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By Page Duffield
It’s crazy to think that we spend approximately ⅓ of our lives asleep, but it also makes a ton of sense. Sleep is a wonderfully complex process that provides the necessary restoration for both the body and the mind, and can be broken down into several different stages, each important to a productive night’s rest. Though often overlooked and undervalued, consistent quality sleep is essential to leading a healthy lifestyle. And while there is still much to learn about the how and why we sleep, a significant amount of information is available to help us get the most out of our nights. This Sleep Guide will outline the science, history, and culture of sleep.
According to the American Sleep Association, sleep is a naturally occurring state of mind that is characterized by altered consciousness, the inhibition of almost all voluntary muscles and sensory activity, and a reduced interaction with our surroundings. Although sleep occurs in an unconscious state, the brain is extremely active throughout the night. During sleep, the body experiences changes in brainwave activity, heart rate, body temperature, and a significant amount of mental processing, restoration, and strengthening. Sleep affects not only our daily functioning, but our long term physical and mental health in numerous ways, many of which scientists are still trying to understand.
It is unclear why all animals, including humans, evolved the need to sleep. Sleep is a basic biological need, just like breathing and eating, that is absolutely necessary for survival. Sufficient sleep is essential to maintaining normal levels of cognitive skills such as speech, memory, and thought, and it plays a significant role in brain development. Additionally, sleep keeps the immune system healthy and allows the muscles, bones, and organs to repair themselves.
The process of sleeping is split up into 5 stages and the body cycles through them continually throughout the night. We complete roughly 5 cycles of these 5 stages each night, with each cycle lasting longer than the one preceding. On average, a complete sleep cycle lasts 90 to 110 minutes. The first 4 stages are known as Non-REM sleep, and the 5th stage is known as REM, or Rapid Eye Movement, sleep. Here are the stages:
Stage 1 is considered the lightest sleep where eye and muscle movement slow down considerably. This is that moment where you find yourself drifting in and out of sleep, only semi-conscious.
Stage 2 lasts about 20 minutes. This is the stage where eye movement stops and the brain begins to produce very short periods of rapid, rhythmic brain wave activity known as Sleep Spindles. Breathing and heart rate are regular, but body temperature drops and you become completely disengaged from your surroundings.
Stage 3 is the transitional period between light and very deep sleep. Slow brain waves, known as Delta Waves, begin to emerge in this stage, blood pressure drops but blood supply to muscles increases, and breathing slows down. Hormones are also released, helping to facilitate tissue growth and produce energy.
Stage 4 is referred to as Delta Sleep and it lasts about 30 minutes. Known as the deepest and most restorative sleep, many reparative processes take place in this stage. But being in such a deep state of sleep has its downsides - if sleepwalking and bedwetting are going to happen, they’ll happen at the end of Stage 4.
Stage 5 is the famous REM Cycle, short for Rapid Eye Movement, which is characterized by the eyes rapidly moving back and forth behind the lids. We first enter into the REM cycle after about 70 to 90 minutes of non-REM sleep. We go through about 5 cycles of sleep each night, with each cycle of REM lasting longer than the previous one. The REM Cycle is the most active stage of sleep for the brain, in fact, electrical activity during REM is very similar to waking consciousness. Both the brain and body are energized, but oddly enough, the body becomes immobile and relaxed. Muscles are actually turned off to prevent the body from physically acting out dreams.
The REM cycle is crucial. It provides critical restoration to support daytime brain activity and facilitates brain connections that are necessary for problem solving, complex thought, and procedural memory. During REM, the brain actually processes and synthesizes memories and emotions critical for learning and higher-level thought.
A lack of REM sleep simply isn’t healthy. It results in significantly slower cognitive and social processing, memory problems, and difficulty concentrating. And even though only ¼ of sleep is REM sleep, most of our dreams occur during this stage. REM dreams are more bizarre, vivid, and emotionally charged than dreams during the other stages of sleep. These are the dreams that you are most likely to remember (and regale to your friends), especially if you’re woken up during this stage.
Scientists have long tried to figure why we dream. Dreams are commonly understood to be unconscious manifestations of the fears, joys, sounds, images, and other sensations in our lives. While dreams can be about anything, they often contain familiar people, places, or events, and are usually a fragment of waking experiences. Beyond providing entertaining (and sometimes scary) content and dinner party conversation, dreams play a crucial part in overall mental health. Dreams help us process and consolidate memories, which is most likely why they often contain recent memories and events. They also help us to understand new experiences and process emotions. For instance, if you are anxious about work you might dream about a time when you were stressed or anxious in college. Pathways are formed between current and past experiences and emotions. We have a need to process and practice new skills, and this often happens in our dreams.
While it’s commonly believed that dreams only occur during the REM cycle, dreams actually occur in every stage of sleep. Dreaming is definitely rare in Stage 1, but it does happen.Those sudden twitches called Hypnic Jerks (sudden and short micro-awakenings followed by a falling sensation) are considered dreams. Short dreams appear intermittently between Stages 2-4 of the sleep cycle. REM is where dreaming becomes more frequent, complex, and intense with more vivid imagery and more bizarre events. In REM we are most aware of our dreams, and if woken during this stage you are very likely to remember some dream fragments. Dreams can last up to 60 minutes. It’s like our minds are directing little (bizarre) movies in our heads every night.
We’ve all been there. Lying awake as the clock reads 3:16 AM, you can’t get comfortable, and your mind is running a mile a minute. This is normal. But if it is difficult to fall asleep, night after night, or if you wake up feeling tired every morning, you might have a sleep disorder.
There are hundreds of sleep disorders caused by a variety of factors. Stress, illness, physical makeup, sleeping environment, and extreme temperature are all relevant. The three most common disorders are Sleep Apnea, Insomnia, and Restless Leg Syndrome. Approximately 50 to 70 million Americans suffer from sleep disorders. No amount of sleep nor new mattress will be able to make up for the poor rest you get with a sleep disorder. If you think you might be suffering from a sleeping disorder, definitely take the time to visit your doctor.
Sleep Apnea Explained. Sleep Apnea is a serious sleep disorder in which breathing repeatedly stops and starts throughout the night, preventing the brain and body from getting enough oxygen. There are 3 main types of Sleep Apnea: obstructive, central, and complex. The most common form is Obstructive Sleep Apnea. In this form, the throat muscles relax too much, causing a blockage of the airway. The 2nd form is Central Sleep Apnea which occurs when the brain fails to send proper signals to the muscles that control breathing. The 3rd form, Complex Sleep Apnea, is actually a combination of both Obstructive and Complex Sleep Apnea.
The Symptoms. All 3 forms of Sleep Apnea are characterized by very similar symptoms. The most common symptom is loud snoring, which is usually more prominent in Obstructive Sleep Apnea. Another common symptom is a temporary cessation of breathing, usually only lasting a few seconds. Both of these symptoms are usually noticed by another person since you’re asleep when you’re displaying them. Other symptoms, ones that you yourself might notice, include waking up abruptly, difficulty staying asleep, excessive daytime sleepiness, irritability, and difficulty paying attention. You also might wake up with shortness of breath, sore throat, headaches, and/or a dry mouth.
The Treatments. While Sleep Apnea can take a significant toll on your overall health, there are many treatments out there that have been successful. For mild cases, especially Obstructive Sleep Apnea, the treatment can be as simple as making a lifestyle change like losing weight, exercising more, avoiding alcohol and sleeping pills, or quitting smoking. Sometimes it can be as simple as adjusting your sleeping position. Lastly, since the throat and nose play a large role in the symptoms of Sleep Apnea, simply using a nasal solution, such as saline, can improve snoring. A more drastic treatment for moderate or severe Sleep Apnea, is having your tonsils removed to help clear the airway. Some more severe cases may require the use of a CPAP machine to deliver air pressure throughout the night. If you have any of these symptoms, you should seek professional medical attention to identify your options and implement treatment - a simple change might make all the difference.
Insomnia Explained. We’ve all heard of, and at some point probably thought we suffered from, insomnia. Insomnia is a super common sleep disorder that consistently makes it difficult to fall and stay asleep. There are 2 different types of insomnia: Acute and Chronic. Acute Insomnia lasts for a shorter period of time, and is often due to stress or a traumatic event. Most people have suffered from this type of Insomnia at some point in their lives. Chronic Insomnia, however, occurs on a regular basis (defined as lasting a month of longer) and isn’t usually tied to a life event.
The Symptoms. There are many symptoms of Insomnia. The major ones include difficulty falling, and falling back, asleep, waking up multiple times throughout the night, waking up too early, and ongoing anxiety around sleep. Other symptoms include grogginess, lingering fatigue, difficulty paying attention or focusing, and slowed mental processing.
The Causes. Acute Insomnia is usually caused by temporary stress, illness, or a traumatic event. Chronic Insomnia cases exhibit a much wider variety of causes which include, but are definitely not limited to, travel and work schedule, medications and medical conditions, mental health disorders, symptoms of other sleep disorders, and caffeine, nicotine, drug and/or alcohol use and abuse. One thing that is super interesting is the relationship between how you use your bed and how your mind perceives that. Believe it or not, improper use of your bed can actually cause Insomnia. If you use your bed for working, watching TV, eating, and other “day” activities, your body actually struggles to associate it with sleep. This dissonance can make it very difficult to fall asleep.
The Treatments. There are several treatments to combat the terrible, and common, curse of Insomnia. Some treatments include stimulus control therapy, relaxation techniques, sleep restriction, remaining passively awake, and light therapy. Some simpler at-home remedies that are easy to implement include tea, yoga, defining and sticking to a sleep schedule, avoiding nicotine, controlling alcohol intake, limiting caffeine and naps, staying active,and making your bed a sleep-only zone.
RLS Explained. Restless Leg Syndrome (RLS) is a neurological disorder characterized by throbbing, pulling, and unpleasant sensations in the legs, combined with an uncontrollable and overwhelming need to move them.
The Symptoms. Symptoms of RLS usually occur at night when a person is simply trying to lay down, or when someone is actively trying to fall asleep. They tend to increase in severity throughout the night. The oddest thing about RLS is that relaxing - either sitting or lying - activates the symptoms. If left untreated, the condition can cause extreme exhaustion and daytime fatigue. And while RLS appears in both men and women, it is found in two times as many women than men.
The Cause. In most cases, the cause is unknown. There is enough significant evidence, however, to suggest that RLS is related to a dysfunction in the brain’s basal ganglia circuits. This misfiring disrupts the transmission of dopamine, which is required for smooth muscle movement, and results in involuntary movements similar to those exhibited by individuals with Parkinson's disease. There may also be a genetic component to the syndrome since RLS often runs in families. In fact, some variants of DNA have been associated with RLS. Though chronic diseases such as kidney failure and diabetes have been linked to RLS, researchers do not know if these factors actually cause RLS. Pregnancy, particularly in the 3rd trimester, can sometimes bring about RLS symptoms. Additionally, certain medications, alcohol use, and sleep deprivation may trigger symptoms, but there is no evidence to clearly link these factors to RLS.
The Treatment. Unfortunately, no single medication has proven to effectively manage RLS for everyone, but medications that increase dopamine, such as gabapentin enacarbil, can be helpful in lessening symptoms. Lifestyle changes such as establishing a bedtime routine, frequent exercise, and a decrease in alcohol and caffeine have been effective for some, in addition to simple at-home remedies like relaxing baths, massages, yoga, and warm or cool packs have been effective in managing RLS.
Sleep deprivation is a condition that occurs when you don’t get sufficient sleep. But you knew that. We’ve all been sleep deprived at some point in our lives. From a college student pulling an all nighter before a final exam, to a new mother up every two hours with a crying baby, to an overworked employee taking an overnight flight. With the hustle and bustle of modern life, many of us fail to prioritize sleep. When we’re in a time crunch or a stressful situation, sleep is often the first thing to go. Since it is very difficult, to near impossible to catch up on sleep, the body continues to experience the detrimental effects of sleep deprivation over time.
Usually we know when we’re sleep deprived. You recognize the symptoms easily - you fall asleep immediately when you get into bed, you’re more impulsive, you’re irritable, you’re unable to concentrate and forgetful over and over again, and you’re hungrier than usual.
Skipping just one night of sleep negatively affects the body. Unreal right? Your memory, ability to focus, and decision making capabilities all suffer the day after a bad night. It happens that fast. Luckily, the short term effects of sleep deprivation can be easily combated by simply getting a good amount of sleep over the the next few nights.
While most of the short term effects are reversible, the long term effects can do permanent damage to your health. Sleep deprivation has been linked to depression, memory problems, overall weakening of the immune system, increased perception of pain, weight gain, blurry vision, loss of brain tissue, obesity, diabetes, and heart disease. Additionally, sleep deprivation can be extremely dangerous as it relates to daytime activities. Sleep deprived people perform as badly, and often worse than intoxicated people in driving simulation tests and hand-eye coordination tasks. Driving fatigue, bought upon by sleep deprivation, causes about 83,000 motor vehicle accidents and about 850 deaths each year, according to the National Highway Traffic Safety Administration. To avoid sleep deprivation, it is recommended that adults get at least 6 to 9 hours of sleep per night.
In times of stress, we should actually strive to make sleep a priority. It allows us to function properly, see clearly enough to make decisions, and transforms that overwhelming feeling into something manageable.
It’s 3pm and suddenly you feel that wave of insurmountable fatigue wash over you. The kind of fatigue where your eyelids actually feel heavy. Sometimes it passes, and sometimes it plagues you for the rest of the day. Productivity goes quickly down the drain.
This feeling is referred to as midday fatigue. While it is completely natural and happens to everyone, it can be heightened by sleep deprivation. Within our natural sleep cycle, humans are programmed to sleep not only at night, but also for a short period of time in afternoon, a temporary, quick energy boosting rest. Unfortunately for most of us, our busy and fast-paced work culture fails to offer a reprieve for midday fatigue.
While the absolute best solution to midday fatigue is napping, there are still several other ways to combat that familiar tired feeling. First, pay close attention to other factors causing your midday fatigue. Our energy output is directly correlated with our dietary input. It makes sense right? Healthy eating habits lead to longer sustained energy throughout the day. Since the body’s energy level is largely regulated by blood-sugar levels, avoid simple carbs (white bread, sugary pastries, candy, etc.). These foods will give you an immediate spike in energy because your body can process them rapidly, but that spike means a crash not long after. Complex carbs (whole grains, oats, brown rice), healthy fats (olive oil, avocado, nuts, etc.) and fruit will provide a longer steady stream of energy without a later crash. While coffee and other caffeinated drinks help maintain energy, it’s important not to rely on them solely to get you through the day. Instead, try eating an apple. Apples (and similar foods) contain fiber and vitamins that will give you the same rush as a cup of coffee, but none of the downsides.
Additionally, midday fatigue hits strongest when you’ve been sitting at your desk staring at your computer for too long. Your body associates sleeping with stillness, so you are more likely to doze off while sitting down for long periods of time. Physical activity, though it might seem counterintuitive since the last thing you want to do during midday fatigue is waste energy on physical movement, helps ward off that sleepiness. So, get up and step away from your work! Go for a walk, do some light exercises, or stretch. You’ll feel more awake and you’ll find you’re productive for longer.
Electronic devices can, and do, have an extremely detrimental affect on our sleep. While beneficial during the daytime, the blue light emitted by electronics wreaks havoc on our natural sleep rhythm. Blue light is comprised of very short, high-energy wavelengths. While natural blue light found in sunlight is really good for us, artificial blue light found in electronic screens and LED lights are a little bit different. Blue light disrupts and confuses the body’s natural tiring process, hindering the body's ability to produce melatonin (the sleep hormone). After spending the day surrounded by blue light emitting technology (computers, cell phones, tablets, TV) the body needs some time away from the harmful light in order to adjust into sleep-mode.
While it is suggested to stay away from blue light starting at least 2 hours before falling asleep, this expectation is pretty unrealistic for most people. Luckily, there are some alternatives. Try switching from blue lights to red lights, which produce less energy and have less of an effect on melatonin. Some examples of red lights are soft lighting light bulbs, candles, and some e-readers. Blue light blocking goggles, which turn blue light into red light, can be used to avoid blue light. If wearing the goggles seems too excessive, trying switching out LED light bulbs. Additionally, utilize the night shift filter on your cell phone, or get f.lux for your to help adjust the spectrum and reduce the screen brightness on your TV or laptop.
Supplementing nighttime sleep with naps can be extremely helpful for your overall health, energy-level, and well-being. While there is somewhat of a stigma surrounding naps, the practice is becoming increasingly more socially acceptable as we learn more about the benefits. If practiced correctly, napping can positively improve upon your performance, cognitive abilities, and overall mood.
Napping gives your brain and body a temporary rest, providing the benefits of sleep in a much shorter pocket of time. A nap can restore alertness, both directly after waking, and for hours afterwards. Naps also enhance performance, reducing the chance of mistakes and poor judgement. They essentially serve as a mini-sleep-vacation providing the rest and relaxation we need in the middle of the day.
There is a common misconception that naps actually make your groggy and interrupts your nighttime sleep. This, though true, only occurs if you nap incorrectly. Yes, there is a proper way to nap, and if practiced correctly, napping can actually restore and re-energize the mind and body for the rest of the day without either of these negative side effects. The key is taking short “power-naps” that avoid deep sleep (Stage Three, Four, and REM). Naps to boost alertness immediately should last for at least 10 to 20 minutes, but no more than 30 minutes in order to avoid deep sleep and REM. Napping for longer than 30 minutes results in the infamous nap grogginess upon waking.
However, if your goal is to improve cognitive memory processing, try taking a 60 minute nap to experience slow-wave sleep. Just be aware that napping for this long increases your chance of grogginess. This is more beneficial in the long term, rather than the short term.
If you are extremely exhausted or coming off a few nights of missed sleep, take a 90 minute to reap the benefits of a full cycle of sleep. To get the most out of napping, make sure to pick a peaceful and comfortable place to lay down so your sleep isn’t interrupted.
While there are many benefits to napping, long and frequent naps can pose some issues for nighttime sleep. If your naps are too long, they could affect your ability to fall asleep later at night. Additionally, if you have insomnia or generally have a difficult time falling and staying asleep, it’s advised to stay away from napping.