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ISLAMIC MEDICAL EDUCATION RESOURCES-04

0610-SLEEP and REST

Background reading material by Professor Omar Hasan Kasule Sr. for Year 2 Semester 1 PPSD session on 11th October 2006.

1.0 CONCEPTS ABOUT SLEEP

Sleep is a period of rest. It is a form of relative physical inactivity and inattentiveness to the environment (temporary suspension of full sensory perception and interaction). It is a recurrent reversible phenomenon.

Sleep and wakefulness are a balance between the activation of the sleep system and the wake system. A sleeping person is not legally accountable for actions during the period of sleep.

 

2.0 PURPOSES and PHYSIOLOGY OF SLEEP

The day is light is for humans to seek sustenance. The night is rest and sleeping. The change or alternation of day and night is among the miracles of creation with profound biological implications. The following biological phenomena are affected by this diurnal variation or biorhythms: sleep, cortisol excretion, and melatonin excretion.

 

Sleep is a biological imperative. An adult needs 8-9 hours of sleep in a 24-hour cycle. The period of sleep is psychological rest (decreased anxiety and sensory stimulation) and biological rest (lower respiration and circulation).

 

We know from studies of physiology that sleep is not a passive activity. Some bodily functions are diminished during sleep (muscle inertia, basal metabolic rate, and sensory reactivity to the environment) whereas others are increased (hand mitosis and electrical activity in the brain). No functions ever stop completely. Thinking and memory take place during sleep. Mitotic activity is highest during sleep. Metabolism continues during sleep but at a lower rate. Reorganization of brain architecture occurs during sleep. Homeostatic adjustments are easier to carry out during sleep because there are no concurrent new changes.

 

3.0 ETIQUETTE OF SLEEPING

Washing is recommended before sleeping. Sleeping is best on the right side of the body. Sleeping on the face is not recommended. Hands are washed on waking up. The face is washed to clear away ocular, nasal, and oral secretions. Sleeping naked is not recommended.

 

A human should take an adequate amount of sleep appropriate to age and physiological conditions. More sleep than is required offensive. Most sleep should be at night. A period of sleep and rest in mid-day is recommended if possible. No work including study should continue at night if sleep is overwhelming.

 

4.0 DREAMS

All people dream in both REM and non-REM sleep but dreams during REM are forgotten. Remembering of dreams is not perfect. Dreams may be review of actual daytime activities with considerable distortion of the reality.

 

Good dreams should be told. It is an offense to lie when reporting a dream. Bad frightening dreams should not be reported.

 

Interpretation of dreams is not reliable and should not be attempted. False conclusions from dream interpretation could lead to actions that adversely affect seeking medical care or complying with medication.

 

5.0 DISORDERS OF SLEEP

Insomnia is a symptom for other illnesses. It is due to activation of the reticular system by pain or emotional factors that causes activation of the limbic system. Somnambulism (sleep-walking) is dangerous because a person can harm himself and others. Bed-wetting (nocturnal enuresis) is normal in children. It stops with age as neurological and bladder functions mature. It may have a genetic basis. Narcolepsy is an irresistible urge to sleep. It may be part of certain disease syndromes.

Professor Omar Hasan Kasule Sr. October 2006