Sleep wake disorder.pptxThese are just a

A sleep-wake disorder is a condition characterized by disturbances in the normal pattern of sleep and wakefulness. These disorders can significantly impact an individual's ability to function during the day and may lead to various health problems if left untreated

1. Sleep wake disorder

2. Definition: Sleep wake disorder: Sleep disorders (or sleep-wake disorders)  involve problems with the quality, timing, and amount of sleep , which result in daytime distress and impairment in functioning .

3. Understanding SWD: These are the group of disorder that involve disturbance in the quality , timing and amount of sleep or in a behavior for psychological condition that associated with the sleep .

4. Importance of Sleep: Sleep is a basic human need C ritical to both physical and mental health. There are two types of sleep : Rapid eye movement (REM) – when most dreaming occurs Non-REM – has three phases, including the deepest sleep S leep is also important circadian rhythm. How much sleep we need varies depending on age and varies from person to person .

5. According to the National Sleep Foundations : M ost adults need about seven to nine hours of restful sleep each night.  Many of us do not get enough sleep. A third of adults report that they usually get less than the recommended amount of sleep and only about 30% of high school students get at least eight hours of sleep on an average school night. 2  An estimated 34 percent of Americans report their sleep quality as “poor” or “only fair.” More than 50 million Americans have chronic sleep disorders 5

6. Types of sleep 6

7. Rapid eye movement sleep: The phase of sleep in which most dreams occur. During rapid eye movement sleep, a person’s brain activity, breathing, heart rate, and blood pressure increase, and the eyes move rapidly while closed . The muscles in the arms and legs become temporarily unable to move. Rapid eye movement sleep is thought to play an important role in memory and learning. Also called REM sleep 7

8. Non-rapid eye movement sleep: The phase of sleep that is considered the quiet or restful phase. During the three stages of non-rapid eye movement sleep, a person falls asleep and then moves from a light sleep into a deep sleep . This is when a person’s brain activity, breathing, and heart rate slow down, body temperature drops, muscles relax, and eye movements stop . Non-rapid eye movement sleep plays an important role in helping the body repair tissues, build bone and muscle, and strengthen its immune system. Also called non-REM sleep and NREM sleep 8

9. Types of sleep wake disorder:

10. Insomnia disorder: Difficulty in initiating or maintaining sleep Dissatisfaction with sleep quantity and quality. This happens even if you have the time and the right environment to sleep well. M ore common among  middle-aged and older adults . APA 10

11. Percentage of insomnia in worldwide : In Asia, studies on the Chinese ageing population show that 6–41% of the elderly experience insomnia. In Egypt, 50% of the patients older than 60 years old had insomnia. An Iranian study conducted in six hospital clinics with 696 individuals reported a much higher prevalence rate of 62.1% In Pakistan study suggest that 42.1% of the people met the criteria of insomnia. 11

12. Different type of insomnia: Acute insomnia Acute insomnia is short-term insomnia that can last from a few days to a few weeks. It’s the most common type of insomnia . Also referred to as adjustment insomnia because it typically occurs when you experience a stressful event. S uch as the death of a loved one or starting a new job.

13. Chronic insomnia: Insomnia is considered chronic if you have trouble sleeping at least three days per week for at least one month. Chronic insomnia   can be primary or secondary . Primary chronic insomnia, which is also called idiopathic insomnia, doesn’t have an obvious cause or underlying medical condition. Secondary insomnia, also called comorbid insomnia, is more common. It’s chronic insomnia that occurs with another condition. Common causes of chronic insomnia include chronic medical conditions, such as  diabetes ,  Parkinson’s disease ,  hyperthyroidism . mental health conditions, such as  depression ,  anxiety , and  attention deficit hyperactivity disorder medications, including  chemotherapy  drugs,  antidepressants . caffeine and other stimulants, such as  alcohol ,  nicotine , and other dugs. 13

14. Onset insomnia: Onset insomnia is trouble initiating sleep. This type of insomnia can be short term or chronic. According to a  2009 study , people with chronic onset insomnia often have another sleep disorder, such as  restless leg syndrome  or  periodic limb movement disorder . Maintenance insomnia: Maintenance insomnia is difficulty staying asleep or waking up too early and having trouble getting back to sleep. This type of insomnia causes you to worry about not being able to fall back asleep and not getting enough sleep. Maintenance insomnia can be caused by mental health conditions, such as depression. 14

15. Hyper somnolence disorder : Hypersomnia is  a condition in which you feel extreme daytime sleepiness. If you have hypersomnia, you fall asleep several times during the day. That occur even after full night sleep. Distress and impairment during day time functioning. 15

16. Who gets hypersomnia? Hypersomnia is more common in females than males. It's thought to affect about 5% of the population. It’s usually diagnosed in adolescence or young adulthood (mean age is 17 to 24 years. Hypersomnolence was more prevalent in adolescent girls compared to boys . The prevalence of hypersomnolence varied by age group in both boys and girls, with teens between the ages of 15–16 years endorsing the highest rates of hypersomnolence , followed by 17–18 year-olds.

17. Narcolepsy The name Narcolepsy come from French word narcolepsie Combination of Greek word narke (numbness) and leptos (seizure) Chronic sleep disorder Cause drowsiness and frequent nap attacks during day time. Occurring at least 3 time a week for past 3 months. Also characterized by cataplexy , hallucination ,and sleep paralysis. 17

18. Hyper somnolence VS Narcolepsy Hypersomnolence: Pathological condition Characterize by unusual sleepiness. Symptoms are excessive night time sleep ,sleepiness daytime . Narcolepsy: Chronic neurological disease Characterize by excessive and sudden daytime sleep. Symptoms are excessive day time sleep , temporary paralysis , hallucination, muscle weakness etc. 18

19. Rate of narcolepsy in PAKISTAN : This result was in agreement with previous studies that were conducted in Karachi, in which the prevalence rate of sleep disorders ranged from 20% to 30% [19–23]. Our study showed that narcolepsy prevalence is 43.5%, and it is dominant in females (45.3%) 19

20. Obstructive sleep apnea Characterized by episodes of complete collapse of the airway or partial collapse with an associated decrease in oxygen saturation or arousal from sleep. It often associated with snoring , chocking , gasping 20

21. Symptoms of OSA Excessive daytime sleepiness. Loud snoring. Observed episodes of stopped breathing during sleep. Waking during the night and gasping or choking. Awakening in the morning with a dry mouth or sore throat. Morning headaches. Trouble focusing during the day. 21

22. REM Sleep behavior disorder: Complex motor behavior during REM sleep. Like punching , shouting , jumping out of bed Often associated with Parkinson disease and other neurological disorder. Characterized by dream-enactment behaviors. That emerge during a loss of REM sleep atonia . 22

23. Non REM Sleep arousal disorder: 23 Incomplete awakening from sleep. Involve behaviors such as sleepwalking, night terrors, or confusion. During these episodes, individuals may exhibit intense fear, panic, or confusion. They may engage in automatic behaviors, such as sitting up in bed, walking around, or even leaving the bed and moving around the house. Although they may seem awake, individuals usually have limited awareness of their surroundings and may not respond to attempts at communication.

24. Sleep related hypoventilation disorder: It is a respiratory disorder Characterized by abnormally slow or shallow breathing during sleep. Leading to insufficient oxygen intake and increased levels of carbon dioxide in the blood. It often associated with obesity, neuromuscular disorder. 24

25. OSA vs SRH Obstructive Sleep Apnea (OSA): OSA occurs when the muscles in the throat relax too much during sleep. Causing the airway to collapse partially or completely. This obstruction leads to pauses in breathing or shallow breathing episodes. Common symptoms include loud snoring, choking or gasping during sleep, daytime sleepiness, and difficulty concentrating. Sleep-related Hypoventilation: Sleep-related hypoventilation refers to a condition where a person's breathing is insufficient during sleep, leading to elevated levels of carbon dioxide (hypercapnia) and reduced levels of oxygen (hypoxemia) in the blood. hypoventilation can occur due to various factors such as reduced respiratory drive, lung diseases, neuromuscular disorders, or obesity hypoventilation syndrome (OHS 25

26. Central sleep apnea: Lack of respiratory effort during sleep. Cause stop of air flow Lead to decree in oxygen saturation. Often associated with heart failure, stroke and other neurological disorder. 26

27. What is Central Apnea? Nerves from the area of the brain called the brainstem control breathing . Any damage to the brainstem or the spinal cord from things such as trauma, brain tumors and brain bleeds can cause breathing to be too shallow or stop all together. This is called central apnea. There are also genetic conditions (something you were born with) which effect the part of the nervous system that control breathing . 27

28. Night mare disorder : A type of sleep disorder that involves undesirable experiences that occur while you're falling asleep, during sleep. Recurrent episodes of disturbing or frighting dream that wake individual from sleep. Associated with significant distress of impairment in social, occupational and other areas of functioning. 28

29. Circadian rhythm sleep wake disorder: Also known as sleep-wake cycle disorders. Problems that occur when your body's internal clock, which tells you when it's time to sleep or wake, is out of sync with your environment. Your internal clock, called a circadian clock. It involve mis – match between an individual sleep wake schedule. Characterized by insomnia , excessive sleepiness or both. Associated with shift of work and irregular sleep schedule. 29

30. Etiology 30

31. Medical condition : Cardiac conditions. Neurological conditions. Endocrine conditions. Pulmonary conditions. Gastrointestinal conditions.

32. Psychological conditions : Depression may cause alternation in REM sleep. 40% people with depression have insomnia. PTSD cause night mares which lead to disturbance in sleep. Anxiety disorder predispose to insomnia . 32

33. Environmental problems: Stress full or life threating event may cause insomnia. Shift work may disturb sleep cycle. Sleep deprivation may occur due to result of our warm or noisy environment. 33

34. Substance use: Drugs of abuse and alcohol have disruptive effects on sleep, Interfering with the ease of falling asleep. Increasing the difficulty in maintaining sleep. Altering the cycling of sleep stages from non-rapid eye movement (NREM) sleep to rapid eye movement (REM) sleep. Insomnia may result of use of caffeine , alcohol or withdrawal from any of these. Medications that cause insomnia include Corticosteroids and Bronchodilator’s 34

35. Treatments 35

36. Treatment: Cognitive behavior therapy.(CBT) Light therapy Alternative therapy Medications: Changing life style :

37. Thank you 37