• Shruti GOCHHWAL

Sleep

Sleep is a recurring state of mind and body in which the individual is in a state of altered consciousness. It is characterized by reduced muscle activity and inhibition of voluntary actions.

We do not have a definitive answer as to why do we need sleep but that we do. We are all aware that we need to sleep at least once in 24 hours.

The human body follows circadian rhythms. Circadian rhythms refer to a 24-hour cycle of the human body. Sleep is an essential part of this cycle.

Stages of Sleep

Sleep cycles have different stages. These stages were detected using EEG (electroencephalogram). The stages of sleep are:

  1. Non-rapid eye movement

Non-rapid eye movement sleep has 4 stages.

  1. Stage 0: This is the stage that occurs between lying down and falling asleep. It consists of 1-2% of the sleep cycle.

  2. Stage 1 or Dozing: Stage 1 is the transition period between wakefulness and sleep. It lasts for 5 to 15 minutes.

  3. Stage 2 or Unequivocal Sleep: This stage starts with the body temperature dropping and the heart rate slowing down. Stage 2 lasts for 20 minutes and people become less aware of their surroundings.

  4. Stage 3 or Deep Sleep Transition: Deepest sleep occurs in stage 3. The breathing rate and blood pressure drop along with the relaxation of muscles.

  5. Stage 4 or Cerebral Sleep: It is also called slow-wave sleep. Stage 4 amounts for 10-20% sleep. Its characteristics are similar to stage 3. Studies suggest night terrors occur in this stage of sleep.

  6. Rapid Eye Movement

This stage is also known as the paradoxical stage because in this the brain becomes more active while the rest of the body muscles become more relaxed. It is characterized by rapid eye movement and dreams.

In a normal night’s sleep, the body undergoes 4-5 sleep cycles. All stages of the sleep cycle have benefits and a good sleep contains all of them.

Functions of sleep

  1. Restoration: Sleep serves as the restoration period of the body. The human body utilises the sleep cycle to remove metabolic waste products and reduce damaging components such as reactive oxygen species which are needed when the individual is awake.

  2. Memory Processing: It is accepted by a majority of experts that sleep is essential in long term processing and recalling experiences.

  3. Dreaming: Many experts have argued that dreams are an essential component of our lives. The contents of dreams are often linked with the mental health of a human being.

How much sleep do we need?

The amount of sleep required for effective functioning can vary among individuals. However, according to the National Sleep Foundation’s sleep time duration recommendations: methodology and results summary, the required sleep according to the age group is:

AgeSleep NeedsNewborns (0-3 months)14-17 hoursInfants (4-11 months)12-15 hoursToddlers (1-2 years) 11-14 hoursPreschoolers (3-4 years)10-13 hoursSchool-age Children (5-12 years)9-11 hoursTeenagers (13-17 years)8-10 hoursAdults (18-64 years)7-9 hoursOlder Adults (65+ years)7-8 hours

Credits: Pexels Caption: Infants require more sleep than adults.

Sleep Disorders:

A group of conditions that affect the sleeping pattern of an individual are known as sleep disorders. The International classification of sleep disorders classifies them into the following categories:

  1. Insomnia:

The inability of falling asleep or sustaining sleep is called insomnia. Insomnia is caused by the following conditions:

  1. Stress

  2. Chronic illnesses

  3. Exhaustive Work Schedule

  4. Medications

  5. Caffeine, Nicotine Alcohol

Credits: Pexels Captions: Drinks that contain caffeine can cause insomnia.

Treatment of Insomnia: The treatment of insomnia focusses on inducing sleep. Various therapies such as stimulus control therapy and light control therapy can be used to induce sleep.

The following medications are widely used to induce sleep in patients suffering from insomnia:

  1. Temazepam

  2. Triazolam

  3. Zaleplon

  4. Zolpidem

  5. Sleep Related Breathing Disorders

These are the disorders that cause difficulty in breathing while an individual is asleep.

The common sleep related breathing disorders are:

  1. Central Sleep Apnea: This condition occurs when the brain does not send a signal to the muscles to take a breath.

  2. Obstructive Sleep Apnea: This occurs when the airway through which muscles take a breath is obstructed while sleeping.

Treatment for Sleep Related Breathing Disorders:

‘The treatment focuses on ensuring that the airway remains open.

The following devices and surgical treatments are used:

  1. Continuous Positive Airway Pressure Device

  2. Bilevel Positive Airway Pressure Device

  3. Tissue removal

  4. Jaw Repositioning

  5. Tissue Shrinkage

  6. Hypersomnia

Excessive sleepiness that interferes with day time activities is called hypersomnia. It is characterized by loss of productivity and excessive tiredness.

The causes of hypersomnia are

  1. Alcohol and Drug Abuse

  2. Head Injury

  3. Lack of sleep

  4. Depression

  5. Narcolepsy

Narcolepsy is a neurological disorder that causes uncontrollable daytime sleepiness. The patient can suddenly fall asleep during any activity.

The cause behind Narcolepsy is not known.

The treatment for hypersomnia includes the following medication:

  1. Antidepressants

  2. Sodium Oxybate

  3. Modafinil

  4. Circadian Rhythm Sleep Disorders

These are the disorders that affect the circadian clock or the internal body clock. They are observed in the following individuals:

  1. Shift workers

  2. Travellers who travel across time zones

  3. Pregnant Women

  4. People with Alzheimer’s

  5. Menopausal Women

Credits: Pexels Caption: Travelling between time zones can cause circadian rhythm sleep disorders.

The treatment focuses on readjusting your body’s internal clock. Some methods to do that are:

  1. Chronotherapy

  2. Improving Sleep Hygiene

  3. Lifestyle Changes

  4. Bright Light Therapy

  5. Parasomnia

Parasomnia is a sleep disorder in which the affected individual shows abnormal behaviour while sleeping. Abnormal behaviour could be talking or performing certain tasks.

In parasomnia, the individual is unaware of the surroundings. This can result in self harming activities.

It can be caused by depression, anxiety, stress and Post Traumatic Stress Disorder.

Types of Parasomnia are:

  1. Sleep Walking

  2. Sleep Talking

  3. Sleep-related groaning

  4. Night Terrors

  5. Bedwetting

  6. Confusional arousal

  7. Sleep Related Eating Disorder

  8. Sleep Texting

  9. Sexsomnia

  10. Sleep Driving

Medications for Parasomnia include

  1. Dopamine agonists

  2. Antidepressants

  3. Benzodiazepines

  4. Levodopa

  5. Sleep Related Movement Disorders

Involuntary movements that occur during sleep. They are caused because of nervous system disorders.

The most common sleep related movement disorders are:

  1. Restless Leg Syndrome

  2. Periodic Limb Movement Disorder

The causes of these disorders are not known. Some individuals have shown improvement with drug treatments while the same drugs have made the conditions worse in others.

Symptoms to Watch Out for

Sleep disorders can have a harmful effect on your life. If you notice any of the following symptoms, you should consult a doctor.

  1. Sleepy during day time

  2. Difficulty in falling asleep

  3. Urges to move while sleeping

  4. Irregular sleep cycle.

  5. Performing activities while sleeping.

Diagnosis of Sleep Disorders

The diagnosis of sleep disorders is done by observing sleeping patterns in detail. The following methods are used:

  1. Polysomnography: A full sleep study in which qualified medical professionals observe people in their sleep.

  2. Multiple Sleep Latency Test: This measures the daytime sleepiness of an individual

  3. Epworth Sleepiness Scale: It is a questionnaire that asks questions about an individual’s sleeping pattern.

Tips to Help you Sleep Better

There are times when it is difficult to fall asleep even if you are not suffering from a disorder. These tips can help you fall asleep. They can also be used by people suffering from insomnia.

  1. Maintaining a Proper Sleep Cycle: Setting a time to wake up and a time to go to sleep can be your 1st step in improving your sleep cycle. The waking up time should be strictly followed and your body will try to adapt.

Credits: Pexels Caption: Waking up at the same time every day is essential for maintaining your sleep cycle.

  1. Eating Before Bed: Avoid having a meal or drinking anything right before you go to bed. A buffer of 1 hour should be there.

  2. Reduce Stress: Stress is one of the primary causes of insomnia.

  3. Workout: Regular exercise helps in improving your sleep cycle.

  4. Avoid Alcohol and Stimulants: Alcohol and stimulants such as caffeine can have harmful effects on your sleep cycle and should be avoided.

Takeaway

A proper sleep cycle is essential for a healthy human being. Sleeping the right amount of time is important to ensure health and productivity.

If you have trouble sleeping or you observe any of the above-mentioned symptoms then you should see a doctor. Sleep disorders have many treatment options. Lifestyle changes can also help in improving your sleep cycle depending on their cause.

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