Tag Archives: Sleep deprivation

Straight, No Chaser: Understanding Normal Sleep and How Much Sleep You Need

normal sleeping

It’s National Sleep Awareness Week, and Straight, No Chaser wants you to wake up, pay attention and learn why sleep is such an important part of your life!

Do you ever think about why we sleep? Our bodies are highly efficient machines that utilize a lot of energy over the course of a day. In particular, our brain utilizes an enormous amount of oxygen and energy. Sleep is meant to be a process organized by the brain and responsive to our body’s needs. Sometimes those needs are immediate, and sometimes those needs are scheduled. Contrary to what is often thought, we’re not designed to just black out when we’re tired. Sleep is actually a process orchestrated by the brain.
How and when we sleep is governed by a number of factors. These include factors under our control, such as whether or not we are sleep deprived, and factors beyond our conscious control. Chief among the latter consideration is the fact that we actually do have an internal “clock” that regulates our biologic rhythm (also called a circadian rhythm) over a 24-hour period. The circadian rhythm maintains our sleep-wake cycle and prompts us to want to sleep during similar times of the day and/or night. Sometimes that internal rhythm and the body’s routine call for sleep can be disrupted, making sleep a response to abnormal functioning within the brain (such as occurs in narcolepsy).
sleep_cycle_graph_1
Sleep also has an internal organization—the sleep cycle—regulated by different areas of the brain. Sleep occurs in two categories, which recur through the night: rapid eye movement (REM) sleep and non-rapid eye movement (non-REM) sleep. Non-REM sleep is further divided into four stages (1 through 4), with stages 3 and 4 often referred to as “deep sleep.” In adults, non-REM sleep occupies around 80 percent of the night, and REM sleep 20 percent. REM sleep occurs every 90-110 minutes. These cycles recur until we awaken due to a schedule or decision to arise. You will feel most refreshed after awakening at the completion of the final stage in a sleep cycle.
The body replenishes and restores itself during non-REM sleep, releasing hormones to repair damage done during the day. During REM sleep, you process memories and thoughts from the day, and you dream. As best as we understand dreams, they also represent a form of processing mental information that you received during the day. During REM sleep, we normally lose the use of our limb muscles. Yes, it’s true that while we’re sleeping (at least in REM sleep), we have an active mind in an inactive body. This is actually a good thing. This normal loss of muscle activity during REM sleep helps prevent us from acting out our dreams. Thus, it stands to reason that sleepwalking and night terrors usually occur in non-REM sleep. When disorders of REM sleep occur and patients lose that protective phase of muscle inactivity, patients may act out violent dreams and harm themselves or others.

sleep how much do you need

How much sleep you need is best defined by how well you function on different amounts of sleep, and as such, there is quite a bit of variation on what is considered normal and needed. For many adults, the average normal amount of sleep is around 7.5 hours per night. Many of you know people that can function on much less, and others that require as much as 9 hours per night. In general, your body feels most rested if you awaken at the end of a full sleep cycle. Given that each cycle takes about 90 minutes, many people find that they’re more refreshed if they sleep some increment of 1.5 hours (e.g., 6, 7.5 or 9 hours).
If you are getting what you consider to be an adequate amount of sleep but are still unrefreshed and sleepy, then you might have an organic sleep disorder and should consider seeking professional consultation. Throughout this week, Straight, No Chaser will review several sleep disorders. Until then, sweet dreams.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Understanding Normal Sleep and How Much Sleep You Need

normal sleeping

It’s National Sleep Awareness Week, and Straight, No Chaser wants you to wake up, pay attention and learn why sleep is such an important part of your life!

Do you ever think about why we sleep? Our bodies are highly efficient machines that utilize a lot of energy over the course of a day. In particular, our brain utilizes an enormous amount of oxygen and energy. Sleep is meant to be a process organized by the brain and responsive to our body’s needs. Sometimes those needs are immediate, and sometimes those needs are scheduled. Contrary to what is often thought, we’re not designed to just black out when we’re tired. Sleep is actually a process orchestrated by the brain.
How and when we sleep is governed by a number of factors. These include factors under our control, such as whether or not we are sleep deprived, and factors beyond our conscious control. Chief among the latter consideration is the fact that we actually do have an internal “clock” that regulates our biologic rhythm (also called a circadian rhythm) over a 24-hour period. The circadian rhythm maintains our sleep-wake cycle and prompts us to want to sleep during similar times of the day and/or night. Sometimes that internal rhythm and the body’s routine call for sleep can be disrupted, making sleep a response to abnormal functioning within the brain (such as occurs in narcolepsy).
sleep_cycle_graph_1
Sleep also has an internal organization—the sleep cycle—regulated by different areas of the brain. Sleep occurs in two categories, which recur through the night: rapid eye movement (REM) sleep and non-rapid eye movement (non-REM) sleep. Non-REM sleep is further divided into four stages (1 through 4), with stages 3 and 4 often referred to as “deep sleep.” In adults, non-REM sleep occupies around 80 percent of the night, and REM sleep 20 percent. REM sleep occurs every 90-110 minutes. These cycles recur until we awaken due to a schedule or decision to arise. You will feel most refreshed after awakening at the completion of the final stage in a sleep cycle.
The body replenishes and restores itself during non-REM sleep, releasing hormones to repair damage done during the day. During REM sleep, you process memories and thoughts from the day, and you dream. As best as we understand dreams, they also represent a form of processing mental information that you received during the day. During REM sleep, we normally lose the use of our limb muscles. Yes, it’s true that while we’re sleeping (at least in REM sleep), we have an active mind in an inactive body. This is actually a good thing. This normal loss of muscle activity during REM sleep helps prevent us from acting out our dreams. Thus, it stands to reason that sleepwalking and night terrors usually occur in non-REM sleep. When disorders of REM sleep occur and patients lose that protective phase of muscle inactivity, patients may act out violent dreams and harm themselves or others.

sleep how much do you need

How much sleep you need is best defined by how well you function on different amounts of sleep, and as such, there is quite a bit of variation on what is considered normal and needed. For many adults, the average normal amount of sleep is around 7.5 hours per night. Many of you know people that can function on much less, and others that require as much as 9 hours per night. In general, your body feels most rested if you awaken at the end of a full sleep cycle. Given that each cycle takes about 90 minutes, many people find that they’re more refreshed if they sleep some increment of 1.5 hours (e.g., 6, 7.5 or 9 hours).
If you are getting what you consider to be an adequate amount of sleep but are still unrefreshed and sleepy, then you might have an organic sleep disorder and should consider seeking professional consultation. Throughout this week, Straight, No Chaser will review several sleep disorders. Until then, sweet dreams.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Horror of Night Terrors

night-terrors-280x280

I wonder how many of you have been exposed to night terrors.  These are different than nightmares, which we all know and experience.  In a nightmare, Little Johnny has had a bad dream, maybe thinking there’s a monster under his bed.  He wants to be comforted by you, and he is still upset the next morning.  That’s not what a night terror looks like.
During a night terror, Little Johnny may be sleep walking, or he seems to wake up in the middle of the night and just starts screaming.  He’s really not communicative; he’s just terrified.  These episodes generally last about 15 minutes. Then he goes back to sleep.  The next morning, the child has no recollection of the event.
The cause of night terrors is unknown but they seem to be triggered by emotional stress and lack of sleep.  Febrile illnesses also seem to correlate with the presence of these episodes.
Who gets these?  Children less than age seven, more frequently boys.  These episodes usually stop by age 10.  There often is a family history.
There’s really no testing or treatment for these until they are frequent and prolonged, or unless a secondary injury occurs from all the trashing about.
I bring this to your attention because many parents are aware of this phenomenon and have no idea what to do when it occurs.  My best advice is to ensure that the child is safe during the episode for otherwise stress free children.  You may want to consider medical or psychological screening if the problem worsens.  Sleep well…
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Your Rebuttals and Questions about Insomnia

hyperinsomnia

You are certainly an entertaining group behind the scenes. Here are some of your questions on insomnia. Be reminded that should you want to leave me a private question, just go to the Home Page, or type https://jeffreysterlingmd.com into your browser. Here’s five questions from yesterday’s post on insomnia.
1. Aw, hell! You’re telling me I can be dying from something causing insomnia? 

  • It’s way more likely that level of stress you’re displaying is keeping you awake at night.

2. How is it that sex makes you sleepy?

  • When you do exert yourself vigorously, the greater utilization of muscles will deplete glycogen (energy) stores and make you drowsy. Also, it’s well established that certain hormones (e.g. prolactin, GABA and oxytocin) that promote sleep are released after an orgasm.

3. You mentioned tea. A good cup of tea at bedtime helps me sleep.

  • If that works for you, go for it. Some people have paradoxical effects to stimulants (In fact, stimulants are the most common treatment for ADHD – a topic for another day.)

4. What about giving my baby Benadryl?
I’m giving information here, not practicing medicine, so that’s a question for your physician. I will say there are many drugs (most notably those in the anticholingeric class) that have drowsiness as a side effect, and many emergency departments will give Benadryl to adults for that purpose. That said, these medications are not primarily used for drowsiness, and you’ll have to deal with other drug effects (such as the intended purpose for the medication) in addition to any possible drowsiness that occurs.
5. Sex at night keeps me wide awake.
That’s why a lot of you are shy about putting comments in the inbox… Sorry, but the answer to that question was not meant for public consumption.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Understanding Normal Sleep and How Much Sleep You Need

normal sleeping

It’s National Sleep Awareness Week, and Straight, No Chaser wants you to wake up, pay attention and learn why sleep is such an important part of your life!

Do you ever think about why we sleep? Our bodies are highly efficient machines that utilize a lot of energy over the course of a day. In particular, our brain utilizes an enormous amount of oxygen and energy. Sleep is meant to be a process organized by the brain and responsive to our body’s needs. Sometimes those needs are immediate, and sometimes those needs are scheduled. Contrary to what is often thought, we’re not designed to just black out when we’re tired. Sleep is actually a process orchestrated by the brain.
How and when we sleep is governed by a number of factors. These include factors under our control, such as whether or not we are sleep deprived, and factors beyond our conscious control. Chief among the latter consideration is the fact that we actually do have an internal “clock” that regulates our biologic rhythm (also called a circadian rhythm) over a 24-hour period. The circadian rhythm maintains our sleep-wake cycle and prompts us to want to sleep during similar times of the day and/or night. Sometimes that internal rhythm and the body’s routine call for sleep can be disrupted, making sleep a response to abnormal functioning within the brain (such as occurs in narcolepsy).
sleep_cycle_graph_1
Sleep also has an internal organization—the sleep cycle—regulated by different areas of the brain. Sleep occurs in two categories, which recur through the night: rapid eye movement (REM) sleep and non-rapid eye movement (non-REM) sleep. Non-REM sleep is further divided into four stages (1 through 4), with stages 3 and 4 often referred to as “deep sleep.” In adults, non-REM sleep occupies around 80 percent of the night, and REM sleep 20 percent. REM sleep occurs every 90-110 minutes. These cycles recur until we awaken due to a schedule or decision to arise. You will feel most refreshed after awakening at the completion of the final stage in a sleep cycle.
The body replenishes and restores itself during non-REM sleep, releasing hormones to repair damage done during the day. During REM sleep, you process memories and thoughts from the day, and you dream. As best as we understand dreams, they also represent a form of processing mental information that you received during the day. During REM sleep, we normally lose the use of our limb muscles. Yes, it’s true that while we’re sleeping (at least in REM sleep), we have an active mind in an inactive body. This is actually a good thing. This normal loss of muscle activity during REM sleep helps prevent us from acting out our dreams. Thus, it stands to reason that sleepwalking and night terrors usually occur in non-REM sleep. When disorders of REM sleep occur and patients lose that protective phase of muscle inactivity, patients may act out violent dreams and harm themselves or others.

sleep how much do you need

How much sleep you need is best defined by how well you function on different amounts of sleep, and as such, there is quite a bit of variation on what is considered normal and needed. For many adults, the average normal amount of sleep is around 7.5 hours per night. Many of you know people that can function on much less, and others that require as much as 9 hours per night. In general, your body feels most rested if you awaken at the end of a full sleep cycle. Given that each cycle takes about 90 minutes, many people find that they’re more refreshed if they sleep some increment of 1.5 hours (e.g., 6, 7.5 or 9 hours).
If you are getting what you consider to be an adequate amount of sleep but are still unrefreshed and sleepy, then you might have an organic sleep disorder and should consider seeking professional consultation. Throughout this week, Straight, No Chaser will review several sleep disorders. Until then, sweet dreams.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Understanding Normal Sleep and How Much Sleep You Need

normal sleeping

This week is National Sleep Awareness Week, so Straight, No Chaser wants you to wake up, pay attention and learn why sleep is such an important part of your life!
Do you ever think about why we sleep? Our bodies are highly efficient machines that utilize a lot of energy over the course of a day. In particular, our brain utilizes an enormous amount of oxygen and energy. Sleep is meant to be a process organized by the brain and responsive to our body’s needs. Sometimes those needs are immediate, and sometimes those needs are scheduled. Contrary to what is often thought, we’re not designed to just black out when we’re tired. Sleep is actually a process orchestrated by the brain.
How and when we sleep is governed by a number of factors. These include factors under our control, such as whether or not we are sleep deprived, and factors beyond our conscious control. Chief among the latter consideration is the fact that we actually do have an internal “clock” that regulates our biologic rhythm (also called a circadian rhythm) over a 24-hour period. The circadian rhythm maintains our sleep-wake cycle and prompts us to want to sleep during similar times of the day and/or night. Sometimes that internal rhythm and the body’s routine call for sleep can be disrupted, making sleep a response to abnormal functioning within the brain (such as occurs in narcolepsy).
sleep_cycle_graph_1
Sleep also has an internal organization—the sleep cycle—regulated by different areas of the brain. Sleep occurs in two categories, which recur through the night: rapid eye movement (REM) sleep and non-rapid eye movement (non-REM) sleep. Non-REM sleep is further divided into four stages (1 through 4), with stages 3 and 4 often referred to as “deep sleep.” In adults, non-REM sleep occupies around 80 percent of the night, and REM sleep 20 percent. REM sleep occurs every 90-110 minutes. These cycles recur until we awaken due to a schedule or decision to arise. You will feel most refreshed after awakening at the completion of the final stage in a sleep cycle.
The body replenishes and restores itself during non-REM sleep, releasing hormones to repair damage done during the day. During REM sleep, you process memories and thoughts from the day, and you dream. As best as we understand dreams, they also represent a form of processing mental information that you received during the day. During REM sleep, we normally lose the use of our limb muscles. Yes, it’s true that while we’re sleeping (at least in REM sleep), we have an active mind in an inactive body. This is actually a good thing. This normal loss of muscle activity during REM sleep helps prevent us from acting out our dreams. Thus, it stands to reason that sleepwalking and night terrors usually occur in non-REM sleep. When disorders of REM sleep occur and patients lose that protective phase of muscle inactivity, patients may act out violent dreams and harm themselves or others.

sleep how much do you need

How much sleep you need is best defined by how well you function on different amounts of sleep, and as such, there is quite a bit of variation on what is considered normal and needed. For many adults, the average normal amount of sleep is around 7.5 hours per night. Many of you know people that can function on much less, and others that require as much as 9 hours per night. In general, your body feels most rested if you awaken at the end of a full sleep cycle. Given that each cycle takes about 90 minutes, many people find that they’re more refreshed if they sleep some increment of 1.5 hours (e.g., 6, 7.5 or 9 hours).
If you are getting what you consider to be an adequate amount of sleep but are still unrefreshed and sleepy, then you might have an organic sleep disorder and should consider seeking professional consultation. Throughout this week, Straight, No Chaser will review several sleep disorders. Until then, sweet dreams.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Copyright © 2015 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Insomnia – You are Not Getting Sleepy…

hypnosis

Talking about insomnia makes me, well, tired. You know what the problem is. You either can’t fall asleep or you can’t stay asleep. You’re tired when you wake and throughout the day. Lack of sleep saps your energy and your productivity.

Insomnia really isn’t very cool to deal with, either as a person or as a physician. Patients are frustrated and sometimes cranky from being tired, or they can be extremely nervous and stressed, which will perpetuate a vicious cycle. There are so many mental factors that can disrupt your ability to sleep.

insomnia

Medical professionals tend to think of insomnia in two forms for purposes of evaluation. Either the insomnia is the main problem (primary insomnia), or it’s secondary to another condition (secondary insomnia) such as reflux, uncontrolled asthma, arthritis or other pain syndromes. It could be due to medications, depression or just stress. It could be due to some undiagnosed condition, such as cancer, an enlarged prostate (making you have to get up to urinate throughout the night), thyroid disease or sleep apnea. Then there’s the caffeine (coffee/tea), nicotine (cigarettes) and drunk scene (alcohol).

hyperinsomnia

The thing is, whether acute, intermittent or chronic, any type of insomnia really is an inconvenience and can even be incapacitating. Before you subject yourself to a million dollar medical workup, just remember: If it’s secondary insomnia, and you know (for example) that your pain is keeping you awake, try dealing with the primary issue. Alternatively, if it’s primary insomnia, there are a lot of things you might try. In fact, consider this my Top Ten Tips presented in the order you might consider implementing them.

  • Adhere to good diet and exercise habits, which make your body perform as it should and which will clean up a lot of potential problems that will affect sleep.
  • Avoid naps during the day. You want to be good, tired and ready to sleep when night comes.
  • Develop the habit of only using your bed for sleep or sex. That conditions your body to be ready to sleep when confronted with the stimulus of your bed.
  • Get your snoring partner some help if s/he is part of what keeps you awake. Check here for tips to deal with snoring.
  • Try not to eat for several (3-4) hours before you sleep. Nothing says “no sleep” like heartburn all night. (By the way, this is the real reason you shouldn’t eat after a certain hour – not concerns about your weight.)
  • Avoid nighttime stimulants (e.g., cigarettes, coffee, tea and exercise close to the time you want to sleep, if this proves to be a problem).
  • Don’t drink and sleep. Although alcohol is a sedative, it’s also on the “don’t do” list, because it can cause restless sleep and interrupt the sleep cycle.
  • Find a way to relax before sleep. Consider a bath, sex, a book or soothing music … or all of them.
  • Set the alarm for the morning. Then hide your clock. You don’t need to have a clock to remind you that you aren’t sleeping all night.
  • Use “white noise” for background if you’re bothered by other sounds.

Here’s a bonus tip: If you fell asleep during the reading of this post, keep it for future reference.
As Edward R. Murrow used to say (well before I was born),

Good night and good luck.

Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Horror of Night Terrors

night-terrors-280x280

I wonder how many of you have been exposed to night terrors.  These are different than nightmares, which we all know and experience.  In a nightmare, Little Johnny has had a bad dream, maybe thinking there’s a monster under his bed.  He wants to be comforted by you, and he is still upset the next morning.  That’s not what a night terror looks like.
During a night terror, Little Johnny may be sleep walking, or he seems to wake up in the middle of the night and just starts screaming.  He’s really not communicative; he’s just terrified.  These episodes generally last about 15 minutes. Then he goes back to sleep.  The next morning, the child has no recollection of the event.
The cause of night terrors is unknown but they seem to be triggered by emotional stress and lack of sleep.  Febrile illnesses also seem to correlate with the presence of these episodes.
Who gets these?  Children less than age seven, more frequently boys.  These episodes usually stop by age 10.  There often is a family history.
There’s really no testing or treatment for these until they are frequent and prolonged, or unless a secondary injury occurs from all the trashing about.
I bring this to your attention because many parents are aware of this phenomenon and have no idea what to do when it occurs.  My best advice is to ensure that the child is safe during the episode for otherwise stress free children.  You may want to consider medical or psychological screening if the problem worsens.  Sleep well…
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what  http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Understanding Normal Sleep and How Much Sleep You Need

sleep_cycle_graph_1

Do you ever think about why we sleep? Our bodies are highly efficient machines that utilize a lot of energy over the course of a day. In particular, our brain utilizes a lot of oxygen and energy. Sleep is meant to be a process organized by the brain and responsive to our body’s needs. Sometimes those needs are immediate, and sometimes those needs are scheduled. Contrary to what is often thought, we’re not designed to just black out when we’re tired. Sleep is actually a process orchestrated by the brain.
How and when we sleep is governed by a number of factors. These include factors under our control, such as whether or not we are sleep deprived, and factors beyond our conscious control. Chief among the latter consideration is the fact that we actually do have an internal “clock” that regulates our biologic rhythm (also called a circadian rhythm) over a 24-hour period. The circadian rhythm maintains our sleep-wake cycle and prompts us to want to sleep during similar times of the day and/or night. Sometimes that internal rhythm and the body’s routine call for sleep can be disrupted, making sleep a response to abnormal functioning within the brain (such as occurs in narcolepsy).
Sleep also has an internal organization—the sleep cycle—regulated by different areas of the brain. Sleep occurs in two stages, which recur through the night: rapid eye movement (REM) sleep and non-rapid eye movement (non-REM) sleep. Non-REM sleep is further divided into four stages (1 through 4), with stages 3 and 4 often referred to as “deep sleep.” In adults, non-REM sleep occupies around 80 percent of the night, and REM sleep 20 percent. REM sleep occurs every 90-110 minutes. These cycles recur until we awaken due to a schedule or decision to arise. You will feel most refreshed after sleeping and waking up at the completion of the final stage in a sleep cycle.
The body replenishes and restores itself during non-REM sleep, releasing hormones to repair damage done during the day. During REM sleep, you process memories and thoughts from the day and you dream. As best as we understand dreams, they also represent a form of processing mental information that you received during the day. During REM sleep, we normally lose the use of our limb muscles. Yes, it’s true that while we’re sleeping (at least in REM sleep), we have an active mind in an inactive body. This is actually a good thing. This normal loss of muscle activity during REM sleep helps prevent us from acting out our dreams. Thus, it stands to reason that sleepwalking and night terrors usually occur in non-REM sleep. When disorders of REM sleep occur and patients lose that protective phase of muscle inactivity, patients may act out violent dreams and harm themselves or others.
How much sleep you need is best defined by how well you function on different amounts of sleep, and as such, there is quite a bit of variation on what is considered normal and needed. For many adults, the average normal amount of sleep is around 7.5 hours per night. Many of you know people that can function on much less, and others that require as much as 9 hours per night. In general, your body feels most rested if you awaken at the end of a sleep cycle. Given that each cycle takes about 90 minutes, many people find that they’re more refreshed if they sleep some increment of 1.5 hours (e.g., 6, 7.5 or 9 hours).
If you are getting what you consider to be an adequate amount of sleep but are still unrefreshed and sleepy, then you might have an organic sleep disorder and should consider seeking professional consultation.
Additional Straight, No Chaser Blogs have addressed several of the sleep disorders.

  • Click here and click here for discussions about insomnia.
  • Click here for a discussion of night terrors.
  • Click here for a discussion of hypersomnia (excessive sleepiness).
  • Click here for a discussion of narcolepsy (sleep attacks).
  • Check back for a discussion of sleep apnea.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Your Rebuttals and Questions about Insomnia

You are certainly an entertaining group behind the scenes. Here are some of your questions on insomnia. Be reminded that should you want to leave me a private question, just go to the Home Page, or type https://jeffreysterlingmd.com into your browser. Here’s five questions from this morning’s post on insomnia.
1. Aw, hell! You’re telling me I can be dying from something causing insomnia?

  • It’s way more likely that level of stress you’re displaying is keeping you awake at night.

2. How is it that sex makes you sleepy?

  • When you do exert yourself vigorously, the greater utilization of muscles will deplete glycogen (energy) stores and make you drowsy. Also, it’s well established that certain hormones (e.g. prolactin, GABA and oxytocin) that promote sleep are released after an orgasm.

3. You mentioned tea. A good cup of tea at bedtime helps me sleep.

  • If that works for you, go for it. Some people have paradoxical effects to stimulants (In fact, stimulants are the most common treatment for ADHD – a topic for another day.)

4. What about giving my baby Benadryl?
I’m giving information here, not practicing medicine, so that’s a question for your physician. I will say there are many drugs (most notably those in the anticholingeric class) that have drowsiness as a side effect, and many emergency departments will give Benadryl to adults for that purpose. That said, these medications are not primarily used for drowsiness, and you’ll have to deal with other drug effects (such as the intended purpose for the medication) in addition to any possible drowsiness that occurs.
5. Sex at night keeps me wide awake.
That’s why a lot of you are shy about putting comments in the inbox… Sorry, but the answer to that question was not meant for public consumption.
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Straight, No Chaser: Insomnia – You are Not Getting Sleepy…

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Talking about insomnia makes me well, tired. You know what the problem is. You either can’t fall asleep, or you can’t stay asleep. You’re tired when you wake and all throughout the day. Lack of sleep saps your energy and your productivity.
Insomnia really isn’t very cool to deal with, either as a person or as a physician. Patients are frustrated and sometimes cranky from being tired, or they can be extremely nervous and stressed, which will perpetuate a vicious cycle. There are so many mental factors that can disrupt your ability to sleep.
Medical professionals tend to think of insomnia in two forms for purposes of evaluation. Either the insomnia is the main problem (primary insomnia), or it’s secondary to another condition (secondary insomnia) such as reflux, uncontrolled asthma, arthritis or other pain syndromes. It could be due to medications, depression or just stress. It could be due to some undiagnosed condition, such as cancer, an enlarged prostate (making you have to get up to urinate throughout the night), thyroid disease or sleep apnea. Then there’s the caffeine (coffee/tea), nicotine (cigarettes) and drunk scene (alcohol).
The thing is, whether acute, intermittent or chronic, any insomnia really is an inconvenience and can even be incapacitating. Before you subject yourself to a million dollar medical workup, just remember, if it’s secondary insomnia, and you know (for example) that your pain is keeping you awake, try dealing with the primary issue. Alternatively, if it’s primary insomnia, there are a lot of things you might consider trying. In fact, consider this my Top Ten Tips, presented in the order you might consider implementing them.

  • Good diet and exercise habits make your body perform as they should and will clean up a lot of potential problems that will affect sleep.
  • Avoid naps during the day. You want to be good, tired and ready to sleep when night comes.
  • Develop the habit of only using your bed for sleep or sex. That conditions your body to be ready to sleep when confronted with the stimulus of your bed.
  • Get your snoring partner some help if s/he is part of what keeps you awake. Check here for tips to deal with snoring.
  • Try not to eat for several (3-4) hours before you sleep. Nothing says ‘no sleep’ like heartburn all night (By the way, this is the real reason you shouldn’t eat after a certain hour – not concerns about your weight.).
  • Similarly, avoid nighttime stimulants (e.g. cigarettes, coffee, tea and exercise close to the time you want to sleep, if this proves to be a problem).
  • Although alcohol is a sedative, it’s also on the don’t-do list because it can cause restless sleep and interrupt the sleep cycle.
  • Find a way to relax before sleep. Consider a bath, sex, a book or soothing music. Or all of them.
  • Set the alarm for the morning, then hide your clock. You don’t need to have a clock to remind you that you aren’t sleeping all night.
  • Use ‘white noise’ for background if you’re bothered by other sounds.

Here’s a bonus tip: If you fell asleep during the reading of this post, keep it for future reference.
As Edward R. Murrow used to say (well before I was born): Good night, and good luck.
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