Transcript SLEEP AND COLLEGE LIFE Waverly Green, III, MD Teresa Green, MD WestCare Sleep Disorders Center: Harris Regional Hospital Sylva, NC.

SLEEP AND COLLEGE LIFE
Waverly Green, III, MD
Teresa Green, MD
WestCare Sleep Disorders Center: Harris Regional Hospital
Sylva, NC
Overview
• Why Sleep is Important
• Consequences of Sleep
Deprivation
• Recognizing Sleep Disorders
• Tips for Good Sleep
Sleep is Vitally Important...
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Growth and physical development
Learning & memory consolidation
Cognitive & physical performance
Mood and emotional stability
Health maintenance and
prevention of disease
Sleep Needs Vary Over
the Life Cycle
Newborns/
Infants
0 - 2 months
2 - 12 months
10.5-18 hours
14-15 hours
Toddlers/
Children
12 - 18 months
18 months - 3 yrs.
3 - 5 yrs.
5 - 12 yrs.
13-15 hours
12-14 hours
11-13 hours
10-11 hours
Adolescents/ On Average
Young Adults
9 hours
Adults/Older
Persons
7-9 hours
On Average
Yet… College Students are
Chronically Sleep Deprived
• Average significantly less sleep (6-7 hours). A 2hr
sleep debt each night!
• Most experience excessive daytime sleepiness on a
regular basis (50-70%)
• Report twice as many sleep problems as the general
population
Why?
• The obvious:
– Academic workload
• The less obvious:
– Social activities, extracurricular activities, and jobs
– Computer / internet / TV / cell phones
– Excessive caffeine use, alcohol and/or recreational
drugs
– Delayed sleep phase and irregular sleep wake
schedules
Social
pressures
Class start
times /
delayed sleep
phase
Substance
abuse
Academic
workloads
Slee
p
Time
Genetic
predisposition
Computer,
Internet, TV,
Cell phones
Delayed Sleep Phase Sleep
Schedule
In order to get to classes on time, many students
must wake early and shorten their sleep time.
QUESTION:
• What do the following disasters have in
common?
• Three Mile Island
• Chernobyl
• Exxon Valdez
• Space Shuttle Challenger
QUESTION:
• What do the following disasters have in
common?
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Three Mile Island
Chernobyl
Exxon Valdez
Space Shuttle Challenger
• All are attributed in some degree to the
poor judgment of sleep deprived workers.
Effects of Sleep Deprivation
1. Impaired alertness/excessive daytime
sleepiness
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Alertness is impaired after:
 3 hrs of sleep for 1 night
 5 hrs for 2 nights
However, although the individual’s subjective
sleepiness levels out, cognitive and performance
impairment does not:
* We are not always aware of the
severity of our impairment *
Effects of Sleep Deprivation
2. Impaired performance (cognitive and
motor)
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Impaired short-term memory
Decreased reaction time and judgment
Increased number of errors
Impaired information processing
All of which can lead to
lower academic performance…
Effects of Sleep Deprivation
Would you ever take an test drunk?……
• 18 hours awake produces performance impairment
= 0.05% Blood alcohol level (BAL)
• 24 hours awake = 0.10% BAL.
• Chronic sleep restriction of 4-6 hrs for 2 weeks also
results in performance deficits = 0.08% BAL
• On 4 hours sleep, 1 beer can have the impact of a sixpack.
Sleep and College Performance
• Study at St Lawrence Univ.
“All nighters” correlated with lower GPAs
• Study at Stanford Univ.
Academic and athletic performance in basketball
players improved with lengthening of sleep time
• Study in South Korea
Staying up late associated with
poorer academic performance
Effects of Sleep Deprivation
3. Health Problems
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Mood disturbances – depression, irritability,
and anxiety
Weight gain
Insulin resistance leading to diabetes
Impaired immunity
Increased cardiovascular problems –
hypertension, stroke, heart attack
The Consequences of
Sleep Deprivation on the
Highway
Sleepiness and Driving
• 15-20% of all MVA’s felt to be sleep related.
• DOT estimates 100,000 MVA’s per year direct
result of driver sleepiness/drowsiness.
• 1500 fatalities / 71,000 injuries per year.
• Excessive sleepiness 2nd leading cause of car
accidents, and a major cause of truck accidents
in the US.
• The peak age for fall-asleep driving accidents is 20.
• Drivers under 30 account for 2/3 of all drowsydriving crashes.
Drowsy Driving
Recognizing The Warning Signs
• Trouble focusing, keeping your eyes open
or your head up
• Daydreaming; wandering/disconnected
thoughts
• Yawning or rubbing your eyes repeatedly
• Drifting from your lane, tailgating, &
missing signs or exits
• Feeling restless & irritable
Drowsy Driving
Countermeasures While Driving
• Stop driving
• Pull off the road at a safe place and take a short
nap
• Let a passenger take over the driving
• Consume caffeine (best combined with a nap)
• Don’t rely on “drowsy driving devices”
• Be aware of shoulder rumble strips
Watch for Sleep Disorders
1. Insomnia
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Affects up to 40% of college students
Involves difficulty falling asleep or staying
asleep, associated with daytime impairment
Can be a normal reaction to short term
stress
When chronic can lead to long-term
problems
Watch for Sleep Disorders
2.
Obstructive Sleep Apnea
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Airway closure during sleep, that leads to partial or complete
pauses in breathing.
This leads to drop in oxygen levels, rise in carbon dioxide
levels, and eventually arousal from sleep
Symptoms: snoring, pauses in
breathing, gasping, frequent
awakenings restless sleep,
and daytime sleepiness
Risk factors: obesity, male
gender, small upper airway
family history,
neuromuscular disease
Watch for Sleep Disorders
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Restless Legs Syndrome
Unpleasant, tingling, painful or
restless feeling in the legs occurring
primarily in in the evening.
Worsened by rest/inactivity and
relieved by movement.
Can be associated with legs
movements during sleep.
Can be associated with sleep
disruption and daytime sleepiness.
Watch for Sleep Disorders
4. Narcolepsy
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Severe excessive daytime sleepiness and
uncontrollable “sleep attacks”, sleep paralysis, and
hallucinations at the onset of sleep
May be associated with sudden episodes of muscle
weakness triggered by emotional situations
1/2000 people and often diagnosed late due to
subtlety of symptoms
Can be very disabling,
but is treatable with
medications
When Should You Get Help?
• Trouble getting to sleep or waking up frequently
during the night for several weeks
• Excessive daytime sleepiness (falling asleep at
inappropriate times despite adequate sleep)
• Sudden attacks of sleep or muscle weakness
(especially associated with emotional situations)
• Loud snoring or witnessed episodes of not
breathing during sleep
Healthy Sleep Tips
• Maintain a regular sleep schedule, even on
weekends.
• Allow for relaxing activities during the hour
before sleep
• Create a sleep friendly environment:
• Go to bed only when sleepy and get out of bed if
unable to fall asleep.
• Exercise daily, but not too close to bedtime
• Avoid caffeine, nicotine, and alcohol, especially
in the late afternoon and evening
• Avoid naps, particularly in the late
afternoon or evening
Make Sleep a Priority!