Sleep disorders Seriously

SLEEP DISORDERS SERIOUSLY

They adversely affect quality of life, efficiency, health and safety. Take them seriously and seek information and treatment

Most people experience difficulty sleeping (insomnia) at some time.  It is the second most common medical complaint with almost one half of older adults experiencing symptoms of insomnia on a few nights a week.  Despite this few people seek help from their doctor. Insomnia costs the Australian community over half a billion dollars each year in direct medical costs and as much as ten times that amount in indirect costs such as lost productivity or days off work.  For both the community and the sufferer it is an issue that should not be ignored.

Sleep hygiene is a term used to describe good sleep habits that is things you can do to give yourself the best chance of a good refreshing sleep.  Most of these things are common sense but in the hustle and bustle of modern life are often neglected. If you’re having trouble sleeping, attention to some of these simple things may help. 

The high standard of health care does not only involve sophisticated medical science and technology. Most health professionals are involved in what is called a caring profession and are passionate about their desire to help people

The debilitating effects poor sleep can have on a person’s work, relationships, and general well-being.

Insomnia; -  is the subjective complaint of poor sleep quality. Some may present one or more sleep disturbances, including difficulty falling asleep, difficulty maintaining sleep, early morning awakening, and unrefreshing sleep. These problems can result in daytime difficulties, including fatigue, decreased concentration, inability to perform complicated tasks, and memory impairment. Table 1 lists DSM-IV criteria for classification of sleep disorders.

Insomnia in the elderly is typically the manifestation of a variety of factors. Age-related physical changes, chronic illness, and depression can play significant roles in the etiology of insomnia. The normal sleep cycle consists of an intricate balance of alternating stages. Non-rapid eye movement sleep comprises stages 1 through 4 and is composed of progressive deep sleep.

Rapid eye movement sleep is the fifth stage, which is a lighter sleep with more autonomic activity. In the normal, healthy adult, sleep begins with shortened periods of sleep stages 1 and 2. In the early part of the night the cycle progresses to deeper sleep stages 3 and 4, also known as delta sleep. In approximately one to two hours, Rapid eye movement sleep begins, with the cycle repeating every 90 minutes. Into the early morning hours, the periods lengthen, with continuing alternation with delta sleep cycles. Young adults usually spend about 75% of the night in Non-rapid eye movement sleep and the remainder in Rapid eye movement sleep.
Older patients spend less time in the delta sleep stages and more time in stages 1 and 2, which may explain complaints of light sleep. A recent review stated that among persons age 65 and older, 25% of men and 40% of women describe themselves as light sleepers. Other alterations in the sleep cycle include shortened REM sleep and decreased total sleep time. These changes in the normal cycle may result in early morning awakening and frequent daytime fatigue or napping.
Insomnia complaints are 1.3 times higher in women than in men and increases with age.

Selected techniques to improve sleep hygiene, stimulus control, and sleep restriction may be effective in inducing and/or maintaining sleep.
Sleep hygiene informs of lifestyle and environmental factors that may contribute to poor sleep quality. It is often helpful to avoid the use of caffeine and nicotine four to six hours prior to bedtime and abstain from alcohol use prior to bedtime.  Sleep-restriction therapy attempts to reduce sleep latency and sleep fragmentation by creating individualized sleep schedules. Relaxation therapy includes a variety of methods that may focus on physical relaxation 
1. People with insomnia may present the following complaints?
·          Improved concentration
·          Daytime fatigue
·          Referred neck pain
·          Memory enhancement
2. recommendations for insomnia include which one of the following?
·          Exercise vigorously just prior to bedtime.
·          Drink a small amount of alcohol (e.g., one glass of wine) to help get to sleep.
·          Refrain from using caffeine and nicotine four to six hours before bedtime.
·          Keep bedroom (or primary sleeping area) at a very cold temperature.

SNORING AND
SLEEP APNOEA
Sleep Apnoea is a condition where the sufferer stops breathing intermittently during sleep. This repeatedly interrupts the normal sleep pattern and may cause low oxygen levels.

SYMPTOMS
·          Snoring, grunting during sleep
·          Restless sleep
·          Headaches on waking
·          Daytime sleepiness
·          Lack of energy and drive
·          Poor memory & reduced concentration
·          Depression
·          Reduced sexual drive or impotence

TREATMENT
If sleep apnoea is confirmed, the choice of treatment depends on the severity of the condition. Possible treatments include:
·          Weight-loss
·          Adjusting body position in sleep
·          Reducing alcohol intake on retiring
·          CPAP therapy
·          Nose or throat surgery
·          Mandibular Advancement Splint
Problems that can arise: -
·          Heart disease
·          Stroke
·          Central obesity
·          Hypertension (high blood pressure)
·          Insulin resistance/diabetes
·          Hyperlipidemia
Road-safety research shows sufferers have a greatly increased risk of having a road accident. Work-related accidents are also increased.

Sleep Hygiene: -
·          Go to bed and wake up at the same time every day
·          Before bedtime have a hot full milk chocolate, herbal tea, Milo but stay away from tea and coffee.
·          Before you go to bed hop into a hot shower- your temperature dropping can trigger sleep
·          Go to bed just to sleep don’t watch TV or read reading can stimulate the brain.
·          Keep a notebook by your bedside and write down anything that comes to mind that worries you
·          Sleep comes in waves and if you miss one you might have to wait some time before the next one comes along.
·          Have a few sniffs of lavender oil it gives you that relaxed feeling.
Learning to relax can help to relieve tension as well as painful emotions, and raises feelings of fear, anxiety, depression or anger.