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Sleep When a cup of warm milk is not enough . K. Van Gundy, M.D. Associate Clinical Professor UCSF. Normal Sleep. Normal Sleep patterns (cycles) Non REM REM Circadian rhythm Drugs influence on sleep Genetics of sleep. Status Americans.

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sleep when a cup of warm milk is not enough

SleepWhen a cup of warm milk is not enough

K. Van Gundy, M.D.

Associate Clinical Professor UCSF

normal sleep
Normal Sleep
  • Normal Sleep patterns (cycles)
  • Non REM
  • REM
  • Circadian rhythm
  • Drugs influence on sleep
  • Genetics of sleep
status americans
Status Americans
  • 62% say the experience sleep problems a week or more
  • 40% report sleepy enough during the day to interfer with activities
  • 62% drive while drowsy
  • 27% have fallen asleep while driving
  • 60% children feel parients are tired during the day
  • 15% children admit falling asleep at school
status men
Status Men
  • On week days one third of men get less than 6 hours sleep
  • 47% truck drivers report falling asleep at the wheel
  • 25% of truck drivers fall asleep yearly
  • OSA cost $2720.00 / year undiagnosed but costs $1384.00 / year if diagnosed and treated.
  • Over all additional cost of OSA in the US is 3.4 Billion dollars.
  • African American Men have a a higher risk of OSA?
status women
Status Women
  • 79% report sleep disturbance during pregnancy
  • 36% women peri- menopausal women report disturbed sleep
  • 25% suffer from significant daytime sleepiness
  • 30% disturbed sleep interferes with daily activity, 27% job performance is impaired, 24% say sleep gets in the way of caring for family
normal sleep6
Normal Sleep
  • Normal Sleep patterns (cycles)
  • Non REM
  • REM
  • Circadian rhythm
  • Drugs influence on sleep
  • Genetics of sleep
insomnia
Insomnia
  • Difficulty initiating sleep
  • Frequent awakenings ( including early morning awakening)
  • Subjective feeling of insufficient sleep
  • Preoccupation with sleep complants
insomnia8
Insomnia
  • Causes of Insomnia (short term insomnia)
    • Change in sleep environments
    • Jet lag
    • Changes in work shift
    • Excessive noise
    • Unpleasant room temperature
    • Stressful life events
    • Medical condition
    • Medications
insomnia9
Insomnia
  • Chronic insomnia
    • Anxiety
    • Schizophrenia
    • Depression
    • Learned insomnia
    • Sleep state misperception
    • Poor sleep hygiene
    • Insufficient sleep
    • High altitude insomnia
    • Restless legs / Periodic limb movments
    • Circadian rhythm disorders
      • Delayed , Advanced , non 24 hour sleep – wake disorder
    • Sleep apneas
treatment
Treatment
  • Nonpharmacologic treatment
    • Hygiene
    • Relaxation
    • Stimulus control
    • Sleep restriction
  • Pharmacologic therapy
    • Benzodiazepines / related hypnotics
    • Antidepressants
    • Antihistamines
    • Melatonin
  • Light
other sleep disorders
Other sleep disorders
  • Narcolepsy
    • Genetic Aspects of narcolepsy
    • DR2, DR2 DQw1 Dw2 = DR2
    • Diagnosis
      • Cataplexy (pathognomonic)
    • Treatment of narcolepsy
      • Stimulants, REM suppressants,
      • Behavioral adjustments
      • child.MOV
sleep apnea
Sleep Apnea
  • Disorders of breathing and sleep
  • Obstructive sleep apnea
    • Clinical manifestations
    • Treatment
  • Central sleep apnea
    • Restrictive lung disease
    • Neuromuscular disease
    • Cardiac
    • Neurological
parasomnias of sleep
Parasomnias of Sleep
  • Non REM
    • Sleep terrors and sleep walking
    • Bruxism
      • CNS disease, Drugs, Cardiac disease can trigger
disrupted sleep
Disrupted Sleep
  • Parkinsonism
  • Neuromuscular disease
  • Respiratory disease
  • Dementia
  • Epileptic seizures
  • Cardiovascular disease