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Transcript of Sleep
How much do
know about sleep?
“Sleep is a
behavioral state of low
attention to the environment typically
accompanied by a
What is sleep?
A person spends 25 years on average asleep
During sleep, your body is working to support healthy brain function and maintain physical health
For adolescents, sleep also supports development and growth
10% of the U.S. population has a clinically significant sleep disorder
The quality of your sleep directly affects the quality of your waking life
Why is sleep important?
Irritability and frustration increase
Motor function and speech is impaired
Concentration and decision-making ability decrease
Car and workplace accidents are more common
Ability to fight illness and disease declines
Mental and physical health disorders worsen
The aging process may speed up
Increased risk of diabetes, obesity, hypertension, heart disease, and cancer
You will form a high sleep debt
What happens when we
do not get enough sleep?
Is there such thing as a "sleep debt?"
What is sleep debt?
due to not getting as much sleep as is
mental and physical functioning."
Why should I care about having a sleep debt?
Here are a few reasons...
If you have sleep debt...
And the external stimuli is reduced, the sleep urge will assert itself and you may fall asleep when you did not intend to such as while driving or at work
Your immune system is compromised leaving you more susceptible to illness
Consuming even very small amounts of alcohol will have a profound effect on mental and psycho-motor function
Now that you know what sleep debt is,
do you have it?
Most people are not very good at judging their sleep debt. Can you figure out if you have a high or low sleep debt?
And the list goes on!
Is there a decrease in your mood, energy, performance, and attention?
Is there an increase in your irritability?
Is there a loss of interest in your social relationships?
Are you unintentionally falling asleep during the day?
Are you craving high-carb, high-fat foods?
If you answered yes to these questions, you may have a high sleep debt!
Do you have an effective mental and physical performance?
Do you have an optimistic mood?
Do you feel alert
If you answered yes to these questions, you may have a low sleep debt!
How do I reduce my
Go to bed and get up at regular times
Get at least 20 minutes of aerobic exercise each day
exercising in the morning helps you feel tired earlier while exercising in the evening helps you feel tired later
Minimize the use of substances such as coffee and alcohol as they both have been found to disrupt sleep
Stop working at least 1 hour before bed and do something relaxing such as reading, taking a bath, or meditating
Go to bed an additional 15-30 minutes prior to your usual bed time
Take an afternoon nap
Make sure you have good circulation during sleep to ensure you do not have frequent awakenings
Basics of Sleep
Sleep is made up of a total of
stages 1, 2, 3, and 4 (Non-REM) and REM
Hazy stage when you are just falling asleep
Very light and easily disrupted
If awakened from this stage, a person probably won't even know they were asleep
Moderately light sleep and still fairly easy to awaken
Heart rate slows and temperature drops
Stage 3 & 4
Grouped together because there is not a large distinction
Stage 4 is the deepest sleep followed by stage 3
Very difficult to awaken someone
Muscle relaxation is complete and heart and breathing rates are slow and regular
When sleep is lost, the body craves deep sleep so it will go into it faster and stay in it longer
When sleep terrors and sleeping walking most likely occur
Believed to be when the body does the most repair work
More on REM coming up!
REM (Rapid Eye Movement)
Named because of the bursts of eye flutters and back-and-forth movements (similar to the eye movements when awake)
Stage when dreaming usually occurs
Brain is highly active but body is temporarily paralyzed
Heart rate increases, blood flow to the brain increases, breathing becomes erratic, faster, and shallower, metabolism increases, blood pressure rises
Can wake someone up fairly easily
Your body is unable to regulate body temperature so you are more susceptible to the temperature of your surroundings
The length of REM periods increase throughout the night
Your body has a strong urge to go into REM so it will go into it sooner if you are sleep deprived
Can become alert more quickly when woken up out of REM
Believed to be especially important in learning and memory processing
A common misconception is that REM is the deepest stage of sleep but stage 4 is actually the deepest
The Sleep Cycle
Another common misconception is that the sleep cycle progresses as stages 1, 2, 3, 4, and then REM. However, this is what a typical adult sleep cycle actually looks like:
Stage 1 - Up to 10 minutes
Stage 2 - 10 to 25 minutes
Stage 3 - About 5 minutes
Stage 4 - 20 to 40 minutes
Stage 3 again - 1 to 2 minutes
Stage 2 again - 5 to 10 minutes
REM - Up to 5 minutes
Each cycle lasts about 90 minutes
What are the public health consequences of sleep debt?
Imagine getting on a plane and discovering that the pilot has a high sleep debt. Do you feel as safe as you would with a pilot who has a low sleep debt? Train conductors, other drivers, doctors, nurses, teachers, therapists, emergency responders, and Comfort Reps: all people that could have cause serious consequences if working with a high sleep debt!
What do the nuclear power plant accident at Three Mile Island, the Exxon Valdez oil spill, the 1984 gas leak in Bhopal, and the disaster of the space shuttle Challenger all have in common?
All of the above were attributed to sleepiness-related impaired judgement!
What is your circadian rhythm? What does it have to do with sleep?
Your circadian rhythm is governed by a part of our brain called the suprachiasmatic nucleus that is better known as your "biological clock." It is located just behind and between your eyes and it rules your body's natural programming, including when you go to sleep. It picks up cues from your eyes to determine whether it is daytime or night time depending on the amount of light present. It then determines when melatonin should be released to help us sleep at appropriate times.
Have you ever gone to a different time zone and experienced jet lag? That "foggy" feeling comes from a disruption in your circadian rhythm and your body trying to reset it.
More on melatonin coming up...
What is melatonin?
A common misconception about melatonin is that it is the "sleep" hormone; however, it is actually a "darkness" hormone.
Melatonin is secreted at sunset in animals that are day-active, such as humans, as well as in nocturnal species. This hormone does not make you sleepy, but rather it lets your biological clock know that it is dark outside so you start to feel sleepy if you are day-active or feel more awake if you are a nocturnal creature.
Does sleep change with age?
Lets start with infants:
Newborns go straight to REM sleep, opposite of adults. They also have 50-60 minute cycles versus 90 minute cycles. Around the age of one, babies start entering sleep through stage one, like adults. However, they have longer durations of stages 3 & 4.
How much sleep should
Below are the number of hours a person should be getting based on their age according to the National Sleep Foundation:
Infants : 14-15 hrs
Toddlers: 12-14 hrs
Pre-schoolers: 11-13 hrs
School-aged children: 10-11 hrs
Teenagers: 9-10 hrs
Adults: 7-8 hrs
Adolescents and young-adults:
Loss of the amount of stages 3 & 4 sleep begins. They have consolidated sleep: they fall asleep quickly, stay asleep, and are able to wake up quickly. A major conflict also happens: their bodies want to go to sleep around 11pm, however, the school day typically starts around 8am. This is why so many children this age experience day-time sleepiness and fall asleep in class (see, it wasn't your fault!). This builds up a large sleep debt which leads to the child being more irritable and difficulty concentrating and learning. The effects of chronic sleep deprivation can also be mistaken for attention deficit hyperactivity disorder (ADHD).
Early to Mid-Adulthood:
People of this age group (18-54 years old) typically need less sleep than they did in earlier years. On average, they are getting 6.7 hours of sleep per night on the weeknights and 7.6 hours on the weekends. However, about 16% of adults usually sleep less than 6 hours per night.
On average, elderly people sleep 7 hours on the weeknights and 7.1 hours on the weekends. Sleep becomes more frayed meaning that the line between sleep and wakefulness is blurred leading to drowsy wakefulness and wakeful sleep. 67% report having sleep problems at least a few times a week; however, only 8 percents have actually been diagnosed with a sleep disorder. There is nothing about the aging process that should cause sleep problems, however, elderly people still have the most difficulty sleeping. This is due to the fact that the better a person's overall health, the better his or her sleep. And vice versa: the higher the number of medical conditions, the more likely it is for the person to report sleep problems. So people who have a more active lifestyle and a more positive out-look on
life tended to have fewer sleeping complaints.
While these are the typical number of hours of sleep necessary to function successfully, there is
a "magic number" needed for every person. There are many factors when it comes to the individual differences regarding sleep.
What are some of these individual differences?
The strongest predictor of how you will sleep depends on your parents and grandparents. For example, if both your parents are "owls", then you will most likely be as well.
Length of sleep
how much sleep you get and how much you need to function effectively varies from person to person
Timing of sleep
some people are "owls" and prefer to stay up late, others are "larks" and prefer to wake up early, and some people can be both
Light vs. deep sleeper
some people are easier to wake up than others and some people take longer to feel awake
Method of awakening
some people prefer alarms while others like to wake up with music or the smell of fresh coffee
Regularity of sleep patterns
some people go to bed and wake up around the same time every day (which is recommended) while others vary their times
Men vs. women
men are more susceptible to sleep disorders while women are more likely to have a depressive episode triggered by sleep loss
Besides melatonin, sleep propensity, the environment and the temperature, there is something else that makes us want to go to sleep:
Sleep gates are times that we feel particularly tired or awake. Typically, you feel a period of high alertness about 4 hours after waking up and a period of low alertness 8 hours after waking up. Here is an example:
If you wake up at 8 am: 11am-1pm(high alertness)
3-5pm (low alertness)
7-9pm (high alertness)
However, if you do not wake up and go to bed around the same time everyday, these sleep gates will not be as consistent. Also, if you do not have a high sleep debt, you most likely will not even notice the times of low alertness.
Sleep is as essential as food and water so do not cut corners! That includes the vessel on which you sleep: your mattress. Given that the average person spends about one third of his or her life sleeping and that a bad mattress can contribute to poor sleep quality, while a good mattress can improve it, its worth investing the time and money to finding the right mattress.
Please feel free to reach out to me or do some research of your own. Here are some great books and websites from which I got most of my information:
"Sleep" by Carlos H. Schenck, M.D
"An Introduction to the Psychology of Dreaming" by Kelly Bulkeley
"The Enchanted World of Sleep" by Peretz Lavie
How does the right (or wrong) mattress affect your sleep?
Your mattress has the potential to either encourage sleep or rob you of it. How rested you feel in the morning depends on whether your mattress is giving you the comfort and support you need.
When you lie on any part of your body for an extended period of time, the weight of it reduces the flow of blood through those blood vessels, which deprives the skin of oxygen and nutrients. This causes nerve cells and pain sensors in your skin to send a message to your brain for you to roll over. Rolling over restores blood flow to the area, but it also briefly interrupts sleep. ideally, a mattress that reduces the pressure points on your body should give you a better night's sleep; however, it is important to remember that the ideal mattress is different for each person.
Now, let's talk about the circadian rhythm...