Sophia L. Dollar, MPH Wellness Coach

Sophia L. Dollar, MPH Wellness Coach

Welcome! Today s Outline: Introduction I. Public Health Problem II. The Sleep Cycle III. IV. I. NREM & REM Cycle II. The Right Mix Insomnia I. Causes and Effects II. Affecting your Work III. Vicious Cycle Chronic Disease Linked to Insufficient Sleep I. Immune System II. Diabetes III. Cardiovascular Disease IV. Obesity V. Depression V. Good Sleep Hygiene: 12 Tips to Better Sleep VI. Guided Relaxation

I. Public Health Problem Sufficient sleep is increasingly being recognized as an essential aspect of health promotion and chronic disease prevention in the public health community. Sufficient sleep is not a luxury it is a and should be thought of as a vital sign of good health.

II. The Sleep Cycle First off, how much do you need? Check the chart for your family members, too. (National Sleep Foundation, 2010)

The Stages of Sleep Sleep is an active physiological process All major organs and regulatory systems continue to function; metabolism slows down 2 types of sleep: and

NREM or Non Rem Non rapid Eye Movement 4 Stages Slow Wave Sleep

REM Rapid Eye Movement Intense brain activity Breathing becomes more rapid, irregular Eyes move rapidly and limb muscles become temporarily paralyzed Heart rate increases and BP rises Dreams occur here

The Right Mix REM and NREM alternate throughout the night predictable pattern Complete cycle consist of NREM and REM cycles that alternate every 90 110 minutes and is repeated 4 6 times per night 4 cycles x 90 mins = 360 mins = 6 hours MINIMUM!

III. What is Insomnia? Insomnia: characterized by an inability to initiate or maintain sleep Waking too early Not being able to get back to sleep % of Americans suffer from poor sleep quality falling asleep on the job absenteeism marital problems CAR ACCIDENTS similar to being intoxicated (National Sleep Foundation)

Causes of Insomnia Causes Lack of exercise Shift work Frequent urination Chronic pain Medications Menopause Sleep apnea Jet lag Cell phone use STRESS!!! At least 50% of all insomnia is stress related

Effects Effects of Insomnia Depressed Immune System Lapse of Attention Slow Thinking Irritability Poor Memory Poor Judgment Anxiety & Depression Increase in Accidents Decrease in Work Productivity

Insomnia = Affects Hormones Cortisol the stress hormone Dips at bed time and increases throughout the night Promote wakefulness, increase near the end of a complete sleep cycle Promote alertness in morning Growth hormones Reproduction hormones Leptin regulates metabolism

Insomnia = Affects Work Presenteeism working hard or hardly working? Lack of Focus Mistakes & Accidents Interpersonal Difficulties Poor Attitude Inspection Failure Rate Absenteeism

Effects of Insomnia Vicious Cycle The more tired you are, the more caffeine you ll consume to stay awake during the day; but the more caffeine you consume, the harder it ll be to fall asleep at night.

IV. Chronic Disease Insufficient sleep has been linked to chronic diseases Immune System Cardiovascular disease High Blood Pressure Obesity Diabetes Depression

Sleep Boosts Your Immune System No wonder we re sleepy when we re sick! Cytokines Chemicals our immune systems use to fight infections Powerful sleep inducers Body s natural way to conserve energy to build your immune system

Diabetes Sleep debt accumulated over a matter of days can impair sugar metabolism and disrupt hormone levels Ability to process blood glucose declines Prompts your body to make more insulin

Cardiovascular Disease Sleep Apnea characterized by episodes of interrupted breathing during sleep the brain has to awaken the individual in order for breathing to start again High prevalence of sleep apnea among people with cardiovascular problems Related to fat build up or loss of Air cannot flow through the wind pipe

High Blood Pressure Study at University of Chicago followed 578 adults over 5 years Ages 33 45; African Americans and Whites Measured blood pressure during periods of rest and activity Those who slept less were 37 percent are more likely to develop high blood pressure over time and that risk grew with each additional hour of lost sleep. (Knutson et. al, 2009)

Obesity Sleepiness can create a larger appetite Leptin levels fall Leptin hormone regulating metabolism Promoting appetite increase carb cravings Psychological manifestations of fatigue, sleep and are similar. Thus, when you re feeling sleepy you might feel like you need to head for the fridge instead of bed.

Obesity Growth Hormones Regulate muscle mass Secreted during sleep Young men studied: having less growth hormone as men get older increases the tendency toward becoming overweight and having a paunch in middle age

Caffeine & Obesity The more tired, the more caffeine you ll go for Creating a Caffeine drinks are usually replete with sugar or artificial sugar and not much else. Replace caffeine with a healthy snack Fruit, granola bar, nuts

Depression A common and serious medical condition that can feel overwhelming and interfere with your ability to function Common characteristics include: Poor appetite or overeating Insomnia or hypersomnia Low energy or fatigue Low self esteem Poor concentration or difficulty making decisions Feelings of hopelessness (American Psychiatric Association, 2000 DSM IV TR)

Depression Depression may cause sleep problems and sleep problems may cause or contribute to depressive disorders An inability to sleep that lasts over a long period of time is also an important clue that someone may be depressed

Sidenote: This info is relevant for every family member.

V. Good Sleep Hygiene 12 ways to increase your sleep Adapted from: Brian Luke Seaward, Ph.D., Paramount Wellness Institute

1. Keep a regular sleep cycle Establish a regular, relaxing Avoid exposure to bright light before bedtime Go to bed and wake up at the same time each day

2. Create an ideal sleep ambiance Quiet Clean Dark Relaxing Comfortable temperature Not too hot or cold

3. Get out and exercise Flush out the stress hormones Stress is related to at least 50% of insomnia cases

4. Decrease your caffeine consumption If you re stressed, caffeine is like throwing gasoline on a fire Caffeine is the #1 drug in the world Decaf does not mean caffeine free

5. Learn to meditate

6. Move the TV out of the bedroom vs. The more and, the less your brain will get into sleep mode

7. Stop using your cell phone after 6 p.m. It will take longer to wind down at the end of the night if your brain is occupied with conversations and text messages Make yourself unavailable it will feel refreshing to have uninterrupted ME TIME

8. Avoid alcohol and nicotine Nicotine is a stimulant, therefore falling asleep is hindered by withdrawal symptoms Although alcohol is thought of as a sedative, it disrupts sleep and causes nighttime awakenings

9. Clear your late night mind Reading, candles, soothing music, warm bath

10. Avoid eating before bed Heavy meals can make you feel groggy and can make it hard to settle down. Some meals also provoke heartburn, which worsens falling asleep and discomfort during the night.

11. Avoid naps during the day If you can t rest for 10 minutes without falling asleep, you re probably sleep deprived

12. Keep your bed for sleeping Refrain from: TV Listening to music Reading Computers Other gadgets

References American Psychiatric Association, 2000 Centers for Disease Control and Prevention (cdc.gov, 2010) National Sleep Foundation (sleepfoundation.org, 2010) World Health Organization (who.int, 2010) Brian Luke Seaward, Ph.D., Paramount Wellness Institute Sleep Wake Cycle: Its Physiology and Impact on Health, 2006. National Sleep Foundation (sleepfoundation.org) Knutson, K. L., PhD;Van Cauter, E., PhD; Rathouz, P. J., PhD; Yan, L. L., PhD; Hulley, S. B., MD, MPH; Liu, K., PhD; Lauderdale, D. S., PhD. Association Between Sleep and Blood Pressure in Mid Life. Arch Intern Med. 2009; 169(11):1055 1061

VI. Guided Relaxation Take this time to simply listen & relax Today s meditation will be made available for at home use