Intrinsic ~ arise from causes within body

Circadian ~ disrupt rhythm of biological clock

 Parasomnias ~ clinical disorders

 An inability to obtain adequate sleep.

  3 Types of insomnia

§       Transient ~ up to 1 week

§       Short term  ~ up to 3 weeks

§       Chronic ~ lasts months or years

 3 types of sleeplessness

§       Sleep Onset Insomnia ~ can’t fall asleep

§       Maintenance Insomnia~ trouble staying asleep

§       Poor sleep quality

 Conditioned insomnia ~ poor sleep habits and associated factors

  Lifestyle and diet ~ stimulants, alcohol

 Psychological problems ~ depression, anxiety

    Medical problems ~ pain, discomfort

   Primary insomnia ~ based on inherited factors

  Different people need different amounts of sleep; there is no normal amount of sleep.

  The average adult needs 7-8 hours of sleep every night.

  The average child needs 10-12.

  The elderly sleep around 6 hours a night.

  Basic, vital function of life to restore damaged tissue and ailments.

  A series of stages with 5 different physiological stages (EEG).

§       Stage 1: relaxed wakefulness, daydreaming ~ alpha

§       Stage 2: between waking and sleeping ~ theta

§       Stage 3: deep sleep and restorative function ~ delta

§       Stage 4: deep sleep and restorative function ~ delta, k-complexes, sleep spindles

§       REM Sleep: dream sleep, highly active brain waves ~ alpha

  Sleep is pervasive across all different species with different levels of physical and neurological complexity.

  Sleep is relatively recent development with the evolution of more complex animals.

  Animals have adapted to their situations using different sleeping techniques.

§       Indus dolphins ~ 4-60 second naps frequently (7 hours total)

§       Owl ~ daytime sleeper

§       Northern Fur Seal ~ rest half of its brain at a time

§       Grazing animals (sheep/cattle) ~ require less sleep (4-6 hours)

§       20-70% of animals life spent asleep

  Physical Exercise

  Physical relaxation techniques

§       Breath control, abdominal breathing

§       Day Method ~ muscles relaxed from the toes to the head

§       Jacobson Method ~ clench muscles then release and relax them

§       Yoga, Tai Chi

§       Meditation

§       Stretching exercises

§       Massage

  Relaxation techniques

§       Relaxing Imagery ~ thinking in terms of pictures

§       Visual Exercises ~ daydreaming or “counting sheep”

§       Calculations ~ count backwards from 500

§       Verbal Methods ~ pronounce groups of letters from the alphabet progressively

  Sounds and Music

§       classical, meditation, slow beats

§       Sleep audio CDs or Cassettes (soothing voices direct breathing/relaxation techniques)

  Stimulus Control Therapy ~ the bedroom is for sleep only

  Sleep Restriction Therapy ~ limits time spent in be

  Cognitive Therapy ~therapists replace harmful thoughts about sleep and insomnia with more realistic, positive thoughts.

  Used as Hypnotic or Sedative

§       Antihistamines

§       Antidepressants ~ relieve depression and aid sleep

§       Chloral Hydrate ~ “knockout”

§       Barbiturates ~ very strong sedating Rx, depresses central nervous system, heart rate, blood pressure and temperature

§       Benzodiazepines

·       short acting

·       intermediate action

·       long acting

  Used as Hypnotic or Sedative

§       Antihistamines

§       Antidepressants ~ relieve depression and aid sleep

§       Chloral Hydrate ~ “knockout”

§       Barbiturates ~ very strong sedating Rx, depresses central nervous system, heart rate, blood pressure and temperature

§       Benzodiazepines

·       short acting

·       intermediate action

·       long acting

  Melatonin (natural)

  Soporific Herbs

§       Lavender oil

§       Chamomile

§       Valerian

   No

§       Addictive

§       Tolerance Problem

§       Secondary Conditioned Insomnia ~over reliance on pills

§       Dangerous ~ overdose

§       Placebo effect ~ excuse

§       Side Affects ~ groggy, withdrawal, uncontrollable nightmares

   Yes

§       Effective for purposes of sleep

§       High success rate

§       Safe with right dosage

§       Aids to achieve circadian rhythm

§       Natural remedies are not as precise or effective for some people

    Conclusion/opinion

§       It is important to give adequate treatment to those that need it.

§       Individuals that suffer from severe insomnia, or with child-onset insomnia, tend to need medications to get their sleep rhythms back to normal.

§       Medicines should be used in conjunction with other therapies.

§       Medicines should only be used if all other remedies failed.

§       Medication should only be short term.

   Melatonin positive

§       Deep sleep

§       Vivid dreams

§       Eliminates jet lag

§       Improves mood

§       Natural

§       More day-time energy

   Negative Aspects

§       Habit forming

§       Overuse

§       Imprecise dosage ~ range .75mg- 10 mg capsules, each affects individuals differently

§       Over-the-counter, uncontrolled

§       Psychological dependence

§       Tolerance ~ constantly taking in more to achieve desired affect

     Conclusion/opinion

§       Melatonin may be a miracle for longevity, but it is not effective for long term sleep treatment.

§       One or three mg of Melatonin each night is about the right general dosage.

§       There is dependence on the drug and conditioned insomnia develops.

§       Although Melatonin is natural and it is easily accessible, people should consult a physician or pharmacist for the correct personalized dosage.

   Every individual has a different chemical composition, so different treatments work for different types; however, the ideal treatment is non-evasive, natural therapies and techniques.

   For transient insomniacs, mild over the counter drugs like antihistamines are useful and appropriate.

   For individuals with poor sleep quality, melatonin can help improve deep sleep.

   For sleep-onset insomniacs and maintenance insomniacs the best treatment involves getting a sleep pattern using good sleep habits. These may be accompanied by the use of temporary prescription drugs like Sonata or Ambien that help get a rhythm back.