SLEEP DISORDERS

Insufficient sleep has become a worldwide epidemic. Poor quality sleepers are  more likely have a higher Body Mass Index(BMI) whereas the chronic sleep deprivation has correlations with medical problems such as obesity, diabetes, cancer and immune deficiency. Both the number of hours and the structure of the sleep are important. The brain has two processes that work against each other to determine whether someone stays awake or goes to sleep. The homeostatic mechanism is the drive to sleep and circadian rhythm is designed to bring about and maintain alertness. This means that alertness increases or decreases throughout the day(over24 hours cycle) due to a pattern set by the body's internal clock.

Life style factors can also influence sleep, like circadian rhythm, sleep disorders like going to sleep late at night, going to sleep too early at night, having an irregular sleep-wake cycle, jet lag and late night shifts may interfere with sleep. Some medical conditions also effect a good night's sleep like asthma, coronary heart disease, depression, chronic fatigue syndrome, chronic pain restless leg syndrome, narcolepsy, snoring, and sleep apnoea, parasomnias like sleep talking and walking, night terrors, nightmares, bedwetting (sleep enuresis) and grinding of teeth(bruxism); grief and stress(60 percent to 80 percent of sleep problems may be due to stress and worry).

Sleep disordered breathing(SDB) in kids includes snoring, frequent arousals during sleep, enuresis and hyper activity children with Down syndrome, mid face-hypoplasia or neuromuscular disorder are at increased risk for SBD.  Tonsillectomy and adenoidectomy are the first-line definitive treatment in children other treatment options include rapid maxillary expansion, allergy treatment and CPAP. Importance should be given to early diagnosis and treatment in children since the consequences of untreated SDB could lead to learning difficulties memory loss, poor growth, depression and a risk of hypertension.

Promotion of sleep by use of complementary and alternative therapies-we found three on environmental i.e. reducing noise, playing white noise such as ocean sounds, and decreasing interruptions to sleep for care and four interventions are massage, music therapy, therapeutic touch, and, melatonin whereas in massage  progressive muscle relaxation shows efficacious improvement in sleep of persons with insomnia. Aromatherapy and alternative sedatives are also used for the sleep.