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Sleep Disorders-NREM

Sleep Disorders-NREM. NREM is 75% of all sleep time (>=slower) Stage 1 -5% of the night Stage 2 -48% of the night Stage 3 (delta) -7% of the night Stage 4 -15% of the night Muscles mover during NREM, metabolic functions slow down & 20% of dreams*. Sleep Disorders-REM.

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Sleep Disorders-NREM

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  1. Sleep Disorders-NREM • NREM is 75% of all sleep time (>=slower) • Stage 1-5% of the night • Stage 2-48% of the night • Stage 3 (delta)-7% of the night • Stage 4-15% of the night • Muscles mover during NREM, metabolic functions slow down & 20% of dreams*

  2. Sleep Disorders-REM • During REM, you have muscle paralysis, erections and much more vivid dreams • Newborns dream 80% of time • By age 2, REM sleep is 33% of total sleep time, approaching adolescent levels

  3. Sleep Disorders • Insomnias (> 30’ to fall or return to sleep, 3+/wk) • Insomnia (middle and late in elderly) • Dysomnias (or less than satisfying sleep) • Psysiological causes • Sleep Apnea (obstructive or central) • Narcolepsy (“REM on a rampage”) • Periodic limb movement/restless leg syndrome

  4. Assessment • Measures • Epworth Sleepiness Scale • Pittsburgh Quality Index • Duration, at least 1 month, but usually 6 • Assess routine (including a 2 week sleep diary* )and meds. • Ex. Recent study found that people who sleep with TV or noise have poorer QOS….even “white noise” • Ex. Acetimiophen has caffiene where Iboprfen does not

  5. How to Become an Insomniac • Keep unrealistic sleep goal • Catastrophize about not meeting this goal • Nap in daytime/spend more time in bed • Spend all of the desperate hours fighting to get to sleep in bed (stimulus for upset) • Make bed center for activity • Start taking sleep medications (REM reb.)

  6. Sleep Hygiene-Avoid • Excessive noise • “Stress” (activities of worries @ bedtime) • Uncomfortable bed • Caffeine (< 2 hours of bedtime) • Cigarettes (< 2 hours of bedtime) • Alcohol • Napping (longer awake, faster/deeper sleep) • Extra wink in morning • Variable bedtimes or morning wake-up times

  7. Sleep Hygiene-Maintain • 60-65 degrees Fahrenheit in bedroom • Early afternoon or evening exercise • Satisfying (safe) sex • Light snacks (hunger aggravates sleep) • Warm milk or Ovaltine • Awake same time/go to bed only when sleepy • Imagine a tranquil place and calming sounds • If repeatedly awake 20 minutes after retiring, relax in another room and return to bed only when tired

  8. Treatment

  9. Treatment • Most treatments are initially behavioral conditioning-stimulus control • Cognitive Arousal/Refocusing • Exs. Paradoxical or focus on the sensation in body part • Physiological • PMR • Imaging • Biofeedback

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