Don’t Sleep on This, part trois
We’ve all heard the saying about waking up “on the wrong side of the bed,” but as it turns out, there’s quite a bit of truth behind this colloquialism. Americans in general are notoriously sleep deprived; lots of folks experience problems sleeping, not getting enough sleep, not feeling rested, and not sleeping well. This can lead to difficulties functioning during the daytime, and have very unpleasant effects on your work, relationships, and social and family life. Most people know firsthand that sleep affects their mental state, but do you know how closely connected sleep is to mental and emotional health? Sleep deprivation has major effects on your psychological state. The two- sleep and mental health- contribute greatly to one another, generally coexisting in a bidirectional relationship. People with mental health diagnoses are more likely to have insomnia and/ or other sleep disorders, and vice versa. Ultimately, mental health disorders tend to make it harder to sleep well, while at the same time, poor sleep and insomnia can be a contributing factor to the initiation and worsening of mental health issues.
Insomnia and other sleep issues have clearly demonstrated links to depression, anxiety, bipolar disorder, and other conditions like ADHD. In fact, chronic sleep problems affect 50% to 80% of psych patients, as compared to 10% to 18% of typical American adults. Both sleep and mental health are complex issues affected by a multitude of factors, but given their close association, there’s good reason to believe that improving sleep can have a hugely beneficial impact on mental health. In my opinion, helping to ensure a patient gets good sleep is an important component of treating most psych disorders.
Why is sleep so important? If you recall from last week, brain activity fluctuates during sleep, increasing and decreasing during different stages of the sleep cycle. In NREM- non-rapid eye movement- sleep, overall brain activity slows, but there are quick bursts of activity. In REM sleep, brain activity picks up very rapidly, which is why this stage is associated with more intense dreaming. Each stage plays a role in brain health, allowing activity in different parts of the brain to ramp up or down, and this enables better thinking, learning, and memory. Research has clearly demonstrated that all this brain activity while you’re sleeping has profound effects on emotional and mental health.
Sufficient sleep, especially REM sleep, facilitates the brain’s processing of emotional information. During sleep, the brain works to evaluate and remember thoughts and memories, and a lack of sleep is especially harmful to the consolidation of positive emotional content. This can influence mood and lead to emotional reactivity, and has been tied to various mental health issues and the severity thereof. It can even lead to suicidal ideation and behaviors. The old timers thought that sleep problems were strictly a symptom of mental health disorders, but after elucidating what goes on in the brain during sleep, science has made it clear that problems sleeping are not just a consequence of mental health issues, they can also be a cause of the same.
One of the major sleep disorders that people face is insomnia, which is basically an inability to get the amount of sleep needed to function efficiently during the daytime. It may be caused by difficulty falling asleep, difficulty staying asleep, or waking up too early in the morning. About 1 in 3 Americans report difficulty sleeping at least one night per week. Short-term insomnia is very common, and has a multitude of causes: stress, lifestyle, work schedule, travel, or other life events. It can generally be relieved by simple sleep hygiene interventions, things like exercise, a hot bath, warm milk, or changing your bedroom environment. On the other hand, long-term insomnia lasts for more than three weeks, and this should really be investigated by a physician, potentially with referral to a sleep disorder specialist.
Why? Because chronic insomnia is rarely an isolated issue, it’s usually a symptom of another illness, be it medical or psych, that requires investigation. Sometimes insomnia can be caused by obstructive sleep apnea, or OSA, which has also clearly been linked to mental health issues. OSA is a disorder that affects your breathing while sleeping. With OSA, your throat muscles intermittently relax and block your airway, causing you to repeatedly stop and start breathing while you sleep. This leads to a drop in the body’s oxygen levels, creating fragmented and disturbed sleep. In fact, OSA can cause as many as 30 sleep disruptions per hour. Yikes. There are serious repercussions for that. The human body likes oxygen, and it can get a little pissy when it doesn’t get enough of it. People with OSA experience these abrupt awakenings, accompanied by gasping or choking, along with morning headache, daytime drowsiness, difficulty concentrating during the day, forgetfulness, mood changes, high blood pressure, and decreased libido. It’s not good. Unfortunately, OSA occurs more frequently in people with psych disorders, and it’s a serious issue, as it detracts from physical health while simultaneously heightening mental distress. A 2017 study found that people with sleep apnea, when compared to those without, were 3.68 times more likely to have anxiety, 2.88 times more likely to experience severe psychological distress, and 3.11 times more likely to have depression. In addition, it found that their odds of suicidal ideation were 2.75 times higher. Sadly, the same study also found these patients with OSA reported a greater lack of mental health care and support.
Multiple studies recognize the correlation between OSA and poor mood, post traumatic stress disorder, and higher prevalence of psychosis and schizophrenia. The presence of OSA in the schizophrenic population has been found to be as high as 48 percent! Smoking and alcohol consumption further complicate this link between schizophrenia and OSA, as both are very common habits in people with schizophrenia, and both confer an increased risk of sleep apnea. And OSA isn’t just linked to schizophrenia. Existing studies note the prevalence of OSA in bipolar patients to be similar to that of schizophrenia.
There’s also a causal relationship between OSA and depression. Decreased oxygen levels overnight, called nocturnal hypoxia, cause chronic stress, which then increases the production of corticosteroids in response. Higher levels of corticosteroids, in turn, cause mood changes and impaired cognitive function, as well as increased inflammation in the body, all of which contribute to the development of depression. Conversely, patients with depression exhibit lower levels of serotonin, a neurotransmitter that’s also linked to muscle tone of the upper airways. Decreased serotonin levels in the body increase the likelihood that the upper throat will collapse, causing even more episodes of apnea. It can create the perfect sleep storm.
Because OSA and depression share several symptoms, it can be difficult to discern the impact of one disease over the other. Both result in disturbed sleep, fatigue and lethargy, restlessness, and loss of concentration. Given those facts, it should come as no surprise that both OSA and depression are associated with increased vehicle and workplace accidents due to increased fatigue and poor concentration.
Insomnia: Cause and Effect
How well you sleep tells a physician like me a lot. About half of insomnia cases are related to depression, anxiety, or general psychological stress. Very often, the qualities of a person’s insomnia, along with their other symptoms, can be helpful in determining the role of mental illness in their inability to sleep. This is why I always ask patients to tell me about how they’re not sleeping… just knowing you can’t isn’t enough. For instance, early morning wakefulness can be a sign of depression, especially if it comes along with low energy, an inability to concentrate, sadness, and a change in appetite or weight. On the other hand, a sudden dramatic decrease in sleep which is accompanied by an increase in energy- or the lack of need for sleep- can be a sign of mania. Many anxiety disorders are associated with difficulties sleeping, and obsessive compulsive disorder is frequently associated with poor sleep as well. Panic attacks during sleep may suggest a panic disorder, while poor sleep resulting from nightmares may be associated with post traumatic stress disorder.
Sleep and Specific Mental Health Diagnoses
The way that sleep and mental health are intertwined becomes even more apparent when you look at how sleep is tied to a number of specific mental health conditions.
It is estimated that over 300 million people worldwide have depression, a mood disorder marked by feelings of sadness or hopelessness. Around 75 percent of depressed people show symptoms of insomnia, and many people with depression also suffer from excessive daytime sleepiness and hypersomnia, which is sleeping too much. Historically, sleeping problems were seen as a consequence of depression, but in reality, poor sleep may also induce or exacerbate depression, and sleep problems and depressive symptoms are mutually reinforcing. It’s essentially a negative feedback loop, where poor sleep worsens depression that then further interrupts sleep. But on the bright side of that, a focus on improving sleep may also have a corollary benefit of reducing the symptoms of depression.
Seasonal Affective Disorder
You may remember from a few months ago that SAD is a subtype of depression that most often affects people during times of the year with reduced daylight hours, typically fall and winter. It’s closely tied to the disruption of a person’s internal biological clock, or circadian rhythm, that helps control multiple bodily processes, including sleep. It shouldn’t surprise you then that people with SAD experience changes to their sleep cycles, and tend to sleep either too much or too little.
Every year, anxiety disorders affect an estimated 20 percent of American adults and 25 percent of teenagers, creating excess fear or worry that can affect everyday life and create risks for other health issues, including heart disease and diabetes. Anxiety disorders- including social anxiety disorder, panic disorder, specific phobias, OCD, and PTSD- have a strong association with sleeping problems. In these disorders, worry and fear contribute to a state of hyperarousal, when the mind is constantly racing, which is a central contributor to insomnia. Sleep problems may then become an added source of worry, creating anticipatory anxiety at bedtime, which makes it that much harder to fall asleep. It can become a vicious cycle. Research has found an especially strong connection between PTSD and sleep. People with PTSD frequently replay negative events in their mind, suffer from nightmares, and experience a constant state of being on alert, all of which can interfere with sleep. PTSD affects many veterans; at least 90 percent of U.S. veterans with combat-related PTSD have symptoms of insomnia. But sleep problems aren’t just a result of anxiety. Research indicates that poor sleep can actually activate anxiety in people who are at high risk for it, and chronic insomnia appears to be a predisposing trait among people who later go on to develop anxiety disorders.
Bipolar disorder involves episodes of extreme moods that can be both high, with mania, and low, with depression. A person’s feelings and symptoms are quite different depending on the type of episode, but both manic and depressive periods can cause major impairment in everyday life. In people with bipolar disorder, sleep patterns change considerably depending on their emotional state. During manic periods, they usually feel less need to sleep, but during depressed periods, they often sleep excessively. Very often, sleep disruptions continue when a person is between episodes. Research has found that many people with bipolar disorder experience changes in their sleep patterns just before the onset of an episode. There is clear evidence that sleeping problems induce or worsen manic and depressive periods, but that because of the bidirectional relationship between bipolar disorder and sleep, treatment for insomnia can reduce the impact of a person’s bipolar disorder.
Schizophrenia is a mental health disorder characterized by a difficulty in differentiating between what is and is not real. People with schizophrenia are more likely to experience insomnia and circadian rhythm disorders, and these issues can actually be exacerbated by medications that are used to treat schizophrenia. But once again, poor sleep and symptoms of schizophrenia may be mutually reinforcing, so there are potential benefits to stabilizing and normalizing sleep patterns.
ADHD is a neurodevelopmental disorder that involves reduced attention span and increased impulsiveness. While usually diagnosed in children, it may last into adulthood, and is sometimes only formally diagnosed when someone is already an adult. Sleeping problems are common in people with ADHD. They may have difficulty falling asleep, frequent awakenings, and excessive daytime sleepiness. Rates of other sleep disturbances, such as obstructive sleep apnea and restless leg syndrome (RLS) also appear to be higher in people with ADHD. Once again, there is clear evidence of a bidirectional relationship between sleep and ADHD; in addition to being a consequence of ADHD, sleep problems may aggravate symptoms, especially in reduced attention span or behavior problems.
Substance use disorders can also cause problems with sleep. While alcohol is sedating in limited quantities, alcohol intoxication disturbs your sleep patterns and can make you wake up numerous times in the night. Some sedative medications may cause sleepiness during intoxication, but it’s far too easy to develop a dependency on them, and ultimately they’ll disturb sleep and cause serious problems sleeping in people who are misusing or withdrawing from them. Illicit drugs like LSD and ecstasy are also associated with interruptions in sleep.
Keep in mind that many mental health conditions don’t arise in isolation, and that coexisting conditions can influence one another, as well as a person’s sleep. For example, it’s not uncommon for people to experience both depression and anxiety, and people with both conditions have been found to have worse sleep than people with “just” depression or anxiety.
As you can see, poor sleep has clearly been shown to significantly worsen the symptoms of many mental health issues. This is down to the bottom line, that lack of sleep will change your brain, at the very least making it harder to get through the day. At the same time, severe sleep problems can decrease the effectiveness of certain psych treatments. Treatment of sleep disorders has been studied in relationship to schizophrenia, ADHD and other psych issues, and all of the scientific data shows the connection between them. Good sleep is necessary for recovery- or prevention- in both conditions. It’s a multifaceted, bidirectional relationship. Sleep has a very important restorative function in ‘recharging’ the brain at the end of each day, just like we need to charge a mobile phone. You know what happens if you don’t plug that in, right? It dies. Enough said. Poor quality of sleep may seem like a minor symptom, but if it’s chronic, it can be a sign of something much bigger. Good sleep can enhance quality of life and positively contribute to managing any concurrent mental illness. In fact, the relationship between mental health and sleep is so strong that steps to improve sleep may even form part of a preventive mental health strategy.
Next week, we’ll talk about what you can do to help ensure good, restorative sleep. I hope you enjoyed this blog and found it to be interesting and educational. Please feel free to share it with family and friends. Be sure to check out my YouTube channel with all of my videos, and I’d appreciate it if you would like, subscribe, leave comments, and share those vids! As always, my book Tales from the Couch has more educational topics and patient stories, and is available in office and on Amazon.
Thank you and be well people!
Don’t Sleep on This, part deux
Hello, people, welcome back to the blog! Last week, we started a new series on sleep, and talked about some of the theories on why we sleep and what it does for us. This week, we’re going to talk about what induces sleep, the stages of sleep, what’s happening in your brain and body while you’re sleeping, and what can happen when sleep is disrupted.
As I mentioned last week, our bodies regulate sleep in much the same way that they regulate eating, drinking, and breathing, and this is indicative of the critical role sleep plays in our health and well-being. But why do we get sleepy? What tells us when it’s bedtime? Each person has an internal “body clock” that regulates his or her sleep cycle, controlling when they feel tired and ready for bed, versus refreshed and alert. This clock operates on a 24-hour cycle known as the circadian rhythm.
After waking up from sleep in the morning, you become increasingly tired throughout the day as it progresses. These feelings will generally peak in the evening leading up to bedtime. This sleep drive- also known as sleep-wake homeostasis- appears to be linked to adenosine, an organic compound produced in the brain. I mentioned adenosine last week. It builds up throughout the day as you become more tired, and then the body breaks it down during sleep to dispose of.
Light influences the circadian rhythm. The brain contains a special region of nerve cells known as the hypothalamus, and a cluster of cells within it called the suprachiasmatic nucleus, which processes signals when the eyes are exposed to natural or artificial light. These signals help the brain determine whether it is day or night, time to be awake, or time to sleep. As natural light disappears in the evening, the body releases melatonin, a hormone that induces drowsiness. And when the sun rises in the morning, the body will release the hormone cortisol, which promotes energy and alertness. This influence that light has on the brain cannot be underestimated, especially blue light from devices. This is the reason why I always tell patients no screen time on devices right before bed. Blue light exposure just before you want to go to sleep is a surefire way to foul up your sleep cycle. I’ll get more into that in a later blog in this series.
The Sleep Cycle
As you sleep, your brain cycles through four stages of sleep. Stages 1 to 3 are considered non-rapid eye movement (NREM) sleep, also known as quiet sleep, while stage 4 is rapid eye movement (REM) sleep, also known as active sleep or paradoxical sleep. These stages occur multiple times throughout the night, with a full sleep cycle generally lasting about 90 to 110 minutes. The stages are repeated four to five times during a 7 to 9 hour sleep period, with each successive REM stage increasing in duration and depth of sleep.
Each stage has a unique function and role in maintaining your brain’s overall cognitive performance, while some stages are also associated with physical repairs that keep you healthy and get you ready for the next day. Fun fact: there used to be five stages of sleep, but this was changed by the American Academy of Sleep Medicine several years ago.
During the earliest phases of sleep, you’re still relatively awake and alert. During this time, the brain produces what are known as beta waves, which are small, fast brain waves that mean the brain is active and engaged. As the brain begins to relax and slow down, it lights up with alpha waves. During this transition, you may experience strange and vivid sensations, which are known as hypnagogic hallucinations. Common examples of hypnagogic hallucinations include the sensation of falling or of hearing someone call your name. There’s also the myoclonic jerk. No, I’m not referring to the person lying next to you… Ever gone to bed and felt like you’re just about to drift off and then BAM… you’re suddenly startled awake for seemingly no reason at all? That’s a myoclonic jerk.
NREM Stage 1
This first stage of the sleep cycle is a transition period between wakefulness and sleep that typically lasts for around 5 to 10 minutes. During this time, the brain is still fairly active and producing high amplitude theta waves, which are slow brain waves that mainly occur in the frontal lobe of the brain. During this stage, your brain slows down, while your heartbeat, eye movements, and breathing slow with it. During this stage, your body relaxes, but your muscles may twitch.
NREM Stage 2
According to the American Sleep Foundation, people spend approximately 50% of their total sleep time during this stage, which lasts for about 20 minutes per cycle. During this stage, your body prepares for deep sleep. You become less aware of your surroundings, your body temperature drops, eye movements stop, and your breathing and heart rate become more regular. The brain also begins to produce sleep spindles, which are bursts of rapid, rhythmic brain waves that are thought to be a feature of memory consolidation, when your brain gathers, processes, and filters the new memories you acquired the previous day.
NREM Stage 3
This stage is when the brain and body repairs, restores, and resets for the coming day, so getting enough NREM stage 3 sleep is essential to feel refreshed the next day. During this stage, which lasts between 20 to 40 minutes, deep, slow brain waves known as delta waves begin to emerge, so this is sometimes called the delta sleep stage. This is a period of deep sleep where any noises or activity in the environment often fail to wake the sleeping person. During this stage, your muscles are completely relaxed, your blood pressure drops and breathing slows, and you progress into your deepest sleep. It’s during this deep sleep stage that your body starts its physical repairs: cells repair and rebuild, hormones are secreted to promote bone and muscle growth, and your body produces elements to strengthen your immunity to fight off illness and infection. During this stage, your brain is still busy too- it’s consolidating declarative memories, general knowledge, personal experiences, facts and statistics, and other things you have learned that day.
REM Sleep Stage 4
The fourth stage of REM sleep begins roughly 90 minutes after falling asleep. During this time, your brain lights up with activity, your body is relaxed and immobilized, your breathing is faster and irregular, your eyes move rapidly, and you dream. It’s during this stage that your brain’s activity most closely resembles its activity during waking hours, but your body is temporarily paralyzed. That’s a good thing, as it prevents you from acting out your dreams. Memory consolidation also happens during REM sleep, but it’s more about emotions and emotional memories being processed and stored. Your brain also uses this time to permanently cement information into memory, making it an important stage for learning.
I should note that sleep doesn’t progress through the four stages in perfect sequence. When you have a full night of uninterrupted sleep, the stages usually progress as follows:
Sleep begins with NREM stage 1 sleep.
NREM stage 1 progresses into NREM stage 2, followed by NREM stage 3. NREM stage 2 is then repeated, and then finally REM sleep. Once REM sleep is over, the body usually returns to NREM stage 2 before beginning the cycle all over again. The amount of time spent in each stage changes throughout the night as the cycle repeats. A person’s “sleep architecture” is the term used to refer to the exact cycles and stages a person experiences in a night. If you see a sleep specialist for any issues, they often do a sleep study, and will then show you your sleep architecture on what’s known as a hypnogram, a graph produced by an EEG during a sleep study.
There are any number of issues that can interrupt your sleep cycles, causing stages to be cut short and cycles to repeat before finishing. Depending on the culprit, it can happen occasionally or on a chronic basis. Any time you have trouble falling asleep or staying asleep at night, your sleep cycle will be affected. Some factors that may affect your sleep stages and that are commonly associated with interrupted sleep include:
Age: As you age, sleep naturally becomes lighter and you are more easily awoken.
Nocturia: Frequently waking up with the need to urinate. This is big for older men due to prostate issues.
Sleep disorders, including obstructive sleep apnea, when breathing stops and starts during sleep, and restless leg syndrome, a strong sensation of needing to move the legs
Pain: Difficulty falling or staying asleep due to acute or chronic pain conditions, like fibromyalgia
Mood disorders such as depression and bipolar disorder
Other health conditions, including Alzheimer’s disease, Parkinson’s disease, obesity, heart disease, and asthma
Lifestyle habits: Getting little to no exercise, cigarette smoking, excessive caffeine intake, and excessive alcohol use all affect your ability to fall asleep and/ or stay asleep.
So how much sleep do you need? It varies a little from person to person, and it really depends on your age. The CDC suggests the following based on a 24 hour period:
From birth to 3 months: 14 to 17 hours, including naps
From 4 to 12 months: 12 to 16 hours, including naps
From 1 to 2 years: 11 to 14 hours, including naps
From 3 to 5 years: 10 to 13 hours, including naps
From 6 to 12 years: 9 to 12 hours
From 13 to 18 years: 8 to 10 hours
From 18 to 60 years: 7 or more hours
From 61 to 64 years: 7 to 9 hours
65 years and older: 7 to 8 hours
Most adults require between seven and nine hours of nightly sleep. Children and teenagers need substantially more sleep, particularly if they are younger than five years of age, as it is vital for their growth and development.
Work schedules, day-to-day stressors, a disruptive bedroom environment, and various medical conditions can all prevent us from receiving enough sleep. Over time, not getting enough sleep and not cycling through the four stages appropriately can cause any number of health issues, along with difficulty with learning and focusing, being creative, making rational decisions, problem solving, recalling memories or information, and controlling your emotions and behaviors. Keep in mind that it’s important not just to get seven to nine hours of sleep per night, but to ensure that it’s uninterrupted, quality sleep that allows your body to benefit from each of the four stages.
Without enough sleep, your body has a hard time functioning properly. Sleep deficiency is linked to chronic health problems affecting the heart, kidneys, blood, brain, and mental health. Lack of sleep is also associated with an increased risk of injury for both adults and children. In older adults, poor sleep is associated with an increased risk of falls and broken bones. Sleep deficit is even linked to an increased risk of early death. Driver drowsiness is a good example. Specific consequences of sleep deprivation can include mood changes, anxiety, depression, poor memory, poor focus and concentration, poor motor function, fatigue, weakened immune system, weight gain, high blood pressure, insulin resistance, and many chronic diseases, like diabetes and heart disease. The bottom line is that sleep keeps you healthy and functioning well. It lets your body and brain repair, restore, and re-energize.
If you experience any of the following issues, make an appointment to see your healthcare provider, as you may not be getting the sleep you need. They can help determine the underlying cause and improve the quality of your sleep.- If you are having trouble falling or staying asleep at least three nights per week- If you regularly wake up feeling unrested- If your daytime activities are affected by fatigue or issues with mental alertness- If you often need to take a nap to get through the day- If a sleep partner has told you that you snore or gasp when you are asleep- If lack of sleep is affecting your mental well-being
That’s a good place to stop, as next week, I’ll be talking about how sleep affects your mental well-being, and vice versa. I hope you enjoyed this blog and found it to be interesting and educational. Please feel free to share it with family and friends. Be sure to check out my YouTube channel with all of my videos, and I’d appreciate it if you would like, subscribe, leave comments, and share those vids! As always, my book Tales from the Couch has more educational topics and patient stories, and is available in office and on Amazon.
Thank you and be well people!
Hello, people! Welcome back to a brand new blog for a brand new year! It’s been a tough one for moi thus far, as I got the gift no one wants… covid. It’s been gnarly, but thankfully, I’m starting to feel more like myself again. This week, we’re starting a new series on a very important topic that I hear a lot of complaints about: sleep. Sleep is a vital part of life; we spend up to one-third of our lives doing it, and can’t live without it. It’s a lot like sex… everyone wants it, and some people get more of it than others.
Don’t Sleep on this…
Lots of go getters and workaholics will say “I’ll sleep when I’m dead.” But the problem is that that might be sooner than you want it to be if that’s your point of view. Why is this? Why is sleep so important? What happens in our bodies and brains during sleep? Why is it so hard for some people to fall asleep, while others are out cold before their heads hit their pillows? How can we get better sleep? How does sleep- or lack thereof- affect mental health? One of my patients recently told me about her latest sleepwalking escapades. What’s that all about? These are just some of the questions I’ll be addressing in this series.
We’ll start with the first question: why do we sleep? At the most basic level, it makes us feel better. A sleepless night usually leads to a dull, lethargic day, but a good night of sleep makes us feel more alert, more energetic, happier, and better able to function. It is as necessary as food, and one way to think about the function of sleep is to compare it to that life-sustaining activity, eating. Hunger is a mechanism that has evolved to ensure that we consume the nutrients our bodies need to grow, repair tissues, and function properly, and feeling tired essentially serves the same purpose. Eating and sleeping are not very different, and both are regulated by powerful internal drives. Going without food produces the uncomfortable sensation of hunger, while going without sleep makes us feel overwhelmingly sleepy. And just as eating relieves hunger and ensures that we obtain the nutrients we need, sleeping relieves sleepiness and ensures that we obtain the sleep we need. But the question remains: why is it necessary? What is the function of sleep?
Despite decades of research and many discoveries about other aspects of sleep, the question of exactly why we sleep has been difficult to answer. Scientists have developed several theories, but as is the case with so many human processes, it’s unlikely that a single theory will ever be proven correct, as sleep is necessary for many biological functions.
Inactivity Theory, aka Adaptive Theory
One of the earliest theories of sleep, sometimes called the adaptive or evolutionary theory, suggests that inactivity at night is an adaptation that served as a survival mechanism by keeping organisms out of harm’s way at times when they would be particularly vulnerable. The theory suggests that animals that were able to stay still and quiet during these periods of vulnerability had an advantage over other animals that remained active. For example, they weren’t killed by nocturnal predators and didn’t have accidents during activities in the dark. Through natural selection, this behavioral strategy of inactivity presumably evolved to become what we now recognize as sleep. But for every yin there’s a yang, and a simple counter argument to this theory is that it may be safer to remain conscious in a dangerous environment, in order to be able to react to an emergency. So there doesn’t seem to be any major advantage to being unconscious and asleep if safety is paramount. I mean, yeah, you’re less likely to be run over by a car, but it’s easier to be eaten if you’re just laying there, conveniently waiting for the predator to get you.
Energy Conservation Theory
The energy conservation theory of sleep suggests that a main purpose of sleep is to reduce a person’s energy use during certain periods when it’s inconvenient and less efficient to hunt for food. This is backed up in our biology, as research has shown that our metabolic rate is significantly reduced during sleep, by as much as 10 percent in humans, and even more in other species. According to this theory, sleeping allows us to reduce our overall caloric requirements by spending part of our time functioning at a lower metabolism. Although it may be less apparent to people living in societies in which food sources are plentiful, one of the strongest factors in natural selection is competition for, and effective utilization of, energy resources. The theory supports the proposition that sleep is a process of natural selection; we’ve evolved to sleep to expend less energy for a certain amount of time each day. And in fact, research suggests that humans getting 8 hours of sleep can produce a daily energy savings of 35 percent over complete wakefulness.
Another explanation for why we sleep is based on the long held belief that sleep serves to “restore” what is lost in the body while awake. The bottom line is that sleep provides an opportunity for the body to repair and rejuvenate itself, and many important processes happen during sleep. In fact, many of the major restorative functions in the body- like muscle growth, tissue repair, protein synthesis, and growth hormone release- occur mostly, or in some cases only, during sleep. There is a great deal of empirical evidence collected in human and animal studies to support the restorative theory. For example, studies have demonstrated that animals deprived of sleep entirely lose all immune function and die in just a matter of weeks. All of the “sleep when you die” folks should probably read that.
Other rejuvenating aspects of sleep are specific to the brain and cognitive function. For example, while we are awake, neurons in the brain produce adenosine, which is a by product of cellular activity. As long as we are awake, adenosine accumulates and remains in high concentrations. During sleep, the body has a chance to clear adenosine from the system, and, as a result, we feel more alert when we wake. In fact, the accumulation of adenosine in the brain is thought to be one factor that leads to our perception of being tired; scientists think that this build-up during wakefulness may promote the drive to sleep.
Brain Plasticity Theory
One of the most recent and compelling explanations for why we sleep is based on findings that sleep is correlated to changes in the structure and organization of the brain. This phenomenon is known as brain plasticity, and its connection to sleep has several critical implications. Simply put, this theory says sleep is required for brain function. Specifically, sleep allows your neurons, or nerve cells, time to reorganize. Sleep affects many aspects of brain function, including learning, memory, problem-solving skills, creativity, focus, concentration, and decision making. Ever have trouble remembering today something you did or said yesterday if you didn’t sleep the night before? That’s because sleep contributes to memory function. While you sleep, short-term memories are converted into long-term memories, and information that is not needed is erased, so as not to clutter the nervous system. In addition, when you sleep, your brain’s glymphatic system clears out waste and removes toxic byproducts from your brain which build up throughout the day, and this allows your brain to work well when you wake up. If you don’t sleep, these things don’t happen, so if it seems like your brain doesn’t work properly when you’ve pulled an all-nighter, it’s because it doesn’t… it’s full of waste and useless info!
What else is sleep essential for?
Not only is sleep needed for physical health, sleep is also necessary for emotional health. Sleep and mental health are intertwined: on one hand, sleep disturbances can contribute to the onset and progression of mental health issues, but on the other hand, mental health issues can also contribute to sleep disturbances. I will cover this in more detail in another blog, but during sleep, brain activity increases in areas that regulate emotion, and this helps support emotional stability. One example of how sleep helps regulate emotions occurs in the amygdala. This part of the brain, located in the temporal lobe, is in charge of the fear response- it’s what controls your reaction when you face a perceived threat, like a stressful situation. When you get enough sleep, the amygdala can respond in a more adaptive way, but if you’re sleep-deprived, the amygdala is more likely to overreact.
Sleep affects your weight by controlling the hunger hormones ghrelin, which increases appetite, and leptin, which increases the feeling of being full after eating. During sleep, ghrelin decreases because you’re using less energy than when you’re awake. But lack of sleep elevates ghrelin and suppresses leptin, and this imbalance makes you hungrier, which increases the risk of eating more calories and gaining weight. Research shows that chronic sleep deprivation, even as few as five consecutive nights of short sleep, may be associated with increased risk of obesity, type 2 diabetes, and other metabolic syndromes. In addition, sleep is necessary for proper insulin function and may protect against insulin resistance. Insulin is a hormone that helps your cells use glucose, or sugar, for energy. But in insulin resistance, your cells don’t respond properly to insulin, and this can lead to high blood glucose levels and eventually, type 2 diabetes. Basically, sleep helps keep your cells healthy so they can properly take up glucose.
A healthy and strong immune system depends on sleep, period. Research shows that sleep deprivation lowers immunity and can inhibit immune response, which obvi makes the body much more susceptible to germs. When you sleep, your body makes cytokines, which are proteins that fight infection and inflammation. It also produces certain antibodies and various immune cells during this “down” time, and together, these prevent sickness by destroying harmful germs. This is why sleep is so important when you’re sick or stressed, as during these times, the body needs even more immune cells. Having had covid recently, I can vouch for that.
While the exact causes aren’t clear, scientists have established a link between heart disease and poor sleep. It is associated with risk factors for heart disease, including high blood pressure, increased sympathetic nervous system activity, elevated cortisol levels, increased inflammation, weight gain, and insulin resistance.
The Centers for Disease Control and Prevention says the average adult needs 7 hours of sleep a night. During that time, the body repairs cells and tissues, restores energy, and releases molecules like hormones and proteins, while the brain stores new information and gets rid of toxic waste, and the nerve cells communicate and reorganize. Without these processes, our bodies can’t function correctly. It’s a lot for a body to do, so give it the time it needs to do it!
Next time, we’ll talk about more what happens while you’re sleeping. I hope you enjoyed this blog and found it to be interesting and educational. Please feel free to share it with family and friends. Be sure to check out my YouTube channel with all of my videos, and I’d appreciate it if you would like, subscribe, leave comments, and share those vids! As always, my book Tales from the Couch has more educational topics and patient stories, and is available in office and on Amazon.
Thank you and be well people!
Why is Sleep Important? Part Deux
When we left part one, I had just explained how lack of sleep can make people fat, and was about to explain how it can also make people ugly. First, just a quick review of the cascade that makes you fat. When you don’t sleep, there is an increase in the hormone ghrelin, which causes hunger, and makes you eat everything in sight at 3am. At the same time, levels of leptin, the hormone that makes you feel full, go way down. So you feel like you’re starving, but you can’t feel full, so you eat and eat and eat. Then, the stress hormone cortisol enters the scene since you’re not sleeping. Cortisol is a bully that pushes insulin around, so insulin picks up his toys and goes home, and this means insulin isn’t around to process all the sugary food you just ate courtesy of ghrelin. With all those sugars floating around, they eventually find their way to fat. But that’s not the end. Cortisol is such a bully that when insulin leaves, it starts picking on growth hormone. Fed up, growth hormone is suppressed, and that’s a bummer, because growth hormone is what repairs, restores, and rejuvenates the body. It builds protein, heals bone, and heals cartilage and connective tissue, as well as parts of the body that are very important to the beauty industry. And at long last, here is where I tell you how lack of sleep can make you ugly.
They did a study centered on determining sleeplessness through imagery. It showed that it took people just four seconds max to look at images and determine which people had not slept. The bottom line is that not sleeping makes you look older. Your skin loses elasticity, making it more wrinkled. Why? Well, remember the 3am date with the Frigidaire? How the stress hormone cortisol crashed the party, bullying insulin and human growth hormone and causing their suppression? Well, without human growth hormone to repair and replenish the cartilage and connective tissue, the skin loses its elastic properties. Without elasticity, the skin wrinkles badly. Also, many restorative and metabolic pathways take place at night. Certain genes present on our chromosomes have specialized jobs. They are involved in creating proteins to restore the skin, connective tissues, cartilage, musculature, and basically to repair the body and fight the aging of the body. The genes that do these jobs turn on at night while sleeping. If you’re not sleeping, those genes can’t do their job normally. All in all, it makes you look old and ugly before your time: your eyes get puffy and bloodshot, your face gets droopy, you have decreased muscle tone and more pronounced wrinkling, and your posture changes, becoming more stooped over. When shown subjects with good sleep patterns, public perception studies show that those subjects are considered more likeable, sexier, more successful, more articulate, healthier, and happier. So now we know, if you don’t sleep, you get fat. If you don’t sleep, you look ugly. And that’s not so good.
Next, let’s talk toxins. In order to be awake with a functioning, metabolizing brain, our body produces waste products, basically like pollution in the brain. These byproducts of metabolism are inflammatory compounds called beta-amyloid and tau proteins, and these are deposited in the brain. These are no bueno; it’s very important that we get rid of these compounds. Why? Both of these proteins are causative factors in Alzheimer’s disease and dementia, and other types of dementia as well. The body has a system, the lymphatic system, and it’s like a garbage disposal system. It coats the entire brain in cerebrospinal fluid and it pushes all the toxins, inflammatory products, beta-amyloid proteins, and tau proteins out and away from the brain, and it takes them away where the liver and the kidney metabolize them and they are ultimately excreted in urine, feces, and sweat. That lymphatic system is critical, but like any system, it can be overloaded. If you don’t sleep, your risk of dementia goes way up, especially if you are chronically sleep deprived. A lot of other things go bad too, but this is a big bad one. You must sleep in order to clear the body of inflammatory products and toxins, and to keep the brain healthy. It is nothing short of critical.
I’ve given you a lot of reasons to give yourself seven to nine hours of sleep each night. During sleep, our bodies undergo transformative changes. Our blood pressure drops, our heart rate drops, our respirations drop. It sets up the conditions that allow us to clear our body of toxins, to heal, to restore, and to grow. But there are plenty more interesting studies related to sleep deprivation that will make you want to give yourself those seven to nine hours. During spring daylight savings time when we lose an hour of an hour of sleep, heart attacks increase by 24 percent. They infer that not sleeping increases the risk of heart attack and stroke, because of hardening of the arteries. If you don’t sleep, arterial repairs aren’t getting done, so there is an increase in blood pressure and heart rate. Couple that with increased levels of uncleared inflammatory products and toxins oozing around the brain and body, and it creates all sorts of problems if it is chronic.
There are also psychiatric reasons that we need to sleep. Essentially, every psychiatric illness either causes sleep disruption or is exacerbated by sleep disruption. Most schizophrenics have an abnormal circadian rhythm that causes them to sleep during the day rather than the night. Sleep deprivation also causes some issues with psychiatric components. If you don’t get enough sleep, you have less empathy, you cannot recognize the pain and suffering of others. You can also lose the ability to understand facial expressions of pain, suffering, happiness, sadness. You can’t effectively ‘read’ someone’s expression or demeanor. Also, impulsivity increases when you do not sleep, and you’re prone to dangerous behaviors. There is no question that depression, anxiety, psychosis, panic disorder, and a host of other psychiatric problems are dramatically increased when people’s sleep wake cycle is impaired. You also can’t effectively concentrate if you do not sleep. Remember our student from part one, Randy Gardner. He deprived himself of sleep and was nearly a basket case by the third day. Speaking of school, I think that kids should not be starting as early as they do. I have seen that they do not regularly get the proper amount of sleep. They should start school at 9am, not before. As it is now, we make these kids get up so early, they are basically in a state where they cannot concentrate because they are sleep deprived, and that’s a huge problem, because this mimics attention deficit disorder. It’s very likely that many kidsdiagnosed with attention deficit disorder and even medicated for it really were just sleep deprived. Also, many studies on learning and sleep have been done. One was set up to study how well students learned a second language. They taught the same cirriculum to all of them, and the results showed that students with adequate sleep had a higher retention rate than sleep deprived students. From that, and many other studies, researchers have confirmed that memory is impaired by not sleeping. They did a similar study focusing on creativity and showed a three-fold decrease in creativity when sleep deprived. We know that the prefrontal cortex of the brain, which does all the decision making, is impaired by sleep deprivation. Scientists believe that the Challenger explosion and the Chernobyl disaster are both a direct consequence of a lack of sleep. There was a pilot program in some county in Minnesota that started school 90 minutes later in the morning, and the number of car crashes in the driving children under age 20 went down, as did the suicide rate.
There is some interesting stuff about the immune system as well. They found that natural killer cells go down in people that don’t sleep. What does all that mean? We all have these primordial cancer cells floating around in us, which are basically little tiny cellular precursors to cancer. But we also have specific immune cells called natural killer cells, and they circulate around and their job is to kill those primordial cancer cells. So, this study showed that if we don’t sleep, the number of those natural killer cells goes down, leaving more primordial cancer cells. This supports all of the studies that have shown that chronically sleep deprived people absolutely do have higher instances of breast, prostate, and colon cancer. Recently, the World Health Organization even went so far as to recognize chronic sleep deprivation as a carcinogen. That’s saying a lot, people. Other immune studies centering on immunizations, flu shots, were completed tolook at antibody response. One group of people were sleep deprived, and the other group was well slept. All were given the same flu shot at the same time. The results showed that the people who were sleep deprived had just half the antibody response of those who were well slept. That’s a dramatic finding. So when you’re chronically sleep deprived, cancer incidence goes up and the ability to mount an immune response goes down. That’s like the perfect storm. This is important, because it has a huge impact on your life, especially now with the coronavirus. If you get fewer than five or six hours a night, your immune system is approximately 40 percent less competent than the immune system of someone who is well swept. Also dramatic, people.
Just a quick review… unless you are among the five percent with a genetic mutation that allows your brain and body to work properly on little sleep, you need to sleep seven to nine hours each night to have optimal health. If you chronically and consistently do not get enough sleep, we have learned that you will overeat and be overweight, you will not be able to learn as well, your concentration and memory will nose dive, you will be less intelligent, and cosmetically, you won’t be very appealing. Basically, fat, dumb, and ugly. That doesn’t sound so great. So you really need to sleep.
Now that you know why you need adequate sleep, here are some tips on how to get it.
– Get into a routine. Go to bed at the same time every day, and try and get up at the same time every day.
– Create the proper environment. Sleep in a quiet place to avoid interference. Also sleep in a dark room, as any light throws off your natural melatonin that tells the body it is time to sleep. A cold room is best for sleep, cool enough to require a comforter. It’s very name tells you why: the weight of a comforter is…well, comforting. You can also buy a weighted blanket; these are great for kids too.
– Situate yourself. Sleep position is important. Many publications say that the best sleep position is on your back with your legs elevated to maintain appropriate spinal cord posture. If you’re unable to sleep that way, then whatever position feels best to you and doesn’t cause pain in the morning is the correct one.
– Blue light is bad. Blue light is emitted from screens on iPads, computers, kindles, etc. You must not have blue light exposure for a minimum of one hour before sleep, so shut it all down at least an hour before you go to bed. This is really important, as the bluelight is very disruptive to the melatonin cycle; it actually tells your body to get up. Speaking of light, there’s nothing as disruptive as bright light in the middle of the night. So if you must get up to use the bathroom in the night, don’t turn on a bright light. Get a dimmer switch and leave it set very very low and only use that.
– Wind down. Consider incorporating a period of time to wind down into your pre-sleep routine. Reading from a book by low light is good, but it must be the old school kind written on paper, not on Kindle or in an e-book. Taking a hot bath is good too. It causes the small capillaries at the skin’s surface to open up, getting blood to the skin surface to radiate heat and cool the body.
– Don’t drink a lot of fluids before sleep, because as your body goes into sleep, if it senses it has to go the bathroom, it wakes the brain, and then you wake up. Your body does have a mechanism for this; the posterior pituitary releases an anti-diuretic hormone to prevent the creation of urine during sleep, but you can override that by drinking too much fluid before sleep. So avoid that.
– Don’t eat big meals before sleep. This also disrupts sleep. A little snack is okay, because you don’t want to go to bed hungry, as that is disruptive as well. Ideally, you really need to have your dinner four to five hours before sleep. Also, along those same lines, don’t have any sugar before bedtime. Sugar tends to inundate the system and then wake you as it’s metabolized, so no sugar before bedtime.
– Alcohol, caffeine, and nicotine. No, no, and no. All are disruptive to sleep architecture. Alcohol: for every drink, you need four hours before going to sleep to not affect sleep. Caffeine: this has a long half life, so you need at least six hours per caffeinated beverage before going to sleep. Nicotine: ideally, you should have four hours before sleeping. This is a tough one, because people who smoke are commonly awakened by withdrawal from nicotine. So if you’re a smoker and you have trouble sleeping, try to quit smoking. I guarantee you’ll sleep and feel better in a short period of time.
– Vitamins and supplements. Magnesium is a calming hormone, so it helps you sleep. Calcium is used to manufacture tryptophan, an amino acid which causes drowsiness, so that helps promote sleep. Vitamin D3 and B vitamins help metabolize calcium, so those are good. You need iron, vitamin E, and melatonin. Also, valerian root is helpful. L-theanine is good, it is another amino acid that has a calming effect.
So now we’ve discussed the risks and repercussions of not sleeping and some tips tohelp you sleep better. If you find you still can’t sleep, consider seeing a physician, especially if you can see that it is impacting your life in a negative fashion.
I’d really appreciate people going to my website, dragresti.com and checking out all of my blogs and sharing them. You can also see all of my videos on tons of different topics on my YouTube channel. Please give me some likes and comments- I love reading comments- and most of all, hit that subscribe button, people! As always, if you want funny, informational, and helpful patient stories, you can find my book, Tales from the Couch available on Amazon.com.Learn More
One of the most important things I deal with in my practice is sleep. Sleep is defined as “a naturally recurring state of mind and body characterized by altered consciousness, relatively inhibited sensory activity, reduced muscle activity, inhibition of nearly all voluntary muscles, and lacking interactions with surroundings.” All animals need to sleep. Evolutionarily, in order to survive and successfully pass on genetics to another generation, sleep is a necessity. Humans are animals in this regard; we’re no different, as we require sleep to live too. And while it is a naturally occuring state, for some people, getting sleep is an absolute battle, fought tooth and nail every night.
Just some fun facts about how a few animals sleep… Can you imagine sleeping for as little as 30 minutes a day? How about for only five minutes at a time? Our giraffe friends can, because that’s exactly what they do. For a large animal in the middle of the open savanna, it’s risky to sleep because of predators. They must remain vigilant, so they nap in short intervals, usually standing up so that they are always ready to run. Dolphins and some of their marine mammal cousins are also unusual in that, unlike us, they must consciously think to breathe, even when they’re sleeping. They also have to be on guard 24/7 for predators or other potential dangers. So how do they do this? Well, they shut down only half of their brain at a time while sleeping. This is called unihemispheric sleep. This prevents them from drowning, while at the same time, allowing them to literally sleep with one eye open and remain on the lookout for potential danger or predators. Great Frigatebirds can stay in flight for months at a time, with their feet never touching ground. This is an impressive feat, but even more so when you think about how they sleep: in 7–12 second bursts. They spend approximately a total of 40 minutes sleeping like this per day while also flying. But when they are on land, they do sleep considerably more.
We humans can’t shut down half of our brains and we can’t fly or sleep underwater, which is a bummer. But really, how important is sleep for humans? Very! Rats are used in research because they accurately portray human systems, and there have been many sleep studies with them. One study showed that rats deprived of sleep for two weeks die. There is even an illness in humans called fatal familial insomnia, where if the people that have it do not sleep, they will eventually die from the cumulative lack of sleep. So let’s talk sleep. Sleep is basically the price we pay for the privilege of being awake, and there’s no way around it. So we have to pay the piper, but what’s the price? How much sleep do we need? The answer is that the vast majority of people need 7 to 9 hours of sleep per night. But, there is an exception. Five percent of the population has a genetic mutation where they only need five hours of sleep per night. Lucky ducks! Fun fact: in the past 50 years, the amount of sleep the average American gets has dropped by about an hour and 15 minutes to an hour and a half each night. That’s actually a lot, and there are consequences in our modern lifestyle. Also, you can’t bank sleep. You can’t say, ‘I slept an extra four hours over the weekend, so I can lose at least four hours of sleep tonight in order to get my big project done at work.” or “I won’t sleep much this week so I can study for a test, but I’ll make up the sleep this weekend.” Nope. It doesn’t work like that. More often than not, you really need to be on a regular sleep schedule, getting about the same number of hours each night. I treat sleep issues more than anything else in my practice. Hands down, every patient who comes in has a problem with sleep. With some people, I can do behavioral management; with others, I use meds or natural supplements. I’ll get to that later. When I’m lecturing, I always get questions about how one spouse gets up early and the other late and is that normal, etc. Yes, that is totally normal. There are certain genetic types, called chronotypes. There are larks, people who get up early, but then go to bed early. And there are night owls, who go to bed very late, and then wake up very late. Your genetic makeup determines what your chronotype is, whether you are a lark or a night owl, it’s perfectly healthy to be either. It doesn’t matter when you sleep, what matters is that you sleep. Ideally seven to nine hours a night. Adolescents sleep more, up to 12 or 14 hours per night, and newborns sleep for 16 or 17 hours each day, mainly because these are growth stages, and that tires the body. But by the time you reach adulthood, age 20 or so, you need that seven to nine hours. It is a myth that older people need less sleep. In reality, they need just as much sleep. The reasons they don’t sleep well can be because they are in pain, have bladder problems and need to use the bathroom, or all the medicines they are on disrupt the sleep architecture. A lot of neurostimulants, diuretics, and other drugs that make them drowsy during the day make it so they do not sleep well at night. It can be a really frustrating mess that’s difficult to untangle.
I want to talk about the reasons why we need sleep. Like many things in life, the reasons why are essentially based on the consequences of not getting it.
The brain makes up just two to three percent of our body mass, but it consumes 25% of the body’s energy. It’s like a car that’s running really fast; as the car burns gas, it makes fumes. Similarly, when the brain is burning calories, it creates waste. That waste is cleaned out when we sleep, and is why most people need 7 to 9 hours per night. Now, some people think they can avoid sleep and just drink coffee or energy drinks, but that’s wrong. One of the byproducts of our brain using all the energy it does is the production of a waste product called adenosine; and it takes sleep to get rid of it. Caffeine blocks the body’s sensors that this toxin is building up, not unlike having a car running in your house. If you ran your car in your garage or house, carbon monoxide would build up and eventually you would die of carbon monoxide poisoning. Caffeine blocks the body’s ability to determine how much adenosine is in it, so the body is tricked into thinking all is well, no need to rest. If it goes on too long, there are consequences to pay, and you eventually collapse.
A story on this topic that I find interesting is one about Randy Gardner, who holds the world record for sleep deprivation. There is some dispute about that, another dude named Tony Wright claims the record is his, but whatever. Anyway, Randy was a high school student in the 50’s and he had a science fair project to do. After much thought, he decided to study sleep deprivation. Randy decides he wants to prove all of his teachers wrong by showing them that people don’t really need sleep. He was normally a pretty affable guy, but right about day two, he started getting moody. Then he started having major problems concentrating at about third or fourth day. On day five, they tell him to start at 100 and to keep subtracting seven. He said “okay, 100 minus 7 is 93, minus 7 is 86, minus 7 is 79, minus 7 is…is…72, minus 7…no, minus 9 is 79, minus 7…wait…what am I adding? I mean…subtracting?” He was totally lost after just three subtractions. When they asked why he stopped, he couldn’t even tell them what he had been doing. And he was not a dumb kid, he was actually a straight A student. It was clear that missing four nights of sleep was clouding his mind to the point that he couldn’t remember simple directions. His inability to concentrate and his short-term memory loss was due to the fact that his brain and body were severely sleep deprived. But he still carried on with the experiment. Then something bizarre started happening around day six and seven. He started checking the windows in his house, making sure they were locked. Then he started looking for people watching him. He was sure that his friends were conspiring against him, and was constantly checking around corners, pulling down shades, and drawing the curtains on the windows in his house. If his mom opened them, he would freak out and hide in his room. Then he started saying that not only were they watching him, they were plotting against him. These people he was referring to were his best friends, but he was sure they had an evil agenda to get him. He still refused to stop his experiment, but his mother convinced him to see his doctor. It backfired: the doctor wanted to give him a B-12 injection, but when the syringe came out, Randy ran out of the room, convinced that the doctor was trying to poison him. He was going downhill very fast. On the eighth day, he started hallucinating, seeing and hearing things that weren’t there. Then he started having problems with pronunciation of simple words; a straight A student couldn’t pronounce everyday words. All because he had not slept, he had not allowed the brain and body to rest, to rid themselves of toxins. Then he stopped recognizing everyday objects. They would put a fork in his hand, and he couldn’t say what it was or what it was used for. By this time, he was like a zombie, walking dead. By the ninth and tenth day, he lost his sense of smell, and then his vision became progressively more blurry. By the eleventh day, he collapsed. He was emotionally, mentally, and physically done. His brain had given out first, then he started to lose normal bodily function, until his body finally gave up. He went 11 days without sleep. That’s 264 hours. 15,840 minutes. They didn’t say how long he finally slept. I suspect he was actually just unconscious at first. And they didn’t say what he got for a grade on his science fair project. I’d like to think it was an A, since the kid basically risked his life for the stupid thing. He went from a smart, gregarious kid to a babbling idiot in eleven days flat.
Lots of bad things happen when people don’t get enough sleep. In sleep deprived adolescents, the suicide rate goes up dramatically. In all ages, but more so in adolescents, the risk of car accidents also goes up considerably. There is also an increased tendency for moral lapses in people who do not get enough sleep; they do things that are typically out of character for them, like rob people or cheat on their spouses. Sleep deprivation also leads to learning problems, regardless of age; studies have shown that the capacity to learn is reduced by 40% when people are sleep deprived. That’s huge! It also causes an inability to recognize facial expressions. You may ask why that’s a big deal. Well, if you can’t tell that you’ve pissed off the big thug on the subway, you might continue to unwittingly irritate him and get yourself beat up… or worse. Reaction times are greatly affected by sleep deprivation; they’re slowed severely. That’s why car accidents increase. But researchers have thoroughly studied sleep and reaction times in sports. Many studies on sleep deprivation come from basketball players. Their accuracy and their performance metrics all go down relative to the hours of sleep missed. Hockey players’ reaction times, after just one night of missed sleep, were off by 30%. A goalie’s reaction time down by 30% is dramatic when it translates to the other team scoring on him 30% more often.
It’s all about getting that seven to nine hours. There are lots of physiological consequences of sleep deprivation. Blood pressure goes up, the risk of heart attack goes up, the risk of stroke goes up, you become obese, and often diabetic as a result. There’s actually a mechanism for it that I’ll explain in a moment. A host of psychiatric and mental illnesses can result from lack of sleep, and studies have shown that people who are chronically sleep deprived die much younger.
Now, let’s talk about your endocrine system. The endocrine system is the collection of glands that produce hormones that regulate metabolism, growth and development, tissue function, sexual function, reproduction, sleep, and mood, among other things. So, it pretty much controls like… everything. In young males, sleep deprivation makes the testosterone levels drop. The ability to produce testosterone is decreased in men who sleep less than six hours a night. What does that mean? Only that their testicles get smaller, they can have erectile dysfunction, and reduced sex drive. In adolescents, it can hamper the development of the bones and muscles, the deepening of the voice, and hair growth; all the stuff that helps boys start to look, sound, and act like men. It has an analagous affect on women, in that fertility goes down and estrogen levels decrease with chronic sleep deprivation. But in a cruel and ironic twist, a decrease in estrogen has been shown to cause insomnia and less productive sleep, or just very poor sleep. So for women, it’s often a vicious cycle.
What else happens to your hormonal system when you do not sleep? I’m sure you can correlate a lot of this stuff with your real life experiences. When you can’t or don’t sleep, do you notice you crave junk food? It’s 3am and you’re standing in the kitchen, scarfing down cold pizza? Or some other high fat or high sugar thing…a big bowl of cereal or ice cream or a doughnut, or three? Or a cinnabun? I love those and I must have one every time I’m at the airport, those are good. Anyway, that’s a distraction- I didn’t mean to bring that up. Remember earlier when I said that I’d explain why obesity is so much more common in people who are sleep deprived? Here we are. So what happens to you’re endocrine system when you don’t sleep? For one thing, you secrete a hormone called ghrelin. Ghrelin is a gnarly beast of a hormone, high on the list of the most hated hormones ever in the history of hormones. It even sounds like the name of a goblin, right? And not a nice goblin. A bad, mean, evil goblin. Ghrelin the gnarly goblin. Why the shade? Ghrelin is the hormone that makes you hungry…and hangry. So here you are, middle of the night, can’t sleep. And all of a sudden you’re starving! Why? Because not sleeping has triggered the release of a crap load of ghrelin, and it’s coursing through your body, making you crave sugary, fatty foods… whatever doesn’t run away when you reach for it is fair game. Ain’t that a bi-otch? But that’s not the worst of it. Ghrelin the goblin has a goody goody cousin named leptin. Leptin is the hormone that makes you feel full. He’s nowhere to be found when the gnarly goblin ghrelin is out on the prowl. So not only are you starving courtesy of ghrelin, but goody goody leptin is home studying, so you won’t be seeing him or feeling full anytime soon. So before you know it, you’ve eaten all the leftover pizza, a bowl of cereal, and a giant bowl of cookies & cream topped with more cookies and whipped cream! And you’re still eyeing the rest of that baked chicken in the fridge. But wait! The hormonal chemical conspiracy isn’t over friends. Without leptin to make you feel full, ghrelin the goblin has made you eat everything that’s not nailed down, but somebody else is coming to join the party…cortisol. Dahn dun duuuuuhhhnnn! Cortisol is the stress hormone, and he gets produced at higher levels when you don’t sleep. When he gets to the party, he pushes insulin around (they have a terrible history; don’t even ask) so insulin feels emasculated, so his levels go down. Why should you care about insulin levels? Well, remember all the carbs and sugar that ghrelin made you gorge on? Insulin is what helps your body break all that down. But since cortisol came to the party, pushing insulin around, all those sugars have nothing to do. What does that sound like? Begins with a “d”? Diabetes! Obvi you don’t become diabetic from one 3am rendezvous with the Frigidaire, but it sets up a diabetes-like condition that leaves those sugars all dressed up with nowhere to go. If that happens chronically, you can end up with diabetes. So what happens to these loose sugars at 3am? They go to fat. It’s squishy and warm there, a great place to land. It’s a whole cascade, a hormonal conspiracy to make you fat and…and…ugly! For real?! How does that happen? The cascade continues! Growth hormone doesn’t get along with cortisol either, so when cortisol shows up, growth hormone is outta there. When growth hormone leaves the party, that’s really a bummer, because he’s what basically restores the body, especially parts of it that are very important to a certain industry…the beauty industry. You now know that not sleeping can make you fat, but how can it make you ugly? Well, check back next week and I’ll tell you!
In the meantime, hop on my website dragresti.com and read some other blogs and like and comment on them, and check out my videos and subscribe to my YouTube channel. If you want more great stories that’ll make you sound really smart at your next cocktail party, check out my book, Tales from the Couch available on Amazon.com.
And people, for better or worse, it seems like the world is re-opening once again, so just please make wise choices. Maintain a little distance, don’t rush out to bars and dance floors to make up for lost time, and if you’re sick, stay home for God’s sake! And bosses, remember the lessons that corona taught us: let your people stay home if they’re sick; don’t make them choose between their health and their livelihood. I’ll now step down off my soapbox. Have a great week!Learn More
10 Secrets to sleeping Better
1.) Get on a schedule and go to bed at the same time every night. Do the same thing before bed every night.
2.) Sleep in a dark, quiet and cool room.
3.) Sleep on your back with a pillow under your feet.
4.) No eating or drinking 2 hours before bedtime.
5.) No caffeine 14 hours before bedtime. No alcohol or nicotine 4 hours before bedtime.
6.) No sugar 2 hours before bedtime.
7.) No blue light from computer, I pad screens 1 hour before bedtime, no bright light of any kind 1hour before bedtime.
8.) Calm your mind before sleep.
9.) Get enough Vitamin D3, Vitamin E, Magnesium, Iron, B complex vitamins and calcium.
10.) Valerian root, Chamomile, L-Theanine and Lavender help you sleep.Learn More
In this blog, I want to talk about sleep. One of the most common complaints I hear from patients in my practice is that they can’t sleep, and they ask what they can do to sleep better at night. It’s brought up so often that I’ve created a list of rules to follow to get better sleep at night. But first, some facts about sleep… and the lack thereof.
While sleep requirements vary slightly from person to person, most healthy adults need between 7 to 9 hours of sleep per night to function at their best. Children and teens need even more. And despite the notion that our sleep needs decrease with age, most older people still need at least 7 hours of sleep per night for optimal functioning.
We all know that good sleep is important. But why? I mean, if we don’t get enough sleep, we’ll be tired, but other than that, it really doesn’t matter, right? Wrong. In terms of importance, getting good sleep, and enough of it, is actually right up there with eating a healthy diet and exercising regularly. Poor or not enough sleep is known to have negative consequences on hormone levels and brain function, and can cause weight gain and increase the risk of obesity and diseases like diabetes and heart disease. On the flip side, adequate or good sleep can keep you healthier, help you maintain physical fitness, and think more clearly and concisely. Unfortunately, sleep quality and quantity have both decreased in recent years, and millions of people battle chronic insomnia for their entire lifetimes. Because it plays such a key role in your health, getting good sleep should be a priority in your life. Toward that end, below are my fourteen rules for good sleep.
Rule 1: Get bright light during the day. Natural sunlight is preferable, but artificial light works too. Your body’s natural clock is called your circadian rhythm; it links your body, brain and hormones, keeping you awake during the day when appropriate and telling you when it’s time to sleep at night. Daytime light exposure keeps your rhythm happy and in sync, improving daytime energy and alertness as well as nighttime sleep quality and duration.
Rule 2: Avoid blue light in evenings and at night. What is blue light? Blue light is what is emitted from your computer, laptop, iPad and smartphone. While daytime light exposure is beneficial, nighttime light exposure is not. This is because of its impact on your circadian rhythm; it tricks your brain into thinking that it’s daytime, and this reduces natural hormones like melatonin, hindering sleep. The more blue light you expose yourself to, the more disruption you’ll have in your sleep. There is a solution for this; there’s an app for your smartphone that filters out the blue light. There’s also something called “F.Lux” that you can put on your computer or iPad which will block out the blue light in those devices as well. So remember, blue light is a serious factor. If you are on your iPad or your computer at night, you’re not going to sleep well.
Rule 3: Avoid caffeine, Captain Obvious. 90% of the US population consumes caffeine on a daily basis, mostly in coffee and energy drinks/ shots. Here are some approximate caffeine counts: an 8 ounce cup of coffee has 95mg of caffeine, a 5-hour energy shot has 75mg and a Red Bull drink has 120mg of caffeine. While caffeine can enhance energy and focus, it can also wreck your sleep. Caffeine stimulates the nervous system, and this can prevent the mind and body from relaxing and falling into a deep sleep. Caffeine can remain elevated in the blood for 6 – 8 hours after ingestion, so consuming caffeine after 2pm is not the best idea, especially if you’re sensitive to it or already have trouble sleeping. In addition, regardless of when you consume it, you should limit caffeine intake to 200mg per day or risk losing sleep over it.
Rule 4: Watch naps during the day. While short power naps can be beneficial for some, taking long naps during the day can negatively impact your sleep. How? That wiley circadian rhythm again! Napping during the day confuses your internal clock, disrupting your sleep-wake cycle and potentially leaving you with problems falling asleep at night.
Rule 5: Try Melatonin. Melatonin is a naturally produced sleep hormone that tells your brain when it’s time to relax and head to bed. Melatonin supplements are an extremely popular over-the-counter sleep aid, helping people to fall asleep more quickly. I usually recommend between 2 and 4mg of melatonin at (or shortly before) bedtime. I find that some patients get daytime hangover from it, so be aware of that and possibly decrease the dose to see if that minimizes the hangover.
Rule 6: Regulate your sleep-wake cycle. How? By getting up at the same time every day and going to bed at the same time every day…. even on weekends. I know, that last bit is a bummer. Our old friend circadian rhythm is at work again here. The circadian rhythm is basically a loop, and irregular sleep patterns disrupt it and alter the melatonin levels that tell your body to sleep. The result? Not sleeping. I recommend that you go to bed at the same time every night and that you set an alarm to get up at the same time every day, no matter how tired you may be. After some time, you will probably find that you wake up on your own without the alarm and that the consistency of your schedule will give you better sleep quality.
7. Try additional supplements for sleep. There are a few dietary supplements that have been found to induce relaxation and help you sleep.
Glycine: This is a naturally produced amino acid shown to improve sleep quality. I recommend 3 grams at night.
Magnesium: This is an important mineral found in the body; it is responsible for over 600 biochemical reactions within the body, and it can improve relaxation and enhance sleep quality. I recommend 100-350mg daily; start at the lower dose and increase gradually if necessary.
L-theanine: Another amino acid, L-theanine can induce relaxation and sleep. I recommend 100–200mg before bed.
Lavender: A powerful herb with many health benefits, lavender can induce a calming effect on anxiety and help induce sleep. I recommend 160mg at night.
Rule 8: No alcohol. I’m sure we’ve all heard people say that a nightcap “helps them sleep better.” Don’t ever believe it…it’s total crap. Downing even one drink at night can negatively alter hormone levels like melatonin, disrupting the circadian rhythm and therefore sleep. In addition, alcohol is known to increase, or even cause, the symptoms of sleep apnea such as snoring, which also disrupts sleep patterns and causes poor sleep quality.
Rule 9: Create a cool, dark and quiet bedroom environment. Minimize external noise and light with heavy blackout curtains and remove devices that emanate artificial light like digital alarm clocks. Make sure your bedroom is a relaxing, clean, calm and enjoyable place. Keep the temperature very cool, I usually recommend 70 – 72 degrees, because the weight of blankets is very comforting. You can even buy weighted blankets for adults and children; I’ve heard many patients say they really relax the body which in turn helps them fall asleep.
Rule 10: No eating late at night. Late-night eating may negatively impact the natural release of HGH (human growth hormone) and melatonin, which leads to difficulty falling asleep. Also, I think that most of the time, people eat bad things late at night, things with a lot of sugar and things high in fat, like chips, candies, and cereal. These all interfere with sleep. Generally, when the body goes into a digestive mood, as it does after eating, it doesn’t want to sleep.
Rule 11: Relax and clear your mind. Many people have a pre-sleep routine that helps them relax to prepare for sleep. Commonly suggested for people with insomnia, pre-sleep relaxation techniques have been shown to improve sleep quality. Strategies can include listening to relaxing music, reading a book, taking a hot bath, meditating, deep breathing and visualization. Stress is a common reason for trouble falling asleep and poor sleep quality and quantity. If your problems are keeping you up at night, you have to come to some resolution on how you’re going to handle those issues in your life so that you can put them to rest, go to bed, and get some sleep.
Rule 12: Spend money on a good quality, comfortable mattress, good pillows and good linens. You’re going to spend a third of your life in your bed…don’t cheap out when it comes to the matress and bedding; spend the money. Make sure your mattress is large enough, comfortable and high quality. Studies have shown that quality mattresses significantly reduce back and shoulder pain. And buy good quality, high thread count (800 thread count minimum, but higher if you can) cotton sheets…they’ll get softer with every wash. Find pillows that feel most comfortable and supportive for you. You may have to try multiple pillows before finding the perfect one, but the search and cost are necessary, and your neck will thank you for it. A quality mattress and pillows and great linens can be an investment, but well worth it. You’ll have them for some time and you’ll be happier for it when you get in bed at night and go “Aaaaahhhh.”
Rule 13: No exercising at night. While daily exercise is key for a good night’s sleep, doing it too late in the day may cause sleep problems. This is because exercise acts like a stimulant, increasing hormones like epinephrine and adrenaline, which increase alertness. Alertness is the antithesis of the relaxation you need to fall asleep. Basically, exercise hypes you up, making it difficult or impossible to fall asleep.
Rule 14: No fluids before bed. While hydration is an absolute necessity for health, it’s best to restrict fluids for one to two hours before bed. You should also use the bathroom right before going to bed, as this may decrease your chances of waking in the night. The reason for this rule is fairly obvious: a full or partially full bladder will wake you up in the middle of the night to go to the bathroom, and that’s a total drag for you and likely for whomever shares your bed.
So those are my 14 rules for better sleep. And now I’ll say goodnight, sleep tight, and don’t let the bedbugs bite!Learn More
Ambien, generic name zolpidem, is the most commonly prescribed sleep aid, accounting for 85% of prescribed sleeping pills. It also ranks in the top 15 on the list of most frequently prescribed drugs in the country. Its popularity is clearly due to its efficacy. Zolpidem works as a hypnotic drug, meaning that it induces a state of unconsciousness, similar to what occurs during natural sleep. How does it do that? Zolpidem affects chemical messengers in the brain called neurotransmitters, specifically a neurotransmitter called GABA. By affecting GABA, it calms the activity of specific parts of the brain. One of the areas in the brain that is affected is the hippocampus. Along with other regions of the brain, the hippocampus is important in the formation of memory. Because of this hippocampal involvement,
zolpidem can cause memory loss, especially at higher doses, an effect colloquially referred to as “Ambien Amnesia.” If you take it and do not go to bed immediately as recommended, this is more likely to occur. When you get right in bed after taking it, a loss of memory is inconsequential…it doesn’t matter if you can’t remember lying awake for a few minutes before falling asleep. But there are many reports of people taking it and remaining awake and out of bed, and they commonly experience an inability to recall subsequent events shortly after taking it. Because of its effects on memory, there is some concern that zolpidem could affect long-term memory and contribute to the development of dementia or Alzheimer’s disease, though there has been no research to prove or disprove these possible associations. Zolpidem comes with a host of known side effects that range from weird and wacky to illegal and downright dangerous behaviors. Included are hallucinations, decreased awareness, disinhibition, and changes in behavior. Very serious problems may occur when someone who has taken zolpidem gets up during the night. They may exhibit very complex sleep-related behaviors while under the influence of zolpidem. These might include relatively innocuous sleeptalking, sleepwalking, sleep cleaning and sleep eating, to more disturbing behaviors like sleep cooking and sleep sex, to potentially deadly sleep driving. While in a confused state, a person on zolpidem may act in a way that is different from their normal waking behavior. This can lead to legal consequences, such as driving under the influence (DUI) or potentially even sexual assault charges stemming from disinhibited sexually charged behavior.
I have a long time patient named Deanna that takes zolpidem and regularly sleepwalks, also known as somnambulation for the Scrabble set. It happens that she has been a sleepwalker ever since she had the ability to walk, so being on the zolpidem now makes her nocturnal activities and behaviors really way out there. Just flipping back through her chart, I see she mentions: taking apart electronics and trying to put them back together with no success. Dumping all of her shoes out of their boxes onto her closet floor. Taking all of her clothes off their hangers and throwing them over her dining room chairs. Gathering all sorts of disparate items together, evidently whatever catches her eye at the time, and putting them in her oven. She said she learned that particular lesson the hard way. This one is whacked. She started “painting” a wall in her house….with a purple sharpie. She showed me a picture of that. She once found several pages of her stationery scrawled in words she knew she didn’t consciously write in a letter to someone, she didn’t know who. She brought that in. She said she would evidently clean in her sleep; she put shower gel all over the tile in her shower and “put things away” in odd places they didn’t belong in. She also sleep eats. Cereal, bread, ice cream, whatever she sees that looks good I guess. She regularly wakes up to a mess in the kitchen and destruction in the house. It used to really freak her out to see the evidence of activities she didn’t remember, but now she just feels unsettled as she surveys the damage from her night time escapades. But since it hasn’t ever been anything dangerous and because zolpidem works well for her, she doesn’t want to change it.
How is it that a person on zolpidem can achieve these complex behaviors while unconscious and asleep? It’s because the parts of the brain that control movement still function, but inhibition, consciousness, and the ability to create memory is turned off. Because of this, the person is disinhibited, and that can lead to unintentional actions and behaviors as discussed above.
Beyond zolpidem’s effects on memory, awareness, and behavior, there may be additional issues associated with its use. Some other common side effects include:
– “Hangover” or carry-over sedation, especially in women
– Loss of appetite
– Impaired vision
– Slow breathing rates
– Muscle cramps
– Allergic reactions
– Memory loss
– Inability to concentrate
– Emotional blunting
– Depression and/or suicidal thoughts
– Back pain
– Diarrhea or constipation
– Sinusitis (sinus infection)
– Pharyngitis (sore throat)
– Dry mouth
– Flu-like symptoms
– Breathing difficulties
– Palpitations (irregular heartbeat)
– Rebound insomnia
Any of these side effects could be bothersome and may interfere with the continued use of the medication. Sometimes the benefits of zolpidem outweigh the risks and/or side effects. If a symptom is particularly bothersome, discuss this with your prescribing doctor to see if an alternative treatment may be a better option for you.
If you take zolpidem, use it exactly as prescribed and get in bed immediately after taking it. It’s best to allow yourself at least 7 to 8 hours of sleep to help ensure avoidance of morning hangover effects. Keeping a regular sleep-wake schedule will also help. Taking zolpidem with other drugs that depress the central nervous system such as alcohol, opioid pain medications, or tranquilizers intensifies the sedative effects of zolpidem and increases the risk of overdose as a result of respiratory depression. Zolpidem is an abusable drug. Individuals who take it for non-medical reasons or at more than prescribed doses are at risk of experiencing intensification of adverse side effects, including the following:
– Excessive sedation
– Confusion and disorientation
– Lack of motor coordination
– Slow response times
– Delayed reflex reactions
– Impaired judgment
Men and women don’t metabolize zolpidem in the same way. Women metabolize it much more slowly, so they often wake up with a zolpidem hang over and feel cloudy in the morning. So an important note for women taking zolpidem is to be extra cautious about allowing at least 8 hours of sleep after taking it and to take lower doses of it due to the potential effects on morning function, especially driving.
Actor Roseanne Barr had probably taken a little too much when she “Ambien tweeted” a racist statement comparing an Obama aid to an ape. She admitted that she had taken zolpidem shortly before the 2am tweet that caused her eponymous show to be cancelled. Elon Musk, Mr. Tesla, can feel her pain. He shocked investors when he tweeted he was considering taking Tesla private at $420 a share and that funding was secured. He said he sometimes takes zolpidem because it’s either that or no sleep. Good thing he has people to protect him from himself when he’s in a zolpidem daze.
Zolpidem can be a safe and effective medication to treat insomnia, but if it affects your memory or causes sleep behaviors or other adverse side effects, you should probably consider alternative treatments for your insomnia. Hello Roseanne and Elon…that means you!!
I talk more about drugs for sleep like zolpidem and a host of other psychoactive drugs in my book, Tales from the Couch, available on Amazon.com.Learn More
For many people, sleep is an important part of their life. When interrupted by tension or anxiety, the loss of sleep can bring about depression. Anxiety sleep disorder treatment is typically no effort to find, specifically if the loss of sleep is occasional, as opposed to chronic.
In some cases, the person may have to consult their physician for a more particular depression anxiety sleep disorder therapy such as prescription medicine. Most of the time, sleep issues are a sign of other problems, and until the underlying problem is resolved, the sleep disorder will continue.
Among the most common sleep problems is tension, as individuals are unable to ease their mind enough to sleep. Often times after they do get to sleep, they awaken in the middle of the night thinking about what is causing their stress. For most, an effective depression anxiety sleep disorder treatment may be a sleep aid to help clear their mind so they can fall asleep quickly. For others, a time release formula might be needed to help them stay asleep throughout the night.
Some nonprescription sleep aids might help at first, but, their effectiveness is iffy as a depression anxiety sleep disorder solution. Finding ways to take care of depression or stress will be more effective in the long term. Many sleep aids affect the nervous system to put an individual to sleep. Those dealing with depression anxiety sleep disorder, treatment may consist of drugs that work as an antidepressant, as well as calm their stress and anxiety.
Many of these have unwanted results such as building an addiction; requiring continued use to help them get to sleep. The good news is that many antidepressants prescribed by their physicians can end the depression and help them sleep without extra sleep aids.
For periodic problems with sleeping, over the counter medicine can help them sleep. For depression anxiety sleep disorder treatment, a physician can help identify the causes of depression and anxiety, and remove them. If it is a temporary circumstance, such as a major life-changing event, short-term aid can eliminate any long-lasting effects.
For a few, depression anxiety sleep disorder treatment could continue for many years without any obvious environmental cause of the depression or stress. As soon as the causes have been recognized and removed, the physician can then prescribe a continuing depression anxiety sleep disorder treatment to assist the patient with their sleep disorder.Learn More
For many people who are up all night, the internet has become a safe-haven for entertainment and relief. However, did you realize that you can actually get help and relief for your sleepless nights by joining one of the many insomnia online forums that have become available.
These forums are populated with hundreds of people, just like you, who also struggle with sleeplessness. Lots of people are embarrassed to join one of these forums, and to admit that they suffer from sleeplessness. In order to help relieve you from that embarrassment, we have put together a list of the leading reasons why anyone who has trouble sleeping can benefit from signing up with insomnia online forums.
If you have been dealing with insomnia for any extended length of time, you may have a hard time discussing it with your loved ones. Sleeping disorder online forums relieve this uncomfortable circumstance by enabling you to join as an anonymous user, and get advice from total strangers.
It has long been stated that occasionally, a stranger is simpler to talk with than a buddy. These online forums certainly prove that theory, as there are hundreds of people similar to yourself you are willing to lend an ear, as well as their own recommendations and ideas, to those struggling with sleepless nights.
One of the nicest aspects of insomnia forums, is that you can join using any name you want. You don’t ever have to offer your actual name, and so, there is no possibility of people discovering who you really are, if you don’t want them to. For instance, you could be a sleepless-mommy or dead-tired-daddy if you wished to be. Nobody ever needs to know your real identification.
While there are numerous doctors that visit sleeping disorder forums, what you find mostly are genuine individuals who are really suffering from the exact same thing you are. You will find out about treatments and natural remedies that you may not have known about before; all from individuals who have actually been there. Recommendations from a physician is wonderful, but in some cases, what works best are the tried and true techniques that others have used and been helped by.
You should not count on insomnia online forums, nonetheless, if you feel that your insomnia might be chronic in nature. Persistent sleeplessness can have disastrous results on your body and mind, and must be treated by a doctor right away. However, if you only experience moderate cases of insomnia, sleeping disorder forums might be just the thing for you.Learn More
Not being able to sleep during the night can truly be frustrating. Yes, no one has actually been reported of passing away because of lack of rest. However, lack of sleep has been identified as one of the primary causes of reduced productivity of people throughout the day. If you are among those individuals who have been suffering from lack of sleep that you cannot operate well throughout the day, it would be a great idea for you to seek treatment for insomnia.
Discovering an effective treatment for sleeping disorders is crucial, particularly if you have been losing sleep for more than a week. According to experts, losing a lot of sleep can weaken the immune system of our bodies. When the defense system of our body is weakened, we become prone to various kinds of health problems.
The very best way to find an effective treatment for sleeping disorders is to seek advice from a professional. Find a specialist on sleep disorders. Ask for an appointment with the specialist to discuss your sleep disorder. When meeting with the specialist, see to it that you ask questions regarding your circumstance and explore your options with the assistance of the specialist. Note that there are various sorts of treatment for sleeping disorders, so you have to pick out the one that is suitable for you.
When choosing the type of treatment for sleeping disorders, consider the effects of this treatment to your body. Do not just choose a sleeping pill right away. Yes, taking that tablet will be much easier, however, that might not be the best that you can do. Always bear in mind that treating a disorder with drugs is not always favorable. If you can discover some natural ways to treat your sleeplessness instead? A natural treatment for sleeplessness does have a great deal of benefits over those medicines. For one thing, natural treatment procedures do not have side effects, and they cost even less compared with those drugs.
Natural treatments for insomnia consist of simple and practical activities that you can do to help you relax before bed time. A good example of a natural treatment for a sleep disorder is a change in lifestyle. For instance, if you love drinking coffee throughout the day, as well as before bedtime, cut down on that habit.
Do not drink coffee or other kinds of beverages that has caffeine in it at least three hours before bedtime. Keep in mind that caffeine in your blood will keep you awake longer. If you get rid of the source of caffeine in your blood hours before bedtime, you will have better chances of getting to sleep easily.Learn More
If your child awakens in the middle of the night shouting in sheer terror, they might be experiencing pavor nocturmus, commonly referred to as sleep terror disorder. Frequently, this is confused with nightmares, but there is a major difference, because the child often remembers exactly what caused their nightmare while they might not wake up at all throughout an episode of sleep terror disorder, and will not remember being awake.
Episodes of sleep terror disorder are prevalent in children between about three and eight years of age, although they can be experienced by older kids, as well as adults. The specific reason for sleep terror disorder is unknown, however, it is typically associateded with stress or lack of rest. During an episode, which can be frightening to the parents, normally the episode will last between ten and twenty minutes, after which the child will go back to sleep and have no memory of the event the next morning.
Figuring out the difference between sleep terror disorder and the child awakening during a bad dream should be simple enough, as the kid might have the ability to explain about monsters under the bed, and falling through space when they have a nightmare. While these frightening dreams happen during the REM sleep stage, the memory of the occasion is typically vivid when the child gets up. They will also be awake instantly after the dream, while being comforted by a parent.
Seldom will a child suffering from sleep terror disorder have any idea the next day of what terrified them awake. While a parent is holding the child throughout an episode, the child will continue to be asleep, entirely unaware they are having a problem. Regardless of repeated attempts by the parents to calm the child, they will not be consciously awake and will be incapable to talk about what triggered the fear.
If a child continues to suffer from sleep terror disorder, removing the environmental causes of the anxiety and seeing to it the child is getting appropriate sleep most evenings can really help decrease the number of sleep terror disorder episodes. In some serious and lasting cases, the physician might suggest sedatives to remove the tension, and help the child sleep throughout the night.
Parents, however, should not try to self-diagnose or medicate the child without speaking with a medical professional. There might be some concealed causes of anxiety to the child that the physician can detect and help eliminate. Usually, after the age of eight, the sleep terror disorder will vanish by itself.Learn More
If you are struggling with a sleep disorder of any kind, you can rest assured that you are not alone. In fact, there may be as many as 40 million individuals in the United States alone who are presently experiencing some kind of sleep disorder.
Some of these individuals have turned to their physician for help, while others are using over the counter remedies or merely suffering through. The good news is that there are symptoms that can be used to accurately diagnose this condition so that effective treatment options can be explored. Sometimes the remedy can be as simple as way of life changes that will help to promote an excellent night’s sleep. In other cases, your physician might recommend medication or suggest therapy as a means of overcoming your sleep disorder.
While it may seem quite simple to recognize a sleep disorder, a lack of a good night’s sleep is not the only sign that doctors will search for. Various other symptoms might include fatigue or irritability throughout the day, inability to focus or remember things, slow reactions, emotional outbursts, and an overall appearance of looking worn out.
You might also drop off to sleep easily during the day, even when carrying out activities like driving or working at your desk. You might turn to caffeinated drinks and various other methods to stay awake and alert throughout the day. Any or all of these symptoms might also point to a possible sleep disorder, and needs to be gone over with your physician.
Treatment of a sleep disorder will depend in part on exactly what type of condition you are diagnosed with. Insomnia, the inability to sleep or remain asleep throughout the night, is commonly dealt with through way of life modifications and occasionally prescribed sleep aids. Depending upon the reason behind the sleeping disorder, therapy may also be suggested. Another common sleep disorder, sleep apnea, should be identified and treated by your doctor, because there are potentially major medical problems that can result from this disorder. Treatment will frequently include devices to use during sleep, behavioral changes, and occasionally, surgery.
There are various other kinds of sleep disorders that are not as typical, but will need their own specialized treatment strategy. The best individual to identify and treat your sleep disorder is your doctor. If you are experiencing any of the above symptoms, and you suspect that a sleep disorder is the reason, it is a good idea to make an appointment with your doctor to discuss your diagnosis and treatment alternatives.Learn More
As an increasing number of people find it difficult to sleep during the night for numerous reasons, many kinds of sleep disorder treatments have actually been invented through the years. Many of these sleep disorder therapies are quite effective, and there are likewise a few of them that simply just don’t work at all.
The effectiveness of a specific sleep disorder therapy is usually influenced by the state of emotions and the environment of the person who is struggling with sleeplessness. Thus, before an individual begins on a sleep disorder treatment, he or she ought to make it a point to delve much deeper into the cause of his or her insomnia. Understanding the causes of insomnia will make treatment easier.
Among the most highly recommended sleep disorder treatments is basic relaxation. According to specialists, the most common cause of sleeplessness is stress. A lot of people who are hyperactive during the day, and those who are handling some personal issues are typically too keyed-up to sleep during the night. As a result, these people lie awake in bed through the wee hours of the morning. Some of them fall into a fitful sleep, and they commonly get up several times in the night. In any case, the outcome is often the same. Not having the ability to sleep at all or fitfully sleeping through the night can make a person feel worn out and drowsy during the day.
To fight off insomnia, a person who is under stress must learn the best ways to relax and loosen up before going to sleep. There are numerous relaxation methods that one can adopt to calm his/her nerves before bedtime. A few of these relaxation techniques consist of yoga exercises, hypnosis or simply reading a great book.
Battling off sleeplessness can be rather complicated for many people. A great deal of people are simply too stressed out and too edgy that they require more potent sleep disorder treatment like drug treatment to help them relax and get some sleep. In cases like this, the sufferer should consult his or her physician initially prior to taking any medications.
Taking over the counter drugs is not actually a great idea. Although taking sleeping pills can be very helpful at times, taking the pill is not actually advisable in the long run. Like any other forms of drugs, sleeping pills can have some adverse effects on the body. Furthermore, there is likewise the danger of becoming dependent on the drug.Learn More
The trouble with some females is that they frequently suffer from pregnancy and insomnia, and even regardless of feeling extremely exhausted and tired, sleep is something that will continue to elude them. It frequently can become a brand-new challenge that impacts both the pregnancy and their own psychological makeup as well.
Such females should follow particular steps in order to come to terms with their pregnancy and insomnia problem, and an initial step in that direction would be to wind down their day at least thirty minutes prior to their bed time.
To get over the difficulty of pregnancy and insomnia, it is suggested for patients to get rid of any tasks that are of a stimulating kind, as well as to remember to not indulge in conversations that lead to stimulation. Therefore, not making phone calls or viewing television is advised, and special mention must be made of having to stay clear of paying attention to newscasts referring to world catastrophes, which are usually highlighted in the ten o’ clock news each night.
It is also a much better idea to take a warm herbal bath with lighting not much brighter than that of candlelight, which ought to promote relaxation prior to turning in for the night. It also happens that in pregnancy and insomnia, mothers-to-be commonly wake up in the middle of the night because of maybe the movement of the unborn baby, or due to various other reasons; in such situations, when sleep does not come to them, it would be advisable to just lie and rest. If you keep a light snack by the bed, you should be able to have something to chew on in the middle of the night rather than having to get up and fetch something out of the refrigerator.
A typical issue in pregnancy and insomnia is that mothers-to-be frequently let insomnia get to them and become anxious and lose rest stressing, which only makes for even more sleep loss. Relying on sleeping pills as a solution is also not suggested, considering that it can endanger the health of your unborn infant. Rather, you would be much better off if you accept your pregnancy and insomnia for what it is. Just let it be because with time it too will have gone by.
Even reading a book at night is a method of conquering pregnancy and insomnia, while getting up and carrying out some activity that is not too stimulating will likewise help, as too will taking short naps throughout the day.Learn More
It’s 3 a.m., you cannot sleep. It’s been like this for many nights now. You understand that there are pills available that you can take to help you sleep, but, a lot of of them have abnormal side effects, and you certainly don’t want to become addicted to anything. Their is still a healthy alternative. You do not have to take a prescription to help you sleep. There are literally hundreds of natural remedies for sleeping disorders just waiting to help you get a good night’s rest.
A lot of individuals have forgotten the older, natural remedies for sleeplessness. It’s a shame, actually. These tricks and tips have been around for hundreds of years, helping folks get a great night’s sleep without using any drugs whatsoever. Our specialists have scoured the world over to find as many all natural treatments for sleeplessness they might discover; and they have brought them all here for you. So settle in, have a read, and, hopefully, you will discover a natural remedy for your sleeping disorder.
When it concerns all natural treatments for sleeplessness, there’s just no beating good old-fashioned chamomile tea. This aromatic tea is a mix of the dried leaves and flowers of the chamomile plant. Consuming two or three cups of this tea is a time honored tradition for those dealing with sleeping disorders.
If chamomile isn’t your style, there are a great number of various other herbal, natural remedies for insomnia. These remedies ought to be taken as directed on the bottle, or by your physician; usually two or three times every day. These natural herbs for sleeplessness include cat nip, valerian root, and vervain tea.
Various other natural treatments for sleeplessness aren’t ingested at all. Taking a bath with lavender fragrance in it is a tried and true technique for getting into a relaxed, sleepy state. This method has actually been proven to be so effective, in fact, that many manufacturers now offer baby bath with lavender fragrance.
Forget your grandma’s cup of hot milk, today’s natural remedies for sleeplessness include foods that should be found in every healthy diet. Believe it or not, each of the following foods can help your body to unwind at bed time, and will help you get a great night’s sleep: bananas, spinach, turkey, yogurt, and lettuce. Make sure to include a lot of these foods in your diet, and you will be able to see a dramatic reduction in your insomnia.
While there are lots of natural remedies for insomnia, they are not all suitable for everybody. If you are pregnant or nursing, talk with your doctor before implementing any of the preceding natural remedies for insomnia into your daily routine.
Everyone deals with a sleep deprived night at one time or another. There are a lot of reasons why sleep can be disturbed for a night or two, however, when sleep deprivation ends up being a chronic condition, it can lead to a lower performance at work, or a negative impact on your overall life.
Not getting sufficient quality rest can even influence your body physically, making you more vulnerable to illness and accidents. This is why it becomes so essential to seek insomnia treatment alternatives if you are experiencing the signs of sleep deprivation over the long term.
Prior to determining which insomnia treatment will work the very best for you, it is great to understand exactly what insomnia looks like. For some, this sleep disorder will suggest the inability to fall asleep during the night. Others will have problems with waking in the middle of the night, or very early in the morning, and not being able to get back to sleep. The end result will be the exact same daytime tiredness and irritability, failure to concentrate, and difficulty staying awake.
If you are experiencing any of these signs, it might be time to talk to your physician about the very best insomnia treatment for you. If your insomnia is still relatively moderate, you might be able to treat the problem by yourself at home. This might consist of modifications to your routine, like staying clear of a heavy meal, or exhausting exercise too close to bed time. You might attempt following a routine evening schedule that consists of a late night bath or various other methods for relaxing. You will likewise want to ensure that you go to bed and get up at the exact same time every day to help train your body to an appropriate sleep time. For many, simple behavioral changes like these are sufficient sleeplessness treatments, and no additional intervention will be needed.
If you find that you need extra insomnia treatment alternatives, your physician will have more remedies for you to try out. These may consist of a medicine that can be used temporarily, in case your sleep deprivation is influencing your life in apparent and unfavorable ways. Your doctor might have additional behavior modifications that you can attempt that will attend to the underlying reasons behind your insomnia. In some cases, your doctor may likewise recommend counseling as an insomnia treatment. The good news is that there are many options in sleeping disorder treatment that will help get you back on the path to an excellent night’s sleep.Learn More
For many people sleeplessness is an occasional annoyance, triggering them to lose rest for a night or two while for others it is a continuous problem. For occasional sleeplessness, medicines offered over the counter can assist an individual sleep and stay asleep throughout the night, nonetheless adverse effects of a few of these medications might cause other troubles. In addition, taking sleeplessness medicines can mask other, more serious rest disturbances.
Usually, insomnia is called the inability to drop off to sleep and remain asleep, and some of the typical causes consist of anxiety and pain. A number of various insomnia medications can assist the person get to sleep. However, some of them can produce a reliance on the medicines after long-lasting use. In addition, some of the over the counter insomnia medicines include antihistamines that can cause an adverse communication with other medications being taken.
Some of the more recent insomnia medications on the market work well in helping people sleep rapidly but throughout tests lots were getting up in the middle of the night. They were then reformulated for an extended release of the medicine to allow them to continue to be sleeping throughout the night. One of the cautions that included many of the present crop of medicines is that the individual must have the time to sleep a minimum of seven or eight hours as getting out of bed faster can trigger drowsiness throughout the day.
In most cases insomnia is a sign of other issues and taking insomnia medicines that are aimed at the issue can be much better than simply taking a sleeping pill. As an example, one medicine is aimed at the sleep cycle and not at depressing the central nerves. This helps reset the circadian clock without the danger of being mistreated and has shown to be safe for lasting use.
Antidepressants might be suggested as one of the sleeplessness medicines for those who have trouble sleeping due to tension or depression. The medication deals with the depression, which in turn normally helps the individual sleep faster. Some of the older sleeping disorder medicines were made to remain in the system longer and are utilized for sleep disorders such as sleep walking and night terror.
These medicines can trigger fatigue during the day along with develop a dependency where the person will always require them to drop off to sleep. These insomnia medicines are not offered over the counter and needs to not be taken unless directed by your physician.Learn More
Dyssomnias are a broad classification of sleeping disorders that make it difficult to get to sleep, or to remain sleeping.
Dyssomnias are primary disorders of initiating or maintaining sleep or of excessive sleepiness and are characterized by a disturbance in the amount, quality, or timing of sleep.
Patients may complain of difficulty getting to sleep or staying asleep, intermittent wakefulness during the night, early morning awakening, or combinations of any of these. Transient episodes are usually of little significance. Stress, caffeine, physical discomfort, daytime napping, and early bedtimes are common factors.
Disorders in this Category
Insomnia (or sleeplessness) is most often defined by an individual’s report of sleeping difficulties. While the term is sometimes used in sleep literature to describe a disorder demonstrated by polysomnographic evidence of disturbed sleep, insomnia is often defined as a positive response to either of two questions: “Do you experience difficulty sleeping?” or “Do you have difficulty falling or staying asleep?”
Thus, insomnia is most often thought of as both a sign and a symptom that can accompany several sleep, medical, and psychiatric disorders, characterized by persistent difficulty falling asleep and/or staying asleep or sleep of poor quality. Insomnia is typically followed by functional impairment while awake. One definition of insomnia is difficulties initiating and/or maintaining sleep, or nonrestorative sleep, associated with impairments of daytime functioning or marked distress for more than 1 month.”
Insomnia can be grouped into primary and secondary, or comorbid, insomnia. Primary insomnia is a sleep disorder not attributable to a medical, psychiatric, or environmental cause. A complete diagnosis will differentiate between:
- insomnia as secondary to another condition,
- primary insomnia co-morbid with one or more conditions, or
- free-standing primary insomnia.
Types of insomnia
Insomnia can be classified as transient, acute, or chronic.
- Transient insomnia lasts for less than a week. It can be caused by another disorder, by changes in the sleep environment, by the timing of sleep, severe depression, or by stress. Its consequences – sleepiness and impaired psychomotor performance – are similar to those of sleep deprivation.
- Acute insomnia is the inability to consistently sleep well for a period of less than a month.
- Chronic insomnia lasts for longer than a month. It can be caused by another disorder, or it can be a primary disorder. Its effects can vary according to its causes. They might include muscular fatigue, hallucinations, and/or mental fatigue. Some people that live with this disorder see things as if they are happening in slow motion, wherein moving objects seem to blend together. Can cause double vision.