Help I Have Problems with My Sleep!

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Transcription:

Help I Have Problems with My Sleep!

Over An 85 Year Lifespan Sleep 31% Work 21% Exercise 1% Food and Drink 11%

Sleep Is Important! You can survive without food for up to 2 months Without water 3-5 days Food and water 24 days, in certain conditions Without sleep?11-32 days

Prominent Theories Energy Conservation Theories Reduction of metabolic rate Enforced inactivity to balance energy input and output Memory reinforcement Evolution of increasing demands on brain to process complex information Reinforcement of complex memory circuits Neural Cleansing

What is Sleep? Non-REM sleep Known as slow wave sleep stages (SWS) and is important for: Physical restoration, repair and growth Immune function. REM (rapid eye movement) sleep Phase of sleep during which dreaming takes place important for: Memory storage and retention Mood maintenance Concentration Cognitive function.

Typical Human Sleep Pattern

More Usual Human Sleep Pattern

So how much is normal?

So how much is normal?

Sleep and Immunity

Sleep and Weight Gain Patel S R et al. Am. J. Epidemiol. 2006;164:947-954 Mean age-adjusted weight of the Nurses' Health Study cohort from 1986 to 2002 as a function of habitual sleep duration in 1986.

Sleep and Other Medical Problems Increasing evidence of role of sleep in: High Blood Pressure Diabetes Cardiovascular Disease Kidney Disease Dementia Cancer Depression Epilepsy

Are You Sleepy? What is the chance of you dozing off while: Sitting and reading? Watching TV? Sitting inactive in a public place (eg. theatre or meeting)? As a passenger in a car for an hour without a break? Lying down in the afternoon? Sitting and talking to someone? Sitting quietly after lunch (no alcohol)? Stopped for a few minutes in traffic while driving? (Epworth Sleepiness Scale) No chance = 0 Mild chance = 1 Moderate chance =2 High Chance = 3

Common Sleep Issues Chronic Sleep Deprivation approx. 20% of the population Insomnia 30% will have a period of insomnia, 10% have chronic problems Sleep Apnoea 4-8% of the adult population Restless Legs Syndrome 5% Sleepwalking and related conditions 1-2% Narcolepsy 1 in 2000 = 270 in L+S alone Circadian rhythm disorders

Snoring and Sleep Apnoea On a spectrum of sleep-disordered breathing Sleep apnoea affects 4% men, 2% women Associated with obesity, large neck circumference, smoking Increasing evidence that it has a contributing role to the development of hypertension, cardiovascular disease, stroke and diabetes Symptoms include unrefreshing sleep, recurrent awakenings with gasping, getting up repeatedly to urinate, dry mouth, sore throat, early morning headache

Snoring and Sleep Apnoea

Restless Legs Syndrome Common neurological disorder, affects 2-5% of population Sensation of restlessness or discomfort, associated with worsening in evening, relieved by movement, worsened by immobility Usually genetic, but associated with iron deficiency, kidney problems or pregnancy Often coincides with periodic limb movement disorder Symptoms include difficulty getting off to sleep, unrefreshing sleep, recurrent awakenings, kicking at night

Parasomnias REM sleep behaviour disorders Non-REM parasomnias Bruxism Epilepsy Transitional parasomnias

Narcolepsy Neurological disorder Failure to control wake and sleep, but also dreaming sleep Sleep attacks Hallucinations Sleep Paralysis Cataplexy

Guy s Sleep Disorders Centre One of the largest sleep centres in the world 13000 patients per year, 3500 in-patient admissions for sleep studies A large multidisciplinary team Respiratory physicians, neurologists, psychiatrists, psychologists, pharmacists Highly trained sleep technologists Close working with paediatric service and Lane Fox Unit Highly specialist Complex problems with referrals from all over the country

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