and comfortable in terms of
mattress, pillow, and temperature