Harvard medical school - Improving sleep.pdf - O spaniu - kuszaba

IMPROVII

A Guide to Getting a GoodNight's Rest

Inthis report

A sleepdiary to help

resohe your sleepproblems

Sleep aids: Whichones

work?

Practical tips fo, a better

night's rest

Thelatest on sleepdisorders

and treatments

Sleeplabs: Are thq nght

fo, you?

M.D., Ph.D.

AssociateDirector,SleepDisorders Program

BnghamandWomen's Hospital

AssistantProfessor of Pqtchiatry

Harvard Medical School

Hart ard Medical School publications

SpecialHealth Reports

end of this report.

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Ann Mane Dadoly

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Newsletters

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Books

Books published by Harvard Medical School

include:

TheArthitis ActronProgram: An Integrated plon

o.fTradttional and Complementatlt

Production Goordinator

A-y E. Yeager

(Simon and Schuster,

Therapies

2000)

Eat,Dnnh", andBeHealtlry: TheHattardMedicul

School GuidetoHealtlry Eating (Simon and

Schuster,

First Printing

October 2001

2001)

Haward MedicalSchool FamrlyHealth Guide

(Simon and Schuster,

lggg)

HealtLty Wornen,HealtW Lives:A Guide to

PreventingDisease

andFellows

lf,urses,

Heulth Study (Simon andSchuster 2001)

SixSteps

from theLandmark

College.

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For the latest information and most

up-to-date publication list, visit us online

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Faculty MedicalAdvisor

John W Winkelman,

Ince

James Clyd. Sellman

Harvard

material

to Increased

in writing

Conception

SleepMechanics

.............3

Quiet Sleep

Dreaming Sleep

SleepArchttecture.

Your

Intgrnal Glock,,, r, r, r.., r r ! r' r......6

Rhythm:

Understanding

HabitsThatDisturhSleep

., ...r... .....I

SleepThroughout

Lifg,, r.r. r,,, r,, ., . 10

. . ,

Adolescence

. .

. . .

MiddleAg, .

TheLatu Years

MedicalGonditions

and $leep Problem$.

. .12

CsrdiovascularDkease

Diabetes

EatingDisorders

Heartburn,.

Rdnq Disease

Menopause

aI Disorders

Nzurologlcal

Disorders

. . . .

Respiratory Problems

TlryroidDisease

Medications

ThatAffectSleeP

Evaluation

ofSleep Disturbances'.,

a...16

Whento Seeh" HIIP

YourSleepHtstary

The Prychiatnc

Inteniew

Sleep Lahoratory

Evaluation,

. rrrr,, ...18

Overni{tt Sleep Tests

Home-Based Tests

lnSOmnia.. r r... r I r r,. r, r.. r ' r., r, ..20

Types

The FirstLineofkeatment: Ltfesryle

Changes - - 70

Medicqtions

for keating Insomnia

Other Therapie.s.

. . . . .

Gircadian

Childhood

Adulthood

. .

Mental ILLness

Musculoshelet

ofInsomnia

Breathing

Disorders

inSleep

... r. r....27

Snonng.

. . .27

Sleep'\pnea

....28

Movement

Disorders

inSleep.

..,..32

Restless

LegsSyndrome

(RLS)

. . . 37

PenodicLimb MoviementDisorder (PLMD)

. . 37

keatments

for MovementDisorders

. . . 32

Narcolepsy.

r., r..,......34

Symptomsof

Narcolepsy.

...34

keatments

for Narcolepsy

. . 34

lking,

and0therParasomnias....

Sleepta

.,.36

Somnambulism

. . 36

SomntloqLLy..

...36

NocturnalEatingDisorder

..36

Bedwetting...

..36

REMBehaviorDisorder

....37

I'{ightmaresandSleepkrcors

....37

Sleep-RelatedPanicAttaclu

.....37

. . .. . . . . .38

DelryedSleepPhase Syndrome . . 38

AdvancedsleepPhasesyndrome.... ..38

JetLag

ofSleepTiming.

....38

SundryInsomnia

.....39

ShtftWorh.

. . . . .39

(SAD) ....39

0therWays to lmprove Sleep. . . rr. . . . . 40

Sleepllyglene

...40

Counseling

..40

SupportGroups

..40

Napping

...40

Rgsourcgs

.,r,

.,r,r..,r,,..r,, ..42

Organizations

...42

Boolu

.....42

Glossary..

,,... r,...43

The goal of materials provided by Hanard Health

Publications is to interpret medical information for the

generalreader.This report is not intended qs a substitute

for personal medical advice, which should be obtained

directly from a physician.

Sleepwalking.

Disturbances

SeasonalAffectiveDisorder

A SPECIALREPORTFROM HARVARDMEDICAL SCHOOL

IuPRovrNG SI-EEP

MethoughtI hearda voicecry "Sleep no more!

Macbethdoesmurder sleep,"the innocentsleep,

Sleepthat knits up the ravell'd sleeveof care,

The deathof eachday'slife, sorelabor'sbath,

Balmof hurt minds, greatnature'ssecondcourse,

Chiefnourisherin life's feast.

- Shakespeare,Mqcbeth, Act II, scene2

fl n thesefew lines, William Shakespeare eloquently capturesthe value of a good

t ! night's sleep.Who among us, like the troubled Macbeth,has not sufferedat

least an occasionalsleeplessnight - tossing,turning, and yearning,perhapsin

vain, for "sore labor's bath," the "balm of hun minds?"

While most everyonecan expect a poor night's sleepnow and then, according

to a recentsurvey,7 in l0 Americanadults experience frequent sleepproblems,from

insomnia to breathing disorders. While the lack of sufficient or restorativesleep

affectsvirtually everyaspectof life - mood, mental alertness,perfiormance,energy

level,saferyand physicalhealth - fewerthan 3o/oof.Americansaretreatedfor their

sleepproblems.

Yetwe lgnore the "chief nourisher in life's feast" at our peril. Nearly I in 5 dri-

versadmits to havingfallen asleepat the wheel, and many more report driving while

drowsy.Both the 1989 E>c<onYaldezoil spill off the coastof Alaska and the 1986

spaceshuttle Challengerdisasterwere found to be, in largepart, the result of the

actionsof thosewho weresignificantlysler

Some forms of sleep disturbance,such a

breathing disordersleepapnea,which affe,

an estimated 18 million Americans, ca

cause potentially life-threateninghealth

problems, including an increasedrisk for

strokeand heart attack.

A recent study conducted at the

Universiry of Chicago found that even

among healthy young men in their late

teens and nventies,curtailing the amounl

of sleepto approximatelyfour hours a nigh

for lessthan one week had an adverseeffe

on the subjects' health. The research

found that a sleep debt of even this relat

Havinga hardtime getting

to oleep?A feweimplechangeein

your habite may reeolvethe problem.

Harvard medical school - Improving sleep.pdf

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