“ The power of sleep “ World Association of Sleep March 15, 2013

1. “The power of sleep“World Association of SleepMarch 15, 2013 Fl.Mihaltan* *Pneumology Institute "M.Nasta", Bucharest

2. 10 laws for a healthy sleep - sleep hygiene • 1. Schedule a bedtime hour and wake up hour • 2.If you have the habit of sleeping in the afternoon not exceed 45 minutes • 3. Avoid alcohol consumption 4 hours before bedtime and also smoking • 4. Avoid coffee consumption 6h before bedtime (coffee, tea, soda, chocolate) • 5. Avoid spicy food, sweets consumption 4 hours before bedtime.

3. 10 laws for a healthy sleep - sleep hygiene • 6. Regular exercise is good but not before going to bed • 7. Use a comfortable bed, comfortable mattress • 8. A comfortable temperature for sleeping and a well ventilated room • 9. Excluding any distracting noise and eliminate as much as possible the light • 10. Bed to be reserved only for sleep or intercourse. Do not use the bed as a desk job or recreation space.

4. The theme of this year is: World Sleep Day 2013 • “Good sleep, healthy aging.” The role of this conference is to draw attention to restorative effects of sleep

5. Why is sleeping vital? • Sleep is just as vital for a child to growth healthy and for an aging adult. • Because we spend 1/3 of life sleeping-effects should be evaluated globally • Lack of sleep or poor quality sleep has a negative impact on short and long term and may be associated with: • Obesity, diabetes, a weakened immune system, some cancers also achieve depression or anxiety conditions

6. The organizer of this day isWorld Association of Sleep Medicine (WASM), • Antonio Culebras, professor of neurology at SUNY Upstate Medical University in Syracuse, New York and co-president of the World Sleep Day. • "We want as many people to be warned of enormous importance of sleep for health. This year we focus on healthy aging and seek all the way to healthy aging "

7. Apnea syndrome–obstructive form(SASO) • Is an interruption of airflow during sleep • Is associated with symptoms such as excessive fatigue, performance deficits, neurocognitive disturbances • Untreated induce: stroke, arrhythmias, hypertension, cardiovascular disease and type 2 diabetes. The majority remain undiagnosed also not receive appropriate treatment

8. Cause SASO • Is the neck muscle relaxation during sleep by closing or reducing airway • The result is reductions in blood oxygenation and can last from 10 seconds to a minute or more • Lack of oxygen and brain register people wake up just to open the airway (pharynx) to begin to breathe and the cycle begins again • Patients in most cases not remember these episodes, but this interrupt, restorative effect of sleep severely fragment. Individuals with moderate or severe wake up hundreds of times a night without realizing.

9. Which are the epidemiological data • Officially, about 4% of men and 2% of women in the U.S. have SASO • The truth is that there are many living with the disease underdiagnosed (up to 14% of adults-24% of men and 9% of women) .. (6) • "SASO is a major health problem worldwide," says Edward Grandi, executive director of the American Sleep Apnea Association. "It is usually underdiagnosed and the untreated effects can be very serious."

10. Symptoms include • Loud snoring and frequent lack of air during sleep, sleepiness and daytime fatigue and concentration difficulties(1,4,6) • SASO generates not only fatigue it can adversely affect health • Untreated contribute to cardiovascular causes such as heart attacks, arrhythmias, hypertension • Untreated may be associated with stroke, epilepsy, diabetes and high blood values. (1,3,4) • Lack of quality sleep can reduce sleep quality, concentration, productivity at work, in educational process and in traffic accidents or control functions(4,6)

11. Education guides / certifications • Accreditation procedures and competence in 2011 • Preparing the course • To the theoretical curriculum Hermes • News about educational activities in 2012 • 5 E-Learning courses for SASO in: Timisoara, Bucharest, Cluj, Craiova, Brasov (Over 200 physicians) • Local courses-13 • Laboratories openings

12. Education Brochure

13. Communication channels, print media, TV, online

14. National Conference of SleepingTimisoara June 2011 Romania's first study of respiratory disorders during sleep on children

15. Organizing courses and scientific events

16. Participating in meetings and training experts

17. www.somn-copii.ro

18. December 2012

19. 2013 The association for sleep disturbance in pediatric patients - partnership- SRP - Society of Pediatrics- Association of Family Physicians

20. Failures and consequences • Lack of partial compensation of CPAP`s • Pleadings made every year and every minister • The risks: • Patients without access to treatment, sometimes with responsibilities (drivers, mechanics locomotive) • Increased mortality

21. Targets for 2013 • Obtain this compensation even a minimum • Bringing together all medical specialties, in Sibiu, June to the National Conference of Sleeping • Starting the process of competence and continuing accreditation of laboratories