Sleep & Well-being Neuroscience of Sleep & Clocks Impact of Sleep Disruption Sleep in the Young Sleep Hygiene Mental Illness Discussion
http://www.eye.ox.ac.uk/research/sleepcircadian-neuroscience-institute
24h body clocks (circadian clocks) and sleep processes have captured the popular imagination
Sometimes not always helpful!
Sleep & Well-being Neuroscience of Sleep & Clocks Impact of Sleep Disruption Sleep in the Young Sleep Hygiene Mental Illness Discussion
5 Mood 10pm 7am 28 Growth Hormone ng/ml 200 Melatonin pmol/l 0 14 100 5 0 0 14 02 14 14 02 14 14 02 14 Core Body Temperature C Systolic Pressure mm Hg Cortisol µg/100ml 37.5 C 150 200 36.75 C 100 100 36 C 50 0 14 02 14 Urine volume ml/min. 14 02 14 Alertness 14 02 14 Sleep 3.0 100 100 1.5 75 50 0 50 0 14 02 14 14 02 14 14 02 14 10
Stroke Frequency 06.00 12.00 06.00 12.00 Oxford Vascular Study (Peter M Rothwell )
Alertness Cognitive Performance Alcohol Intake Clock Time Cognitive Performance 06:00 Time of day Rajaratnam SMW, Arendt J. Health in a 24-h society. Lancet 2001; 358: 999-1005.
Lifetime Activities Telephone/ Mail/Email 1% Sleep 36% Sport/Exercise 1% Socialising 3% Household work 8% Eating & Drinking 11% Watching TV 11% General activities 19% Work & Work related 16% Data from - American Time Use Survey Summary 2011 http://www.bls.gov/tus/
~21.5 years asleep!
"Enjoy the honey-heavy dew of slumber". Julius Cesar O sleep, O gentle sleep, nature's soft nurse, how have I frighted thee.. Macbeth Sleep is the golden chain that ties health and our bodies together. Thomas Dekker (1572 1632)
Thomas Edison Sleep is a criminal waste of time and a heritage from our cave days
Light Sleep Slow Wave Sleep Rapid Eye Movement Sleep SLEEP (NREM and REM) WAKE (States and Activity) Wake
Acetylcholine Noradrenaline Histamine Dopamine Serotonin Glutamate GABA Galanin Orexin SLEEP (NREM and REM) WAKE (States and Activity)
Cortex Thalamus Mid-Brain Hind-Brain Cortex Hypothalamus Pons Sleep is a global brain event!
SLEEP (NREM and REM) WAKE (States and Activity) Clock Sleep Pressure Social Timing
The Generation of 24h Rhythms Suprachiasmatic nuclei (SCN) The master body clock
Suprachiasmatic nuclei (SCN)
Cognitive Health Emotional/Mental Health Overall Health Pineal Melatonin SLEEP (NREM and REM) WAKE (States and Activity) Eye Clock Sleep Pressure Social Timing
Sleep & Well-being Neuroscience of Sleep & Clocks Impact of Sleep Disruption Sleep in the Young Sleep Hygiene Mental Illness Discussion
Sleep Disruption Loss of Attention High level of Micro-Sleeps Failure to process information Memory Impairment Reduced Cognition and Creativity Immune Suppression Increased Cancer Risk Increased Cardiovascular Disease Risk of Diabetes II and Metabolic Syndrome Mood Instability Anxiety Increased Stimulant/Sedative Use Impulsivity Increased Risk of Acute/Mental Illness
In USA 100,000 crashes every year are related to sleepiness. 1989 Accident investigators determined that fatigue was a factor in the crash, and the Exxon Shipping Company was criticised for failing to provide a rested crew 2010 1986 The International Nuclear Safety Group determined that human error related to sleep deprivation was a factor in the accident. Air India Express Accident investigators said that the pilot could be heard snoring on the cockpit voice recorder shortly before the disastrous landing.
Rested Effect of sleep deprivation on brain activation while performing mathematical tasks (fmri)
Effect of sleep deprivation on brain activation while performing mathematical tasks (fmri) Rested Sleep Deprived
Appetite - + Leptin Ghrelin Adipose Tissue Sleep Disruption
Sleep Disruption + STRESS + Immunity Blood Pressure Impaired Memory Anxiety & Depression Pituitary Gland Adrenal Gland CORTISOL Glucose Insulin Gastric Acid Mood Instability
Sleep & Well-being Neuroscience of Sleep & Clocks Impact of Sleep Disruption Sleep in the Young Sleep Hygiene Mental Illness Discussion
Ideal Good Sleeper Tue Mon Sun Sat Fri Thur Wed Tue Mon WAKE WAKE WAKE WAKE WAKE WAKE WAKE WAKE WAKE SLEEP SLEEP SLEEP SLEEP SLEEP SLEEP SLEEP SLEEP SLEEP 7am DAY 11pm NIGHT 7am Stable Sleep
Elderly Sleep/Wake Pattern Tue Mon Sun Sat Fri Thur Wed Tue Mon WAKE WAKE WAKE WAKE WAKE WAKE WAKE WAKE WAKE SLEEP SLEEP SLEEP SLEEP SLEEP SLEEP SLEEP SLEEP SLEEP 7am DAY 11pm NIGHT 7am Reduced and Fragmented Sleep
Teenager Sleep/Wake Tue Mon Sun Sat Fri Thur Wed Tue Mon WAKE WAKE WAKE WAKE WAKE WAKE WAKE WAKE WAKE SLEEP SLEEP SLEEP SLEEP SLEEP SLEEP SLEEP SLEEP SLEEP 7am DAY 11pm NIGHT 7am Greatly Delayed and Reduced Sleep
Delayed Body Clock (Biology)
Evening Morning vs Evening Preference changes with age Chronotype (MSF sc, time around midnight) 5.5 5.0 4.5 4.0 3.5 Male Morning 3.0 10 20 30 40 50 60 70 80 Age Roenneberg et al., Curr Biol, 2004
Evening Morning vs Evening Preference changes with age Chronotype (MSF sc, time around midnight) 5.5 5.0 4.5 4.0 3.5 Male Female Making a teenager get up at 07.00 is the same as making a 50 year old getting up at 05.00! 2 hour difference Morning 3.0 10 20 30 40 50 60 70 80 Age Roenneberg et al., Curr Biol, 2004
Reduced Sleep (Sociology)
Mary Carskadon at Brown University suggests that, on average, US teenagers are getting about 7.5 hours a night's sleep on school nights, but as many as 25% get fewer than 6.5 hours per night. Mary estimates that to be optimally alert, teenagers need approximately 9 hours of sleep.
Impact of a later school start time
Pilot Study - Monkseaton School (Newcastle, UK). Headmaster: Paul Kelly Students 15-16 taking GCSEs % Students Reaching Government Standard 5+ GCSE Passes Grade C or Higher 60 50 40 30 20 10 0 n = n = 35% 12% 08.50 (2010) National Average 53% 42% 10.00 (2011) 10.00 (2012) 169 166 164 29 30 49 School Start Time 52% 44% All Students Socially Disadvantaged Kelley, P., Lockley, S.W., Foster, R.G. and Kelley, J., (2014) Synchronizing education to adolescent biology: Let teens sleep, start school later, Learning, Media and Technology, Neuroscience and Education Special Issue, (in press)
Sleep & Well-being Neuroscience of Sleep & Clocks Impact of Sleep Disruption Sleep in the Young Sleep Hygiene Mental Illness Discussion
Opinion 22 April 2013 Why teenagers really do need an extra hour in bed
Not getting enough sleep if. Opinion 22 April 2013 You are dependent upon an alarm clock, or parent, to get you out of bed. You over-sleep extensively on free-days. You take a long time to wake up. You feel sleepy and irritable during the day. Your behaviour is overly impulsive. Crave caffeinated and sugar-rich drinks. If your friends and family notice changes in your normal behaviour irritable, loss of empathy; disinhibited..
So. Take control. Opinion 22 April 2013 Why teenagers really do need an extra hour in bed Bedroom must be dark and not too warm. Calm down prior to sleep. Prepare for sleep ~ 9h before the morning alarm. Don't text, watch TV, use computer etc. 30min before bed. Avoid bright lights 30min before bed. Try not to nap during the day. Avoid caffeinated drinks after lunch. Seek out natural light in the morning to adjust the body clock and sleep patterns to an earlier time.
Environmental Lighting Typical Range Lux Situation 100,000 Bright sunny day 10,000 Cloudy day > 4000 lux 1000-2000 Watch repairman's bench 100-600 Typical office setting 1-10 Residential street lighting 0.25 Cloudy moonlight < 100 lux
Sleep & Well-being Neuroscience of Sleep & Clocks Impact of Sleep Disruption Sleep in the Young Sleep Hygiene Mental Illness Discussion
Cognitive Health Emotional/Mental Health Overall Health SLEEP WAKE Eye Clock Sleep Pressure Social Timing
Emil Kraepelin (1856-1926) Noted in his 1883 textbook that abnormal sleep patterns and mental health are linked.
Since the 1970 s.. Sleep/Clock disruption in schizophrenia has been viewed merely as the by-product of antipsychotic medication
And.Abnormal sleep in schizophrenia is often dismissed on the basis of lack of work. Typical comment: my patients can t hold down a job - so no wonder they get up late, miss my clinic and don t have friends. (annon)
How bad is sleep and circadian rhythm disruption in schizophrenia?
Activity/Rest (Sleep) Profile Sleep Onset Wake Days 1 Melatonin Peak 45
Unemployed 00 h Schizophrenia 1 Schizophrenia 2 Schizophrenia 3 midnight 00 h Schizophrenia 7 Schizophrenia 6 Schizophrenia 5 Schizophrenia 4 Wulff, K., Middleton, B., Dijk, D-J., Foster, R.G., Joyce, E. (2012) Sleep and circadian rhythm disruption in schizophrenia patients. British Journal of Psychiatry 200(4) 1-9.
Acetylcholine Noradrenaline Histamine Dopamine Serotonin Glutamate GABA Galanin Orexin SLEEP WAKE Eye Clock Sleep Pressure Social Timing
Do the networks in the brain that generate normal sleep and mental health overlap? Mental Illness Overlapping Brain Pathways & Mechanisms Sleep Disruption Wulff, K., Gatti, S., Wettstein, J.G. and Foster, R.G. (2010) Sleep and Circadian Rhythm Disruption in Psychiatric and Neurodegenerative Disease. Nature Reviews Neuroscience 11(8), 589-599.
Sleep Disruption Observed in those at risk of Bipolar Low risk Time of Day (hours) 00 12 00 12 00 High risk Time of Day (hours) 00 12 00 12 00 Days of measurements
Partial consolidation of SCRD using CBT reduces symptoms in schizophrenia 50.00 50.00 * Mean Score 40.00 30.00 20.00 Baseline Post-Treatment Follow-up Mean Score 40.00 30.00 20.00 Baseline Post-Treatment Follow-up 10.00 10.00 00.00 Insomnia 00.00 Delusion
Do the networks in the brain that generate normal sleep and mental health overlap? Mental Illness Overlapping Brain Pathways & Mechanisms Sleep Disruption THERAPUTICS MECHANISMS BIOMARKER Wulff, K., Gatti, S., Wettstein, J.G. and Foster, R.G. (2010) Sleep and Circadian Rhythm Disruption in Psychiatric and Neurodegenerative Disease. Nature Reviews Neuroscience 11(8), 589-599.
Sleep & Well-being Neuroscience of Sleep & Clocks Impact of Sleep Disruption Sleep in the Young Sleep Hygiene Mental Illness Discussion