1. SLEEP Dr Himalee Abeya

2. Phases of sleep REM Eye movements + High brain activity Recall complex dreams more Increase body work Muscles lose tone maximally Non – REM No/low movements Reduced activity Less recall of dreams Less body work Muscle tone more

4. Insomnia Insufficient quality and quantity of sleep Up to 50% prevalence Common in –· females –· the middle aged –· unemployed –· separated –· lower socioeconomic class

5. Causes of insomnia Life stress Environment Physiological Psychiatric Physical illness Substance use Obstructive Sleep apnoea

6. Poor sleep leads to……… Daytime sleepiness Shortened life span Increased risk of heart and stomach problems Irritability, depression Explosive outbursts and mood swings Increased risk of accidents Poor work and memory performance Marital, social and employment problems

7. Hypersomnia Excessive daytime sleepiness and sleep attacks – disturbs life 4% of population Due to – -insufficient night time sleep -pathological sleep – Narcolepsy – Sleep apnoea

8. TROUBLE SHOOTING FOR EXCESSIVE SLEEPINESS Am I sleep deprived? Do I have an infection? Am I taking other medications now? Drinking alcohol? Am I eating foods that perhaps might be making me worse? Am I depressed or under unusual stress? (Women only)-where am I in my menstrual cycle? Am I less physically active than before?

9. Managing Sleep problems Good sleep hygiene Hypnotics Behavioral techniques

10. Sleep Hygiene – do ’ s Go to bed at the same time each day. Get up from bed at the same time each day. Get regular exercise each day, preferably in the morning. Get regular exposure to outdoor or bright lights, especially in the late afternoon. Keep the temperature in your bedroom comfortable. Keep the bedroom quiet when sleeping. Keep the bedroom dark enough to facilitate sleep. Use your bed only for sleep and sex. Take medications as directed. Use a relaxation exercise just before going to sleep. Or a sleep ritual.

11. Sleep Hygiene – don ’ ts Exercise just before going to bed. Don’t exercise 4 hours before bed. Engage in stimulating activity just before bed Have caffeine in the evening (coffee, many teas, chocolate, sodas, etc.) Read or watch television in bed. Use alcohol to help you sleep. Go to bed too hungry or too full. Take over-the-counter sleeping pills Take daytime naps. Sleep less than one hour before 3pm Command yourself to go to sleep.