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แพทย์หญิง กาญจนา พิทักษ์วัฒนา นนท์ อายุรแพทย์ผู้เชี่ยวชาญระบบประสาท แพทย์ประจำศูนย์สมอง โรงพยาบาล สมิติเวชศรีราชา.

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Presentation on theme: "แพทย์หญิง กาญจนา พิทักษ์วัฒนา นนท์ อายุรแพทย์ผู้เชี่ยวชาญระบบประสาท แพทย์ประจำศูนย์สมอง โรงพยาบาล สมิติเวชศรีราชา."— Presentation transcript:

1 แพทย์หญิง กาญจนา พิทักษ์วัฒนา นนท์ อายุรแพทย์ผู้เชี่ยวชาญระบบประสาท แพทย์ประจำศูนย์สมอง โรงพยาบาล สมิติเวชศรีราชา

2  Brain development  Memory / cognition / long term potential  Immunity  Conservation energy  Repair & Restoration

3  Regular sleep time  Proper sleep environment  Stimulation control  Avoidance of time in bed worrying  Avoidance of poorly timed alcohol and caffeine  Regular exercise but not within 3 hours of bedtime  Wind-down time  Late-night high-tryptophan snack

4  Human circadian clock generates a rhythm slightly longer than 24 hours when it has no external cue to set it.  Most people can adjust to 23- or 25- hour day but not to a 22- or 28- hour day.  Bright light late in the day can lengthen the circadian rhythm.

5 Duration of sleep Circadian rhythm Circadian clock Zeitgeber Circannual rhythm  The purpose of the circadian rhythm is to keep our internal workings in phase with the outside world.  Light is critical for periodically resetting our circadian rhythms.  A zeitgeber is a term used to describe any stimulus that resets the circadian rhythms.  Exercise, noise, meals, and temperature are others zeitgebers.

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7  Mechanisms of the circadian rhythms include the following: The Suprachiasmatic nucleus. Genes that produce certain proteins. Melatonin levels.

8 Physiological pathway of the biological clock: Light levels  retina  suprachiasmatic nucleus of hypothalamus  pineal gland  secretion of melatonin

9 The suprachiasmatic nucleus (SCN) is part of the hypothalamus and the main control center of the circadian rhythms of sleep and temperature.

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15 Hz - depression Hz - wakeful dreaming, vivid images 4-8 Hz - dreaming sleep, deep meditation, subconscious mind Hz - relaxation 5.8 Hz - dizziness 7 Hz - increased reaction time Hz - induces sleep, tingling sensations Hz - increased mental ability 18 Hz - significant improvements in memory 55 Hz - Tantric yoga

16  Meditation = practices that train attention to heighten awareness and bring mental processes under greater voluntary control  Yoga, Zen, transcendental meditation (TM) Potential physiological benefits  Similar to effective relaxation procedures

17  EEG ( electro-encephalography )  EOG ( electro-oculograms )  Chin EMG ( electro-myograms )  Left & Right anterior tibialis EMG  Intercostal EMG  ECG ( electro-cardiogram )  Pulse oximetry ( oxygen saturation )  Nasal & Oral thermistors ( airflow )  Chest & Abdominal strain guages

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21 EEG:- rhythmic alpha waves (8-12Hz) // only if the eyes are closed - beta waves (20-30Hz) EOG:- eye movement (observation process) EMG:- continual tonically activity of muscles

22  Loss of eye blink  Attenuation of Alpha rhythm  Slow rolling eye movements  Fronto central Theta activity  Increased Beta activity  Vertex waves

23 EEG:- the absence of alpha activity - Vertex sharp waves EOG: - slow eye movement EMG:- relatively lower amplitude

24  Sleep spindles Brief, 12 – 16 Hz, synchronous bursts of activity, usually maximal in the central, or less commonly frontal, regions  K complexes Often accompany sleep spindles. A sharp negative wave followed by a high-voltage slower wave  Vertex waves Named for tendency to phase reverse in central regions. Sharp waves May occur in trains  K complexs & Vertex waves may result from brief sleep disturbances

25 EEG:- sleep spindles (oscillating with the frequency between Hz) - K-complexes (high voltage, sharp rising and sharp falling wave) - relatively low voltage mixed frequency EOG:- the absence eye movements EMG:- constant tonic activity

26  > 20 % but < 50 % of the background rhythm is Delta activity

27 EEG:- consists of high-voltage (>=75uV) - slow delta activity (<=2 Hz) // electrodes Fpz-Cz or Pz-Oz EOG:- the absence eye movement - delta waves from EEG EMG:- low tonic activities

28  > 50% of the background rhythm is Delta activity

29  Bursts of rapid eye movement  Loss of muscle activity  “ Desynchronization ” of the background rhythm. The predominant delta rhythm of slow wave ( stage III & IV ) sleep is replaced by faster frequency ( beta and theta ) rhythms normally seen during the wakeful state.  Sawtooth waves

30 EEG:- relatively low voltage - mixed frequency EOG:- contains rapid eye movements EMG:- tonically suppressed ( Sleep Paralysis )

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35  Insomnia – difficulty falling or staying asleep  Narcolepsy – falling asleep uncontrollably  Sleep Apnea – reflexive gasping for air that awakens  Nightmares – anxiety arousing dreams – REM  Night Terrors – intense arousal and panic – NREM  Somnambulism – sleepwalking

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