Chapter 7: Exercise, Sleep, and Injury Control

Sleep Patterns: Newborns

- 15 to 17 hours daily; one to three hour segments - Sleep needs decrease as brain develops

Circadian Rhythm: sleep

- 24-hour cycle of night and day Internal biological clock - Zeitgebers: "timekeepers", (factors that influence the timing of the circadian clock) - Gender and age differences: Adolescents thinking improves as the day goes on. After 20, thinking is best early in the morning, especially for women.

Sleep Patterns: Adults

- 6.8 hours sleep on weekdays, 7.4 hours a night on weekends for North American adults - Influences - Social jet lag - Insufficient sleep correlates - Sleep debt and partial sleep loss

Homicide

- Age and gender differences in rate of severe injuries and violent deaths - Gun violence related to gender, ethnicity/race, geographical region and public policy

Physical Activity

- Bodily movement - Produced by skeletal muscles - Requires energy expenditure

Metabolic Syndrome (MetS)

- Cluster of conditions that include increased blood pressure, high blood sugar level, abdominal obesity, low HDL "good" cholesterol level and high triglyceride level - Occur together - Increase a person's risk of heart disease, stroke and diabetes - Closely linked to obesity, lack of physical activity and insulin resistance - Lower prevalence estimates in adults who exercise regularly, especially resistance

Strategies in Injury Prevention Programs (Healthy People 2020)

- Education and behavior change - Legislation and enforcement - Engineering and technology

Injury Control: Childhood

- Healthiest time for school aged children in developed nations - Over 5000 U.S. children between ages 1 and 14 die each year - Age 1 to 4: drowning, motor-vehicle accidents - Age 5 to 9: motor-vehicle, fire/burns, drowning - Age 10 to 14: motor-vehicles

Anaerobic Exercise

- High-intensity exercise - Performed for short periods of time - Examples include weight training and spinning

Injury Control

- In 2010, 180,811 Americans died from injuries, most often due to motor-vehicles crashes, poisoning, firearms and falling - Intentional injuries - Unintentional injuries - Risk of injury varies considerably across the lifespan.

Targets for Interventions (Healthy People 2020 )

- Individual behaviors - Physical environment - Access to service - Social environment - Societal-level factors

sleep deprivation disorders

- Insomnia, Narcolepsy, Sleepwalking or Sleep Apnea - Consequences: Thinking and memory problems

Aerobic Exercise

- Light to moderate intensity exercise - Performed for extended period of time - Examples include swimming, cycling and running

Cardiorespiratory Endurance

- Most important attribute of physical fitness - Ability of heart, blood vessels and lungs - Supplies oxygen to working muscles during physical activity for prolonged periods of time

Suicide

- Nearly one million people worldwide commit suicide each year - Prevalence rates varying from country to country - Greatest number of U.S. suicides occur between age 45 to 54 - Firearms are involved in 57% of U.S. suicides

Types of Sleep

- Non-rapid eye movement (NREM) and rapid eye movement (REM) - Different brain waves, breathing in changes and muscle tension, other bodily changes

Sleep Patterns

- Patterns influenced by genes, work schedule, Internet and other diversions - Insufficient sleep related to SES, race, ethnicity, workplace, neighborhood and other social factors

Physical Exercise

- Physical activity - Planned, repetitive and purposeful - Intended to improve or maintain one or more aspects of physical fitness

Levels of Prevention (Healthy People 2020)

- Primary prevention - Secondary prevention - Tertiary prevention

Sleep Deprivation: Are YOU getting 8.5 to 9.5 hours? - prevalence

1 in 5 Adults

Two Broad Categories of Physical Exercise

1) Aerobic Exercise 2) Anaerobic Exercise

Challenges for some older adults to start exercising

1) Ageist stereotypes 2) Lack of confidence (exercise self-efficacy) 3) Motivation

Barriers for exercising

1) Attitudes and intentions toward exercise 2) Education—ability to find and understand health-related information 3) Financial resources 4) Matched stage of participant readiness 5) Positive, realistic expectations for exercise program 6) Inclusion of relapse prevention techniques 7) Integration of individual and environmental factors

Sleep Improvement

1) Avoid caffeine close to bedtime 2) Avoid alcohol 3) Exercise regularly 4) Establish consistent schedule and bedtime routine 5) Create sleep-conducive environment 6) Hide the clock face

Preventive Measures for Young Drivers

1) Graduated drivers licensing (GDL) 2) Restricted night driving 3) No teenage passengers 4) Zero tolerance for driving under the influence of alcohol

Why Do We Need a Biopsychosocial Model?

1) Having a biomedical defect indicates disease potential, not disease existence. 2) Beliefs about illness matter. 3) Two people with the same biomedical problem may have different disease outcomes. 4) Successfully treating the biomedical problem doesn't necessarily make a patient healthy. 5) Behaviors matter.

Psychological Well-Being: Benefits from Physical Activity

1) Improved mood and well-being 2) Increased buffer against stress, anxiety and depression 3) Predicts better cognitive functioning and reduced risk of dementia and Alzheimer's disease

Protection Against Chronic Illness: Benefits from Physical Activity

1) Increase physical strength, maintain bone density with regular exercise 2) Reduction of risk for chronic adult illnesses: cardiovascular disease, certain cancers, diabetes and metabolic syndrome 3) Lowered triglycerides, lower LDL "bad" cholesterol levels and higher HDL "good" cholesterol levels 4) Delay of some age-related declines in white blood cells

Chronic Sleep Loss

1) Increased body weight, BMI and obesity 2) Higher percentage body fat 3) Increased ghrelin and decreased leptin 4) Elevated levels of cortisol 5) Suppressed immune functioning and chronic inflammation 6) Insulin resistance 7) Cardiometabolic disease promotion 8) Impaired concentration, memory and creativity

Weight Control: Benefits from Physical Activity

1) Lower ghrelin during aerobic and resistance exercise 2) Elevated peptide tyrosine-tyrosine (PYY) after aerobic exercise 3) Reported reduced feelings of hunger after aerobic and resistance exercise

Health Benefits Aerobic Exercise

1) promotes growth of new neurons in brain 2) decreases resting heart rate and blood pressure 3) improves blood sugar regulation 4) increases max O2 consumption (VO2 max) 5) increases strength and efficiency of heart 6) Increases slow wave deep sleep 7) increases HDL (good) and reduced LDL cholesterol 8) decreases risk of cardiovascular disease 9) decreases obesity 10) relaxation promotion 11) decreases menstrual cycle length 12) increases longevity 13) decreases risk of some cancers 14) improves immune system functioning 15) improves mood

Speeding Drivers in Fatal Crashes

For drivers involved in fatal crashes, young males are the most likely to be speeding. The relative proportion of speeding-related crashes to all crashes decreases with driver age.

Basal Metabolic Rate (BMR)

Includes about 50 to 70 percent of total energy your body burns for cell and vital organ functioning; 7 to 10 percent for breaking down food; remaining percent result of physical activity

Physical Fitness

Includes set of attributes or characteristics that people have or achieve that relates to ability to perform physical activity 1) Muscular Strength 2) Muscular Endurance 3) Flexibility 4) Body Composition

Why Don't More People Exercise

Successful exercise habits are difficult to adopt and maintain - Minority group members and gender differences - People with low incomes - People with lower levels of education

Leading Causes of Death by Age Group

The five leading causes of death for those aged 1-24 years include: - a number of external causes (accidents, homicide and suicide) - followed by cancer and heart disease. - This pattern shifts as age increases. In older age groups: - chronic conditions account for more deaths than do external causes.

alpha and beta waves: sleep

The small, fast beta waves of an alert state and the larger alpha waves of a relaxed state form the slower, large delta ways of NREM-3 sleep.

Injury Control:Adolescence and Emerging Adulthood

Unintentional injury leading cause of death - Poor decision making and impulsivity may be due to different growth rate of limbic system and prefrontal cortex - fMRI scans indicate brain areas that respond to excitement and pleasure are more active than areas that control inhibition and urge caution

Ghrelin

a peptide hormone, produced predominantly in the stomach, that stimulates the secretion of growth hormone from the pituitary gland and increases appetite.

Healthy People 2020

identified as targets for interventions aimed at reducing the risk of unintentional injury and violence

Neuroimaging data: Benefits from Physical Activity

vividly demonstrates one benefit of aerobic exercise: - increased activity in the prefrontal cortex, the part of the brain that plays a key role in planning and emotional regulation.

Leading Causes of Death in Adulthood: Age 65 and older

Falls, car accidents, suicide

Sleep Stages

Brain operates on 90-minute biological rhythm: 4 distinct sleep stages

Leading Causes of Death in Adulthood: Age 25 to 34

Car accidents, poisoning, homicide

Leading Causes of Death in Adulthood: 55 to 64

Car accidents, suicides, poisoning

Myths associated with exercise

Exercise can accelerate bone density loss, lead to arthritis and increase risk of death by heart attack

Falls

Falls are second leading cause of unintentional injury deaths worldwide

Calorie

Measure of food energy equivalent to the amount of energy needed to raise temperature of one gram of water to one degree Celsius

Exercise Interventions

People are most likely to stick with exercise programs: 1) Enjoy exercise and believe in individual responsibility for personal health 2) Have previously formed the habit of regular exercise and come from families that exercised 3) Have social support for exercising from relatives, friends and coworkers 4) Have a favorable attitude and a strong sense of self-efficacy toward exercising and self as athletic

Leading Causes of Death in Adulthood: Age 35 to 54

Poisoning, motor-vehicle accidents, suicides