Sleep Disorders
1
, CHAPTER I
INTRODUCTION
Sleep is a brain process that is needed by a person to function properly. Ordinary
people are not very familiar with sleep disorders so they rarely seek help. The opinion
that no one dies from not sleeping is not true. Some sleep disorders can be life-
threatening either directly (eg, hereditary and fatal insomnia or obstructive sleep apnea)
or indirectly, such as accidental sleep disturbances.
Sleep disturbance is one of the most common complaints in patients who visit the
practice. Sleep disorders can be experienced by all levels of society, be it rich, poor,
highly educated and low educated as well as young people, and are most often found in
old age. In normal people, prolonged sleep disturbances will result in changes in their
biological sleep cycle, decreased endurance and decreased work performance,
irritability, depression, lack of concentration, fatigue, which in turn can affect their own
safety or that of others. 1,2
In the United States, the annual cost of sleep-related accidents is approximately
one hundred million dollars. Insomnia is the most common sleep disorder. Every year it
is estimated that around 20% -50% of adults report sleep disturbances and about 17%
experience serious sleep disturbances. 1,2
Sleep disturbances are also known to be a significant cause of morbidity. There
are several serious effects of sleep disorders such as excessive sleepiness during the day,
impaired attention and memory, depressed mood, frequent falls, inappropriate use of
hypnotics and decreased quality of life. Mortality, heart disease and cancer rates are
2
,higher for someone who sleeps for more than 9 hours or less than 6 hours per day when
compared to someone who sleeps between 7-8 hours per day. 1,2
According to some researchers, prolonged sleep disturbance is found to be 2.5
times more likely to have a car accident than people who get enough sleep. It is
estimated that the number of sufferers due to sleep disorders is increasing every year,
causing health problems. In daily practice, the tendency to use hypnotic drugs, without
first determining the underlying cause of the disease, often creates new problems due to
inadequate drug use. Seeing the above, it is clear that sleep disorders are a health
problem that will be faced in the years to come. 1,2
3
, CHAPTER II
LITERATURE REVIEW
A. SleepPhysiological
Sleep is one way to release physical fatigue and mental fatigue. With sleep
all complaints disappear or decrease and will return to get the energy and
enthusiasm to solve the problems at hand. All living things have a rhythm of life
according to the circulation of time in a 24-hour cycle. The rhythm that coincides
with the rotation of the globe is known as the circadian rhythm. The control center
for circadian rhythms is located in the ventral anterior hypothalamus. The part of
the central nervous system that organizes synchronization activities is located in
the substantia ventriculo reticularis medulo oblogata which is called the sleep
center. The part of the central nervous system that eliminates
synchronization/desynchronization is found in the rostral portion of the medulo
oblogata, which is known as the arousal center or aurosal state.1,2
Sleep is divided into 2 types, namely:1,2
a. Rapid eye movement (REM) type
b. Non-rapid eye movement (NREM) type
The initial phase of sleep is preceded by the NREM phase which consists of 4
stages, then followed by the REM phase. The normal sleep state between the
NREM and REM phases occurs alternately between 4-7 cycles a night. Newborns
sleep a total of 16-20 hours/day, children 10-12 hours/day, then decrease to 9-10
hours/day at the age of over 10 years and about 7-7.5 hours/day in adults .1,2
NREM type is divided into 4 stages, namely: 3, 4
a. Stage one sleep.
4
1
, CHAPTER I
INTRODUCTION
Sleep is a brain process that is needed by a person to function properly. Ordinary
people are not very familiar with sleep disorders so they rarely seek help. The opinion
that no one dies from not sleeping is not true. Some sleep disorders can be life-
threatening either directly (eg, hereditary and fatal insomnia or obstructive sleep apnea)
or indirectly, such as accidental sleep disturbances.
Sleep disturbance is one of the most common complaints in patients who visit the
practice. Sleep disorders can be experienced by all levels of society, be it rich, poor,
highly educated and low educated as well as young people, and are most often found in
old age. In normal people, prolonged sleep disturbances will result in changes in their
biological sleep cycle, decreased endurance and decreased work performance,
irritability, depression, lack of concentration, fatigue, which in turn can affect their own
safety or that of others. 1,2
In the United States, the annual cost of sleep-related accidents is approximately
one hundred million dollars. Insomnia is the most common sleep disorder. Every year it
is estimated that around 20% -50% of adults report sleep disturbances and about 17%
experience serious sleep disturbances. 1,2
Sleep disturbances are also known to be a significant cause of morbidity. There
are several serious effects of sleep disorders such as excessive sleepiness during the day,
impaired attention and memory, depressed mood, frequent falls, inappropriate use of
hypnotics and decreased quality of life. Mortality, heart disease and cancer rates are
2
,higher for someone who sleeps for more than 9 hours or less than 6 hours per day when
compared to someone who sleeps between 7-8 hours per day. 1,2
According to some researchers, prolonged sleep disturbance is found to be 2.5
times more likely to have a car accident than people who get enough sleep. It is
estimated that the number of sufferers due to sleep disorders is increasing every year,
causing health problems. In daily practice, the tendency to use hypnotic drugs, without
first determining the underlying cause of the disease, often creates new problems due to
inadequate drug use. Seeing the above, it is clear that sleep disorders are a health
problem that will be faced in the years to come. 1,2
3
, CHAPTER II
LITERATURE REVIEW
A. SleepPhysiological
Sleep is one way to release physical fatigue and mental fatigue. With sleep
all complaints disappear or decrease and will return to get the energy and
enthusiasm to solve the problems at hand. All living things have a rhythm of life
according to the circulation of time in a 24-hour cycle. The rhythm that coincides
with the rotation of the globe is known as the circadian rhythm. The control center
for circadian rhythms is located in the ventral anterior hypothalamus. The part of
the central nervous system that organizes synchronization activities is located in
the substantia ventriculo reticularis medulo oblogata which is called the sleep
center. The part of the central nervous system that eliminates
synchronization/desynchronization is found in the rostral portion of the medulo
oblogata, which is known as the arousal center or aurosal state.1,2
Sleep is divided into 2 types, namely:1,2
a. Rapid eye movement (REM) type
b. Non-rapid eye movement (NREM) type
The initial phase of sleep is preceded by the NREM phase which consists of 4
stages, then followed by the REM phase. The normal sleep state between the
NREM and REM phases occurs alternately between 4-7 cycles a night. Newborns
sleep a total of 16-20 hours/day, children 10-12 hours/day, then decrease to 9-10
hours/day at the age of over 10 years and about 7-7.5 hours/day in adults .1,2
NREM type is divided into 4 stages, namely: 3, 4
a. Stage one sleep.
4
