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Sleep Better

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Sleep Better

Part I: Understanding Sleep

Dr. Kamal Kant Anand


Torture
• “In the head of the interrogated prisoner a haze begins to form. His
spirit is wearied to death, his legs are unsteady, and he has one sole
desire: to sleep. Anyone who has experienced this desire knows that
not even hunger and thirst are comparable with it.”

– Menachem Begin
Former PM of Israel
(White Nights : the Story of a Prisoner in Russia)
Why should I care about Sleep now?

Quiz Time!
Insufficient Sleep Epidemic
• Problem Statement: The prevalence of sleep disorders in India is high.
A study has pegged the percentage of insomnia to be as high as 33%
among adults in India. (Silent Sleep Epidemic)

Various studies worldwide have shown the prevalence of insomnia in


10%–30% of the population (Prevalence of chronic insomnia in adult
patients and its correlation with medical comorbidities - PMC (nih.gov))
But why should I care about these facts?
Because…
• Diminished immunity
• Doubled risk of cancer
• Increased risk for Alzheimer’s
• Diabetes, Hypertension, Heart Attack, Stroke
• Depression, Anxiety, Suicidality
• Accidents: workplace, roads, doctors, pilots, Chernobyl
• Sleeping Pills and Aids
• Fatal Familial Insomnia
• Rats without sleep
“…averaging 4 hours nightly with an almost 10 month old. I haven't
slept more than 6 hours a night in well over a year. I struggle to run
even a couple miles, I'm constantly sore, emotional and generally
pissed nearly 24 hours a day. I get to sleep in maybe once a month
depending on my husband's work schedule and the weekend
schedule.”
“I feel I might as well sleep late since I keep sleeping in the day so I get
more hours of productivity... I really want to be a morning person but I
can't...”
“I feel incredibly sluggish, I get headaches, nausea and vomiting, and
occasionally auditory hallucinations.”
“After working 14-16 hour shifts in a row in an ER…yeah, I can definitely
say that it affected my ‘ability to feel for others’….”
Agenda
Understanding
• Need for sleep
• How sleep works (Physiology of sleep)
• Good sleep vs Poor Sleep
• Consequences of Poor Sleep
• Sleep related myths

Assessing:
• Your sleep quality
• Consequences of poor sleep
The Need for……..Sleep
Need for Sleep- a physiological drive
• Physical: restorative functions, repair, metabolism, immunity, waste
clearance
• Psychological: stability of mood, better mood, lower anxiety
• Social: improved interactions
• Cognitive: brain development, ability to learn, making new memories,
and make logical decisions and choices
• Professional and Academic
• Economical
How Sleep works?
The Biological Clock
How sleep works?
• Body and the Environment
• The Biological Clock (Circadian Rhythm): SCN
• Sleep Homeostasis (sleep/wake balance)
Light: Cortisol
Dark: Melatonin
Adenosine (Sleep pressure)

• The Stages: NREM (1-4), REM

• Dreams
Your Biological Clock

Source: nobelprize.org
Stages of Sleep- what I need to know
What factors determine a healthy sleep
pattern
Light and Dark • Stimulants- caffeine, nicotine
• Pineal Gland and Melatonin • Depressants- Alcohol, Cannabis
• Adenosine • Anxiety/Stress
Physical Activity • Artificial lights/Screens
Food- what, when and how much
What does science recommend?
How can I assess my sleep pattern? Questionnaires, Devices/Sensors,
Polysomnography and Home Sleep Tests, Sleep Labs…….

Sleep Disorders (clevelandclinicmeded.com)


Healthy sleep is…..
1) Duration: (in hours)
Babies: up to 17 hours
Adolescent: 8 to 10
Adult: 7 to 9
Elderly: 7 to 8

Also…..
Genetics, daily schedule, and activity level determines the right duration
Morning or Evening person
Napper/non-napper
2) Quality: continuous, uninterrupted sleep is desirable
Regularity
Latency: 10-20 minutes
Sleep efficiency: 85 percent or above
Awakenings:
-Observable: 2 to 3 per night
-All: up to 20 per hour (<10 percent of sleeping time)
Common Sleep Issues
• Sleep Deprivation- Quantitative and Qualitative loss
• Snoring and OSA
• Daytime sleepiness
• Insomnia
• Others: Restless Leg Syndrome, Somnambulism, Bruxism
Consequences of an unhealthy sleep pattern
• Health related
a) Physical- hypertension, diabetes, heart attack, stroke, poor sexual health,
Alzheimer’s, Cancers (shift work-probable carcinogen), reduced life span
b) Psychological (Trouble staying alert, Feelings of irritation, Memory
problems, Trouble focusing, Difficulty retaining new concepts, Difficulty
making decisions, Slower reaction times, Risk-taking
behaviors)/sexual/lifespan)
• Familial- discord, common sleep issues in other members
• Professional: errors at work, accidents, irritability, diminished empathy,
poor leadership
Short Sleep=Short Life
Sleep related myths
A) Sleep duration:
• Your Body Gets Used To Getting Less Sleep
• Many Adults Need Five or Less Hours of Sleep
• How Long You Sleep Is All That Matters
• More Sleep Is Always Better
• It Doesn’t Matter When You Sleep as Long as You Sleep Enough Hours

• Your Brain Shuts Down During Sleep


Sleep related myths
B) Others:
• Napping Makes up for Lack of Sleep at Night
• If You Can’t Sleep, It’s Best To Stay in Bed Until You Fall Back Asleep
• Hitting Snooze Provides Meaningful Extra Rest
• Alcohol helps in your sleep
Activities
• SATED Questionnaire
• Sleep Diary
• Journaling
• Complications
• Meditation
Tomorrow’s sessions
1) Meditation Session (Morning)
2) Solutions for Better Sleep (Evening)
• Sleep hygiene
• Tools and techniques
• Special Groups and Settings

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