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MMSleep &
Chronophysiology Laboratory
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
Functions of SleepSWS – 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 childhoodMM
Sleep & Chronophysiology
Laboratory
AMPS
POWERSPECTRA
% ZERO-CROSS% FIRST DERIVATIVE
POWER
*FREQUENCY BAND WIDTHS DIFFER BETWEEN LABORATORIES
A/D CONVERSIONBOARD RESIDENT
IN COMPUTERSAMPLING RATE
128-1000Hz
BETA 12-32 Hz*SIGMA 12-16 HzALPHA 8-12 HzTHETA 4-8 HzDELTA 0.5-4 Hz
PSA or PAA
RAW DATA STORAGE
DIGITIZED VALUES
OFF-LINE VISUAL SLEEP-STAGESCORING
REM
Stage 4
AwakeMoveREMStg 1Stg 2Stg 3Stg 4
SLEEP EFFICIENCY: 96.8%REM LATENCY: 94.5 minSLEEP 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
How much sleep do you need?
• Not everyone needs the same amount of sleep Natural short and long sleepers
• BUT sleeping less than 6.5 or more than 9 hours is associated with 1.7 x greater mortality & risk of disease.
MMSleep &
Chronophysiology Laboratory
Is it Enough Sleep? More than 40 % of adults have sleep
complaints 25 % women & 16 % men
# 1 Complaint: Feeling unrested # 2 Complaint: Difficulty Falling Asleep
Among college students 71 % had sleep complaints in 2000 compared to 24 % in 1978
MMSleep &
Chronophysiology Laboratory
How Has Sleep Changed Historically?
Estimated 8-9 hrs in early 20th Century 7-8 hrs mid 1980s-2002 College Students:
1980s reported 7-7.5 hrs 2002 reported 6-6.9 hrs
Going to bed later is the culprit Bedtime is 1-2 hrs later
than it was 25 yrs ago
MMSleep &
Chronophysiology Laboratory
Napping
30-50 % of students nap Nappers have delayed bedtime of >1 hr 30 % naps >1.7 hrs Mostly late afternoon naps Sleep >1 hr less than non nappers
MMSleep &
Chronophysiology Laboratory
Consequences of Sleep Loss
Poor academic performance correlated with insomnia & poor sleep quality
Automobile Accidents: Fatigue is a leading cause Minor medical Illness: Cold & Flu rates higher in
poor sleepers Circadian dysregulation: Creating Jet Lag in the
home environment
Psychiatric Illness: Depression & Anxiety
MMSleep &
Chronophysiology Laboratory
Sleep & Depression
Sleep disturbance > 2 wks is a risk factor for the development of depression
Sleep abnormalities are common symptoms of depression: >80% pts
Often the presenting symptom: Common to notice the sleep problem first
MMSleep &
Chronophysiology Laboratory
Sleep & Depression
Worse clinical outcome and increased risk of relapse in recovering patient
Increased risk of suicide Daytime fatigue/ reduced functioning Worry about insomnia may cause
further insomnia and anxiety
If sleep problems persist into clinical remission:
MMSleep &
Chronophysiology Laboratory
Depression in College Students
Incidence is 2 x greater than general population Approximately 20 % of students
Often goes undiagnosed and untreated Increasing risk of another episode
MMSleep &
Chronophysiology Laboratory
Sleep and Depression in College Students
Worsening of depression and sleep problems at exam time (particularly in males)
Minor medical problems 2-4 x more prevalent in depressed students with sleep problems >2 wks duration
Attending University does increase
both incidence of sleep problems
& depression
MMSleep &
Chronophysiology Laboratory
AwakeMoveREMStg 1Stg 2Stg 3Stg 4
SLEEP EFFICIENCY: 79.2%REM LATENCY: 49.0 minSLEEP 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
Sleep & Biological Rhythms
Ultradian <24 hrs Most common 90 min REM/NREM sleep cycle Task Performance
Infradian >24 hrs Lunar cycle Menstrual cycle
MMSleep &
Chronophysiology Laboratory
Circadian Rhythms 24 hr rhythms in biology, physiology, mood &
performance that are entrained to the light dark cycle
Controlled by the SCN in the hypothalamus Light is the most potent zeitgeber
Sleep, Cardiovascular Activity, Body Temperature, Hormones, Endocrine & Metabolic Function,
Liver & Kidney Function, Gastrointestinal Activity, Immunology
MMSleep &
Chronophysiology Laboratory
HIGH COHERENCE
LOW COHERENCE
100
100
0
0
EPOCHS
EPOCHS
100
200
300
400
500
600
700
800
900
100
200
300
400
500
600
700
800
900
% T
ime-
In-F
req
uen
cy%
Tim
e-In
-Fre
qu
ency
C3
C4
.99
.43
Coherence in Girls at High-RiskCoherence in Girls at High-Risk
0.2
0.4
0.6
0.8
1
HIGH RISK NC
CUTPOINT= .70
MMSleep &
Chronophysiology Laboratory
>50 % of girls with extreme low >50 % of girls with extreme low values had 1st episode 3-5 yrs latervalues had 1st episode 3-5 yrs later
How Do We Improve Sleep & Depression In College Students?
Education about Sleep Education about Depression Clearly identify Biological & Familial Risks Early Intervention Development of Easy,
Practical Guidelines for
Good Sleep HygieneMM
Sleep & Chronophysiology
Laboratory
Good Sleep & Biological Rhythm Hygiene
Maintain regular rise & bed times every night including weekends i.e. 11:00 P.M.-6:00 A.M. ESPECIALLY FOR WOMEN
Very hot bath (~15 min. Duration) 1 1/2 hour before bedtime ESPECIALLY FOR SWS PROBLEMS
Turn down thermostat, no electric blankets Use very dark curtains or use a sleep mask
No napping especially in afternoon
or eveningMM
Sleep & Chronophysiology
Laboratory
Restrict caffeine (not just coffee) 1-2 cups before 10
a.m.
Warm milk 1/2 hour before bedtime
No food or exercise within 2 hrs of bedtime
Avoid time zone changes
Good Sleep & Biological Rhythm Hygiene
MMSleep &
Chronophysiology Laboratory
Schedule for Light Exposure
• Early morning bright light will advance the circadian clock i.e make you sleepy earlier
• Late afternoon bright light will delay your body clock i.e make you sleepy later
• Wear dark glasses to minimize light to retina if your body clock is already shifted
• Avoid bright light at night, use incandescent light with the lowest wattage possible.
MMSleep &
Chronophysiology Laboratory
MMSleep &
Chronophysiology Laboratory