Sleep & Well-being Neuroscience of Sleep & Clocks Impact of - - PowerPoint PPT Presentation
Sleep & Well-being Neuroscience of Sleep & Clocks Impact of Sleep Disruption Sleep in the Young Sleep Hygiene Mental Illness Discussion http://www.eye.ox.ac.uk/research/sleep- circadian-neuroscience-institute
http://www.eye.ox.ac.uk/research/sleep- circadian-neuroscience-institute
10 14 14 02
Urine volume ml/Min.
3.0 1.5 14 14 02 28 14 14 14 02
Systolic Pressure mm Hg
150 100 50 14 14 02
Melatonin pmol/l
200 100 14 14 02
Cortisol µg/100ml
200 100 14 14 02
Mood
5 5
Growth Hormone ng/ml
14 14 02
Alertness
100 75 50 14 14 02
Core Body Temperature °C
37.5°C 36.75°C 36°C
Sleep
14 14 02 100 50 7am 10pm
Oxford Vascular Study (Peter M Rothwell )
Stroke Frequency
06.00 12.00 06.00 12.00
Alertness
Rajaratnam SMW, Arendt J. Health in a 24-h society. Lancet 2001; 358: 999-1005.
06:00
Time of day
Cognitive Performance Cognitive Performance
Alcohol Intake Clock Time
General activities 19%
Data from - American Time Use Survey Summary 2011
Watching TV 11%
Household work 8% Eating & Drinking 11% Socialising 3% Sport/Exercise 1% Telephone/ Mail/Email 1%
Lifetime Activities
http://www.bls.gov/tus/
Work & Work related 16%
~21.5 years asleep!
"Enjoy the honey-heavy dew of slumber". Julius Cesar “O sleep, O gentle sleep, nature's soft nurse, how have I frighted thee…..” Macbeth “Sleep is the golden chain that ties health and our bodies together.”
Thomas Dekker (1572 – 1632)
“Sleep is a criminal waste
heritage from
days”
Thomas Edison
SLEEP (NREM and REM) WAKE (States and Activity)
Light Sleep Slow Wave Sleep Rapid Eye Movement Sleep Wake
SLEEP (NREM and REM) WAKE (States and Activity)
Serotonin Glutamate GABA Galanin Orexin Acetylcholine Noradrenaline Histamine Dopamine
Hypothalamus Thalamus Mid-Brain Hind-Brain Cortex Cortex
Pons
Sleep is a global brain event!
SLEEP (NREM and REM) WAKE (States and Activity)
Clock Sleep Pressure Social Timing
The Generation of 24h Rhythms
Suprachiasmatic nuclei (SCN) The “master” body clock
Suprachiasmatic nuclei (SCN)
SLEEP (NREM and REM) WAKE (States and Activity)
Eye Emotional/Mental Health
Overall Health
Pineal Melatonin
Cognitive Health
Clock Sleep Pressure Social Timing
Sleep Disruption
In USA 100,000 crashes every year are related to sleepiness.
Accident investigators determined that fatigue was a factor in the crash, and the Exxon Shipping Company was criticised for failing to provide a rested crew Air India Express Accident investigators said that the pilot could be heard snoring on the cockpit voice recorder shortly before the disastrous landing. The International Nuclear Safety Group determined that human error related to sleep deprivation was a factor in the accident.
1989 2010 1986
Effect of sleep deprivation on brain activation while performing mathematical tasks (fMRI) Rested
Effect of sleep deprivation on brain activation while performing mathematical tasks (fMRI) Sleep Deprived Rested
Adipose Tissue
Ghrelin Leptin
Appetite
Sleep Disruption
STRESS
Pituitary Gland Adrenal Gland
CORTISOL
Glucose Insulin Immunity Gastric Acid Blood Pressure Impaired Memory Mood Instability Anxiety & Depression
DAY NIGHT 11pm 7am WAKE SLEEP 7am Mon Tue Wed Thur Fri Sat Sun Mon Tue WAKE SLEEP WAKE SLEEP WAKE SLEEP WAKE WAKE WAKE WAKE SLEEP WAKE SLEEP SLEEP SLEEP SLEEP
“Ideal” Good Sleeper
Stable Sleep
DAY NIGHT 11pm 7am WAKE SLEEP 7am WAKE SLEEP WAKE SLEEP WAKE SLEEP WAKE WAKE WAKE WAKE SLEEP WAKE SLEEP SLEEP SLEEP SLEEP
“Elderly” Sleep/Wake Pattern
Reduced and Fragmented Sleep
Mon Tue Wed Thur Fri Sat Sun Mon Tue
DAY NIGHT 11pm 7am WAKE SLEEP WAKE SLEEP WAKE SLEEP WAKE SLEEP WAKE WAKE WAKE WAKE SLEEP WAKE SLEEP SLEEP SLEEP SLEEP
“Teenager” Sleep/Wake
Mon Tue Wed Thur Fri Sat Sun Mon Tue 7am
Greatly Delayed and Reduced Sleep
Morning vs Evening Preference changes with age
Roenneberg et al., Curr Biol, 2004
10 20 30 40 50 60 70 80
Morning 3.0 3.5 4.0 4.5 5.0 5.5 Chronotype (MSFsc, time around midnight)
Age
Evening
Male
Morning vs Evening Preference changes with age
Roenneberg et al., Curr Biol, 2004
10 20 30 40 50 60 70 80 3.0 3.5 4.0 4.5 5.0 5.5
Age
Male Female
Morning Chronotype (MSFsc, time around midnight) Evening
2 hour difference
Making a teenager get up at 07.00 is the same as making a 50 year
05.00!
Mary Carskadon at Brown University suggests that, on average, US teenagers are getting about 7.5 hours a night's sleep on school nights, but as many as 25% get fewer than 6.5 hours per night. Mary estimates that to be optimally alert, teenagers need approximately 9 hours of sleep.
60 50 40 30 20 10 School Start Time 08.50 (2010) 10.00 (2011) 10.00 (2012) 12% 42% 44% 52% 53% 35% Socially Disadvantaged All Students
% Students Reaching Government Standard 5+ GCSE Passes Grade C or Higher
National Average
Pilot Study - Monkseaton School (Newcastle, UK). Headmaster: Paul Kelly Students 15-16 taking GCSEs 29 30 49 n = 169 166 164 n =
Kelley, P., Lockley, S.W., Foster, R.G. and Kelley, J., (2014) Synchronizing education to adolescent biology: ‘Let teens sleep, start school later’, Learning, Media and Technology, Neuroscience and Education Special Issue, (in press)
22 April 2013
“Why teenagers really do need an extra hour in bed”
22 April 2013
Not getting enough sleep if….
parent, to get you out of bed.
your normal behaviour – irritable, loss of empathy; disinhibited…..
22 April 2013
“Why teenagers really do need an extra hour in bed”
So…. Take control.
before bed.
body clock and sleep patterns to an earlier time.
Typical Range Lux Situation 100,000
Bright sunny day
10,000
Cloudy day
1000 - 2000
Watch repairman's bench
100 - 600
Typical office setting
1 - 10
Residential street lighting
0.25
Cloudy moonlight
Environmental Lighting
> 4000 lux < 100 lux
SLEEP WAKE
Sleep Pressure Social Timing Eye Emotional/Mental Health
Overall Health
Clock
Cognitive Health
Emil Kraepelin (1856 -1926)
Noted in his 1883 textbook that abnormal sleep patterns and mental health are linked.
Sleep/Clock disruption in schizophrenia has been viewed merely as the by-product of antipsychotic medication
Since the 1970’s……..
And……….Abnormal sleep in schizophrenia is often dismissed on the basis of lack of work. Typical comment: “my patients can’t hold down a job - so no wonder they get up late, miss my clinic and don’t have friends”. (annon)
Sleep Onset Wake Days 1 45 Melatonin Peak
Activity/Rest (Sleep) Profile
Schizophrenia 2 Schizophrenia 3 Schizophrenia 1 Schizophrenia 4 Schizophrenia 5 Schizophrenia 6 Schizophrenia 7 Unemployed 00 h midnight 00 h
Wulff, K., Middleton, B., Dijk, D-J., Foster, R.G., Joyce, E. (2012) Sleep and circadian rhythm disruption in schizophrenia patients. British Journal of Psychiatry 200(4) 1-9.
SLEEP WAKE
Serotonin Glutamate GABA Galanin Orexin Acetylcholine Noradrenaline Histamine Dopamine
SLEEP WAKE
Sleep Pressure Social Timing Eye Clock
Mental Illness
Overlapping Brain Pathways & Mechanisms
Wulff, K., Gatti, S., Wettstein, J.G. and Foster, R.G. (2010) Sleep and Circadian Rhythm Disruption in Psychiatric and Neurodegenerative Disease. Nature Reviews Neuroscience 11(8), 589-599.
Do the networks in the brain that generate normal sleep and mental health overlap?
Sleep Disruption
Low risk
00 00 00 12 12 Time of Day (hours) Days of measurements
High risk
00 00 00 12 12 Time of Day (hours)
Sleep Disruption Observed in those “at risk” of Bipolar
50.00 40.00 30.00 20.00 10.00 00.00
Mean Score
Insomnia
Baseline Post-Treatment Follow-up
Partial consolidation of SCRD using CBT reduces symptoms in schizophrenia
50.00 40.00 30.00 20.00 10.00 00.00
Mean Score
Delusion
Baseline Post-Treatment Follow-up
Mental Illness
Overlapping Brain Pathways & Mechanisms
Wulff, K., Gatti, S., Wettstein, J.G. and Foster, R.G. (2010) Sleep and Circadian Rhythm Disruption in Psychiatric and Neurodegenerative Disease. Nature Reviews Neuroscience 11(8), 589-599.
Do the networks in the brain that generate normal sleep and mental health overlap?
Sleep Disruption
MECHANISMS BIOMARKER THERAPUTICS