SLEEP, glorious sleep.

Sleep,What is it?

Sleep is something that everyone on the planet does; some love it, some regard it as a waste of time, and a few seek it desperately.

The dictionary defines sleep as “A natural periodic state of rest for the mind and body, in which the eyes usually close and consciousness is completely or partially lost, there is a decrease in bodily movement and responsiveness to external stimuli. During sleep the brain in humans and other mammals undergoes a characteristic cycle of brain-wave activity that includes intervals of dreaming.”

When we sleep we go through a cycle of 4 different stages: in the 1st stage we are relaxed and ‘sleepy’. And we may experience muscle jerks, called hypnic myoclonia. The 2nd stage is a deeper sleep, although you may feel awake. In this stage our eye movements stop, and our brain waves (fluctuations of electrical activity that can be measured by electrodes) become slower, with occasional bursts of rapid waves called sleep spindles. We spend around 50% of our sleep in this stage. Stage 3 is deep sleep where there is very little physiological [body] activity, and no eye movement or muscle activity. Slow brain waves called delta waves begin to appear between the faster waves. The 4th stage is the dream state, REM (rapid eye movement) sleep, in which we spend around 20% of our total sleep time, in contrast to infants who are in REM sleep for 50% of their sleep. When we start to dream, our breathing becomes more rapid, irregular, and shallow, our eyes jerk rapidly in various directions, and our limb muscles become temporarily paralyzed. Our heart rate increases, our blood pressure rises, and males may develop penile erections. In stage 4, the brain produces delta waves almost exclusively. It is very difficult to wake someone during stages 3 and 4, which together are called deep sleep.

The first REM sleep period usually occurs about 70 to 90 minutes after we fall asleep, with a complete sleep cycle taking 90 to 110 minutes on average. The first sleep cycles each night contain relatively short REM periods and long periods of deep sleep, but as the night progresses, REM sleep periods increase in length while deep sleep decreases. By morning, people spend nearly all their sleep time in stages 1, 2, and REM.

How important is our sleep?

Sleep is not a luxury, but a necessity. Many people today are sleep deprived, due to the pressure of life and there not being enough hours in a day, and while some people may like to believe that they can train their bodies to require less sleep, this is not true.  Sleep is essential to our well being, and severe deprivation leads to physical illness and eventually death; even one bad night affects our thinking ability as well as our whole metabolism. There is a very rare disease called familial fatal insomnia, in which the victim becomes totally unable to sleep, even with the aid of drugs, and this inevitably leads to death, often within a year.

Sleep is needed to regenerate certain parts of the body, especially the brain. After periods of reduced sleep neurons may begin to malfunction, visibly affecting a person's behavior. Lost sleep is lost forever, and continued lack of sleep has a cumulative effect when it comes to disrupting your health. It weakens your immune system and increases the likelihood of stress-related disorders such as heart disease, stomach ulcers and mood disorders. When we are sick, our body naturally tells us that we need more sleep in order to restore our health. Loss of sleep can also play havoc with weight control, as not only does tiredness make you less physically active, but lack of sleep also upsets the hormones that control appetite, making you hungry more quickly. This includes Growth Hormone, the hormone that helps you look and feel younger, which is normally released by your pituitary gland during deep sleep; lack of sleep interferes with its production, leading to premature aging.

One study has shown that people with chronic insomnia have a three times greater risk of dying from any cause.

Sleep apnea is a condition in which the sleeper stops breathing for a period, then wakes with a snort, gasping for air. This may happen hundreds of times in the night, leaving the sufferer sleepy in the day, and also putting a strain on the heart. It usually affects overweight individuals, and is made worse by too much alcohol.

Narcolepsy is a condition in which the person uncontrollably falls asleep repeatedly during the day. They may not be aware of it, and it may be mistaken for petit mal epilepsy with ‘absences’.

What are the Causes of insomnia?

Some causes are obvious, such as noise, worry, or physical discomfort, but some people may not be aware of the use of stimulants before bed. Not only coffee and tea, but also chocolate, energy/sports drinks and soft drinks as well as over-the-counter medications such as pain relievers, appetite suppressants and cold medicines all contain caffeine. Caffeine and MSG [‘Aromat’] both enhance alertness, activates stress hormones, and elevate heart rate and blood pressure, reducing the chances of falling asleep easily.

What is the usual Treatment?

Most Doctors used to prescribe a sleeping pill of the benzodiazepine family. The members of this family such as Diazepam [Valium] are now well known to be addictive, but the newer ‘non diazepine’ sleeping pills [mostly with names beginning with Z-] are marketed as being safe. However all carry some risk, so that after several nights of continued use, the user cannot sleep without them. There are alternatives, such a very low doses of the familiar old tricyclic antidepressant amitryptilene. This is used in doses of 75-100 mg for depression, but doses as small as 10-25mg can aid sleep effectively. It is very safe in such small doses, and the side effects of dry mouth and occasional morning drowsiness usually pass within a few days of use.

Antihistamines such as ‘allergex’ and ‘phenergan’ are safe and non addictive, although the body can get used to them so they lose their effect.

Alcohol is probably the substance used most often for sleep, However, even small to medium intakes of alcohol can suppress melatonin (a hormone that helps regulate sleep), interfere with restorative sleep cycles, and prevent dreaming.

What Other treatments are available?

There are many things that you can do to help yourself sleep better.

Practice “sleep hygiene”:

Ensure that your bedroom is a sleep sanctuary: remove the TV, computers etc, and ensure that all is peaceful. Also remove any unnecessary sources of light, such as the clock radio, night lights etc, as our bodies are naturally programmed to sleep when it is dark and waken when it is light.

Try to go to bed at the same time every night, and get up at the same time, about 8 hours later. I see people who come complaining of poor sleep, who go to bed at 7pm and expect to sleep until 7 am! Develop a sleep ritual by stopping working at least 2 hours before bed, so that your brain can wind down and stop worrying about deadlines etc, then prepare yourself for sleep by doing something relaxing, such as reading a light book, meditating etc. It should be something that you do every night to signal to your body that it's time to unwind. If you often lay in bed with your mind racing, it might be helpful keep a journal and write down your thoughts before bed.

Take a hot bath, shower or sauna before bed. When your body temperature is raised in the late evening, it will fall at bedtime, facilitating slumber. The temperature drop from getting out of the bath signals your body it is time for bed.

Sleep researchers recommend keeping your bedroom cool but not cold. This allows your core body temperature to drop, which helps induce sleep. Proper air circulation and lighter-weight blankets can also facilitate a drop in body temperature. Cooling the head is a surprising sleep aid: ‘Researchers found that giving insomniacs caps with cool water circulating inside allowed participants in the study to fall asleep in around 13 minutes (healthy control patients fell asleep in about 16 minutes) and slept for 89 percent of the time they were in bed (around the same amount of time as the healthy control patients).’   You could try wrapping an ice pack in a towel and placing the wrapped pack on the back of your neck, which can help cool the spinal fluid, which circulates around the brain.

If your sleeping partner is disturbing your slumber, it may be necessary to consider separate bedrooms. Recent studies suggest that for many people sharing a bed with a partner (or pets) can significantly impair sleep, especially if the partner is a restless sleeper or snores.

Avoid sugary snacks before bed, as these will raise your blood sugar. Later, when blood sugar drops too low (hypoglycemia), you may wake up and be unable to fall back asleep.

Melatonin 3 mg can be very helpful especially if your circadian rhythms are disrupted, for example those working night shifts.

5-HTP is a serotonin precursor, i.e. it is a building block for serotonin. Doses of100-200mg, or 2mg/kg body weight for children can be a useful sleep aid. Tryptophan 1-4mg has a similar effect. Both should be taken with a small amount of carbohydrate in order to help the brain absorb them. Please first talk to your Dr about these if you are taking any form of antidepressant medicines.

Calcium and magnesium supplements taken in the evening can help relax muscles, and have been shown in some studies to help restless legs.

Valerian root is a natural relaxant that has been shown to be equal to valium in effectiveness, without the addiction. Dose is around 600mg.

Passion flower is a known sedative in doses of 100-200mg.

St John’s Wort is a serotonin regulator and antidepressant, which will help sleep in the long term, but is better taken in the morning.

Hops 200mg are also useful -before being made into beer!

Chamomile tea is a relaxant.

Lavender used as an aromatherapy oil, in your bath or sprinkled on the pillow, will help you relax.

Research has shown that: "Sleep deprivation induces memory impairment, and treatment with vitamin E prevented this impairment probably through its antioxidant action in the hippocampus."

Homeopathy has many remedies:

  • Aconitum – a very helpful remedy for restlessness; anxious dreams and much tossing about always accompanied by anxiety or a sense of fear with a need to keep cool.
  • Arsenicum Alb – similar to Aconitum, this remedy assists with restless sleep that is full of anxiety and fear. However, there is a desire for warmth.
  • Coffea – for sleeplessness caused by much mental activity; flow of ideas; when you just can’t switch off.
  • Kali Brom – for restless sleep, with grinding of teeth or night terrors/bad dreams.
  • Kali Phos – select this remedy if you are suffering from mental or physical exhaustion and yet cannot sleep well; sleep is full of anxiety.
  • Passiflora – this remedy has a soothing effect on the nervous system and brings about peaceful sleep;particularly suited to the over-tired, overworked, exhausted or the over-anxious.
  • Pulsatilla – if you experience sleepiness in the afternoons yet find yourself wide awake near bed time – give this remedy a try.
  • White Chestnut Bach Flower Remedy – for insomnia from obsessive thoughts (you might even jump out of bed to write down ideas or things to remember!), internal conversation and arguments – when you simply can’t switch off and rest.
  • Sleep easy & sweet dreams formula - Helps to relieve symptoms associated with sleeplessness, insomnia and an overactive mind at bedtime or during the night. This formula is gentle enough for infants, strong enough for hyper-stressed executives and exhausted new moms. It contains a combination of the above remedies known to have a soothing effect on the nervous system, and is particularly indicated to assist with restless sleep, anxious dreams and much tossing about; sleeplessness caused by much mental activity and night terrors. Well-suited to the over-tired, overworked, exhausted or the over-anxious, who simply can’t switch off and rest.

So you see there are many ways to obtain that needed shut eye, but most important of all is to switch off the day’s cares before you try!

Sweet dreams...

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