According to the US CDC, how many adults do not get enough sleep?
1 in 3
How is sleep insufficiency defined?
Sleeping on average for less than 7 hours a night
What are people with sleep insufficiency more at risk of?
Immediate health and performance problems
e.g. risk of motor accidents/impaired cognitive performance
What are people with sleep insufficiency more at risk of in the long term?
Chronic health problems such as obesity, diabetes, heart disease and mental health problems
How does sleep insufficiently affect employers?
Sleep insufficiency leads to a loss of productivity
There are higher levels of employee absenteeism, showing up to work ill or impaired
What are the 3 areas which can be modified to improve sleep?
- ambience optimisation
- routine modification
- therapeutic treatment
Who wrote a report on the growing sleep-health economy?
What is this?
It is a response to the growing problem of sleep insufficiency
What is ambience optimisation?
Turning the bedroom into a ‘sleep sanctuary’ to improve the sleeping environment
What is involved in routine modification?
Having a regular bedtime will set an individual for a good night’s sleep
What is involved in therapeutic treatments to improve sleep?
Both prescription and over-the-counter sleep aids
As well as natural and homeopathic sleep products
What factors can be modified to improve ambience in the bedroom?
- sound control
- temperature control/humidfiers
What factors could be modified to help improve routine?
- sleep monitors
- smart alarm clocks
- sleep apparel
- dietary considerations
- bath/personal care
What does the sleep staircase show?
The basic architecture of sleep, including episodes of rapid eye movement sleep (REM)
How is sleep described as a behaviour?
It is a highly organised behaviour that is not unstructured
It is a predictable and biologically regulated state of consciousness
How does the sleep staircase describe one night of sleep?
A sleeper passes through different levels of sleep in a cyclic fashion
This happens between 5 and 7 times
What are levels 1 and 2 on the sleep staircase?
How are they characterised?
Characterised by an irregular EEG pattern
What is an EEG recording?
A recording of the electrical activity of the brain
What are levels 3 and 4 in the sleep staircase?
How are they characterised?
Deeper levels of sleep that are characterised by regular wave patterns on EEG
What is stage 4 on the sleep staircase?
deep sleep or slow wave sleep
What happens after the sleeper has reached stage 4 on the sleep staircase?
They move back up the sleep staircase to level 2
There is then a period of REM sleep for 15-20 minutes
How do sleep states alternate during the night?
It begins with a rapid descent into deep sleep
This is followed by progressively increased episodes of lighter sleep and REM sleep
How is REM sleep characterised?
Rapid eye movements, more dreaming and bodily movement, faster pulse and breathing
What type of diagram is used to give a pictorial representation of the different stages of sleep?
What is core sleep?
It is the essential part of sleep and is mainly slow wave sleep
What is core sleep composed of?
Stages 3 and 4 of non-REM sleep
Around half of REM sleep
When is core sleep obtained?
During the first 3 sleep cycles - this is the first 5 hours of sleep
When does core sleep occur? What happens after this?
During the first part of the night
The remainder of the night’s sleep is optional sleep
What is significant about optional sleep?
This is the time when you are most likely to remember your dreams
When does optional sleep occur?
Later in the night, it is the 2+ hours that follows core sleep
What is core sleep composed of?
Mostly stage 1 and 2 sleep
What is the Bunker study?
People taken to a bunker in the alps for 6 weeks with no indication of time
What did the Bunker study show?
People slip into a circadian rhythm of 25 hours, rather than the expected 24
What is a circadian rhythm?
A physical, mental or behavioural change that follows a daily cycle
How long does a new-born baby spend sleeping?
How much of this is REM sleep?
They are asleep for around two thirds of the time
Half of their sleeping time is REM sleep
How much sleep time will a 20-year-old spend in REM sleep?
around 20% of sleeping time
Why does the foetus spend a long time in REM sleep?
It has a role in neural reorganisation
REM sleep has a different function in a developing brain and is essential
How are sleep and wakefulness separated?
There is a clear divide between sleep and wakefulness
How does the pattern of sleep change with age?
reduction in total sleep time
early reduction in % of REM sleep
Later reduction in the amount of stage 3 and 4 sleep
What other characteristic of sleep is reduced with age?
They tend to disappear early in childhood
What is a parasomnia?
A disorder characterised by abnormal or unusual behaviour of the nervous system during sleep
e.g. sleep walking/talking
What is the mean sleep duration?
Around 7.75 hours
Few people sleep less than 4.5 hours or more than 10.5 hours
What is a microsleep?
A sleep for a very short period of time - e.g. 90 seconds
They help individuals catch up with the later sleep that will be missed
What does the pattern of sleep look like in a microsleep?
Falling very quickly into deep sleep but also emerging from it very quickly
What are the 4 methods used to investigate sleep?
- subjective sleep quality
- movements during sleep
- EEG output
- dream content
What is involved in using a diary/rating scale to monitor sleep?
A diary is repeated every morning for at least 2 weeks
This observes a change over time in sleeping patterns
When may a diary be used to monitor sleep?
It can be used to show the improvement in sleep quality when pain treatment is given
What is sleep latency?
The time taken to fall asleep
What is meant by latency?
The period between trying to engage in a behaviour and the behaviour actually happening
What is a sleep log and why is it used?
It visually represents behaviour and helps to find strategies to overcome the issue
How is movement during sleep recorded?
Microswitch on a bed, videoing the sleep or placing a mobile phone under a pillow
What is movement like during REM sleep?
People do not move during REM sleep
This is body paralysis as the body is shut down in terms or movement, but the brain is still active
During which period are dreams more likely?
During REM sleep, but not exclusively in REM sleep
What are the characteristics of dreams during REM sleep?
- dreaming is 2x more likely in REM sleep
2. dreams tend to be around 6x longer and are more vivid
What are the 7 characteristics of dreams?
- intensely visual
- no smell, taste or pain
- contain movement
- often bizarre and illogical
- no awareness of dreaming
- nature of a soundscape can influence contents of a dream
What is a lucid dream?
When an individual has an awareness that they are dreaming and is able to control their dream
What is insomnia?
A sleep disorder where people have trouble sleeping
They may have difficulty falling asleep or staying asleep for as long as desired
What is insomnia typically followed by?
daytime sleepiness, low energy, irritability and depressed mood
What % of people have insomnia?
30% of the population have insomnia
1/3 of these have sever insomnia
What is significant about diagnosing insomnia?
It is usually secondary to another problem - it is a symptom of another underlying issue
What are the 3 diagnostic markers of insomnia?
- delayed sleep onset
- disturbed sleep
- early morning waking
How does the proportion of time spent in deep sleep change in an insomnia patient?
Proportionally the time spent in deep sleep is the same as someone who does not have insomnia
They wake up for brief periods during the night
Why does an insomnia patient feel like they only slept 3 hours rather than the actual 5?
They wake up many times during the night and only remember the times that they are awake
What types of psychological problems cause insomnia?
Depression and anxiety
What other medical disorder commonly causes insomnia?
Pain disrupts sleep
Loss of sleep increases an individual’s experience of pain
How can social environments cause insomnia?
the use of drugs and alcohol
What 4 methods are used to treat insomnia?
- hypnotic drugs
- sleep education
- sleep hygiene
- dealing with tension and intrusive thoughts
What is sleep education and how does it work?
Talking to people about sleep and reassuring them that it is not constant
Knowledge builds confidence and allows people to take control of their disorder