Sleep and Sleep Disorders

1. Sleep and Sleep Disorders Peter Della Bella, MD November 21, 2013

2. True or False? • You can catch up on missed sleep • Everybody dreams many times every night • Teens naturally have delayed sleep patterns • Having warm milk before bedtime promotes sleep • Snoring is not such a big deal • People with sleep disorders are more prone to alien space abductions

3. Can Sleep Deprivation Kill You? In 1965, a 18 year old high school senior from San Diego attempted to become the Guinness World Record holder and stay awake for as long as possible. What happened to Randy Gardner?

5. Why do we sleep? Keep us safe Pull together family To give our body/brain a rest To allow memory to consolidate To UNlearn

6. Wakefulness • Stage 1 • Stage 2 • Stage 3 • Stage 4 • REM Deep sleep: stage 3, 4. Sleepwalking, night terrors, bedwetting: stage 4

7. REM vs. nREM Body temp drops stage 2 Breathing, heart regular 3,4: Tissue growth and repair Declarative memory consolidated 3,4 Growth hormone released: inhances muscle development • Eye movement, dreaming • Incr heart, resp rate • Increased brain activity - “paradoxical sleep” • Large muscle paralysis - “playing possum” • Procedural and spatial memory consolidated • Muscles are turned off

8. How much sleep do we need?Can you catch up on your sleep?

11. So What’s the Big Deal about Not Enough Sleep? Impaired memory, concentration, thought processes looks like ADHD Fatigue, impaired performance Dangerous driving Headaches, stomach-aches Impaired immune system Screws up your body’s clock Weight gain Link with depression Long term: obesity, high blood pressure, diabetes

12. BIOLOGICAL RHYTHMS…On February 13, 1972, 33-year-old French geologist Michel Siffre climbed into Midnight Cave near Del Rio, Texas. He didn’t come out again until September 5th. Siffre was isolated in a large cave chamber 440-feet from the entrance. His furnishings included a tent on a wooden platform, a bed, table and chair, and machines to take medical readings. The chamber was also stocked with frozen food and almost 800 gallons of water. …No clocks, no outside light, nothing that indicated time, day, or date.Why did he do it?What did he find? Siffre, Michel. “Six Months Alone in a Cave,” National Geographic (March 1975), 426-435.

13. Sleep disorders • Advanced or Delayed sleep phase disorder • Insomnia • Disorders with Hypersomnia • Obstructive sleep apnea • Narcolepsy • Seasonal Affective Disorder • REM sleep disorders

14. Sleep and Substances • Caffeine has a half life of 5-12 hours • Alcohol makes you fall asleep, but… • Marijuana? It depends.

15. Sleep hygiene • Comfort • No light, noise, extreme temps • Remove stimulants… • Remove screens • Stimulus control

16. Stanford Basketball Team Sleep Extension Study • 2002, swimmers set records • 2005-8 10 hours for 5-7 weeks • Sprint time 16.2-> 15.5 seconds • 3 point shot accuracy and foul shot accuracy improved 9% Cheri Mah, Stanford July, 2011, Sleep The US Olympic Training Center in Colorado Springs now pushes its athletes to get 9-10 hours of sleep per night.

17. Sleep promotion • White noise • Shower • Exercise • Cool down • Stimulus control

18. Back to Randy Gardner

19. How’d you do? • You can catch up on missed sleep • Everybody dreams many periods each night • Teens naturally have delayed sleep patterns • Having warm milk before bedtime promotes sleep • Snoring is not such a big deal • People with sleep disorders are more prone to alien space abductions