I can’t get no sleep
We spend half of our lives sleeping, so why don’t we prepare our bodies better for such a vital activity? Criss Noice, Venetia Rainey and Holly Thomas look at the science of sleep, dreams, and the curse of insomnia.
You probably don’t spend much time thinking about sleep. For most its just a necessary part of the daily routine, something to be factored in during those early hours in the morning when there is nothing else to do anyway.
Your body, however, is constantly thinking about it. As the course of a normal day comes to a close, the brain becomes overworked, much like an old computer when it overheats, and needs to find a way to shut down. Studies have shown that neurons in the brain stem release an inhibitory neurotransmitter called adenosine that increases in its levels throughout the day. As the day draws in, adenosine levels will get to a point where they will begin to counter the effects of serotonin and other stimulants which keep the mind active when we are awake, thus aiding the process of falling asleep.
Sleep can be divided into two different types: Rapid Eye Movement and Non-Rapid Eye Movement (REM and Non-REM). Non-REM sleep occurs before REM sleep, and consists of four separate stages.
Stage 1 describes the lightest state of sleep, so light that if you were disturbed you would not even feel as if you had been asleep. During this period, which normally only lasts a few minutes, your muscles relax and your breathing slows down.
Stage 2 sees a burst of electrical activity in your brain, otherwise known as spindles, which conversely slows down your brain waves even more. It is during this 15-20 minute stage that most sleep talking and sleepwalking occurs.
In stage 3 the brain enters deep sleep mode, with even slower waves (Delta) being emitted and simple dreams beginning to appear. It is hardest to wake someone at this point in the cycle.
Stage 4 is the most important stage of sleep for teenagers, as growth hormones are released, and the body repairs itself. The older you get, the less stage 4 sleep you need, and once over the age of 70, stage 4 sleep is non-existent. These last two stages of deep sleep last about 30-40 minutes. After stage 4 the brain retreats quickly back through the previous stages, finally entering the REM stage.
This is the most interesting stage. The brain shows a sudden surge in activity, and as the heartbeat quickens and the eyes dart rapidly from side to side, sexual arousal can occur, and dreams become more vivid and more complex. It is during this stage that the brain “rests” and restores its memory capabilities. Freud believed that dreams during this period were sub-conscious manifestations of repressed events from during the day, and that dreaming was essentially about wish-fulfillment, things that we do, or don’t, want to happen to us. The body also paralyzes the main muscles, which explains why you sometimes feel that you can’t run or scream in nightmares. This is a self-defense mechanism to stop the body self-harming from in response to anything experienced whilst asleep. After REM sleep has occurred for anything from 5-30 minutes, the brain descends back into stage 1, ready to go through the cycle again.
Throughout the night a sleeper will go through several cycles of non-REM and REM sleep, with the later stages of non-REM sleep becoming shorter and shorter, and REM sleep phases increasing in length. Each cycle lasts roughly 60-90 minutes depending on the how long the person has been asleep.
Sleep is incredibly important for the body and brain, as it provides an opportunity for cell repair, and, even more crucially, allows the brain to convert information learned into more permanent forms of knowledge, massively improving memory formation. This is why it is so important to get a good night’s sleep before an exam rather than stay up cramming; the brain needs the time to be able to function at its best the next day. Reaction times, judgement, sensory performance and motivation are all affected by a lack of sleep. Despite all of this, scientists are still not entirely sure why we sleep, and are only really able to answer the question in terms of what would happen if we didn’t sleep.
Sleep disorders, consequentially, present huge problems, mentally, emotionally and physically. Snoring, sleepwalking, sleep talking, etc. can all be disruptive to the process, but none of these is as frustrating and damaging as insomnia.
Much like food, water and television, sleep is essential to human survival. People can live for weeks without food, but for a normal person to be entirely deprived of sleep for a few days would be life threatening. After just 24 hours without sleep, you are considered to have to equal reactions and concentration levels to someone too intoxicated to drive. After 48 hours, you are likely to become irritable and experience a loss in arousal and calculatory skills. If you make it to 72 hours without sleep, you would become delirious and start to experience visual and auditory hallucinations. Any further deprivation of sleep starts to fall into the dangerous category, with people falling seriously ill as brain function decreases.
Students in particular have a tendency to abuse their sleep patterns, staying up late into the night and sleeping in until the middle of the afternoon. Consequentially we are one of the groups of people in the country most susceptible to the sleep condition known as insomnia.
Although widely recognised in both medical and psychological circles, insomnia in itself is not actually a disorder – due to ambiguities over the possible causes and treatments.
On a strictly biological level, it is the blocking of the function of adenosine and another inhibitor called melatonin that keeps people awake at night. However, every single day, anything a person does can potentially have an effect on their sleep that night. Whether it be eating too much chocolate, having an argument or even going to the gym too late in the evening – all such factors can contribute to a sleepless night. In essence, anything that alters the delicate natural chemical balance of the body. A person’s night time environment can also have an adverse effect on the quest for a good eight hours. Excess light and noise, especially from appliances such as laptops and televisions, are particularly disruptive to the sleeping process.
Insomnia can be broken down into three different degrees of severity:
Transient insomnia is the least serious of the three as it only lasts around two to three nights. It is often caused by a change in environment or psychological state – such as jet lag or minor stress.
Short term insomnia is generally caused by more severe emotional trauma, such as the loss of a family member or serious financial problems. Other causes include side effects of medication. Short term insomnia usually lasts for about three weeks. Paul Carney, co-author of Clinical Sleep Disorders says: “Short term insomnia occurs at the beginnings of chronic insomnia, and the management of short term insomnia raises issues that carry over to the chronic form.” If sufferers of short term insomnia do not seek some form of treatment or change in lifestyle, they are likely to develop into chronic sufferers and will end up requiring a more drastic change to return to normal sleep patterns.
Chronic insomnia, the most serious of the three types, occurs when a person consistently encounters sleep disturbances for over a month. More complex in its causes than the other two, chronic insomnia occurs when a number of factors, both physical and psychological, combine to affect a person for a prolonged period of time. Those most at risk to chronic insomnia are people who work long night shifts and frequently misuse of caffeine.
The problem with insomnia, is that often the sufferer is their own worst enemy. People who worry themselves about sleeping all day are more likely to stay awake at night thinking about sleep than those who relax and go with the flow, although of course this is often easier said than done. Generally, it is the sufferers’ own mind that takes them by the hand and leads them into the delirium of chronic insomnia.
All is not lost, however. A quick google search renders a plethora of treatments and approaches to tackling insomnia. These range from small lifestyle changes to more structured or clinical measures, alongside a veritable pick and mix of both herbal and pharmaceutical remedies.
Dr Natheera Indrasenan, NLP Master Practitioner and regular on BBC London’s Late Show, spoke to Nouse about the best way to get a good night’s sleep. “Most importantly, people have to train themselves into a regular pattern, even at the weekends. Try to go to bed and wake up at the same times every night to train your mind to recognise when it should wind down.”
Another important factor is ‘sleep hygiene’. This isn’t about showering before bed – it encompasses a range of variables. Foremost, a bedroom should be dark, quiet, and cool, as “one of the main chemicals that controls our sleep is melatonin, and if the room is too light during the night this can be inhibited… disturbing sleep.” Exposure to bright light reduces the production of melatonin, a ‘drowsy’ hormone which normally increases during the evening as it gets dark, prompting sleep. TV and computers should therefore be avoided an hour before bed. Concurrently, natural light exposure and exercise during the day regulates the body’s circadian ‘sleep’ rhythms, and it is a good idea to build these into a regular routine.
According to Dr Indrasenan, “a lot of people don’t realise, but bedroom temperature can hinder sleep, especially if the room is too hot.” She advises: “Keep the room ambient so that you don’t have to remove the covers in the night to stop yourself overheating.” In addition, “it is important to try and keep all work related items out of the bedroom. Subconsciously, it is difficult for the mind to switch off when surrounded with laptops and books, as the mind associates these things with working, instead of seeing the bedroom as a place of relaxation.” She goes on to say that bedroom activities should be limited to sleeping to encourage the mind to see it in this way, otherwise known as Cognitive Behavioural Training. Such an approach is entirely impractical for students, however, most of whom will use their only private space for more than just sleep.
“If you have to drink coffee, do so before 11am,” she continues. “Also, in terms of food, try to stop eating at around 8pm, depending on what time you go to bed.” Alcohol is another culprit. “The majority of people believe that alcohol will send you to sleep… but those who sleep under the influence of alcohol will not be able to enter a deep sleep and may end up restless and fatigued the next morning.” Finally, rather obviously, sleeping for longer than 30 minutes during the day is a bad idea, as it disrupts the formation of regular night time sleep patterns.
Other forms of relaxation exercises to promote sleep are designed around the idea of tension release. Progressive Relaxation simply involves tensing then relaxing all your muscles, starting at your toes and gradually working your way up the body. Autogenic (self-generated) Training requires somewhat more specific techniques. Designed by the German psychiatrist Joannes Schultz as a means of treating stress induced psychosomatic disorders, it involves assuming one of the various recommended positions and working through a series of meditative visualizations, e.g. – ‘my heartbeat is calm and regular’, to induce relaxation. The practice is similar in style to meditation and yoga, both of which, incidentally, are approved forms of insomnia treatment. Massage, acupuncture and acupressure (where pressure is applied to the same spots used in acupuncture but without penetration) are other non-medical treatments which sufferers may find useful.
For more prolonged or serious insomnia, the treatments available are wide-ranging, although their effects are mixed. Over-the-counter remedies should only be used in the short term, at the risk of developing a dependency. Antihistamines are a common choice, found, for example, in medicines like Nytol. It is believed that sedation is caused by blocking histamine action in the brain, although the exact mechanism in unknown. Side effects of antihistamines include a drowsy ‘hangover’ effect during the day, a dry mouth, constipation, and possible aggravation of asthma and heart problems. Ironically, these drugs can also cause excessive excitation, leading to nervousness and, irritatingly, insomnia.
Melatonin is currently the only hormone available over the counter to treat sleeplessness. Causing decreased body temperature and alertness it is produced in the body by the pineal gland, but because it is present in small quantities in some foods it is sold as a supplement, and therefore not regulated by the FDA. Consequentially, it should be approached with caution.
Chronic insomnia should be treated by a doctor, who can advise the best course of action. As a last resort, prescribed medication can, in the short term, help to ‘impose’ a more regular sleep cycle. According to a York University doctor, who wishes to remain anonymous, “the danger of such drugs is that they treat the symptoms as opposed to the cause.” Therefore if the cause is more complex than mere ingrained habit it will remain despite any drug treatment.
For more information on sleep disorders see www.helpguide.org.
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I found your blog via Google while searching for herbal snoring remedies and your post regarding I can’t get no sleep looks very interesting to me. I just wanted to write to say that you have a great site and a wonderful resource for all to share.
I just had a question. What if a person sleeps for a alternate days and he is been practising it since long?
What does it mean. I have a live example with me.
I no longer sleep “at all” since traumatic brain injury! Am always tired.