Uddip TalukdarMD (Psychiatry)

Uddip Talukdar

• Sleep is a regular, recurrent and easily reversible state that is characterized by relative quiescence and a great increase in the in the threshold of response to

external stimuli relative to the waking state.

Uddip Talukdar

Stages of sleep

• REM

• NREM

– Stage I, II, III, IV

Uddip Talukdar

Uddip Talukdar

NREMstages

Uddip Talukdar

Typical sleep pattern

Uddip Talukdar

Sleep disorders

• Insomnia

• Hypersomnia

• Parasomnia

Uddip Talukdar

Insomnia

• Difficulty in

– Falling asleep

– Maintaining sleep

– Refreshing sleep

Uddip Talukdar

Insomnia: Treatment

• Benzodiazepines

• Zolpidem, Zeleplon

• SLEEP-HYGIENE

Uddip Talukdar

Sleep-hygiene

�Arise at same time daily

�Limit daily in bed time to premorbid level

�Avoid stimulants

�Avoid day time naps

�Graded exercise at early day time

�Avoid evening stimulation , watching TV

�Hot, 20 min bath

�Regular meals- no heavy meal at bedtime

�Practice relaxation

�Maintain comfortable sleeping conditions

Uddip Talukdar

Hypersomnia

• Excessive day time sleepiness

• Sleep attacks

• Sleep drunkenness (Prolonged full awakening)

• Rx: Stimulants

Uddip Talukdar

Disorders of Sleep-Wake schedule

• Out of synchrony with the desired sleep-wake pattern because of societal demands and shared by most people in the individual’s surroundings

– Delayed sleep phase

– Jet lag

– Shift work

Uddip Talukdar

Parasomnias

• Nightmare Disorder (REM)

• Sleep Terror Disorder (NREM)

• Sleepwalking disorder (NREM)

• REM sleep behaviour disorder (Acting out the dream)

• Sleeptalking (REM/ NREM)

• Sleep related head banging (NREM)

Uddip Talukdar

Obstructive Sleep apnoea syndrome

• Apnoeic spells during sleep

• Rx:

– Nasal continuous airway pressure

– Weight loss

Uddip Talukdar

NARCOLEPSY

• Daytime sleepiness, with

• Early REM sleeps

• Hypnagogic hallucinations

• Sleep paralysis

• Potentially dangerous condition.

Uddip Talukdar

Secondary Sleep disorders

• Insomnia:

• Hypersomnia:

Uddip Talukdar

Happiest people are those, whocan sleep anytime, anywhere,and as long they want to.

Uddip Talukdar

Sleep well, always……