How to

SLEEP DISORDERS
manage [{{{

Dr. Ira Hope Salonga-Militante

Occupational Health Physician
Many things – such as loving, going
to sleep, or behaving unaffectedly –
are done worst when we try hardest
to do them.
~ C.S. Lewis
  Sleep
 Sleep problems
 Sleep Disorders
 Treatment
Outline Summary
 Sleep
 Sleep problems
 Sleep Disorders
 Treatment
 Summary

Sleep
Sleep is crucial for your overall health.
According to National Sleep Foundation,
one key benefit of getting enough good sleep
is strengthening your immune system to help
you prevent or limit infection in your body.
Healthy sleep can support boosting the body’s
immune defense and can even help you from
getting sick as often.
 Sleep
 Sleep problems
 Sleep Disorders
 Treatment • Circadian Rhythm
 Summary
• Your body’s biological clock located in the brain in the
suprachiasmatic nucleus (SCN) produces circadian
rhythms and regulates the timing of things in your body
like when you want to sleep or eat.
• These rhythms are named circadian meaning “about a
day” because they tend to occur at least every 24-hours.
• Natural factors in your body produce circadian rhythms
but signals in the environment, like daylight, as well as
exercise and temperature, also affect them.
• Problems can occur when your biological clock is not
lined up with the day-night cycle. This type of
abnormality has been linked to health conditions like
obesity, diabetes, depression, and sleep disorders.
 Sleep
 Sleep problems
 Sleep Disorders
 Treatment
 Summary
 Sleep
 Sleep problems
 Sleep Disorders
 Treatment
 Summary
Age group Recommendation
School-age 9-11 hours
children
Teenagers 8-10 hours

Adults 7-9 hours

Adults over 65 7-8 hours

years old

How Much Sleep Do You Really Need? | National Sleep Foundation (thensf.org)
 Sleep
 Sleep problems
 Sleep Disorders
 Treatment
 Summary

• DSM-5 Category: Sleep-Wake Disorders.

Out of 12 Disorders:
•  Insomnia disorder is a DSM-5 (Diagnostic
and Statistical Manual of Mental
Disorders, 5th ed.) diagnosis assigned to
individuals who experience recurrent poor
sleep quality or quantity that causes
distress or impairment in important areas
of functioning.
 Sleep
 Sleep problems
 Sleep Disorders
 Treatment
 Summary
Sleep Problems
InsomniaIndex (ons.org)
 Sleep
 Sleep problems
 Sleep Disorders
 Treatment
 Summary Sleep Disorders
 Sleep
 Sleep problems
 Sleep Disorders
 Treatment Sleep Disorders
 Summary

• Narcolepsy
• Excessive daytime sleepiness despite being awake and well-rested
• Recurrent episodes of rapid-onset, overwhelming sleepiness more than
or equal 3 times in a week for the last 3 months
• Treatment:
• Good sleep habits
• Daytime stimulants (Amphetamines: ADHD)
• Nightime sodium oxybate
 Sleep
 Sleep problems
 Sleep Disorders
 Treatment
 Summary
Sleep Disorders
• Sleep Terror Disorder
• Periods of inconsolable terror with screaming in the middle of the night
• Most common in children
• Occur along with sleep walking or enuresis
• No memory of the arousal episode
• Triggers: Emotional stress, fever and lack of sleep
• Self-limited

• Enuresis
• Urinary incontinence more than or equal to two times in a week for more than three months
in person more than 5 years old
• Treatment:
• Scheduled voiding
• Night time fluid restriction
• Positive reinforcement
 Sleep
 Sleep problems
Treatment
 Sleep Disorders
 Treatment Insomnia disorder may be treated through medication or with therapy. Often,
 Summary a comprehensive approach is taken that incorporates two or more of the
following:

Medication
•Sleeping pills that treat insomnia are known as hypnotics. Eszopiclone
(Lunesta), ramelteon (Rozerem), zaleplon (Sonata)
and zolpidem (Ambien, Ambien CR) are prescription medications that
may be used to treat insomnia disorder with varying efficacy.
Sleep hygiene education
•Sleep hygiene is the habits and practices that contribute to getting a
good night’s sleep and include factors like diet and exercise, as well an
environmental elements like light and sound levels at bedtime.
Cognitive behavioral therapy (CBT)
•A person’s attitudes and beliefs about sleep may be contributing to the
insomnia - CBT challenges sufferers to rethink their beliefs and
behaviors in order to bring about positive change.
 Sleep
 Sleep problems
 Sleep Disorders FOR CHRONIC INSOMNIA:
 Treatment
 Summary
•Relaxation therapy - Sufferers of insomnia
disorder are often highly aroused - relaxation
therapy may help deactivate the arousal system
through techniques like imagery training and
progressive muscle relaxation.

•Stimulus control therapy - This type of

treatment encourages the patient to associate
their bedroom with sleeping and establish a
sleep/wake pattern.
 Sleep
 Sleep problems
 Sleep Disorders
 Treatment •Biofeedback - Designed to help the sufferer recognize when they
 Summary
are not relaxed, biofeedback sensors are attached to the body and
connected to a machine, measuring functions like heart rate and
muscle tension.

Sleep restriction therapy – Limiting the time spent in bed to bring

about a state of mild sleep deprivation, which should, theoretically,
promote more rapid and efficient sleep.

Paradoxical intention - Challenging the sufferer to try to stay

awake. This is used for patients who have trouble falling asleep but
not for sufferers who struggle to maintain being asleep.
With the right treatment, individuals suffering from insomnia disorder
may find their condition improves and symptoms can be managed or
brought under full control.
 This Presentation is Prepared by

Dr. Ira Hope Salonga-Militante