Senior Passport: Sleep

Senior Passport:SleepPresented By:Haley Lydstone & Jaclyn LeeKSC Dietetic Interns, 2012-2013Interns introduce themselves and their topicSnack will be handed out at this point, along with an explanation of its ingredients, and how they relate to the following presentation

1What will we learn today?Define what sleep is, and what the 5 stages are.How much sleep do we need, and why.Clarify some of the myths associated with sleepDefine the pros & cons of napping.

Introduce objectives2What will we learn today?Identify the hormones associated with sleep, and the effect of certain foods.List foods that should be avoided before sleepList appropriate bedtime snacks.

Introduce objectives.

Explain ice-breaker activity:Dream snow-ball fight?Have participants write down a dream they had the night before, if they had one, if not write down no dream, crumple up paper, and throw it into the middle. Read through a few of them, and explain that oftentimes foods we eat can impact our sleep, not only our dreams but our overall quality of sleep.

3What is sleep?Unaware of environmentUsually takes 15 minutes

What is sleep: Stages 1 & 2Stage 1:Twilight ZoneTransitional stageFeelings of floating or fallingDuration: 10 minutesStage 2:Twilight ZoneRequires strong stimulus to awakenTwitchingDuration: 20 minutes

Stage 1: Twilight zonesomeone in this stage is no longer aware of their external environment but can wake easily to soft noises or light changes. This is a transitional stage, often associated with feelings of floating or falling, and typically lasts approximately 10 minutes. ** dreams at this stage are not coherent, more like dream-like images

Stage 2: twilight zoneAlso referred to as twilight zone, due to the fact that the first two stages take you from being awake to a deepened sleep. In order to be awakened from this stage, a stronger stimulus would be needed, and you often experience muscle jerks, or twitchingthis stage lasts approximately 20 minutes.

5What is sleep: Stages 3 & 4Stage 3/4:Truly restfulRequires strong stimulus to awakenVital signs slow and become stableRestorative stageImportant for physical and mental well-being

Stage 3/4:This is the truly restful stage of sleep, and one would need a very strong stimulus to wake, such as an alarm clock or large noise. At this point your heart rate slows and BP drops, and then stabilize. This is the most restorative stage of sleep, and is very important for children because Growth Hormone is stimulated, and also promotes rebuilding process in adults. This stage is necessary for both physical and mental well-being.

REM:rapid eye movement, fairly new, discovered in the 1950s. There is a rapid, flitting movement of the eyeballs behind the eye lids during this stage. This is the stage when dreams happen. When you dream you are actually seeing with your brain and your eyes are following with the movements. In REM sleep, the block of transmissions seem to be chemical rather than mechanical; we will discuss the chemical influence on sleep later in the presentation when we discuss the various associated hormones. We are essentially paralyzed, but this paralysis is broken as soon as we awaken. People dont tend to snore during REM sleep, but rather in stages 3 and 4.* most people spend 2 hours of every sleep cycle dreaming, most of which occurs in REM stage* During the night we spend 25% in deep sleep, 25% in REM sleep, and 50% in awakenings and twilight zones.

6What is sleep:Rapid eye movement (REM)REM:Discovered in the 1950sRapid movement of eyeDreams occurMore of a chemical influenceTemporary paralysis until awakened

REM:rapid eye movement, fairly new, discovered in the 1950s. There is a rapid, flitting movement of the eyeballs behind the eye lids during this stage. This is the stage when dreams happen. When you dream you are actually seeing with your brain and your eyes are following with the movements. In REM sleep, the block of transmissions seem to be chemical rather than mechanical; we will discuss the chemical influence on sleep later in the presentation when we discuss the various associated hormones. We are essentially paralyzed, but this paralysis is broken as soon as we awaken. People dont tend to snore during REM sleep, but rather in stages 3 and 4.* most people spend 2 hours of every sleep cycle dreaming, most of which occurs in REM stage* During the night we spend 25% in deep sleep, 25% in REM sleep, and 50% in awakenings and twilight zones.

7How much sleep do we need?No magic numberEnough to feel restedOlder adults sleeping patterns change

What happens if I do not get enough sleep?May be ineffectiveIncrease likelihood of getting sickBecome overweight

There is no magic number for everyone. We need enough sleep so we awaken easily, maintain alert wakefulness during the day, and be able to fall asleep the next night without any difficulty. Some people need more sleep than others. The average adult sleeps 7-7.5 hours a night.Older adults need about the same amount of sleep as younger adults. As you get older, however, your sleeping patterns may change. Older adults tend to sleep more lightly and awaken more frequently during the night than do younger adults. This may create a need for or tendency toward daytime napping.Why? Not getting enough sleep is bad for your health, and can make you ineffective (impairs performance and judgment), sick (weakens immune system) and overweight.

8Sleep Myth Busters!

mythbusters2012.eventbrite.comAsk participants if they have heard any myths regarding sleep & introduce game.9Sleep MythsYou need 8 hours of sleep?More sleep is always better?Some people function well on little sleep?Certain foods enhance your dreams?

To function best you need eight hours of sleep. (FALSE) There's nothing magic about that number. Everyone has different sleep needs, and you'll know you're getting enough.If you can get it, more sleep is better. (FALSE) Some studies have found that people who slept more than eight hours a night died younger than people who got between six and eight hours. What scientists don't know yet: Whether sleeping longer causes poor health or is a symptom of it; longer sleepers may suffer from problems such as sleep apnea, depression, or uncontrolled diabetes that make them spend more time in bed.Some people function well on only 4 hours of sleep. (FALSE) Legendary short sleepers, including Bill Clinton, Madonna, and Margaret Thatcher, don't necessarily do better on fewer Zs, they are just unaware of how sleepy they are. Certain foods enhance your dreams. (TRUE!) Dairy products, especially sharp cheeses promote vivid dreams. The research is not in for how fruit juices, ice cream, popcorn, pickles and fish affect our dreams. Some researches state that supplements, most notably B-6 promote dreams.

10Sleep myths

Waking up is bad?If you have insomnia you need drugs?You can always catch up on weekends?Tylenol PM is a hidden sleep secret!Waking up during the night means that youll be tired all day. (FALSE) It might be our natural cycle. Many animals sleep this way, and there are a lot of indications that our ancestors did, too, perhaps stirring nightly to talk or have sex.You need prescription drugs if you suffer from insomnia. (FALSE) Sleeping medications are designed for short term issues, caused by stressful events. People with longer-term problems benefit more from cognitive behavioral therapy essentially, retraining your perceptions of sleep and learning better sleep habits, such as going to bed at the same time every night, avoiding TVs and computers before bed, staying away from caffeine at least six hours before sleep, and other lifestyle changes.You can make up for lost sleep on weekends. (FALSE) binging on sleep can upset your natural circadian rhythms, and makes it increasingly difficult to get refreshing sleep. Set up a sleep schedule and try to stick with it, even on weekends, the body loves consistency! Tylenol PM is better than a prescription sleep medication for occasional insomnia. (FALSE). Tylenol PM is no better than a prescription drug for people who have trouble falling asleep, and may be less effective than some prescription drugs. Also, the active ingredient in Tylenol PM is an antihistamine, and its side effect is that it makes you drowsy; prescription sleep drugs are thought to allow the body to go through all stages of sleep cycle, this has not been determined with antihistamines.

11NappingPositives:RelaxationLess tiredMore alertBetter mood and performanceNegatives:Varying locationsFeeling groggyDifficulty falling asleep at night

Pros: provides feelings of relaxation, reduced fatigue, increased alertness, improved mood, improved performance and better memory.Cons: Difficulty falling asleep in alternate locations, or during the day. Other issues include sleep inertia, (feeling groggy), and having trouble falling asleep at normal bedtime.

12NappingTips:Take short naps, approximately 10-30 minutesTry to take naps in the afternoonCreate a restful environment for you nap to ensure that you get adequate restPay attention to changes in your sleeping pattern

Tips: take short naps, (10-30 minutes), nap in the afternoon and create a restful environment for your nap. If you find that naps are becoming more frequent, or lasting a few hours, and there's no obvious cause of new fatigue in your life, talk to your doctor. You could have a sleep disorder or another medical condition that's disrupting your nighttime sleep.

13How food affects sleepMelatonin and serotonin are activated by certain foodsTryptophan and carbohydrateTryptophan is necessary for serotonin productionFound in protein rich foods

The right combination of foods, including CHO, can activate certain chemicals in our brains (melatonin and serotonin), which help you to sleep. These hormones are released via a long chain reaction that begins with eating foods with CHOs and tryptophan (found in protein sources). Tryptophan is known for being a sedative, (think of Thanksgiving dinner, tryptophan is found in high amounts in turkey). Its an amino-acid component of many plant and animal proteins. Tryptophan is one of the ingredients necessary for the body to make serotonin, the best known for creating feelings of calm and for making you sleepy.

Foods rich in tryptophan include: red meat, dairy, nuts, seeds, legumes, soy beans & soy products, tuna, shellfish & turkey*** How sleepy? A 2005 study of people with chronic insomnia found that after three weeks, those who ate foods with high amounts of tryptophan with carbohydrates or who took pharmaceutical-grade tryptophan supplements had improvements on all measures of sleep and the food sources worked just as well as the supplements! (we should focus on this)

14How food affects sleepCarbohydrates stimulate pancreasRelease of insulinMore tryptophan can enter the brainIncreased production of melatonin and serotonin

CHOs stimulate the pancreas to release insulin, (hormone that helps us either use/store glucose we get from food )which allow for more tryptophan to enter the brain, triggering your brain to manufacture more melatonin and serotonin, ultimately producing relaxed/sleepy feelings. (Use image to demonstrate)

15How food affects sleepTryptophan & proteinSlows digestionCarbohydratesAffect blood sugarsCalcium & melatoninTry to combine carbohydrates and protein rich foods!

An important tip to remember is that tryptophan containing foods are found in proteins, which take longer to digest, this simultaneously can help maintain blood sugars, helping to manage sleep.CHOs affect our blood sugars, so the best choice is to combine CHO containing food with proteins; just consuming high CHO foods will result in feeling full & relaxed, but then as your blood sugars drop your stress hormones are activated which will keep you awake.Calcium is also associated with promoting melatonin production (via the induction of serotonin, which promotes melatonin production), so try to incorporate Ca rich foods into late night snacks.*** Portion sizes: Also, having a small snack before bedtime, (2-3 hrs) can alleviate feelings of extreme hunger in the morning, and keep you from over eating at breakfast. We will discuss snack choices later in the presentation.

16What to avoid before sleepCaffeineAlcoholLarge mealsLiquidsSpicy foodsVery high carbohydrate foods

Caffeine, found in coffee, tea, many soft drinks, and chocolate, several hours before bed. Caffeine is a natural chemical that activates the central nervous system, which means that it revs up nerves and thought processes. If you drink caffeinated drinks too close to bedtime, chances are it will keep you awake. Of course, what too close means varies from person to person.Sensitive people should stop drinking caffeine at least eight hours before bedtime (that means by 3:00 p.m. if you hit the sack at 11:00 p.m.). You can play with your particular timingjust dont experiment on a night when youre counting on getting a good nights sleep. Alcohol. Its true that a drink (or two) can make you sleepy and may help you get to sleep. After a few hours, alcohol can cause frequent awakenings and lighter, less restful sleep.Large Meals. Eating a huge dinner, or even a large before-bedtime snack, may make you feel drowsy, but the sleep wont necessarily take. When you lie down and try to sleep, theres a good chance youll feel uncomfortably full, which can keep you awake. May develop heartburn or gas, which will only increase your discomfort. Recommend eating a dinner that has no more than 600 calories (and optimally at least three hours before bed). Or if you have an early dinner, have a light snack consisting of a balance of protein and CHO similar to what we mentioned previously.Liquids: avoid drinking water or any fluids within 90 minutes of bedtime. It takes that long for your body to process liquid of any type. If you must have something to drink, for example, to take a prescribed medication, take a few small sips. If the medication requires a full glass of water, take it earlier in the evening if possible.Spicy foods: these may irritate the GI tract, causing discomfort along with heart burn.High CHO foods: As we mentioned earlier you want a late night snack with a balanced combination of protein and CHO; having a very CHO rich snack can spike your blood sugars, and may cause you to feel stressed versus feeling relaxed. (Avoid foods with lots of sugar!)

17Recommended late night snacksWhole grainsFruitsVegetablesFat free/low fat dairy

Whole-grain breads, crackers, and cereal; whole-wheat pasta; brown rice, wild rice; oatsfruits, especially mangoes, bananas, grapes, papaya, oranges, grapefruit, and plumsvegetables, especially spinach, yams, sweet potatoes, white potatoes, corn, winter squash (acorn, butternut, etc.), green peas, broccoli, brussels sprouts, kale, asparagus, cauliflower, sugar snap peas, pumpkin, celery, beetsmilk (fat-free, 1% low-fat), yogurt (fat-free, low-fat), low-fat ice cream, low-fat frozen yogurt

18Call to actionRecognize how certain foods affect our sleep, and what steps we can take to improve our sleep patterns and overall quality.

If you have further questions or concerns feel free to contact the sleep center at Cheshire Medical at 603-354-5454 ext. 5484.

The sleep center is located on the fifth floor of Cheshire Medical.Read slide: Our call to action today for you is to recognize what types of foods can have an affect on sleep, and what you can do to improve your sleep. Also, if you have questions, you can reach out to the sleep center at CMC at 603-354-5454 ext. 5484. Located on the fifth floor of CMC.

Evaluation:Ask audience to answer the following questions, either by stating the answer or by raising their hands:What are two foods that should be avoided at bedtime?What component(s) of our snack today contained tryptophan?What are the two hormones that regulate sleep?What two foods should be combined for a good bed time snack?19Thank You!Questions/CommentsReferenceshttp://www.webmd.com/sleep-disorders/features/7-myths-about-sleep?page=http://www.joybauer.com/insomnia/how-food-affects-sleep.aspx http://www.livestrong.com/article/540208-do-carbohydrates-help-you-sleep/What are some things that aid/improve sleep?, http://www.ane.pl/pdf/5229.pdf,http://www.mayoclinic.com/health/napping/MY01383,http://www.livestrong.com/article/467873-foods-that-might-stimulate-dreams/http://www.whfoods.com/genpage.php?tname=nutrient&dbid=103http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/insulin/insulin-basics.htmlhttp://kerlynb.hubpages.com/hub/Health-Benefits-of-Greek-Yogurt-Age-Old-Super-Foodwww.crossfitbalboa.comwww.aarp.orgwww.michigandentalhealth.orgwww.pregnancyandbaby.comwww.hiren.infoAll-wallpapers.netwww.sritweets.comwww.halliefreedman.comwww.zagat.comwww.vegfamily.comwww.pixoto.comwww.animalsw.comwww.truthabouttabs.comwww.foxnews.comwww.fitsugar.com