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Understanding Sleep & Sleep Wellness

Sleep Cycle

Learning Objectives

What is sleep?

  • Sleep is the body's rest cycle which is triggered by hormones in the body
  • There are four stages of sleep broken up by two main types of sleep: Non-rapid eye movement (NREM) and rapid eye movement (REM)

What is Sleep?

Stage 4: REM

1. Understand the importance of sleep

2. Learn how health can be compromised

from sleep hygiene

3. Discuss strategies to improve sleep

The first three stages are NREM:

  • Stage 1: The transition from awake to asleep (5-10 min)
  • Stage 2: Deepening of sleep where the body temperature drops and breathing becomes more regular (20 minutes)
  • Stage 3: Deep Sleep where the blood pressure and goes down and muscles relax
  • This stage is called Rapid Eye Movement because of the eye movement that takes place, along with increased breathing rates and increased brain activity
  • REM Begins after 90 minutes
  • 20% of sleep is spent here!

You spend the night bouncing between stages 2-3-4, with the goal of reaching REM 5 times

Immediate Effects of Sleep:

Importance of sleep

Day-to-day sleep performance impacts:

  • cognitive performance
  • attention
  • memory storage
  • emotional regulation

Over time, poor sleep will not only continue to affect those four areas, but can also negatively affect mental and physical health.

How Much Sleep is Needed?

It is often said that everyone needs 8 hours of sleep, but that is not necessarily true!

Infants and school age children need to sleep well over 8 hours, whereas some older adults are operating with 5 hours of sleep.

Click ahead to see what each age needs

Sleep & Age

Sleep Across the Lifespan

14-17

Newborns need much more sleep than any other age group.

12-15

11-14

Sleep Needed

10-13

Age Group

in hours

9-11

8-10

7-9

Can be as few as 5!

Many older adults develop insomnia due to lifestyle changes, metabolic changes or disorders, or neurological conditions

7-8

How Does Sleep Affect Mental Health?

Sleep and Mental Health

While the General US Population experiences chronic sleep problems between 10-18%, individuals with a mental health diagnoses experience chronic sleep problems between 50-80%

Relationship between Sleep and Mental Health

Sleep & Mental Health:

Sleep and Mental health often exist in a cycle

Mental Health Diagnoses where sleep can be affected:

For example, a person experiencing depression may see a cycle of poor sleep and may experience insomnia

Depression

This can affect treatment efforts, create symptom relapses or even heighten suicidal ideation

Insomnia

Lack of sleep can worsen symptoms of depression such as mood, irritability, and daily functioning

In addition to depression, sleep deprivation is commonly experienced by individuals who are diagnosed with:

  • Bipolar Disorder
  • Anxiety Disorders
  • Attention-deficit/hyperactivity disorder
  • Schizophrenia

Sleep Disorders

There are over 70 types of sleep disorders

The 4 most common sleep disorders are:

  • Insomnia: Difficulty falling asleep or staying asleep during the night
  • Sleep Apnea: Abnormal breathing patterns while you are sleeping (there are several types of sleep apnea)
  • Restless Leg Syndrome: An uncomfortable sensation and the urge to move the legs while trying to fall asleep
  • Narcolepsy: characterized by extreme sleepiness during the day and falling asleep during the day

Over time these sleep disorders can affect various aspects of your physical health

Physical Health & Sleep

As previously mentioned, sleep plays a vital role in our day-to-day cognitive functioning and memory.

The CDC reports that while adults need at least 7 hours of sleep a night, one third of Americans report experiencing inadequate sleep.

The two sleep disorders that predominantly affect health are insomnia and sleep apnea.

Sleep & Physical Health

Heart Health

Heart Health

  • Heart health is affected greatly by sleep.
  • According to a recent study, sleep even reduced to 6 hours showed predictive signs for a heart attack, or heart disease related death.

  • Someone with Sleep Apnea has increased risk of heart disease, hypertension, and stroke.

  • During an ideal sleep cycle, blood pressure decreases. Having sleep disturbances means your body has less time for your blood pressure to go down during the night, which can lead to the more severe complications mentioned above.

Diabetes

Diabetes

Lack of sleep can even create higher risk of Type 2 Diabetes.

Type 2 Diabetes is a condition that causes sugar build up in your blood which can damage your blood vessels.

Luckily, studies have shown that regulating sleep again can reduce the effects of Type 2 Diabetes.

Obesity

Adult Obesity & Sleep

One study followed 68,000 female nurses for 16 years to track how exposure to night shifts affected their bodies.

The study found that the more night shifts a nurse worked, the more likely they were to develop type-2 diabetes and obesity.

Obesity

How can poor sleep lead to obesity?

Researchers have several suggestions:

  • Increased hunger hormone activity
  • More time in the day to eat with less sleep
  • Irregular eating patterns
  • Decreased physical activity as exhaustion increases
  • Lower body temperature which means less energy is expended

Immune System

Immunity

Lack of sleep can also affect the immune system!

While you sleep, the body's immune system releases cytokines, which is a protein needed to fight infection and inflammation.

With lack of sleep, the body will create less cytokines and increases the chance of getting sick and will make it more difficult to fight off disease.

References

Sleep Strategies

Sleep is important for mental and physical health, as well as day to day functioning!

Sleepless nights can feel helpless, anxiety-inducing, and exhausting.

The next slides will present several behavioral approaches and medical interventions to improve sleep

Strategies for Better Sleep

Cognitive Behavioral Therapy & Sleep:

Methods to try at Home:

The Wellness Corner has an excellent handout for 5 tips for better sleep!

Many principles of Cognitive Behavioral Therapy (CBT) can be applied to practicing healthy sleeping patterns.

There are 4 main aspects of CBT for insomnia:

  • Sleep Restriction Therapy
  • Stimulus Control Instructions
  • Sleep Hygiene Education
  • Relapse Prevention

Part of this process includes keeping a sleep diary to pinpoint causes of sleep disruption

Additionally, you can try meditation apps like Calm or Headspace

Medications

Whether the choice is behavioral changes or medical interventions, sleep affects every aspect of life and health! It is important to speak with doctors, clinicians or a therapist to determine the best course of action. No one should suffer sleepless nights!

Be mindful of any changes or side effects sleeping pills can cause and read the medication guide carefully.

If sleep problems persist after trying behavioral approaches discuss options with a doctor or PCP about prescription sleeping pills.

There are 2 main versions of sleeping pills: Pills that help you fall asleep and pills that help you stay asleep. Some will do both!

This presentation was brought to you by the Thresholds Health Literacy Center!

If you have any questions or need additional resources, contact Nicole Pashka @ Nicole.Pashka@thresholds.org

Works Cited

6 steps to better sleep. (2019, February 8). Retrieved March 11, 2020, from https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/sleep/art-20048379

Boost Your Health with Better Sleep. (n.d.). Retrieved March 11, 2020, from https://www.sleepfoundation.org/articles/how-sleep-affects-your-immunity

Brain Basics: Understanding Sleep. (n.d.). Retrieved March 11, 2020, from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Understanding-Sleep

Can lack of sleep make you sick? (2018, November 28). Retrieved March 11, 2020, from https://www.mayoclinic.org/diseases-conditions/insomnia/expert-answers/lack-of-sleep/faq-20057757

CBT for Insomnia: Techniques & Case Study. (n.d.). Retrieved March 11, 2020, from https://www.sleepfoundation.org/articles/cognitive-behavioral-therapy-insomnia

Cherry, K. (2019, July 14). The 4 Stages of Sleep (NREM and REM Sleep Cycles). Retrieved March 11, 2020, from https://www.verywellhealth.com/the-four-stages-of-sleep-2795920#the-sequence-of-sleep-stages

Felson, S. (2018, October 26). Stages of Sleep: REM and Non-REM Sleep Cycles. Retrieved March 11, 2020, from https://www.webmd.com/sleep-disorders/sleep-101

How Does Sleep Affect Your Heart Health? (2018, December 3). Retrieved March 11, 2020, from https://www.cdc.gov/features/sleep-heart-health/index.html

Jackson, C. L., Redline, S., & Emmons, K. M. (2015, March 18). Sleep as a potential fundamental contributor to disparities in cardiovascular health. Retrieved March 11, 2020, from https://www.ncbi.nlm.nih.gov/pubmed/25785893

Knutson, K. L. (2012). Does inadequate sleep play a role in vulnerability to obesity? Retrieved March 11, 2020, from https://www.ncbi.nlm.nih.gov/pubmed/22275135

Prescription sleeping pills: What's right for you? (2018, January 30). Retrieved from https://www.mayoclinic.org/diseases-conditions/insomnia/in-depth/sleeping-pills/art-20043959

Sleep. (2016, April 13). Retrieved March 11, 2020, from https://www.hsph.harvard.edu/obesity-prevention-source/obesity-causes/sleep-and-obesity/

Sleep and Growing Older. (n.d.). Retrieved March 11, 2020, from http://sleepeducation.org/news/2013/08/07/sleep-and-growing-older

Sleep and Health. (n.d.). Retrieved March 11, 2020, from http://healthysleep.med.harvard.edu/need-sleep/whats-in-it-for-you/health

Sleep Diary. (n.d.). Retrieved March 11, 2020, from https://www.nhlbi.nih.gov/health-topics/all-publications-and-resources/sleep-diary

Sleep disorders. (2019, August 10). Retrieved March 11, 2020, from https://www.mayoclinic.org/diseases-conditions/sleep-disorders/symptoms-causes/syc-20354018

The Complex Relationship Between Sleep, Depression & Anxiety. (n.d.). Retrieved March 11, 2020, from https://www.sleepfoundation.org/excessive-sleepiness/health-impact/complex-relationship-between-sleep-depression-anxiety

Twelve Simple Tips to Improve Your Sleep. (n.d.). Retrieved March 11, 2020, from http://healthysleep.med.harvard.edu/healthy/getting/overcoming/tips

Understanding Sleep Cycles. (n.d.). Ret

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