Sleep: A Forgotten Component of Overall Health Demarcus Sneed Health and Human Sciences Educator Madison County October 5, 2016

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Sleep: A Forgotten Component of Overall Health Demarcus Sneed Health and Human Sciences Educator Madison County October 5, 2016 Lesson Objectives Understand the importance of having consistent, quality and adequate sleep Identify the differences between poor sleep hygiene and sleep disorders Learn about different ways to improve sleep health 1

Sleep Health at Ag. Conference? Agricultural Safety In 2012, 374 farmers and farm workers died from a work related injury Every day, about 167 agricultural workers suffer a lost work time injury Of the leading sources of fatal injuries to youth, 23% percent involved machinery In 2012, an estimated 14,000 youth were injured on farms; 2,700 of these injuries were due to farm work In 2014, many deaths among rural Americans were potentially preventable, including 12,000 from unintentional injuries 2

Sleep Overview Sleep The natural state of rest during which your eyes are closed and you become unconscious. Types of sleep Non Rapid Eye Movement (NREM) Four Stages Rapid Eye Movement (REM) Physiological State/Changes During Sleep 3

Activity: NREM vs REM Each person will receive a card that describes a characteristic of either the NREM or REM type. Each persons job is to connect with those in the room whose characteristics fall under the same sleep type. At the end of the activity there should be two groups. An NREM group and a REM group. After everyone believes they re in the right group the answers will be revealed. NREM Brain activity decreases from wakefulness Not associated with memory consolidation Heart rate slows from wakefulness Blood pressure decreases Does not consist of rapid eye movement Consists of four sleep stages Sympathetic nerve activity decreases The second stage of this type makes up 45 55 percent of total sleep. Muscle tone similar to wakefulness Blood flow to the brain decreases from wakefulness Respiration decreases from wakefulness Airway resistance increase from wakefulness Dreams do not occur during this type The fourth stage of this type is the most difficult for a person to be awakened. Sexual arousal occurs infrequently The last two stages of this type are considered Slow Wave Sleep Body temperature is regulated at lower set point 4

Brain activity increases in motor and sensory areas Heart rate increases Blood pressure increases up to 30% Sympathetic nerve activity increases significantly from wakefulness Muscle tone absent Respiration increases Dreams occur during this type REM Babies can spend up to 50% of their sleep in this type of sleep. Sexual arousal is greater during this type Airway resistance increases Blood flow to the brain increases depending on the brain region Does not consist of four sleep stages Consists of rapid eye movement Associated with memory consolidation This type has brain activity SIMILAR to the first two stage of the other type. Body temperature is not regulated This sleep type usually occurs about 90 minutes after you fall asleep. Sleep Recommendations Age Group Adults Teens School aged Children Preschoolers Newborns Daily Recommendations 7 to 8 hours 9 to 10 hours 10+ hours 11 to 12 hours 16 to 18 hours 5

Health Benefits of Sleep Get sick less often Stay at a healthy weight Lower your risk of high blood pressure and diabetes Reduce stress and improve mood Think more clearly and do better in school and at work Get along better with people Make good decisions and avoid injuries (For Example, sleepy drivers cause thousands of car crashes each and every year.) Adult Sleep Statistics Gender Percent Reporting Sufficient Sleep Males 69.4% Females 68.8% Overall 69.1% Age Percent Reporting Sufficient Sleep 18 24 63.7% 25 44 69.7% 45 64 66.8% 65 and older 76.3% 6

Adolescent Sleep Statistics (Grades 9 12) Gender Percent Reporting Sufficient Sleep Males 34.5% Females 28.9%% Overall 31.7% Grade Percent Reporting Sufficient Sleep 9th 39.9% 10 th 33.5% 11th 28.5% 12th 23.3% Causes of Insufficient Sleep Personal choice Illness Work schedule Jet lag/new time zone Sleep disorder Medications The sleeping environment Poor sleep hygiene Babies and young children 7

Consequences of Insufficient Sleep Vehicle Accidents Occupational Errors Hypertension Obesity Diabetes Heart Disease Stroke Depression Too Much Sleep a Problem? Oversleeping linked to diabetes, heart disease, and increased risk of death Depression and low socioeconomic status strongly associated with oversleeping Can also be caused by a variety of other factors such as Medical Disorders Use of Certain Substances Medications 8

Activity: Fact or Fiction? Participants at each table will get a Fact or Fiction handout The groups will then discuss whether each statement is true or false. After allowing for a few minutes to discuss, the presenter will share the correct answers. No cheating using electronic devices. Today, 75 percent of us dream in color. Before color television, just 15 percent of us did. Sleep Fact 9

Sleep Fact If it takes you less than 5 minutes to fall asleep at night, you re probably sleep deprived. Ideally, falling asleep should take 10 to 15 minutes Being awake for 16 hours straight decreases your performance as much as if your blood alcohol level were.05%. (The legal limit is.08%.) Sleep Fact 10

Sleep Fact Scientists still don't know and probably never will if animals dream during REM sleep, as humans do. Sleep Fact Some car rental contracts make you promise not to drive on fewer than 6 hours of sleep. 11

Sleep Fact Doing without sleep is likely to make you hungry as levels of leptin, an appetite regulating hormone, fall. Sleep Fact The body never adjusts to shift work! 12

Sleep Fact According to the results of NSF's 2008 Sleep in America poll, 36 percent of American drive drowsy or fall asleep while driving. Common Sleep Disorders Insomnia Sleep apnea Restless legs syndrome Narcolepsy 13

Insomnia Definition Disorder in which you may have trouble falling asleep, staying asleep, or both. Symptoms Lying awake for a long time before you fall asleep Sleeping for only short periods Being awake for much of the night Feeling as if you haven t slept at all Waking up too early Sleep Apnea Definition Sleep disorder that causes your breathing to stop or get very shallow. Most common type is obstructive sleep apnea, which occurs when throat muscles relax. Symptoms Loud snoring Episodes of breathing cessation during sleep witnessed by another person Abrupt awakenings accompanied by shortness of breath Awakening with dry mouth or sore throat Morning headache Difficulty staying asleep Excessive daytime sleepiness Attention problems Irritability 14

Restless Legs Syndrome/Willis Ekbom Disease Definition Condition that causes a powerful urge to move your legs. Cause is unknown in most cases Symptoms Sensation starts after being at rest Relief by movement Worsening of symptoms in the evening Nighttime leg twitching Narcolepsy Definition Chronic brain disorder that involves poor control of sleep wake cycles. Can be caused by several factors including: Low levels of hypocretin Family History Loss of brain cells Brain Injuries Symptoms Excessive daytime sleepiness Cataplexy Sleep paralysis Hallucinations Disrupted nocturnal sleep Obesity 15

Activity: Diagnosis Unknown 1. Divide into groups of at least five at each table. 2. Each group will determine the diagnosis and recommended treatment for their assigned sleep case by completing the Sleep Specialist s Evaluation Form. 3. To assist groups in completing the form, groups will be given the following information: a. Primary information about the patient b. Secondary information about the patient. c. Sleep Disorders Reference Manual. 4. Once the evaluation form is completed, answer the discussion questions for your groups specific case. 5. Check your answers using the answer sheet AFTER completing the evaluation form and answering the discussion questions. 6. All necessary information is included in the Manila envelopes on your tables. Sleep Strategies Purposefully go to bed earlier each night Monitor your eating habits Establish a regular exercise routine Improve your sleeping environment Remove distractions from your bedroom Use relaxation techniques to help you fall asleep Seek professional assistance for sleep disorders such as snoring 16

Talk to your doctor if you have Frequent, loud snoring Pauses in breathing during sleep Trouble waking up in the morning Pain or itchy feeling in your legs or arms at night that feel better when you move or massage the area Trouble staying awake during the day Any general concerns about your sleep Survey 17

References Centers for Disease Control and Prevention. Are you getting enough sleep? (2014, April 14). Retrieved September, 2016, from https://www.cdc.gov/features/sleep/ Centers for Disease Control and Prevention. Insufficient Sleep is a Public Health Problem. (2015, September 03). Retrieved September, 2016, from http://www.cdc.gov/features/dssleep/ Cleveland Clinic. (2014, May 2). 22 Facts About Sleep That Will Surprise You (Infographic). Retrieved September, 2016, from https://health.clevelandclinic.org/2014/05/22 facts about sleep that willsurprise you infographic/ Department of Health & Human Services, State Government of Victoria, Australia. (2014, June). Sleep deprivation. Retrieved September, 2016, from https://www.betterhealth.vic.gov.auhealthconditionsandtreatments/sleep deprivation Institute of Medicine (US) Committee on Sleep Medicine and Research. (2006). Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Retrieved September, 2016, from https://www.ncbi.nlm.nih.gov/books/nbk19960/ MedlinePlus. (2016, September 27). Sleep Disorders. Retrieved September, 2016, from https://medlineplus.gov/sleepdisorders.html?phpsessid=465253 0e6191a618354a397254379d National Institutes of Health. Narcolepsy Fact Sheet. (n.d.). Retrieved September, 2016, from https://www.ninds.nih.gov/disorders/patient Caregiver Education/Fact Sheets/Narcolepsy Fact Sheet National Sleep Foundation. (2016). 25 Random Facts about Sleep. Retrieved September, 2016, from https://sleepfoundation.org/sleep news/25 random facts about sleep Ohio Sleep Medicine Institute. (2017). Narcolepsy and Idiopathic Hypersomnia. Retrieved September, 2016, from http://sleepmedicine.com/disorders.cfm?disorder=5 U.S. Department of Health and Human Services: Healthy People 2020. Sleep Health. (2016, September 26). Retrieved September, 2016, from https://www.healthypeople.gov/2020/topics objectives/topic/sleep health/national snapshot U.S. Department of Health and Human Services: HealthFinder. Get Enough Sleep. (2016, July 25). Retrieved September, 2016, from http://healthfinder.gov/healthtopics/category/everyday healthyliving/mental health and relatioonship/get enough sleep U.S. Department of Transportation: National Highway Traffic Safety Administration. (n.d.). "Wake Up And Get Some Sleep": Workers Brochure. Retrieved September, 2016, from http://www.nhtsa.gov/people/injury/drowsy_driving1/human/drows_driving/wbroch/wbroch_lg/wbroch_lg.html WebMD. (2010). 9 Surprising Reasons to Get More Sleep. Retrieved February 22, 2017, from http://www.webmd.com/sleep disorders/features/9 reasons to sleep more#1 WebMD. (2016). 10 Tips to Beat Insomnia. Retrieved February 22, 2017, from http://www.webmd.com/women/guide/insomnia tips WebMD. (2016). Oversleeping Side Effects: Is Too Much Sleep Harmful? Retrieved September, 2016, from http://www.webmd.com/sleep disorders/guide/physical side effects oversleeping?page=1#2 18