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Sleep When a cup of warm milk is not enough

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

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  1. SleepWhen a cup of warm milk is not enough K. Van Gundy, M.D. Associate Clinical Professor UCSF

  2. Normal Sleep • Normal Sleep patterns (cycles) • Non REM • REM • Circadian rhythm • Drugs influence on sleep • Genetics of sleep

  3. 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

  4. 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?

  5. 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

  6. Normal Sleep • Normal Sleep patterns (cycles) • Non REM • REM • Circadian rhythm • Drugs influence on sleep • Genetics of sleep

  7. Insomnia • Difficulty initiating sleep • Frequent awakenings ( including early morning awakening) • Subjective feeling of insufficient sleep • Preoccupation with sleep complants

  8. 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

  9. 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

  10. Treatment • Nonpharmacologic treatment • Hygiene • Relaxation • Stimulus control • Sleep restriction • Pharmacologic therapy • Benzodiazepines / related hypnotics • Antidepressants • Antihistamines • Melatonin • Light

  11. 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

  12. Sleep Apnea • Disorders of breathing and sleep • Obstructive sleep apnea • Clinical manifestations • Treatment • Central sleep apnea • Restrictive lung disease • Neuromuscular disease • Cardiac • Neurological

  13. Parasomnias of Sleep • Non REM • Sleep terrors and sleep walking • Bruxism • CNS disease, Drugs, Cardiac disease can trigger

  14. Disrupted Sleep • Parkinsonism • Neuromuscular disease • Respiratory disease • Dementia • Epileptic seizures • Cardiovascular disease

  15. Sleep hygiene

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