Sleep
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Introduction
On average, we sleep 1/3 of our lives. Why do we sleep? Energy conservation, cell and itssue repair, enhanced immunity, brain protein synthesis increases in non-REM sleep.
memory consolidation
Sleep is not pasive; it is a series of complex, controlled events
Sleep after learning is extremely important for memory (Stickgold et al, 2000).
Nightly Sleep Requirements
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Naps
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Healthy sleep cycle
begins with stage 1; progresses through deeper,
4-6 cycles per evening.
be cautious with drugs: ie caffeine, alcohol (leads to sleep fragmentation), nicotine
avoid sleeping pills
Non-REM sleep
REM sleep
Paradoxical or active sleep; brain activity levels and EEG patterns
Sleep Hygiene
Have naps of less than 30 minutes
Dark, quiet room
No caffeine or alcohol after lunch
Have only sleep and sex in the bedroom
Good, regular exercise.
(JAMA 1999, 281_991-999.
Sleep in Children
baby sleeping
co-sleeping (same room) for the first 6 months is good to reduce sleep
bed sharing makes it easier to nurse at night, but can be dangerous, especially with smokers or people who drink
can have little cots which pull up to bed
should sleep on back until they can roll over
Norms
<12 months: 16-18 hours; average 3 wakings/night
- toddler: 11-12 hours, naps, with organized circadian rhythms
- school aged: 9-11 hours: good organization
- adolescents: 8.5-9.25 hours/night, with sleep fragments and phase shifting
No single cultural norm; a preconcenption can create a problem where there is not.
Poor sleep is associated with injury, mood, and attention problems
Bedtime is three things
- physiologic transition
- separation
Nightmares
Common in boys 4-7 years old
associated with REM sleep
child is alert and recounts frightening dream upon awakening
can be precipitated by daytime anxiety
Night Terrors
Occurs at least occasionally in 15% of kids
Children awake abruptly, screaming, with autonomic arousal and panic
Occurs in early hours of non-REM sleep
No memory of event
unable to be calmed by parents
usually resolve spontaneously at puberty
Resources and References
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