רישום שינה, מבנה השינה, פוליסומנוגרפיה

תמר עציוני ד"ר ,

המרכז לרפואת שינההפקולטה לרפואה - טכניון

Methods for Recording Sleep• Direct behavioral observation / video

• Actigraphy

• Ambulatory devices

• PAT

• Polysomnography

SNAP• Flow (nasal pressure)

• Snoring

• O2Sat

• Pulse Rate

Apnea Risk Evaluation System (ARES)• Head movements and position (actigraph)

• O2Sat

• Flow (nasal pressure)

• Pulse rate

• Snoring sounds

Watch_PAT100

FDA approvedActigraphy, Oximetry, PAT, HR

Polysomnographyהקלטה רציפה וסימולטנית של משתנים מרובים •

במהלך השינה.

הערוצים המוקלטים:•EEG, EOG, EMG(S)ECGAIRFLOWRESPIRATORY EFFORTEMG(T)OXYGEN SATURATION

Electroencephalogram (EEG) Electrodes

Sleep staging criteria depend on EEG, EOG and EMG

Polysomnography

Characteristics of the various EEG waves

Frequency Amplitude Stage

Beta >15 Hz <50 mcv Wake

Alpha 7.5-10.5 Hz 50 mcv Relaxed, REM

Theta 4-7 Hz 50 mcv 2, REM

Delta 0.5-2 Hz >75 mcv 3, 4

Stages of sleep and wakefulness

Wake

stage 1

stage 2

stage 3

stage 4

REM

EEG

alpha, fast

some theta

theta, spindles

moderate delta

much delta

fast

high

moderate

moderate

moderate

moderate

very low

rapid

slow

rare

rare

rare

rapid

EMG Eye movementsNREM

עירות

1מעבר מעירות לשלב

1שלב

2שלב

SWS - 3שלב

- 3SWSשלב

Stages of Non-REM sleep

1 sec.

REMשנת

Rapid Eye Movements:

• REM Sleep

• Dream Stage

• Paradoxical Sleep

The sleep cycle

Changes of sleep time and content with age

Sleep Time

(h)

Stages 1-2

(%)

Stages 3-4

(%)

REM (%)

Infants 13-16 10-30 30-40 40-50

Children 8-12 40-60 20-30 20-30

Adults 6-9 45-60 15-25 15-25

Elderly 5-8 50-80 5-15 15-25

Various points:

• Sleep Posture

• Siesta

• Environmental factors (light, temp, noise, comfortable bed, bed direction?, …

שינה בבעלי החיים השונים

Sleep in animals:• Small animals sleep a lot (bats-16h, platypus-14h). Large ones sleep less (elephant–3h, giraffe–4.5h). More need of food?

•Birds sleep with alternating half brain (like the dolphin) (no automatic vent system)

• Winter “sleep” is rather a comatous state, with very low and slow EEG, with occasional “escapes” into sleep.

?שאלות