Sleep Physiology and Disorder

7/28/2019 Sleep Physiology and Disorder

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Sleepphysiology

and disorder


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Sleep

Is a recurrent, altered state of consciousness

that occurs for sustained periods, restoring physical

health and mental well being. It is a sensoryexperience and can be selective


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Why do we sleep?


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Sleep cycle

REM Rapid eyemovement

NREM Non-rapideye movement


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Non-REM sleep

Reduced muscle tension through outbody

Minimal movementbody capable ofmovement, but brain rarely commands to

Low temperature & energy consumption

Heart rate, respiration & kidney function

slow down Increased digestive process


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Non- REM sleep stages

Stage 1transitional sleep; lightest stage.- eyes make slow rolling movements -

duration few minutes Stage 2slightly deeper - eye movements

almost stop - duration 5-15 minutes

Stage 3 - large amplitude slow rhythms -no eye or body movements

Stage 4deepest stage - duration 20-40minutes


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REM sleep Dreaming period EEG almost indistinguishable from that of an active

brain High oxygen consumption Increased and irregular heart & respiration rates Muscle atony- exception: muscles controlling eye movements &

tiny muscles in inner ear

- respiratory muscles barely operate- eyes occasionally dart rapidly back & forth Body temperature drops


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Timing Sleep timing is controlled by the circadian

clock sleep-wake homeostasis. The circadianclockan inner timekeeping, temperature-

fluctuating, enzyme-controlling deviceworksin tandem with adenosine, a neurotransmitterthat inhibits many of the bodily processesassociated with wakefulness. Adenosine iscreated over the course of the day; highlevels of adenosine lead to sleepiness.

Homeostatic sleep propensity (the need forsleep as a function of the amount of timeelapsed since the last adequate sleepepisode) must be balanced against thecircadian element for satisfactory sleep.


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Optimal amount in humans

Newborns (02 months)12 to 18 hours

Infants (311 months)14 to 15 hours

Toddlers (13 years)12 to 14 hours

Preschoolers (35 years)11 to 13 hours

School-age children (510 years)10 to 11 hours

Adolescents (1017 years)8.5 to 9.25 hours

Adults, including elderly7 to 9 hours


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FACTORS AFFECTING SLEEP

1. DevelopmentalLifespan Considerations

2. Psychological Stress Anxiety

Depression

3. Motivation Desire to stay awake ..overcome sleepiness

Opposite can occur also

4. Life style Shift work Dietary Habits (caffein, smoking)


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4. Medication Antidepressantssupress REM

Narcotics--- supress REM

Heart medicationsnightmares, insomnia

Some Steroids, Decongestants,Antiparkinsonian can disrupt

6. Illnesses

Hypothyroidism.less NREM

Respiratory conditionscongestion

Need to urinate

Temperature increases.. less NREM and REM

Discomfort from restricted movement


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Sleep disorder1. Insomnia

It is a term applied to

people who have acomplaint of un-refreshingsleep, difficulty initiating ormaintaining sleep.

Also defined as less than5.5hrs of sleep/24hrs

Most patients with insomnia

have daytime effects ofthe disturbed nighttimesleep such as fatigue,tiredness, irritability orinability to concentrate.


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2. Nocturnal MyoclonusRestless leg syndrome Urge to walk ,irritating

ache or creepy feelingin calves and thighs

Common in elderly It may be associated with

nerve damage in the legsdue to diabetes, kidneyproblems or alcoholism.

Stress, diet may play arole in it.


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3. Primary Snoring :

also known as simplesnoring, snoring withoutsleep apnea

rhythmical snoring andcontinous snoring is

characterized by loudupper airwaybreathing sounds insleep without episodesof apnea (cessation of

breath).


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4. Hypersomnia Excessive sleep

especially duringthe day

Medical conditionor frequently acoping mechanismto avoid a problem


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5. Narcolepsia

Is a chronic neurologicaldisorder caused by thebrain's inability to regulatesleep-wake cyclesnormally

Its usually accompanied

by Cataplexy(sudden andtransient episode of lossof muscle tone)

A person with narcolepsyis likely to become drowsyor fall asleep or just be verytired throughout the day

Patients with narcolepsycan be substantiallyhelped, but not cured


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6. Sleep paralysis - inability to moveespecially the limbs durring sleep7. Hallucinations - vivid visual and or

auditory imagines

8. Parasomnia - Some disruptive eventoccurs during specific sleep periodsand/or transitions.


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10. Nightmare Disorder:Usually begins in children between the age of 3 and6. It can persist into adulthood. The individualexperiences repeated awakenings with detailed

recall of frightening dreams. Episodes generallyoccur during second half of sleep period.11. Sleep Terror Disorder :Occurs both among children and adults. Individualexperiences repeated episodes of abruptawakening during the first third of a sleep cycle.

Individual awakes with a scream and physiologicalsymptoms similar to those of a panic attack.Individual is generally unresponsive to attempts to becomforted and when finally awake, no memory ofthe dream.


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12. Sleepwalking Disorder:

Begins in childhood andends during adolescence.Initial onset of sleepwalking inadulthood is unusual.

Involves the client getting upand walking around, usuallyduring the first third of thesleep cycle. Very difficult to

awake and no memory ofthe incident.


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Bibliography Consciousness, 17 January 2013,

http://en.wikipedia.org/wiki/Consciousness

Non-rapid eye movement sleep, 10 January2013 http://en.wikipedia.org/wiki/Non-rapid_eye_movement_sleep

Rapid eye movement sleep, 9 January 2013,http://en.wikipedia.org/wiki/Rapid_eye_movement_(sleep)

Sleep, 17 January 2013,http://en.wikipedia.org/wiki/Active_Sleep#Physiology

Factors Affecting Sleep- Lifestyle, Videojug,http://www.videojug.com/interview/factors-affecting-sleep-lifestyle

Insomnia, 15 January 2013, http://en.wikipedia.org/wiki/Insomnia

Restless Legs Syndrome Center, WebMD, 01 February 2011,
http://en.wikipedia.org/wiki/Consciousnesshttp://en.wikipedia.org/wiki/Non-rapid_eye_movement_sleephttp://en.wikipedia.org/wiki/Rapid_eye_movement_(sleep)http://en.wikipedia.org/wiki/Active_Sleephttp://www.videojug.com/interview/factors-affecting-sleep-lifestylehttp://en.wikipedia.org/wiki/Insomniahttp://en.wikipedia.org/wiki/Insomniahttp://www.videojug.com/interview/factors-affecting-sleep-lifestylehttp://www.videojug.com/interview/factors-affecting-sleep-lifestylehttp://www.videojug.com/interview/factors-affecting-sleep-lifestylehttp://www.videojug.com/interview/factors-affecting-sleep-lifestylehttp://www.videojug.com/interview/factors-affecting-sleep-lifestylehttp://www.videojug.com/interview/factors-affecting-sleep-lifestylehttp://www.videojug.com/interview/factors-affecting-sleep-lifestylehttp://en.wikipedia.org/wiki/Active_Sleephttp://en.wikipedia.org/wiki/Rapid_eye_movement_(sleep)http://en.wikipedia.org/wiki/Non-rapid_eye_movement_sleephttp://en.wikipedia.org/wiki/Non-rapid_eye_movement_sleephttp://en.wikipedia.org/wiki/Non-rapid_eye_movement_sleephttp://en.wikipedia.org/wiki/Consciousnesshttp://en.wikipedia.org/wiki/Consciousness


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Snoring, 10 January 2013, http://en.wikipedia.org/wiki/Snoring Sleep and Hypersomnia, 28 July 2012

,http://www.webmd.com/sleep-disorders/guide/hypersomnia

Narcolepsy, 17 January 2013,

http://en.wikipedia.org/wiki/Narcolepsy

Nightmare disorder, http://www.minddisorders.com/Kau-

Nu/Nightmare-disorder.html Sleep terror disorder, http://www.minddisorders.com/Py-

Z/Sleep-terror-disorder.html

Sleep Disorders Health Center, WebMD,15 October 2011,

http://www.webmd.com/sleep-disorders/guide/sleepwalking-

causes
http://en.wikipedia.org/wiki/Snoringhttp://www.webmd.com/sleep-disorders/guide/hypersomniahttp://en.wikipedia.org/wiki/Narcolepsyhttp://www.minddisorders.com/Kau-Nu/Nightmare-disorder.htmlhttp://www.minddisorders.com/Kau-Nu/Nightmare-disorder.htmlhttp://www.minddisorders.com/Py-Z/Sleep-terror-disorder.htmlhttp://www.minddisorders.com/Py-Z/Sleep-terror-disorder.htmlhttp://www.webmd.com/sleep-disorders/guide/sleepwalking-causeshttp://www.webmd.com/sleep-disorders/guide/sleepwalking-causeshttp://www.webmd.com/sleep-disorders/guide/sleepwalking-causeshttp://www.webmd.com/sleep-disorders/guide/sleepwalking-causeshttp://www.webmd.com/sleep-disorders/guide/sleepwalking-causeshttp://www.webmd.com/sleep-disorders/guide/sleepwalking-causeshttp://www.webmd.com/sleep-disorders/guide/sleepwalking-causeshttp://www.minddisorders.com/Py-Z/Sleep-terror-disorder.htmlhttp://www.minddisorders.com/Py-Z/Sleep-terror-disorder.htmlhttp://www.minddisorders.com/Py-Z/Sleep-terror-disorder.htmlhttp://www.minddisorders.com/Py-Z/Sleep-terror-disorder.htmlhttp://www.minddisorders.com/Py-Z/Sleep-terror-disorder.htmlhttp://www.minddisorders.com/Py-Z/Sleep-terror-disorder.htmlhttp://www.minddisorders.com/Py-Z/Sleep-terror-disorder.htmlhttp://www.minddisorders.com/Kau-Nu/Nightmare-disorder.htmlhttp://www.minddisorders.com/Kau-Nu/Nightmare-disorder.htmlhttp://www.minddisorders.com/Kau-Nu/Nightmare-disorder.htmlhttp://www.minddisorders.com/Kau-Nu/Nightmare-disorder.htmlhttp://www.minddisorders.com/Kau-Nu/Nightmare-disorder.htmlhttp://en.wikipedia.org/wiki/Narcolepsyhttp://www.webmd.com/sleep-disorders/guide/hypersomniahttp://www.webmd.com/sleep-disorders/guide/hypersomniahttp://www.webmd.com/sleep-disorders/guide/hypersomniahttp://en.wikipedia.org/wiki/Snoringhttp://en.wikipedia.org/wiki/Snoring

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Sleep Physiology and Disorder