Saré: Béda antarrépisi
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Kiwari, pungsi saré pikeun kaséhatan jeung kasakit téh keur loba ditalungtik, utamana di nagara-nagara maju kayaning Jepang jeung AS. Teu ukur [[insomnia]], kasakit lianna kayaning ''sleep apnea'' jeung [[narkolépsi]] ogé ditalungtik.
== Pisiologi saré ==
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===Régulasi saré===
The cycle of sleep and wakefulness is regulated by the [[brain stem]], [[thalamus]], external stimuli, and various [[hormone]]s produced by the [[hypothalamus]]. Some [[neurohormone]]s and [[neurotransmitter]]s are highly correlated with sleep and wake states. For example, [[melatonin]] levels are highest during the night, and this hormone appears to promote sleep. [[Adenosine]], a [[nucleoside]] involved in generating energy for biochemical processes, gradually accumulates in the human [[brain]] during wakefulness but decreases during sleep. Researchers believe that its accumulation during the day encourages sleep. The stimulant properties of [[caffeine]] are attributed to its negating the effects of adenosine.
The [[suprachiasmatic nucleus]] (SCN) of the hypothalamus plays an important role in the regulation of [[circadian rhythm]]s. The SCN is influenced by external light and also generates its own rhythm in isolation. In the presence of light it sends messages to the [[pineal gland]] that instruct it to cease secreting [[melatonin]].
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=== Hambalan-hambalan saré ===
[[Gambar:Sleep-cycle.gif|right|Hambalan saré]]
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[[Gambar:SWS.jpg|thumb|200px|right|Saré hambalan ka-4. EEG dicirian ku kotak beureum.]]
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Studi ngeunaan saréna manusa ngabagi saré kana lima hambalan dumasar kana rékaman [[éléktroénsefalografi]] (EEG) jeung [[polisomnografi]]:
* Saré non-REM ([[NREM]]), ngawengku 75-80% total saré:
** '''Hambalan ka-1''', ditandaan ku ampir leungitna [[gelombang alpa]] nu aya dina kaayaan nyaring, sarta mucunghulna [[ritme téta|gelombang téta]]. Hambalan ieu katelahna "nundutan" (''somnolence'' atawa ''drowsy sleep''). Dina hambalan ieu, nu nundutan téh leungiteun kadali otot sarta kaawas ka sabudeureunana; dianggap salaku lawang antara nyaring jeung saré.
** '''Hambalan ka-2''', ditandaan ku "gelombang saré" (''sleep spindle'') 12–16
** '''Hambalan ka-3''', ditandaan ku ayana [[gelombang délta]] nu ogé katelah ''ritme délta'' (1–2
** '''Hambalan ka-4''', nyaéta saré délta (''true delta sleep'' alias tibra), ngawengku 10-15% ti total waktu saré. Kajadian [[ngalindur]] téh biasana lumangsung dina hambalan ieu.
* '''hambalan ka-5''', atawa saré REM (''Rapid eye movement''), patali jeung [[ngimpi]]. Saré REM ayana dina sapertilu tungtung saré, nu waktuna patali jeung ritme sirkadian jeung hawa awak. EEG dina periode ieu nérékél sarupa jeung hambalan ka-1, sarta kadang ngawengku [[gelombang béta]].
Saré téh lumangsung dina daur fase [[NREM]] jeung REM. Di manusa, daur ieu kira 90 menit. Unggal hambalan mibanda fungsi fisiologis nu béda-béda. Obat sabangsaning [[inuman alkohol|alkohol]] jeung [[pél saré]] (''pil tidur'' téa) bisa neken sababaraha hambalan saré (baca ''[[#Deprivasi saré|deprivasi saré]]'' di handap) nu ngabalukarkeun leungitna kaawas tapi ogé teu nedunan fungsi fisiologisna.
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<!--Restorative theories of sleep describe sleep as a dynamic time of healing and growth for organisms. For example, during stages 3 and 4, or [[slow-wave sleep]], [[growth hormone]] levels increase, and changes in immune function occur. The myriad illnesses associated with sleep deprivation testify to its restorative function.
According to the [[ontogeny|ontogenetic]] hypothesis of REM sleep, the activity occurring during neonatal REM sleep (or [[active sleep]]) seems to be particularly important to the developing organism (Marks et al., 1995). Studies investigating the effects of deprivation of active sleep have shown that deprivation early in life can result in behavioral problems, permanent sleep disruption, decreased brain mass (Mirmiran et al. 1983), and an abnormal amount of neuronal cell death (Morrissey, Duntley & Anch, 2004). Given sleep's heterogeneous nature, however, no single theory predominates, as it is difficult to describe one single "function" of sleep.
One process known to be highly dependent on sleep is [[memory]]. [[Rapid eye movement|REM]] sleep appears to help with the consolidation of [[Spatial memory|spatial]] and [[Procedural memory|procedural memory]], while slow-wave sleep helps with the consolidation of [[Declarative memory|declarative memories]]. When experimental subjects are given academic material to learn, especially if it involves organized, systematic thought, their retention is markedly increased after a night's sleep. Mere [[Rote learning|rote memorization]] is retained similarly well with or without an intervening period of sleep.
Non-REM sleep is an [[Anabolism|anabolic]] state marked by physiological processes of growth and rejuvenation of the organism's immune, nervous, muscular, and skeletal systems. Sleep also restores [[neuron]]s and increases production of brain [[protein]]s and certain [[hormone]]s. Wakefulness may perhaps be viewed as a cyclical, temporary, hyperactive [[catabolic]] state during which the organism acquires nourishment and procreates. Asking the question "Why do we [[awake|awaken]]?" instead of "Why do we sleep?" yields a different perspective toward understanding how sleep and its stages contribute to a healthy organism.
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== Ngimpi ==
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<!--The demonstrably necessary phenomenon of dreaming would suffice to prove the importance of sleep to humans, and perhaps to other animals as well. Dreaming involves an involuntary conjuring up of images in a sequence in which the sleeper/dreamer is usually more a participant than an observer. Most scientists agree that dreaming is stimulated by the [[pons]] and occurs during the [[Rapid Eye Movement|REM]] phase of sleep.
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== Deprivasi saré ==
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<!--A common misperception is that everyone needs eight hours of sleep. The amount of sleep needed is different for each person. This amount needed is individually and biologically determined. Some can do with six hours of sleep, others need nine. However, as a general rule, eight hours is recommended. Sleep experts state that you cannot "store" sleep by sleeping more on the weekends in preparation for the normal work week. Just how much sleep deprivation leads to death in humans is unknown.[http://www.nytimes.com/specials/women/warchive/980331_1363.html]
Another commonly held view is that the amount of sleep one requires decreases as one ages, but this is not necessarily the case. The ability to sleep, rather than the need for sleep, appears to decrease when people get older. [http://www.aafp.org/afp/991001ap/1431.html]
Failure to sleep results in progressively severe psychological and physical distress. In 1965, California teenager [[Randy Gardner (sleep deprived)|Randy Gardner]] attempted to resist sleep in an uncontrolled "experiment". As his ordeal progressed he fell into a silent stupor, bringing into doubt whether he was actually awake in any practical sense.
A [[1999]] [[University of Chicago]] team led by Eve Van Cauter limited a group of lean young men to four hours of sleep per night for 16 days. The subjects showed decreased levels of [[leptin]] and increased levels of [[cortisol]]. The subjects also increased their daily caloric intake by 1,000 calories. The team discovered that the subjects' [[insulin]] and [[blood sugar]] levels resembled the impaired [[glucose]] tolerance of
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== Gangguan saré ==
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Sacara umum, gangguan saré dibagi kana tilu golongan:
# [[Disomnia]] nu dicirikeun ku hésé saré, kayaning [[insomnia]] primér, [[narkolépsi]], jeung [[sindrom suku motah]] (''restless legs syndrome'').
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== Saré jeung obat ==
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The [[pharmacological]] approach to facilitating sleep involves the use of [[depressant]] drugs, with the goal of inducing sleep without producing excessive drowsiness the following morning. [http://www.mdausa.org/publications/Quest/q75sleepingpills.html]. Until the 1970s, [[barbiturate]]s were commonly prescribed for sleep, but today [[benzodiazepine]]s and other newer families of drugs with less potential for abuse and overdose are more commonly used. Non-prescription antihistamines also have a sedative effect, and are commonly marketed as sleep aids.
[[Sleeping pill]]s are best prescribed only on a short-term basis and only if symptoms of [[insomnia]] are marked enough to interfere with a patient's life. Habitual consumption of any depressant drug to aid sleep may result in psychological and/or physical drug dependence. [[Drug tolerance]] may also develop, in which increasingly higher doses are required to produce the desired effect. They also may lead to a [[withdrawal]] syndrome involving insomnia and anxiety, and in some cases more severe problems, including seizures. Chronic use can also cause "paradoxical insomnia," where the drug produces the opposite of the intended effect.
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* [http://www.smh.com.au/articles/2003/05/15/1052885324622.html Dysfunction Associated with Sleep-disordered Breathing Increases the Risk of Cardiovascular Morbidity and Mortality]
* [http://ajrccm.atsjournals.org/cgi/content/full/169/2/139 Improvement of Metabolic Function in Sleep Apnea]
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