Underlying Issues Associated with Sleep Disorders and Stress

Introduction Refreshing sleep is critical for good health and well-being. Sleep presents the human body a period of time to restore energy, grow, repair cellular damage, detoxify vital organs, including allowing the brain a much needed opportunity to dream, generate neurotransmitters that are essential for stable mental health, and assimilate newly learned information (Vukovic, 2010).Advertising We will write a custom research paper sample on Underlying Issues Associated with Sleep Disorders and Stress specifically for you for only $16.05 $11/page Learn More More importantly, recent studies have identified a positive correlation between adequate sleep and enhanced capacity to cope with stress, while sleep deprivation have been positively associated with increased mood disturbances and impaired mental, emotional, and physical performance (Levy et al, 2006). The need to understand about normal sleep and sleep disorders, therefore, has never been so urgent. It is the purpose of this paper to argue and demonstrate evidence that sleep disorders have a negative impact on our ability to handle stress and whether caused by stress or simply adding to our stress, they have a profound impact on our work life and our home life. There exists compelling evidence to demonstrate that sleep research had been neglected for decades as this important facet of our own being was viewed to be of no germane consequence to the wellbeing of humans, and therefore was dropped back into a void (Sleep Mechanics, 2010). Yet, new studies underscore a huge transformation in the way psychologists, scientists, and sleep researchers have taken a keen interest on sleep and sleep disorders (Carey, 2007). Human beings sleep for one third of their life (Levy et al, 2006), and the devastating effects caused by sleep disorders are too painful to imagine, necessitating a keen interest on this broad topic. There has been a convergence of interest for many researchers on the topic of sleep disorder and stress. Indeed, among a multiplicity of factors affecting healthy sleep, a wealth of literature has reported the unfavorable influence of psychological stress and psychiatric disorders (Brand et al, 2010). Some researchers are of the opinion that sleep disorders occasions psychological stress, while others support a more liberal view that sleep disorders and stress are geometrically related and affect each other proportionately depending on the variables at play (Overeem Reading, 2010).Advertising Looking for research paper on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More The situation is further compounded by the fact that it is exceedingly difficult to define stress as it encompass all types of stimuli of varying intensities and duration , not mentioning the fact that divergent types of stressors brings with them diverse impacts on sleep (Eui-Joong Dimsdale, 2007). What is known at this stag e is that sleep disorder and stress are inexorably linked, and both are associated with undesirable outcomes. Normal Sleep and its Positive Effects For decades now, it has proven difficult for researchers to offer an objective and unified definition of what normal sleep entails (Lichstein et al, 2004). Sleep researchers, aware of the complexities involved in offering a holistic definition, have developed benchmarks that could be used to offer a justifiable description of normal sleep. In simple terms, however, normal sleep can be defined as â€Å"†¦normally distributed range of sleep† (Lichstein et al, 2004, p. 73). Normal sleep should be viewed and evaluated within the realms of both good and poor sleepers since it is not necessarily true that poor sleepers have a sleep disorder. Still, normal sleep can be defined as the lack of or absence of sleep disorder, known as a state of normality (Vukovic, 2010). NINDS (2010a)1 posits that â€Å"†¦for most adults, a normal night’s sleep lasts about 8 hours and is composed of four to six separate sleep cycles†¦A sleep cycle is defined by a segment of non-rapid eye movement (NREM) sleep followed by a period of rapid eye movement (REM) sleep† (para. 4). It is imperative to note that sleep, which is defined as a natural sporadic state of rest, comes in phases and different individuals forms their own conceptions of what is enough sleep for them. However, the inability to accomplish the sleep cycle in a single night must never be viewed as a sleep disorder (Brand et al, 2010). The intrigues of definition notwithstanding, the positive effects of normal sleep have been confirmed and well-documented by researchers (Cai Richard, 2009). On the physical front, numerous studies have demonstrated that normal sleep is positively correlated to improved vigilance, alertness, improved reaction time, vibrant energy, improved accuracy, and decreased fatigue, among others (Overeem Reading, 2010). Bio logically, enjoying normal sleeping patterns is not only critical to the proper functioning of the brain, but also enhances its performance, including concentration, learning capacities and memory formation. As such, normal sleep is indispensable for our mental health, vitality, and intellectual development.Advertising We will write a custom research paper sample on Underlying Issues Associated with Sleep Disorders and Stress specifically for you for only $16.05 $11/page Learn More In equal measure, normal sleep is ingeniously needed to give our bodies an opportunity to repair worn out body cells, a process that makes us wake up feeling refreshed and ready to face the challenges of the day. This is indeed important as it necessitates us to fulfill our work and family responsibilities without feeling fatigued or stressed out to unhealthy limits (Levy et al, 2006). The debate about normal sleep is multifaceted in nature and scope owing to the very fact th at it not only benefits people at an individualized level, but it also benefits the organizations that these people work for. Seminal studies by Shaw and Bernard2 on 500 employees working for different organizations demonstrated that employees who received adequate sleep were more likely to be productive and creative at work than those who slept less than 3 hours a night or those who worked in nightshifts. Productive employees are an asset to the organization. According to Patlak (2005), â€Å"†¦as many as 70 million Americans may be affected by chronic sleep loss or sleep disorders, at an annual cost of $16 billion in health care expenses and $50 billion in lost productivity† (p. 2). This serves as a wake up call for organizations to allow their employees adequate time for sleep since it becomes counterintuitive to the management’s performance objectives if they deny their employees adequate time for sleep and rest. Sleep Disorders and their Negative Effects Slee p disorders are a category of syndromes or medical disorders characterized by disturbances in a person’s sleep patterns, quality of sleep, or in psychological or physiological conditions that must come into play for one to fall asleep (Overeem Reading, 2010). Epidemiological studies on sleep have identified about 70 diverse sleep disorders affecting populations worldwide, bringing with them different ramifications ranging from mild complications to life-threatening episodes (Levy et al, 2006). According to Patlak (2005), an estimated 40 million Americans are affected by sleeping disorders. It is also estimated that more than 50 percent of U.S. citizens aged 65 and older suffers from a sleeping disorder (Levy et al, 2006). It should be noted at this early juncture that lack of sleep for a few days cannot be equated to a sleep disorder. On the contrary, a sleep disorder is a far more serious and persistent condition that causes the sufferer substantial emotional distress and i mpede his or her social or work-related functioning (Sleep Mechanics, 2010). Sleep researchers and psychologists have particularly focused attention to the correlation between sleep disorders and stress. It is a well known fact that psychological stress affects the amount and quality of sleep, making it extremely difficult to sleep normally or attain REM sleep (Patlak, 2005).Advertising Looking for research paper on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More Stoppler Marks (2010) are of the opinion that â€Å"stress is simply a fact of nature — forces from the outside world affecting the individual†¦The individual responds to stress in ways that affect the individual as well as their environment† (para. 1). Such forces may arise from the death of a loved one, medical condition, job-related experiences, family relationships, financial difficulties, and alcohol and substance dependence, among others. Internal determinants determine our bodies’ capacity to react to, and deal with, the forces that induce stress. Of fundamental importance to this research paper is the realization that the amount of sleep that an individual gets is one of the internal factors that influence his or her own capacity to handle stress (Stoppler Marks, 2010). As such, it can be logically concluded that sleeping disorders are positively correlated to enhanced stress levels. Sleep disorders brings with them a myriad of negative effects, e specially on an individual’s social, physical, emotional, and mental wellbeing. According to the National Institute of Neurological Disorders and Stroke, the severity of sleep disorders is further compounded by well-entrenched rules of modern living, which is fast-paced and aggressive, thereby keeping sleep in extreme disregard (Levy et al, 2006). The reality is that sleep disorders can lead to a range of negative outcomes, causing mild to potentially life-threatening ramifications, from weight gain to cardiovascular seizures. Below, some of the most common sleep disorders are discussed. Sleep Apnea Sleep researchers and medical professionals have for years tried to understand the dynamics and causative agents of these condition that is far more widespread than holistically understood. By description, sleep apnea is a breathing disorder typified by short interruptions of breathing occasioned by muscle relaxation during sleep (Levy et al, 2006). At a general level, the conditi on usually arises in association with lack of fitness, fat accumulation, and loss of muscle tone that comes with aging (Overeem Reading, 2010). This potentially life-threatening condition is a serious concern for vital body organs such as the brain and cardiovascular system. The condition, which was first identified in 1965, is much feared for its episodes of pausing of breathing. During an episode, a person’s attempt to inhale air during sleep produces suction that occasions the windpipe to collapse. According to Levy et al (2006), the collapsed windpipe obstructs the air flow for duration of time ranging from ten seconds to a minute, while the person, already in sleep mode, tries to grasp for breathe. As the episode progresses, the blood oxygen level drops forcing the brain to react by waking up the person in a response that is aimed at contracting the upper airway muscles and open the collapsed windpipe (Overeem Reading, 2010). The person may grunt or gasp for a while as he or she attempts to respond before resuming normal breathing. This most excruciating cycle can be repeated numerous times in a single night, compounding the condition even further. The frequent awakenings brought about by sleep apnea are counterintuitive to the health and wellbeing of an individual. A study conducted on subjects with known condition of sleep apnea identified a strong relationship between the condition and personality problems such as irritability, stress, depression, and perceived instability of mental health. The deprivation of oxygen during the seizures may have grave consequences, including brain damage, decline in mental functioning and performance, enhanced risk of suffering from stroke, heart failure, coronary heart disease, injury from accidents, and high blood pressure, among others (Lichstein et al, 2004). In the U.S., sleep apnea and its complications accounts for an estimated $42 million in treatment and hospital bills. Hypersomnia Hypersomnia is a sle ep disorder characterized by recurring and excessive amounts of daytime sleepiness or extended nighttime sleep (Grohol, 2010). Available literature demonstrates that hypersomnia is a rare disorder, occurring in less than 5 percent of the adult population worldwide (Levy et al, 2006). The condition usually affects people between ages 15-30, and progresses gradually over a period of years. Unlike feelings of tiredness or fatigue felt by people largely as a result of lack of adequate sleep at night, people suffering from this condition are compelled to sleep frequently during daytime, often at unsuitable times such as working hours thereby lessening their productivity. Of particular interest is the fact that these daytime naps hardly offer any relief from symptoms of fatigue and disorientation experienced by people with this condition (Overeem Reading, 2010). Hypersomnia is evaluated along a continuum of duration and level of severity. According to Overeem Reading (2010), an individu al must exhibit symptoms related to the condition for at least three weeks to be diagnosed with hypersomnia, not mentioning the fact that the symptoms must have a substantial effect on the person’s life for the person to be categorized as suffering from hypersomnia. Studies conducted over time has identified some unique symptoms or behaviors exhibited by people suffering from the condition. In one particular study, Levy et al (2006) identified excessive daytime sleep (EDS), diminished levels of alertness and energy, anxiety, depression, disorientation, prolonged sleep at night, diminished mental functioning, memory difficulty, and enhanced irritation. Other symptoms include restlessness, slow or retarded speech, antisocial behavior, appetite loss, and hallucinations (Brand et al, 2010). In severe cases, a person suffering from this condition loses his ability to undertake his or her family, social, or occupational responsibilities. Hypersomnia is occasioned by the presence of another sleeping disorder, medications, drug or alcohol dependence, injury or impairment of the central nervous system, and head tumors, among others (Brand et al, 2010). The condition, according to Levy et al (2006), can also be caused by other medical complications such as multiple sclerosis, epileptic seizures, post traumatic stress disorder, and obesity. Of importance to the broad objective of this report is that this condition can be caused by medications used to alleviate stress. As such, a correlation between sleep disorders and the negative outcomes brought about by stress can be drawn. Narcolepsy There is no known cause for this chronic disorder, which is described as excessive and overwhelming sleep attacks especially during daytime even after having adequate sleep at night (Levy et al, 2006). Some sleep researchers defines narcolepsy as a chronic neurological disorder which weaken the capacity of the central nervous system to regulate normal sleep patterns (Overeem Read ing, 2010). As such, a person suffering from this condition is more likely to become sleepy and fatigued at inappropriate times and situations. According to the NINDS (2010a), â€Å"†¦people may involuntarily fall asleep while at work or at school, when having a conversation, playing a game, eating a meal, or, most dangerously, when driving an automobile or operating other types of potentially hazardous machinery† (para. 2). If the urge to sleep becomes irresistible, people with this condition fall asleep for periods ranging from a few seconds to one hour or even for longer periods of time. Other symptoms that characterize narcolepsy include abrupt loss of voluntary muscle tone, hallucinations, and brief periods of total paralysis especially at the beginning or end of every episode (NINDS, 2010a). It is inarguably difficult to diagnose narcolepsy. For a person to be fully diagnosed as suffering from the condition, he or she must have suffered repeated episodes of sleep a ttacks for a period not less than three months (Sleep Mechanics, 2010). The situation is further compounded by the fact that the condition is not ultimately diagnosed in most victims until 10 to 15 years after the onset of the first symptoms (NINDS, 2010a). Scientists have now formed the opinion that narcolepsy is occasioned by disease processes which affects the brain’s capacity to regulate REM sleep. Of particular relevance to this report is the fact that narcoleptic sleep seizures can occur anywhere at any given time, profoundly disabling the victim’s productive capabilities. Restless Legs Syndrome Restless legs syndrome (RLS) is a neurological sleep disorder characterized by uncomfortable, stinging sensations in the legs followed by spontaneous urge to move the legs when at rest or sleeping in an attempt to relieve these unpleasant and often painful feelings (NINDS, 2010b). According to Buchfuhrer Kushida (2007), â€Å"†¦the medical term for these sensations is dysesthesia, which is defined as disagreeable or abnormal sensation† (p. 3). These sensations normally occur in the calf sections of the legs but may also be felt elsewhere. The most unique or extraordinary characteristic of RLS is that relaxing or lying down for prolonged periods of time automatically activates the symptoms. The sensations vary in severity from slight uncomfortable feelings to painful episodes. Some individuals have reported experiencing the sensations in the arms too. Accounts of people with RLS reveals a trend whereby the sensations are more pronounced at night than during the day (NINDS, 2010b). In most occasions, the uncomfortable sensations disappear by early morning, allowing the person some time to sleep. Despite extensive research, the causative agents of RLS remain unknown. Although many people don’t take the condition seriously, especially in mild cases, severe cases of RLS can disrupt daytime functions due to the onerous interruption of sleep during the night. More importantly, the syndrome is known to cause exhaustion, stress, and daytime fatigue if left untreated (NINDS, 2010b). Such a scenario bears obvious ramifications on the victims’ work-related responsibilities, personal and family relations, and other activities of daily living. In addition, people with RLS are unable to concentrate, and therefore are unable to accomplish their daily roles (NINDS, 2010b; Buchfuhrer Kushida, 2007). Exploding Head Syndrome According to American Sleep Association (2007), â€Å"†¦exploding head syndrome is a rare and relatively undocumented parasomnia event in which the subject experiences a loud bang similar to a bomb exploding, a gun going off, a clash of cymbals or any other form of loud, indecipherable noise that seems to originate from the head† (para. 1). This condition is not associated with pain or any other physical characteristic. Many people have only reported shortness of breath after experienci ng the syndrome. This noise occurs just before a person enters into deep sleep, and occasionally upon waking up. Attacks can, on their own volition, increase or decrease with time or even disappear altogether. People with this condition often experience fear and distress after an episode, followed by elevated heart rate. Though the condition is not life-threatening, it is highly associated with stress and overbearing fatigue in most people. At this stage, the cause of this syndrome is not yet known (ASA, 2007). Population Affected by Sleeping Disorders Sleep disorders are known to affect people based on their age, lifestyle behaviors, immediate environment, and their mental and health status, among other factors (Levy et al, 2006). It is difficult to draw a fine line between who is at risk of being affected by the sleep disorders because situations keep shifting and our experiences at an individual level keep on changing inline with the trends of modern living. One thing that has re verberated all along the discussion, though, is the fact that sleep disorders and stress are inexorably linked, and that one variable triggers a spontaneous response from the other. This notwithstanding, extensive research carried out on these disorders has explicitly identified the percentage of Americans who may be at risk and, in some occasions, stated the age categories that are most affected. A cohort study conducted in 1993 revealed that one in every 15 people in the U.S were affected by at least one form of sleep apnea, a figure that is equivalent to 18 million Americans (CureResearch.com, 2010). It is also estimated that 2-4 percent of Americans lives with the condition but are yet to be diagnosed. People in middle-age are thought to be more at risk of being affected by the condition, with figures demonstrating that as many as 9 percent of American women and a massive 24 percent of American men in middle-age are affected by the condition yet they remain undiagnosed and untre ated (Levy et al, 2006). Available data on hypersomnia demonstrate that the condition affects an estimated 5 percent of the population as they progress through the lifespan (AllPsychOnline, 2004). However, hypersomnia is more widespread in males than in females. The symptoms appear before an individual celebrates his or her 30th birthday, and continue to advance as one ages unless treated. Narcolepsy is a common sleep disorder in populations around the world, but it often goes unrecognized or misdiagnosed. It is therefore hard to account for the total percentage of the population suffering from the condition. But going by NINDS (2010a) estimates, one in every 2,000 people living in the U.S. is affected by the condition. Narcolepsy is neither gender specific nor racial or ethnic specific; it affects people from all walks of life globally. It is feared that a larger segment of the population might be suffering from the condition in silence. According to NINDS (2010a), the disorder â⠂¬Å"†¦prevalence rates vary among populations†¦Compared to the U.S. population, for example, the prevalence rate is substantially lower in Israel (about one per 500,000) and considerably higher in Japan (about one per 600)† (para. 6). Researchers put the figure of Americans suffering from restless legs syndrome (RLS) at 12 million (NINDS, 2010b). However, this is a provisional figure because RLS, as is the case with narcolepsy, is thought to be grossly misdiagnosed and, in some instances, under-diagnosed. Still, some people with the condition fail to go for medical checkup on the belief that theirs is not a serious condition that warrants medical attention. As such, the prevalence levels could be higher than currently estimated. There exist no objective statistics on people affected by exploding head syndrome due to the fact that the disorder is relatively new. What is known at this stage is that individuals over the age of 50 stands more chance of being affected by the syndrome. It is also known that women are at higher risk of being affected by the disorder than men (ASA, 2007). How Sleep Disorders Affect Family Life Evidence adduced in this report has demonstrated that the amount of sleep that an individual gets is one of the internal factors that influence his or her own capacity to cope with stress (Stoppler Marks, 2010). This therefore implies that sleep and the capacity to handle stress are proportionately linked, with the amount of sleep serving as a variable over the capacity to handle stress. More importantly, it has been revealed that sleep disorders affect family life in numerous ways. A good starting point in this discussion would be to reinforce the proven concept that normal sleep is indispensable for our mental health, vitality, and intellectual development (Sleep Mechanics, 2010). In the absence of normal sleep, individuals will be deprived of these critical aspects that enhance their ability to cope with stress. Fatigue and s tress occasioned by sleep disorders makes a person to be unproductive at the family level. As a matter of fact, these undesirable characteristics are not only counterproductive to the family as a unit, but they also impact substantial harm on the victim and his or her own personal and social relationships (Brand et al, 2010). The frequent awakenings occasioned by sleep apnea, according to available literature, are counterintuitive to the health and wellbeing of an individual. According to Lichstein et al (2004), these individuals may be unable to maintain a long term relationship with their partners, not mentioning that the disorders takes a toll on their quality of life, denying them the confidence and vigor that is copiously needed for modern living. Subjectively, some of the sufferers of serious sleep disorders such as sleep apnea think of themselves as abnormal human beings. There exists a strong relationship between sleep disorders such as sleep apnea and personality problems, including irritability, stress, depression, and perceived instability of mental health. Hypersomnia is known to decrease the level of alertness and energy while enhancing depression, disorientation, antisocial behavior, and enhanced irritation, among others (Levy et al, 2006). These undesirable outcomes not only reduces our capacity to effectively cope with the stressors experienced in modern living, but also entraps the sufferers in a vicious cycle of unresponsiveness and low quality life on the family front. Studies have positively correlated these characteristics to increased suicide rates (Vokovic, 2010). It is, therefore, not difficult to see that people suffering from sleep disorders stands a high risk of losing their ability to holistically undertake their family responsibilities. Family breakups and divorces may be witnessed in cases where the sufferer is the sole breadwinner of the family since the disorder will force him or her to forego family responsibilities. Sleep diso rders comes with profound financial obligations in medical costs that are bound to weigh heavily on the family. Statistics demonstrates that an estimated $16 billion is used annually in the U.S. to treat people with sleep disorders (Patlak, 2007). Such costs may have an overbearing effect on the family, affecting its ability to function normally and, in some cases, draining all the resources earmarked for other activities. This only serves to increase stress levels. More importantly, some of the medical complications associated with sleep disorders such as stroke, brain damage, coronary heart disease, and high blood pressure have the capacity to bring permanent ramifications on family life (Eui-Joong Dimsdale, 2007). How Sleep Disorders Affect Work Life It is indeed true that work environments are stressful environments. Our ability to handle and cope with stress therefore becomes of critical value if we are to perform to expectations and remain productive at work. However, this is better said than done when it comes to sleep disorders and work life as many of the negative outcomes associated with sleep disorders only serves to diminish our own abilities to handle stress. Some symptoms such as fatigue, depression, loss of memory, disorientation, and daytime sleepiness (Eui-Joong Dimsdale, 2007) curtails people’s productive and creative nature at work. Chances are that, such symptoms increases cases of absenteeism from work and enhances turnover. According to Lichneistein et al (2004), productive employees are an asset to the organization. Sleep disorders, however, works against the grain to make people with such complications become less productive in their work and therefore a liability to the organization. Patlak (2007) opines that the U.S. alone loses in excess of $50 billion annually in lost productivity due to complications associated with sleep disorders. This is an astronomical figure whose effect on the economy cannot be wished away. People wi th sleep disorders such as hypersomnia or narcolepsy are unable to optimize their work life owing to the fact that they are compelled to sleep frequently during daytime, often at unsuitable times such as work hours (O vereem Reading, 2010). In particular, people with narcolepsy cannot operate hazardous machinery or drive for long hours as they are bound to involuntarily fall asleep on the job and if they do, other expenses may have to be incurred in terms of covering for accidents and hospital bills. Other stress disorders such as RLS and exploding head syndrome are known to cause exhaustion, stress, lack of concentration, and daytime fatigue, profoundly disabling the person’s productive capabilities at work (NINDS, 2010b; Buchfuhrer Kushida, 2007). Conclusion Clearly, the facts have been laid bare that not only does sleep disorders affects our ability to handle stress, but they also have a profound effect on our work and home life. Specifically, the paper has focused atten tion to the interrelations between sleep disorders and stress, and how the resulting multiplicity of negative outcomes affects our family and work life. The paper has gone a step further to discuss some of the most common sleep disorders and the populations that are most at risk of being affected. The astronomical costs in terms of lost productivity, medical complications, family breakups, stress and stress-related complications, lack of creativity, among others calls for action among all stakeholders directed at offering practical yet manageable solutions to the millions of people suffering from these devastating yet treatable complications. Reference List AllPsychOnline. (2004). Psychiatric disorders: Primary hypersomnia. Retrieved from http://allpsych.com/disorders/sleep/hypersomnia.html Brand, S., Gerber, M., Puhse, U., Holsboer-Tracchsler, E. (2010). Depression, hypomania, and dysfunctional sleep related cognitions as mediators between stress and insomnia: The best advice is n ot always found in the pillow. International Journal of Stress Management, Vol. 17, Issue 2, p. 114-134. Retrieved from psycARTICLES Database Buchfuhrer, N.J., Kushida, C.A. (2007). Restless legs syndrome: coping with your sleepless nights. Montreal Avenue, Saint Paul, MN: AAN Enterprises Carey, B. (2007, Oct. 24). New studies suggest sleep is vital to learning and memory. The New York Times. Retrieved from http://www.nytimes.com/2007/10/23/health/23iht-snsleep.1.8015084.html?_r=1 CureResearch.com. (2010). Statistics about sleep apnea. Retrieved from http://www.cureresearch.com/s/sleep_apnea/stats.htm Eui-Joong, K., Dimsdale, J.E. (2007). The effects of psychosocial stress on sleep: A review of Polysomnographic evidence. Behavioral Sleep Medicine, Vol. 5, Issue 4, p. 256-278. Retrieved from Academic Source Premier Database Grohol, J.M. (2010). Hypersomnia, Primary Symptoms. Retrieved from http://psychcentral.com/disorders/sx85.htm Levy, P., Viot-Blanc, V., Pepin, J.L. (2006). Sle ep disorders and their classifications – An overview. In: W.J. Randerath, B.M. Sanner, V.K. Somers (Eds) Sleep Apnea: Current diagnosis and treatment. Karger Publishers Lichstein, K.L., Durrence, H.H., Riedel, B.W., Taylor, D.J. (2004). Epidemiology of sleep: Age, gender, and ethnicity. Mahwah, New Jersey: Taylor Francis National Institute of Neurological Disorders and Stroke. (2010). Narcolepsy fact sheet. Retrieved from http://www.ninds.nih.gov/disorders/narcolepsy/detail_narcolepsy.htm Overeem, S., Reading, P. (2010). Sleep disorders in neurology. Oxford: Blackwell Publishing Patlak, M. (2005). Your guide to healthy sleep. U.S. Department of Health and Human Services. Retrieved from http://www.nhlbi.nih.gov/health/public/sleep/healthy_sleep.pdf Sleep Mechanics: A guide to guide to getting a good night’s rest. (2010). Retrieved from MasterFILE Premier Database Stoppler, M.C., Marks, J.W. (2010). Stress. MedicineNet.com. Retrieved from http://www.medicinenet.com /stress/article.htm Vukovic, L. (2010). The power of sleep. Better Nutrition, Vol. 72, Issue 4. Retrieved from MasterFILE Premier Database Footnotes 1 National Institute of Neurological Disorders and Stroke 2 See: Lichstein et al (2004) This research paper on Underlying Issues Associated with Sleep Disorders and Stress was written and submitted by user D'KenNeraman1 to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

The road to World War II essays

The road to World War II essays In the early days of the First World War, the United States was desperate to stay out of the European war and institute a neutrality policy. However, the two sides fought for U.S. support, often even at a danger to the U.S. The passive stand that America took in involvement in World War I only prolonged the inevitable and came at a price to the U.S. The American public didnt want to be involved in World War I, and Wilson and the democrats knew it, although neutrality was a difficult stand to take. The British, who wanted the Americans to back their side in the war, refused to back U.S. peace drives. The Germans, who wanted the U.S. on their side, against Britain, violated pledges for the waters when it began U-boat attacks. This campaign was extended over many years. The two countries of Germany and England were desperate for the western giants support that would threaten American neutrality. The American people, however, would rather stay of war, and lose their right to the seas. Both sides became increasingly angry with the American position of neutrality. England publicly declared, Anyone who talked of peace was a friend of Germany. This created only hostility towards the British, but continued diplomacy with Germany. The underlying cause of this friendly nature was not to remain neutral. Wilson thought that if the Americans werent going to stand up for their rights to the seas, that this would be the way to reduce the submarine warfare. Wilson promoted peace at every turn, but both sides disliked the idea, in fact the Chancellor of Germany predicted that peace talks would be unsuccessful. Wilson wanted to demand an end to the war, but at this point in the war, it would have ruined the Allies. If that were to ensue, the U.S. would risk war with France or England. Then there was a breaking point. The German government deported 300,000 Belgians, which fired up anger in the ...

A Time of Reflection Essay Example | Topics and Well Written Essays - 1250 words

A Time of Reflection - Essay Example Military tension was culpable between the two world powers, and they even engaged in proxy wars as they tried to outdo each other. The tension created by the Cold war affected day to day lives of Americans. Between 1946 and 1964, it is estimated that some 20 million babies were born in the US. This is the generation that grew up during the tension filled years of the Cold War. It is also the generation that witnessed the Civil Movement. I am a proud member of this generation which is commonly referred to as the Baby Boomers. I grew up during a time when the politics of the United States seemed almost uncertain. There was the ever threatening return-to-war feeling among the general populace. The never-ending tug-of-war between the US and USSR created a fear among citizens. This generated into a phenomenon that came to be known as Duck and Cover as people were afraid that the enemy (that is, the USSR) would drop a nuclear bomb on any part of the country and we had to be ready to duck a nd find cover if and when that happened. This kind of tension was particularly unnerving for the young generation born after the war. I think the older generations were able to deal with the situation since they had experienced the Second World War and were used to such tension. In my understanding at that time, they were too afraid to speak out of the effects that war was having on the common citizens. But I was not. I felt that it was my right to speak out what I thought should be spoken out. If I thought that something was wrong and it needed to be corrected I was bold enough to say it. My outspokenness was a behavior I had picked up from my grandmother since when I was a child. The Civil Rights Movement In 1961 I joined college and like many other young people at the time, I had great expectations for my future. I knew I wanted a good life for myself and I understood that a college education would at least guarantee me a good job with good pay, of course. The 60s were tumultuous years, especially in regards to the Civil rights Movements and the conflicts that came with it. I had heard stories told of how Rosa Parks had defied the high and mighty to secure herself a seat in bus seat that was reserved for whites only. I grew up admiring her courage to face up to people whom she knew could do anything to her if they wanted to. The first time I heard her story, I went home and during dinner asked my mother why people hated parks so much that they did not want her to sit in a set that she had paid for in a bus. My mother tried to explain that people did not hate her, that it was just that people like her could only seat at a designated place in the bus. I was too young to understand the concept of discrimination, but something at the back of my head told me that the treatment Rosa Parks had received was not fare. I think that was the first time I really was able to develop an anti-status quo attitude which I would carry on later into my adulthood. We had an Afr ican housekeeper at home whose son, Jeremy was more or less the same age as me. We were quite good friends and even though we attended different schools (I was in an all-white school while he was in an all black one), we did our school work together. I found him to be brighter than some of the students at my own school. He practically taught me everything I needed to know in all my science subjects. After high school we both went to different colleges but we remained good friends until he

Paris - Gertrude Stein's Salon Essay Example | Topics and Well Written Essays - 250 words

Paris - Gertrude Stein's Salon - Essay Example Her greatest and lasting influence though was perhaps in her role as a collector of post-modernist art, and through the artistic salon she maintained in her Parisian home ( A and E Television 2010) . Together with her brother until 1913 when they separated, she played host to many writers from many different countries. Her artistic purchases helped to establish and to support now well-known artists such as Picasso and Matisse in their early years. The walls of her French home were almost invisible under the number of artistic efforts that covered them. Stein tried to bring the principles of Cubism and prose into her writing, which resulted in works which were not understandable to even intelligent readers, but at least she attempted to experiment, and so moved on literature from its Victorian state, and demonstrated that experimentation was at least possible. Her home was also open to various Americans visiting Paris such as F. Scott Fitzgerald. As Lewis points out ( 2012) her influence on literature by others , far outweighed the influence of her own output. Ernest Hemingway for instance received encouragement and tuition from her. Stein is perhaps remembered today more for her long relationship with Alice B. Toklas, but her art purchases are celebrated today. It is through these that from the 21st century we can look back to see what a huge change Modernism was for the artistic world. In 2011 her collection, now dispersed, was brought back together in San Francisco, more than 150 pieces, but not the work of unknowns as they were when first purchased. Stein helped these great artists to be recognized, and so helped to establish Cubism, Fauvism and Surrealism and for that she should be

Clinical Practice Analysis Nursing Models Health And Social Care Essay

Clinical Practice Analysis Nursing Models Health And Social Care Essay Concepts should not be considered as either being permanent or static but should be considered open to new knowledge, perception, experiences and also data (Alligood and Tomey 2006). The nursing models were established to help clinical nurses in developing new roles and partnerships and also create better models of nursing care in order to facilitate a better clinical practice (www.health.nsw.gov.au/nursing/projects/models_of_care.asp). Nursing models are usually referred to as operational models for redesigning the nursing practice that will provide better nursing care for the patient on an organizational setting, primarily hospitals and long term care facilities. The models however can take a different form on the organizational level. They however only mean that that there has been some form of redesigning. This redesigning is usually mainly at the patient care delivery level or the nursing level. The only way to differentiate such models at the level of organization is by attaini ng those that do not care delivery. These are mainly levels such as innovative pay and also the programs of clinical advancement. Nursing practice models differ from the traditional models in either of the following structural dimensions. It is either through the degree to which the practice by individual nursing is differentiated based on their individual educational level, the degree to which nursing practice is more of self managed rather than managed by traditional supervisors, the degree to which case management is deployed and also the degree by which teams are employed. Teams in this case mean either nursing or multi-displinary. According to Mayer, Madden, and Lawrenz (1990), the models that they evaluated have varying degrees of employing various structural approaches to reorganize the nursing practice. Past studies and also the present studies show reflections on the applicability of the models and also the nursing models. This allows the validation and construction of new action forms in nursing care. It also helps to identify limits and relations between professions and individuals who are in need of care. In order to give a description, explanation, forecasting or even a prescription of nursing care, there is need to have articulated and communicative conceptualizations of reality which can either be invented or discovered. Case study: HIV/AIDS patients Among many cases that affect the human nature other than the cancer kind of diseases, Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS) has the greatest negative effect on mankind. The case study within the practice which best utilizes the nursing models is on the Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS). This case study best shows how the nursing model by Dorothea Orem can best service the patients and bring a form of relief to the patients. There have been models and theories that have been put in practice or give an explanation of the self-care related phenomena guide solutions that respond to the involved people ¿Ã‚ ½s needs and interests and equip nurses to help patients take care of themselves, as AIDS is a chronic illness that depends on the patient ¿Ã‚ ½s personal care to gain a better quality of life and prolong survival. Models including that of Dorothea Orem are used in nursing to ensure that there is adequ ate care given to those with HIV/AIDS. The use of this model or theory is because those who suffer HIV/AIDS have low immunodeficiency. This has a great effect on the normal functioning of the body. It however rests upon the patients to ensure that they maintain good health. People suffering from HIV/AIDS require constant care and support from the society. They also require not to be looked down upon by those who offer the care delivery to them. It therefore shows that the model of nursing by Orem can easily boost the morale of the patients if they a re given a chance to have the self care by themselves. It however also requires that there be moderate to high levels of participation by the health care deliverers in order to ensure that the patients are well equipped on how to go round the self care. Nursing models by Orem Models are considered conceptual reference frameworks, constructed representations on some aspect in the environment, using abstractions as fundamental blocks. The self care model of nursing or better known as the Orem model of nursing was established by Dorothea Orem in 1959. In her theory of administering care the patient is looked upon or is encouraged to be an independent person. This helps in the recovery of the patient as they are directed to use the best ways possible to ensure their well being. Self care is considered as an individual ¿Ã‚ ½s performance towards a better health, life and also well being through practice of given activities. The recovery and development of health is achieved when a patient apprehends the orientations. This helps to retain the structural integrity and also the human functioning. For those suffering Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS), there are diseases which are related that occur. They may include the acquisition of opportunistic infections as the body has a low immune system, difficulty in taking sufficient food intake, lack or deprived sleep, nausea and/ or altered palate due to collateral medical effects, weight loss, fatigue, an decrease in body mass. Other than the physical changes, the patient may also have an onset of psychological alteration such as low self image and self esteem. There are also changes in lifestyles of the patient due to maybe prejudice, side effects of the medication and even constant and frequent visits to the health centre. Areas of changes The self care model by Orem consists of mainly three theories which revolve mainly around the nursing theory, self-care deficit and also the self care theory itself. On the theory of self care there are three levels that are of concern such as universal care, health deviation and also developmental. This means care which aims at maintaining the integrity of human functioning and structure. According to the self care deficit theory, it shows that the patient has to be dependent and in a situation whereby the patient is incapable or has limitations to providing self care. This is what needs to be changed in the Dorothea Orem ¿Ã‚ ½s model of nursing in order to deliver better care. By doing away with such theories it will prove better and well managed to finally offer better care towards the patients. It therefore becomes relevant to view such a case scenario as a way to improve self care through the use of the Orem nursing model where a patient should be considered as an independent person. There have been researches done that have articulate the use of this model of nursing. Outcome of the use of the nursing model by Orem a. The use of the theory by Orem by patients suffering from HIV/AIDS As such was the case scenario of patients in an educative proposal of how to have eye self exam by those who suffer from Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS). There were several detailed diagnosis that were identified from most of the patients. Based on the profile that was as a result from the analysis of the patients, it proved that patients require help. The demand on self care on universal and developmental level ensures that patients get moderate if not high levels of help. Basing the facts from the deduced results it showed that there was a level of competency in the patients. This shows that the patients can conduct their own eye self exam. The results also justify that for patients suffering HIV/AIDS, it is possible for them to have adequate nursing care. Through the analytical questions that were posed in order to achieve the analysis of the model showed that nursing care systemization for self-care among HIV/AIDS patients, using the n ursing process; to the patient ¿Ã‚ ½s possible accomplishment of the eye self-exam; to the identification of HIV patients ¿Ã‚ ½ self-care attitudes and deficits through the universal, developmental and health deviation requisites. Besides, the nursing model collaborated as a method to help patients. The resulting results show that the Orem ¿Ã‚ ½s theory can give guidance. This guidance however serves as a guide to how care delivery is done on those with HIV/AIDS. It also elaborates more on the need to have assessment on the HIV/AIDS patient on self eye exam. The analysis of the study also showed that the nursing model by Dorothea Orem can also be used in the nursing curriculum. b. The use of Orem ¿Ã‚ ½s model of nursing involving the HIV/AIDS patients The analyzed study offered important information to guide nursing research, as it demonstrated that the use of Orem ¿Ã‚ ½s Theory permitted testing an eye self-exam teaching model in HIV/AIDS patients, which can be included in the nursing curriculum. There were discoveries that were made in the Orem ¿Ã‚ ½s theory. This included the fact that there was little or small input from the limited number of participants. It therefore proved hard to make a possible. However, there was qualitative results that made it possible to have a view on the competency in HIV/AIDS patient to run an eye self test. The tested propositions were based by the fact that a higher proportion of HIV patients at different stages had irreversible eye alterations due to lack of early diagnosis and treatment. It therefore goes to show that patients require help for universal development and health deviation requisites. c. Orem model of nursing for the purpose of nursing management Based on the research done on people with HIV/AIDS, there is a considerable gap that the nurses should bridge. Mainly this gap is mostly in the learning of nursing based on the educative and supportive system of nursing there has been detailed nursing curriculums that help in implementing the Orem ¿Ã‚ ½s model of nursing. The outstanding results from the use of Orem ¿Ã‚ ½s model in nursing showed that there could be use of the model in the management of the nursing in care services. This was a measured achievement towards self care for patients suffering from HIV/AIDS. It proved to be a success and therefore can be used in the nursing management. The practice of nursing is becoming more targeted as the self care proved to be an instant success. Mainly after the nursing interventions, the care quality in nursing can be measured to form an assessment. d. Better instruments for future and further diagnosis of diseases Based on the findings of how effective the Orem ¿Ã‚ ½s model of nursing is on Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS) it only goes to show that with future studies of other diseases, this Orem ¿Ã‚ ½s model of nursing can be utilized to the advantage of the patients and also to the advantage of the nursing practice as a whole. In the practice of this Orem ¿Ã‚ ½s model of nursing, it proves comforting to the patient which should be the general idea behind nursing (Alligood and Tomey 2006). It offers comfort to the patient as they have the knowledge that someone else has faith in them to take good care of themselves. It also boosts their morale in knowing that they are yet capable of taking care of themselves to attain better health General conclusion For nurses who undertake the use of Orem ¿Ã‚ ½s model of nursing they can easily find out gaps or self care deficits which they can try to fill in. The act of learning more in order to fill in the deficit can also help in the diagnosis which might be corresponding. By the use of the Orem ¿Ã‚ ½s model of nursing, it becomes easy for those in the nursing practice to identify means and ways through which they might better the practice. Basing on facts that the Orem ¿Ã‚ ½s model of nursing was established in the early 1965, it has been used widely in nursing areas such as on pregnant women, HIV/AIDS patients, adolescents and also hypersensitive patients. There has been progress from theory to practice by the use of the use of the model in nursing by Orem. There is proven and theoretical framework as it has helped nurses to offer support to patients of HIV/AIDS. Besides just intervention for those with HIV/AIDS, the model of nursing by Orem ensures that attitude of the patient and a lso the self care deficits are clearly identified. It therefore proves that the model in nursing by Orem can is actually a valid instrument. It can therefore be used to bridge the gap between the researchers and also the research subject. As a means of ensuring that those in the nursing practice utilize the Orem ¿Ã‚ ½s model in nursing, there can be a venture into other areas other than HIV/AIDS to areas such as diabetes. By the use of the Orem ¿Ã‚ ½s model in nursing it has opened up more opportunities through which support education can offer. There is better service offered since the Orem ¿Ã‚ ½s model in nursing was established and more research in this area is proving fruitful. This is because of the research done based on people with Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS) has been seen as a step closer to ensuring that the patients do not suffer. It also has ensured that there is better treatment both at a physical and psychological l evel. Though it might prove as a remedy or cure to the disease it has definitely given the patients a better understanding of themselves. It has also created ways in which the patients can be self reliant based on the stages of the Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS). Recommendations It therefore goes without saying that the Orem ¿Ã‚ ½s model in nursing is a true model that should be utilized more for the sake of the patients. It helps in boosting the self esteem of the patient which giving a detailed analysis to those in the profession of nursing. It provides a better view on how strategies should be laid out in order to achieve better health care delivery. Patients no matter the kind of ailment they suffer from but especially those suffering from Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS) should be taken as independent patients. They should be taught various ways of self care other than the eye self care. Through such ways it proves profitable for both the patients and also those in the nursing practice. The model in nursing by Orem proves a sufficient way to manage the practice of nursing and on the other hand creates a study for other patients who might benefit from the model.

The Impact Of The Social Changes Of The Civil War Essay examples -- Am

The Impact of the Social Changes of the Civil War As the United States began to establish itself as a country, more and more problems began to surface within the nation. A perfect example of this would be the American Civil War, which significantly affected society. This brought about many changes within America such as women’s rights movements and decisions regarding African American freedom. Also many of the problems are country had previously left unresolved were soon to be resolved too. The social changes of the American Civil War and Reconstruction Era greatly affected the years that followed it as well. The American Civil War was different from many of the wars the United States had fought in at this time. Mostly this nation had only helped out in wars for other countries, or to just become one country itself. By the mid-1800s though, the separate areas of the U.S. had begun to develop diverse ideas regarding many important decisions. The separate areas of the Unites States quickly shifted into the North or the South. One of the matters in particular that the North and the South greatly disagreed on was slavery. [Slave owners] feared that the activities of abolitionists would make it more difficult to run their plantation system. Where possible they wanted to see an expansion of slavery into other areas. (Simkin 2) While the North believed it should be abolished, the South felt that the African American slaves were important to their economy. (Simkin 1-3) As the tensions rose between the North and South, the South began talks of seceding from the North and forming their own country. After Abraham Lincoln was elected president, South Carolina, Mississippi, Florida, Alabama, Georgia, Louisiana and Texas d... ...ns, the state of America was socially impacted. The social changes of the American Civil War and Reconstruction Era greatly affected the years that followed it as well. Works Cited Davis, Kenneth. Don't know much about the Civil War : Everything You Need to Know About America's Greatest Conflict But Never Learned . New York: William Morrow, 1996. Dudley, William. The Civil War: Opposing Viewpoints. San Diego: Greenhaven Press, Inc., 1995. Nosotro, Rit. "USA Civil War: moral and social changes." The Amreican Civil War: A national redefinition. 3/28/2007. 28 Mar 2007 . Simkin, John. "American Civil War." American Civil War. 30 Apr 2007 . Stalcup, Brenda. Reconstruction: Opposing Viewpoints. San Diego: Greenhaven Press, Inc., 1995.

Qin Shi Huang, First Emperor of China Essay

Qin Shi Huang (or Shi Huangdi) was the First Emperor of a unified China, who ruled from 246 BCE to 210 BCE. In his 35-year reign, he managed to create magnificent and enormous construction projects. He also caused both incredible cultural and intellectual growth, and much destruction within China. Whether he should be remembered more for his creations or his tyranny is a matter of dispute, but everyone agrees that Qin Shi Huang, the first emperor of the Qin Dynasty, was one of the most important rulers in Chinese history. Connect with over 120,000 suppliers from Hong Kong, China and Taiwan Fall of Rome London Family History Chinese Warriors Terracotta Army Dynasty Early Life: According to legend, a rich merchant named Lu Buwei befriended a prince of the Qin State during the latter years of the Eastern Zhou Dynasty (770-256 BCE). The merchant’s lovely wife Zhao Ji had just gotten pregnant, so he arranged for the prince to meet and fall in love with her. She became the prince’s concubine, and then gave birth to Lu Buwei’s child in 259 BCE. The baby, born in Hanan, was named Ying Zheng. The prince believed the baby was his own. Ying Zheng became king of the Qin state in 246 BCE, upon the death of his supposed father. He ruled as Qin Shi Huang, and unified China for the first time. Early Reign: The young king was only 13 years old when he took the throne, so his prime minister (and probable real father) Lu Buwei acted as regent for the first eight years. This was a difficult time for any ruler in China, with seven warring states vying for control of the land. The leaders of the Qi, Yan, Zhao, Han, Wei, Chu and Qin states were former dukes under the Zhou Dynasty, but had each proclaimed themselves king as the Zhou fell apart. In this unstable environment, warfare flourished, as did books like Sun Tzu’s The Art of War. Lu Buwei had another problem, as well; he feared that the king would discover his true identity. Lao Ai’s Revolt: According to the Shiji, or â€Å"Records of the Grand Historian,† Lu Buwei hatched a new scheme to depose Qin Shi Huang in 240 BCE. He introduced Zhao Ji to Lao Ai, a man famed for his large penis. The queen dowager and Lao Ai had two sons, and in 238 BCE, Lao and Lu Buwei decided to launch a coup. Lao raised an army, aided by the king of nearby Wei, and tried to seize control while Qin Shi Huang was traveling outside of the area. The young king cracked down hard on the rebellion; Lao was executed in a grisly fashion, along with his family. The queen dowager was spared, but spent the rest of her days under house arrest. Consolidation of Power: Lu Buwei was banished after the Lao Ai incident, but did not lose all of his influence in Qin. However, he lived in constant fear of execution by the mercurial young king. In 235 BCE, Lu committed suicide by drinking poison. With his death, the 24-year-old king assumed full command over the kingdom of Qin. Qin Shi Huang grew increasingly paranoid (not without reason), and banished all foreign scholars from his court as spies. The king’s fears were well-founded; in 227, the Yan state sent two assassins to his court, but he fought them off with his sword. A musician also tried to kill him by bludgeoning him with a lead-weighted lute. Battles with Neighboring States: The assassination attempts arose in part because of desperation in neighboring kingdoms. The Qin king had the most powerful army, and neighboring rulers trembled at the thought of a Qin invasion. The Han kingdom fell in 230 BCE. In 229, a devastating earthquake rocked another powerful state, Zhao, leaving it weakened. Qin Shi Huang took advantage of the disaster, and invaded the region. Wei fell in 225, followed by the powerful Chu in 223. The Qin army conquered Yan and Zhao in 222 (despite another assassination attempt on Qin Shi Huang by a Yan agent). The final independent kingdom, Qi, fell to the Qin in 221 BCE. China Unified: With the defeat of the other six warring states, Qin Shi Huang had unified northern China. His army would continue to expand the Qin Empire’s southern boundaries throughout his lifetime, driving as far south as what is now  Vietnam. The king of Qin became the Emperor of Qin China. As emperor, Qin Shi Huang reorganized the bureaucracy, abolishing the existing nobility and replacing them with his appointed officials. He also built a network of roads, with the capital of Xianyang at the hub. In addition, the emperor simplified the written Chinese script, standardized weights and measures, and minted new copper coins. The Great Wall and Ling Canal: Despite its military might, the newly unified Qin Empire faced a recurring threat from the north: raids by the nomadic Xiongnu (the ancestors of Attila’s Huns). In order to fend off the Xiongnu, Qin Shi Huang ordered the construction of an enormous defensive wall. The work was carried out by hundreds of thousands of slaves and criminals between 220 and 206 BCE; untold thousands of them died at the task. This northern fortification formed the first section of what would become the Great Wall of China. In 214, the Emperor also ordered construction of a canal, the Lingqu, which linked the Yangtze and Pearl River systems. The Confucian Purge: The Warring States Period was dangerous, but the lack of central authority allowed intellectuals to flourish. Confucianism and a number of other philosophies blossomed prior to China’s unification. However, Qin Shi Huang viewed these schools of thought as threats to his authority, so he ordered all books not related to his reign burned in 213 BCE. The Emperor also had approximately 460 scholars buried alive in 212 for daring to disagree with him, and 700 more stoned to death. From then on, the only approved school of thought was legalism: follow the emperor’s laws, or face the consequences. Qin Shi Huang’s Quest for Immortality: As he entered middle age, the First Emperor grew more and more afraid of death. He became obsessed with finding the elixir of life, which would allow him to live forever. The court doctors and alchemists concocted a number of potions, many of them containing â€Å"quicksilver† (mercury), which probably had the ironic effect of hastening the emperor’s death rather than preventing it. Just in case the elixirs did not work, in 215 BCE the Emperor also  ordered the construction of a gargantuan tomb for himself. Plans for the tomb included flowing rivers of mercury, cross-bow booby traps to thwart would-be plunderers, and replicas of the Emperor’s earthly palaces. The Terracotta Army: To guard Qin Shi Huang in the afterworld, and perhaps allow him to conquer heaven as he had the earth, the emperor had a terracotta army of at least 8,000 clay soldiers placed in the tomb. The army also included terracotta horses, along with real chariots and weapons. Each soldier was an individual, with unique facial features (although the bodies and limbs were mass-produced from molds). The Death of Qin Shi Huang: A large meteor fell in Dongjun in 211 BCE – an ominous sign for the Emperor. To make matters worse, someone etched the words â€Å"The First Emperor will die and his land will be divided† onto the stone. Some saw this as a sign that the Emperor had lost the Mandate of Heaven. Since nobody would fess up to this crime, the Emperor had everyone in the vicinity executed. The meteor itself was burned and then pounded into powder. Nevertheless, the Emperor died less than a year later, while touring eastern China in 210 BCE. The cause of death most likely was mercury poisoning, due to his immortality treatments. Fall of the Qin Empire Qin Shi Huang’s Empire did not outlast him long. His second son and Prime Minister tricked the heir, Fusu, into committing suicide. The second son, Huhai, seized power. However, widespread unrest (led by the remnants of the Warring States nobility) threw the empire into disarray. In 207 BCE, the Qin army was defeated by Chu-lead rebels at the Battle of Julu. This defeat signaled the end of the Qin Dynasty. Sources: Mark Edward Lewis, The Early Chinese Empires: Qin and Han. Cambridge: Harvard University Press (2007). Lu Buwei, The Annals of Lu Buwei, trans. John Knoblock and Jeffrey Riegel. Stanford: Stanford University Press (2000). Sima Qian, Records of the Grand Historian, trans. Burton Watson. New York: Columbia University Press (1993).