1. Healthy Sleep Patterns By Dr. Anthony Wallace, ND P.C.D.I Healthcare and Consultants of Texas L.L.C

2. Introduction This presentation will educate the community regarding the importance of a restful sleep. This presentation will address issues such as stressful sleep, common sleep disorders, and the alternative approach to treatment. We will discuss the terms used in sleep medicine and the techniques used to diagnose sleep disorders. In this presentation I will give you some resources on how to get a sleep study recommendation from your doctor. This is also a good resource in researching a new career as a sleep technologist.

3. Disclaimers This presentation is used to educate or reinforce education that your primary care practitioner may have already given you. This information is used educate those that are seeking relief for sleep deprivation. It is important that when using herbal sleep aids or any other alternative methods please consult your primary care practitioner or licensed naturopath. Some supplements or teas may interfere with other prescriptions. This may cause adverse reactions, unwanted side effects, and even death.

4. Sleep Terms Sleep - The body processes of healing (cells, getting rid of waste products, and healing the organs) Sleep Tech – This certified professional conducts sleep test using a EEG waves. This person records all the events that are displayed through out the night and gives the data to the doctor. Sleep Doctor – This is an MD (Medical Doctor) that specialized in sleep medicine. PSG – Polysomnogram Titrate – Term used in sleep study to measure how much air is needed to stop the events. Events – Activities that occur during the night (kicking, snoring, and fighting.

5. Sleep Terms RLS – Restless Leg Syndrome Apnea – The patient has stop breathing Neurons – Brain cells CPAP – Continuous Positive Air Pressure BIPAP – Bi-level Positive Air Pressure. REM – Rapid eye movement Scoring - the amount of events that occurs on the Polysomnogram. Sa02 – Oxygen Saturation level (90 and above is a good value)

6. The Importance of Sleep The human body needs at least 8 hours of rest to heal and rejuvenate. In today’s society, most of the American population may get 6 hours of rest due to our fast pace society. Most people may not get the required rest because of their mate sleeping habits, work related stress, or sickness that may cause chronic pain.

7. Sleep Patterns The body will go through all four stages of sleep with in an 8 hours time period. Most patients may will get to REM much faster than other because of the activities of the day. In the figure to the right is a display of stages of sleep. This is an example of how your brain reacts to sleep. Delta waves show that the patient is relaxed are daydreaming.

8. Stages of Sleep Stages 1 and 2 are waves that display daydreaming Stages 3 and 4 are waves that display the patients brain waves of deeper sleep patterns Stage REM is the deepest sleep patterns. This is the stage when you are dreaming and the body has paralyzed itself so that you will not sleep walk. Most are able to remember their dreams in this stage. This is the stage also where most events may occur.

9. CPAP CPAP is defined as continuous positive air pressure. CPAP is used with several devises to titrate the patient to a healthy SAo2 level in the blood. To much air during the titration phase of the test can cause heart arrhythmias. Most patient need a CPAP machine to ensure that the saturations will not fall below 90% of 100. The CPAP machine is room forced air that is mixed with water (humidifier actions) The misconception is that all patients that use a CPAP are obese and this is not true. Patient that snore will decrease their episodes with a CPAP.

10. BIPAP BIPAP is defined as Bi-level positive air pressure. This is a form of treatment that mixes room air and Oxygen together to ensure the patients O2 level will not fall during REM sleep. Most BIPAP machine are used in the hospitals such as the picture describes. The BIPAP machine will display the rate of breathing, Oxygen and room air mixture. BIPAPA can also be conducted at home.

11. Chain of Command Sleep Doctor – This is a Medical Doctor that has a specialty in sleep medicine. The Doctor will read the score information and based on the scoring the patient will either be prescribed CPAP or BIPAP therapy. Sleep Director – This is a professional that has passed on e of the major board of sleep therapist. This position oversees the quality and accuracy of the test. This position may require scoring experience. Sleep Technologist - This is a professional that may be a certified technologist or a student. This professional may perform test under the direction of the sleep director.

12. Sleep Testing When going for a sleep test it is important not to take any sleep medication before going in. If you have taken sleep medication please let you technologist know. Most sleep studies will take 6 -8 hours to complete to get a true value of the test. When the technologist is doing the test it is important to know that the technologist will be coming into your room to adjust the leads and the CPAP machine. There are several tools that are used to conduct the test. Most of the patient wake up to a very loud sound that is continuous air from the CPAP. This is normal The conductive gel that is used in the patients hair, forehead, and in the face may be washed out by conditioner first then household shampoo to follow.

13. Alternative Treatments Jasmine - This herb (plant) will aid in sleep by relaxing the body. (mild) and aids in promoting liver health. Chamomile – This herb will aid in relaxing the body. It is good for migraine headaches and nocturnal (night) pain. (mild) Kava Kava - This root works like valium but can be toxic if taken in high dosages. (strong) Skull Cap – This herb is used to relax the body from head to toe. It is used for extreme migraine headaches. (strong) The medicines that are described above can cause side effects of drowsiness, rashes, nausea, vomiting, hallucinations, these medicines can not be combined with other relaxants unless authorized by your license Mater Herbist or Naturopath.

14. Resources American Academy of Sleep Medicine www.aasmnet.org American Association of Sleep Technologist www.aastweb.org Richard O’ Boyle, Maintaining Proper Sleep Hygiene, 2002