• Sleep Apnea


  • How Much Sleep Is Enough?

    • Individual Variation

      – Sleep deprived have ↓latency and ↑ sleep drive

    • Sleep duration not a true reflection of need – tolerance to sleep debt/adenosine

    • Physiologic studies of normal adults – 8 hours/night (young adults)
      – 7.5 hours/night (elderly)

    • Sleep-Heart Health Study – 7.2 hrs/night

     

    • Sleep Foundation Poll – 7.3 hrs/night

     


    Sleepy vs. Excessive Sleepiness

    Sleepiness (somnolence) – a normal and expected effect mediated by endogenous homeostatic processes, circadian rhythms, metabolic expenditure, and prolonged wakefulness

    Excessive Sleepiness (hypersomnolence)– pathologic state of inappropriate sleepiness that impairs normal daytime function or results in the inappropriate onset of sleep

    30% of Americans suffer from this.

     


    Insomnia

    • 2 flavors:
    – Chronic insomnia disorder
    – Short-term insomnia disorder

    • Main distinction: Duration is either greater than or less than 3 months

    • For chronic insomnia, symptoms must be present at least 3 days per week 

     


    Insomnia- common features

    • The patient (or parent/caregiver) report:

      • –  Difficulty maintaining sleep

      • –  Waking up earlier than desired

      • –  Bedtime resistance

      • –  Difficulty sleeping without parent/caregiver intervention 


       

      Insomnia- common features

      Results in one of more daytime consequences:

      • –  Fatigue/malaise

      • –  Attention, concentration, memory impairment

      • –  Impaired social, family, occupational or academic performance

      • –  Mood disturbance/irritability

      • –  Daytime sleepiness

      • –  Behavioral problems (hyperactive, impulsive)

      • –  Reduced motivation/energy/initiative

      • –  Proneness for errors/accidents

      • –  Concerns about dissatisfaction with sleep 

         


      Insomnia- common features-continued

      • The reported sleep/wake complaints cannot be explained purely by inadequate opportunity (i.e. enough time allotted for sleep) or inadequate circumstances (i.e. environment is safe, dark, quiet and comfortable) for sleep 

       


      Modern Sleep Habits

      • Over the past 30 years, self-reported sleep duration ↓ by 1.5 - 2 h among Americans

      • >50% of Teenagers obtain <7hrs sleep/night (2014)

      • Young adults reporting <7 h sleep per night – 15.6% in 1960
        – 37.1% in 2002
        – 64.4% in 2012

      • Sleep habits in 2012: (mean sleep duration) – American adults – 6.8 hr/night
        – Military – 6.2 hr/night
        – Urban professionals – 5.8 hr/night

        – Surgical residents – 5.6 hr/night