Transcript insomnia - Braincoremembers.com

INSOMNIA
Difficulty falling asleep
Waking up too early and not being
able to get back to sleep
Frequent awakenings
Waking up feeling unrefreshed
HOW IMPORTANT IS SLEEP?
HOW MUCH SLEEP DO YOU NEED?
• While sleep requirements vary slightly from person to
person, most healthy adults need between 7.5 to 9 hours
of sleep per night to function at their best.
• Infants require about 16 hours a day
• Teenagers need about 9 hours on average
HOW MUCH SLEEP DO YOU NEED?
• The amount of sleep a person needs increases if
he or she has been deprived of sleep in previous
days.
• Getting too little sleep creates a "sleep debt" which
is much like being overdrawn at a bank. Eventually,
your body will demand that the debt be repaid.
HOW MUCH SLEEP DO YOU NEED?
• If you're averaging only four hours a night, your brain reacts
as though you haven't slept at all for three consecutive
nights.
• Many people are too tired to realize how sleep-deprived
they are, but they have slower reaction time, weaker
memory, and other thinking impairments.
In the United States:
• Average number of fatal crashes caused by drowsy
driving each year: 1,550
• 39% of Health care workers who have had a near miss
accident at work because of fatigue in the last year
• 19% of health workers who report worsening a patient’s
condition because of fatigue
• 44% of law enforcement workers who report having
taken unnecessary risks while tired
• 80% of US regional pilots reporting they sometimes
nod off in the cockpit
FACTS ABOUT INSOMNIA
• Stress Relationships: Disruption of a bed partner's sleep
due to a sleep disorder may cause significant problems for
the relationship (for example, separate bedrooms, conflicts,
moodiness, etc.).
• Poor Quality of Life: You might, for example, be unable to
participate in certain activities that require sustained
attention, like going to the movies, seeing your child in a
school play, or watching a favorite TV show.
FACTS ABOUT INSOMNIA
• Occupational Injury: Excessive sleepiness also contributes
to a greater than twofold higher risk of sustaining an
occupational injury.
• Automobile Injury: The National Highway Traffic Safety
Administration (NHTSA) estimates conservatively that each
year drowsy driving is responsible for at least 100,000
automobile crashes, 71,000 injuries, and 1,550 fatalities.
FACTS ABOUT INSOMNIA
• Several major disasters have been linked in part with too
little sleep in the workplace: Three Mile Island, Chernobyl,
and the Exxon Valdez
• Sleep-deprived drivers are just as dangerous as drunk
drivers, Kaplan says. In one study, people who drove after
being awake for 17 to 19 hours performed worse than those
who had a blood alcohol level of .05%. (A blood alcohol
level of .08% is considered legally intoxicated in many
states.)
HEALTH RISKS
• In the long term, the clinical consequences of untreated
sleep disorders are large indeed. They are associated with
numerous, serious medical illnesses, including:
• High blood pressure
• Heart attack
• Heart failure
• Stroke
• Obesity
• Psychiatric problems, including depression and other mood
disorders
• Attention Deficit Disorder (ADD)
HEALTH RISKS
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Mental impairment
Fetal and childhood growth retardation
Injury from accidents
Disruption of bed partner's sleep quality
Poor quality of life
HEALTH RISKS
• Studies show an increased mortality risk for those reporting
less than either six or seven hours per night.
• One study found that reduced sleep time is a greater
mortality risk than smoking, high blood pressure, and heart
disease.
• Sleep disturbance is also one of the leading predictors of
institutionalization in the elderly, and severe insomnia triples
the mortality risk in elderly men.
INSOMNIA AND OBESITY
• How much a person sleeps at night can impact their weight.
• Remarkably, sleep loss may also be a contributing factor to
obesity. John Winkelman, MD, PhD, medical director of the
Sleep Health Center at Brigham and Women's Hospital and
assistant professor of psychiatry at Harvard Medical School
sums up this finding up nicely:
• "What most people do not realize is that better sleep habits
may be instrumental to the success of any weight
management plan.“
INSOMNIA AND CHRONIC PAIN /
FIBROMYALGIA
• Sleep disorders always accompany Chronic Pain and
Fibromyalgia
• In 1975, two Canadian physicians and researchers,
Harvey Moldofsky, MD, and Hugh Smythe, MD suspected
sleep disorders as a factor in Fibromyalgia.
• They conducted sleep studies to prove their theory
INSOMNIA AND CHRONIC PAIN /
FIBROMYALGIA
• They concluded that the patients not only had
sleep abnormalities but also had dysregulation of
normal body circadian rhythms affecting periods
of wakefulness too.
• Circadian rhythms are primarily controlled by
brainwaves
THE MEDICAL
APPROACH TO
INSOMNIA
TYPES OF MEDICATIONS
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Over the Counter Medications
Non-Benzodiazepine Hypnotics
Benzodiazepine Hypnotics
Antidepressants
NON BENZODIAZEPINE HYPNOTICS
• Included in this family of drugs is:
– Ambien
– Sonata
– Lunesta
– Imovane
– Rozerem
NON BENZODIAZEPINE HYPNOTICS
• General side effects may include:
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Drowsiness
Dizziness
Fatigue
Headache
Diarrhea
Sleep-driving
Making phone calls
Preparing and eating food while asleep.
BENZODIAZEPINE HYPNOTICS
• Commonly prescribed benzodiazepines:
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Flurazepam (Dalmane)
Clonazepam (Klonopin)
Quazepam (Doral)
Triazolam (Halcion)
Lorazepam (Ativan)
Alprazolam (Xanax)
Temazepam (Restoril)
Oxazepam (Serax)
Prazepam (Centrax)
Estazolam (ProSom)
Flunitrazepam (Rohypnol).
BENZODIAZEPINE HYPNOTICS
• Side effects include:
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Severe allergic reactions, including facial swelling
Respiratory problems
These drugs may increase depression
Residual daytime drowsiness
Significantly increased risk for automobile accidents and falls
Memory loss (so-called traveler's amnesia), sleepwalking, sleep
driving, eating while asleep, and other odd mood states may occur.
– Urinary incontinence may occur
– Because these drugs cross the placenta and enter breast milk
pregnant women or nursing mothers should not use them.
– Benzodiazepine use in the first trimester of pregnancy may be
associated with the development of cleft lip in
BENZODIAZEPINE HYPNOTICS
• Withdrawal symptoms usually occur after prolonged use
and indicate dependence. They can last 1 - 3 weeks after
stopping the drug and may include:
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Gastrointestinal distress
Sweating
Disturbed heart rhythm
In severe cases, patients might hallucinate or experience seizures,
even a week or more after the drug has been stopped.
BENZODIAZEPINE HYPNOTICS
• Rebound insomnia, which often occurs after withdrawal,
typically includes 1 - 2 nights of sleep disturbance, daytime
sleepiness, and anxiety.
• In some cases, patients may experience the return of the
original severe insomnia.
HIGHER DEATH RISK WITH
SLEEPING PILLS
Considerable media
attention has recently
been focused on
a San Diego State
University study that has
reared close to proving
that insomnia patients
who choose to get off
sleeping pills could, quite
possibly, be saving their
own lives.
HIGHER DEATH RISK WITH
SLEEPING PILLS
• "What our study shows is that sleeping pills are hazardous
to your health and might cause death by contributing to the
occurrence of cancer, heart disease and other ailments,"
said author Daniel F. Kripke, MD, of the Viterbi Family Sleep
Center at Scripps Health in San Diego.
• Even among patients who were prescribed 1 to 18 sleeping
pills per year, the risk of death was 3.6 times higher than
among similar participants who did not take the
medications.
INSOMNIA
AND
NEUROFEEDBACK
What is Neurofeedback Used For?
Over 40 years of peer reviewed, university
based research has demonstrated the
efficacy of neurofeedback in addressing
many neurological conditions
ADHD
Anxiety
Panic Attacks
Insomnia
Chronic Pain
Bedwetting
Migraine
Fibromyalgia
TBI
Tension Headache
PTSD
Depression
Learning Disorders
Autism / Asperger’s
Tics
As well as other conditions
TREATING INSOMNIA WITH
NEUROFEEDBACK
• A number of quality studies have been published that show
the effectiveness of neurofeedback in not only easing the
withdrawal symptoms of sleeping pills, but also normalizing
a patients sleep patterns without the use of any medications
at all.
• Neurofeedback research is based upon the principle that
insomnia Is connected with what is called hyper-arousal
within the brain and central nervous system. This hyperarousal is bio-electrical, or brainwave based in nature
INSOMNIA AND NEUROFEEDBACK
• Mental states are associated with specific brainwaves
• Each brainwave represents a specific processing
speed of the brain– also known as arousal level
• These brainwaves include:
– Delta
– Theta
– Alpha
– Beta
INSOMNIA AND NEUROFEEDBACK
• Delta and Theta represent the slowest processing
speeds and are associated with a twilight state
• Alpha represents a slightly faster processing speed and
is associated with quiet wakefulness such as when you
meditate
• Beta represents the fastest processing speed and is
associated with external focus, thought and
concentration
THE AROUSAL SPECTRUM
A healthy, regulated brain is able to shift easily between
arousal states as the demands arise
LOW AROUSAL
SLOWER
PROCESSING
Delta and Theta
IDLE STATE OF
THE BRAIN
Alpha
HIGH AROUSAL
FASTER
PROCESSING
Beta
OPTIMAL ZONE OF PERFORMANCE
The Brain has an optimal zone of performance
LOW AROUSAL
SLOWER
PROCESSING
IDLE STATE OF
THE BRAIN
HIGH AROUSAL
FASTER
PROCESSING
Depending on the circumstances and everyday demands, the brain
may move toward low arousal or high arousal but a well regulated
brain stays within its optimal zone of performance
THE DYSREGULATED BRAIN
UNDER-AROUSED
INHIBITED
OVER-AROUSED
• A dysregulated brain has a tendency to
habitually operate from one of the 3
arousal states
THE DYSREGULATED BRAIN
An individual’s habitual arousal state might be too high or
too low to support optimal function
UNDER-AROUSED
Impulsive
Socially
Inappropriate
Hyper-active
Easily Distracted
Excessive Speech
Disorganized
Hyper-emotional
INHIBITED
Victim Mentality
Excessive Self Concern
Rumination
Anger
Self Deprecation
Agitation
Irritability
Passive Aggressive
OVER-AROUSED
Excessive Rationalization
Poor Emotional Self
Awareness
Worry
Hyper-vigilant
Obsessive Thinking
Dislike of Change
Restless
THE DYSREGULATED BRAIN
An individual’s habitual arousal state might be too high or
too low to support optimal function
UNDER-AROUSED
Excessive
Delta and Theta
These patients usually
present with cognitive
impairment, focus and
attention issues,
ADHD, TBI, dementia,
learning disorders
INHIBITED
Elevated Alpha
These patients usually
present with symptoms of
depression, irritability,
lethargy, fibromyalgia,
metabolic issues
OVER-AROUSED
Elevated Beta
These patients usually
present with anxiety, panic
attacks, OCD, worry,
migraine, tension
headache, chronic pain,
insomnia
NEUROLOGICAL DYSREGULATION
• Brainwave Imbalance or Neurological Dysregulation
may be caused by:
– Variations in brain structure
– Drugs
– Toxins
– Poor Nutrition
– Subluxation
– Trauma
– Stress – both physical and emotional
BRAINCORE THERAPY
Painless
Drugless
Non-Invasive
And Has No Side Effects
How is it Done?
All neurofeedback begins by performing a
Brain Map
The BrainCore Brain Map
A Brain Map provides us with the information
that is required to perform neurofeedback
training
THE BRAINCORE BRAIN MAP REPORT
The BrainCore Brain
Mapping software
analyzes thousands of
different variables and
compares your patient’s
brain map with a
database of normal
brain maps to produce a
the Brain Map report
THE BRAINCORE BRAIN MAP REPORT
The BrainCore Brain
Map Report provides
the neurofeedback
protocols that will be
used during the
neurofeedback
training
HOW IS NEUROFEEDBACK DONE
Individuals are hooked up to a computer using
wires and sensors and the computer reads
their brainwaves
Information about these brainwaves is
displayed on the doctors monitor
The software automatically detects when the
brainwaves are properly ordered and it feeds
that information back to the patient
This feedback appears in the form of a game,
movie, or sound which signals the patient that
the brainwaves are becoming more ordered
Rollercoaster Video
DVD’s and Movies
THE BIG IDEA:
When you have
information on what
your brain waves are
doing, your brain can use
that information to
change how it works.
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Learning Is Permanent
• Once we learn
something it becomes
a permanent part of
our behavior.
• Follow up studies in
neurofeedback show
that the effects
continue for up to 30
years.
How Long Does it Take to Get Results?
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Trainees typically come for 20 sessions of training.
Trainees come twice a week or more.
Each session is 30-45 minutes long.
They typically begin to see changes in about 5 to 8 sessions
NEUROFEEDBACK IS
BASED IN OVER 40
YEARS OF CLINICAL
RESEARCH PROVING IT’S
EFFICACY
In fact, Dr Frank H. Duffy, a Professor and
Pediatric Neurologist at Harvard
Medical School, stated that
“Neurofeedback should play a major therapeutic
role in many difficult areas. In my opinion, if any
medication had demonstrated such a wide
spectrum of efficacy it would be universally
accepted and widely used”
BRAINCORE THERAPY
QUESTIONS
A GIFT