The ABC’s of ZZZ’s

Pixmac000084096124By Moshe Lewis and Raymond Chou

The Importance of Sleeping Well

One of my patients made an amusing observation this week: as infants we sleep most of the time. Children and teens, on the other hand, often want to stay up as long as they can. By the time we enter
college, pulling all-nighters by any means necessary is the norm. In adulthood, the shoe is on the other foot; it seems we just can’t find a way or enough time to sleep.

So why is it so difficult for most to get their required amount of sleep? Perhaps our sleep-starvation is partly because we forget just how important sleep is to our health and well-being. There is still significant debate about the reasons why we actually need sleep. However, medical science and practical experience have repeatedly demonstrated that in order for sleep to be effective, it must be deep and prolonged. This is so that the body can proceed properly through the different stages of sleep.

The Stages of Sleep

During a healthy night’s rest, we cycle between four equally important stages of sleep. In stage one, or “drowsy sleep”, we are aware of noises around us and can be easily awakened. Often we will experience
a rush of ideas and even light hallucinations as the body begins to relax and unwind.

Generally, we spend about five to ten minutes in stage one before proceeding to stage two, a deeper level of sleep. Here we lose consciousness and muscle tone. Our bodies start their reparative
process and begin to relax. Though we quickly drop from stage two to stage three, we return to stage two over and over; in total, we spend about half of our night in stage two. As we progress to our deepest sleep level stage three, our relaxation, repair, rejuvenation and restoration increases. Skeletal muscles of the limbs lose their tension and go limp. Smooth muscle cells lining the blood vessels relax and dilate. Our blood pressure falls; our heart rate decreases; our body temperature drops; and our respiration
becomes less frequent. This increases the blood flow to all tissues in the body, allowing them to get bathed with the oxygen and nutrients found in the blood. This influx of blood also removes waste products and toxins that have accumulated throughout the day.

During stages two and three, our peaceful deep sleep is periodically interrupted by a dramatic change. The brain becomes very active, sending nerve impulses throughout the body. As a result, blood pressure, heart rate, body temperature and respiration all increase. Our muscles begin to contract, even those that control eye movement. These eye movements give this active final sleep stage its name: REM, or the rapid eye movement stage.

Try to establish a routine to let your body and mind know the plan beforehand, going to sleep at the same time every night might be a good way to start. But perhaps the most interesting feature of REM sleep is dreaming.

Experts believe that dreaming is a means for our bodies to deal with stress at a subconscious level — a way to heal ourselves intellectually, emotionally, cognitively, psychologically and
spiritually. This psychological rejuvenation can happen directly or indirectly through the symbolization and role-playing in our dreams. Without our REM stage dreams, many of the stresses that we internalize throughout the day would continue to build. This might lead to irritability, poor concentration, emotional dysfunction and diminished physical performance. For this reason, insomnia and sleep disorders can effects far beyond a few restless hours at night. Sleep deprivation affects our mental well-being as well as our physical acuity.

What About Sleep Aids?

It’s impossible to mention the devastating effects of poor sleep without a word about medical sleep aids. In the last ten years we’ve seen a boom of prescription sedatives, each with a television ad promising peaceful slumbers and bright mornings. Though these medications are helpful on a temporary basis, it’s important to remember that these products are not intended for ongoing use, and that they may have numerous side effects. This is doubly true for over-the-counter drugs like antihistamines. Though many of the newer the newer formulations have been designed to minimize side effects, they simply should not be considered a permanent cure. It’s always best to discuss ongoing sleep problems with your doctor.

The Melatonin Mystique

One of the most provocative prescription sleep aids is melatonin. In its natural form, melatonin is a hormone produced in the body of most living things. Unlike other familiar hormones like seratonin, which can be produced at any time, melatonin only comes out at night—darkness affects the production of melatonin, and in turn melatonin seems to help entrain us to a 24-hour cycle of wakefulness and sleep.

Prescription melatonin is appealing because it isn’t a sedative– it simply boosts the melatonin present in our own bodies. Despite melatonin’s current popularity and notoriety in the press, it remains controversial and the effects of its long-term use are unknown. Melatonin also has side effects, which can include headaches and stomach problems. Therefore, it is important to talk to your healthcare provider to determine the right dosage for you.

Tips for a Good Night’s Sleep

It has been estimated that 90 million Americans suffer from a sleep disorder at one time or another in their lives. Those of us who are free of medical disorders are still susceptible to poor sleep habits. If you’re having difficulty capturing a full night of rest, try these simple tips to cultivate better sleep practices and happier mornings.

1. Darken the room so your brain releases more of its own melatonin for better sleep.
2. Try not to eat or drink much just before bed, and try not to take medications with stimulants—for example, avoid antidepressants, caffeine, Ritalin, and Straterra. Food and stimulants shorten the REM
stage in unhealthy ways.
3. Turn off the television and radio an hour before bedtime. Decreasing stimulation will help to ease your brain into a state of restfulness.
4. Incorporate restful practices into your waking life. For example, try yoga, or take time to pamper yourself at a spa or with a massage.
5. Take vacation time and use your paid time off, especially when it does not accrue year to year. Fatigue builds over time, so be kind to yourself.
6. Take naps, especially on the weekend when there is some extra time.

Sources
 Wald, Matthew L. “The Costs of Sleeping on the Job.”
 http://www.webmd.com/sleep-disorders/excessive-sleepiness-10/sleep-101
 http://www.webmd.com/sleep-disorders/stages-of-sleep
 http://www.webmd.com/sleep-disorders/tc/melatonin-overview
 http://www.aasmnet.org/Resources/FactSheets/Insomnia.pdf

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Author: fizzniche

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