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Insufficient Sleep Syndrome is categorized as a type of hypersomnia, which is characterized by an overwhelming tendency to feel excessively sleepy during daytime hours and challenges in maintaining wakefulness. Those who suffer from hypersomnia often log more than 9 hours of sleep daily. Unlike other sleeping disorders, the extreme sleepiness seen with this syndrome is not due to disturbances in the body’s circadian rhythm or a decline in nighttime sleep quality, but rather it arises from a deliberate choice to cut back on sleep duration. Often referred to as behaviorally induced insufficient sleep syndrome, this condition stems from an individual’s choice to forego sleep in favor of engaging in different activities. Insufficient Sleep Syndrome prominently contributes to feelings of drowsiness throughout the day, fluctuations in mood, an increase in weight, and overall fatigue. Furthermore, it serves as a precursor for a variety of additional health complications that are linked to a lack of sleep.

Even though the disorder is voluntary, it is also unintentional. How is that possible? Well, many individuals suffering from this syndrome can’t recognize that sleep deprivation symptoms are the consequences of their actions. The syndrome happens when you regularly fail to get the proper sleep amount at night, which results in sleep deprivation. Because of all this, you are not able to be alert or focused during the day, and your daily life quality severely deteriorates.

People nowadays sleep 25% less than they did a century ago. There is no significant difference between our generation and our ancestors, and no reason why we should need less sleep than they did and no reason why they needed more sleep than us, and yet that is the situation. This is probably because life today is more hectic than it was back then. With school, after-school activities, work, sports, at home commitments, entertainment, and socializing, people are busy at all times and, as disappointing as it is, there is not much time for sleep. Because of this situation, people sacrifice their sleep for other activities and tasks. Sure, a few hours a week does not seem like a big sacrifice or loss, but it can quickly turn into a sleep disorder.

Symptoms

Insufficient sleep is classified as a central disorder of hypersomnolence, along with other sleep disorders like idiopathic hypersomnia, narcolepsy, and Kleine-Levin Syndrome. The symptoms for the insufficient sleep syndrome include regularly sleeping for less than the average 6-8 hours per night, excessive daytime sleepiness, fatigue, lowered energy level, reduced alertness, memory problems, lack of concentration and focus, muscle weakness and pain, distractibility, attention problems, falling asleep during sedentary activities (like watching TV, reading, driving, working), irritability, mood and behavior changes. However, the long-term effects can include metabolic changes, depression and even death.

Risk Factors

The insufficient sleep syndrome affects about two percent of people who ask for help in a sleep center. It mostly happens to adults in their mid-to-late 30s, and it is undetected until their 40s when it starts affecting their daily life. The syndrome affects more men than women, and it can be the result of the day-shift work schedule that needs you to be at work very early or work during the night.

Causes

There is no specific known cause of the insufficient sleep syndrome or a connection to another sleep disorder.  People with long hours of work or night shift workers are at risk of having this sleep syndrome, but anybody who suffers from chronic sleep deprivation is susceptible.

Diagnosis

Prior to diagnosing insufficient sleep syndrome, the doctor needs to rule out any other health condition that can cause excessive sleepiness. Among those conditions are idiopathic and any other type of hypersomnia, narcolepsy, shift work disorder, any circadian rhythm disorder, and sleep apnea.

Polysomnography (sleep study)

Having a polysomnogram may be the best way to track your brain, heart and lung activity overnight. The polysomnography is essentially an overnight sleep study and a proven method for diagnosing sleep syndrome. The study is performed in a lab that is explicitly equipped to study your mind and body while you are sleeping. The doctors watch you and all the data about your heart rates, oxygen levels, breathing rates, brain waves, and sleep patterns to determine if you have a sleep disorder. It also records the movements of your arms and legs.  Additionally, a sleep study of a daytime nap can also be an excellent way to check for disorders because it tracks your sleep patterns in a short sleep period.

Actigraphy

Actigraphy is a non-invasive method used to determine if a person has a sleep disorder or syndrome. The goal of this method is to watch human rest and activity cycles. This is done by wearing a small and portable device called an actigraph, around any joint, but most commonly around your wrist or ankle. Sleep actigraphs are usually worn on the wrist of the non-dominant arm. You wear the device for a week and during that time the device measures the level, the time of day, and how your body reacts to certain activities.

Treatment

Once other sleep disorders are excluded, patients will need to make a significant effort to improve their sleep quality. The primary treatment for the insufficient sleep syndrome is to improve sleep hygiene which involves changing sleep habits and adjusting sleep and wake times. Sleep hygiene is a group of habits and practices that can help individuals get quality sleep. It can also include changes to the environmental and behavioral factors that are causing restricted nighttime sleep. Also, eating healthy foods is also a recommended habit that will improve your sleep hygiene and quality. If patients follow treatment recommendations, the insufficient sleep syndrome symptoms quickly improve and resolve.  

Chronotherapy

A chronotherapy is a cognitive behavioral technique that provides an exact sleeping and waking schedule that will train our brains to follow a certain rhythm. When going through this treatment, you are expected to follow a one-month schedule and after that make changes to your sleep. During this schedule, you need to avoid naps and have a three-hour delay for your bedtime. The idea is to gradually make changes so you will be able to retrain your brain before reaching the proper amount of sleep.

Light therapy

Light therapy is a treatment that involves exposure to artificial light that mimics sunlight. Using a lightbox, the person is exposed to full-spectrum light consisting of thousands of lux of white and blue light. These lights act as cues for the brain to regulate the circadian rhythm of the body and maintain a sleep schedule. Because of that, this therapy is extremely helpful to individuals who need to synchronize a specific schedule and rest, among which are those who suffer from night shift work disorder and night owls that experience night as day.

Risk of Untreated Sleep Deprivation

Individuals that are chronically tired have a bigger chance of having accidents while at work or when driving, as well as decreased performance with activities like sport, exercise or work, obesity, disrupted sociability, cognitive troubles, and diabetes.

Practicing Good Sleep Hygiene

Having good sleep hygiene is an excellent way to treat any sleep disorder. Maintaining good sleep hygiene involves following a sleep routine that will provide structure to your sleep and help develop a habit for your body to go to sleep and wake up at the same time each day. The routine needs to be directed at mains period of waking and sleeping, so you will need to reduce the number of naps or any daytime rest periods you previously had, and increase the duration of sleep. The essential thing is to keep sleep logs to track your routine, so you will be sure to follow the routine correctly. For this, you can use phone apps that were made to monitor your sleep or sleep trackers that you can wear.

As time passes, to minimize the risk of relapsing into old sleep patterns, a more strict bedtime will be needed. This strict bedtime means you will have an alarm that will wake you up at the same time in the morning each day. To have the regular sleep-wake rhythm, you need to keep a consistent sleep and wake-up time, even if there are obligations that require you to get up at that time. Sunshine exposure and exercise during the day are recommended but need to be avoided in the evening.

Have a Comfortable Sleep Environment

The best way to fix your sleep problems is to follow a sleep routine properly. When doing so, you need to reserve your bed for rest only. Your bedroom must be a comfortable sleep environment that is reserved just for sleep. The best way to do that is to keep it dark, cool and quiet. Rooms with bright light rooms can upset your circadian rhythm, while noisy environments keep you up during the night. Watching TV or doing work in bed are activities that need to be avoided because your brain will create associations to these things and this can impact your sleep. Generally, electrical devices should not be in bedrooms. If it is necessary for them to be there, then they should be placed at least a few feet away from the bed. Also, the bed must be comfortable, and the mattress cannot have any sagging or lumps that can wake you up. If possible, you should invest in a mattress that will help promote sleep and fit your sleep needs.

Avoid Stimulants

Taking stimulants like caffeine or alcohol is not recommended before sleep. Caffeine is an excellent wake-up method for mornings, but after 2 pm it needs to be avoided because it remains in the body for an extended time and it can keep you up at night. Nicotine is also not recommended before bed because it stimulates the production of adrenaline which will wake you up. And of course, eating greasy food or sweets before needs to be avoided.

In many American households, pets are considered an integral part of the family. This includes a wide variety of animals, such as dogs, cats, birds, rabbits, and more, with Americans cherishing the companionship these pets provide.According to recent studies, around 68% of homes in the United States have pets. Dogs are the most popular, found in 48% of these homes, followed closely by cats at 38%. In addition, 10% of these families have freshwater fish, and birds are included in 6% of homes with pets. It’s also worth noting that 46% of pet-owning households have a diverse range of pets, with dogs and cats coexisting in 32% of these homes and dogs living alongside fish in 11% of homes that have multiple pet types. This information highlights the preference for dogs and cats as the most beloved pets. 

Having a pet has many benefits, and it can have a positive impact on our quality of life. Pet owners tend to be healthier and happier compared to those who don’t own pets. According to studies, dog owners do more exercise compared to non-dog owners, which is most likely due to walking them a few times on a daily basis and playing with them. As you can see, pet ownership will not only make you feel happy, but it will also keep you healthy by helping you with weight maintenance. Walking your dog regularly will burn calories and help you shed off a few extra pounds, which will reduce the risk of obesity, diabetes, cardiovascular issues, and other problems associated with weight. 

Most animal owners regard their pets as valued family members, and it is not a surprise that sharing a bed with one is very widespread. Many people allow their pets to sleep with them, mostly dogs and cats, but the question remains – is sleeping with your pet a good idea? Is dog sleeping in bed bad for health? Once you make enough room for your furry friend, and it gets used to it, it may be very difficult to break the cycle. That’s why you need to do your research and explore the benefits and drawbacks of letting an animal sleep in your bed.  

However, before we dive into the advantages and disadvantages of sleeping in the same bed as your pet, we need to discuss something else. Although sleeping with our furry companion is our solution to spend more quality time together, especially if we are at work most of the day, we should avoid it if we don’t find it comfortable. In case you have troubles sleeping comfortably throughout the night, it would be a much better idea to get a pet bed and place it on the floor in your bedroom.  

Another thing that you should keep in mind is that, if you are a parent, you shouldn’t let your young child sleep with the family pet. Children shouldn’t sleep alone with their animals if they can’t handle the responsibility. If they tend to ignore the animal’s needs, play roughly, pull a pet’s tail, or do similar things, it is a sign that your kid is simply not mature enough to let it sleep on his or her bed. Cat and dog sleeping with child is a bad idea in the case of immature kids.  

Benefits of Letting Your Pet Sleep in Your Bed 

Some of the positive sides of sleeping with a pet include: 

Pets Provide Comfort 

People who live alone or those who have a great bond with their pets are comforted by the presence of their furry companion nearby. Cuddling with animals, especially dogs, is a very comfortable and pleasant experience. In case you suffer from nightmares, or have a sleep disorder, sleeping in the same bed as your pet can benefit you as it will provide companionship, relaxation, and security that will aid your shut-eye. 

Pets Can Improve Your Psychological Well-Being 

Some of the psychological benefits that pets provide include an emotional bond, better mood, decreased loneliness, stress relief, a distraction from worries, and reduced depression. Pets can also improve our social interactions. Animals give us loyalty and unconditional love without question, and this type of connection is often hard to come by. When people dealing with depression receive this connection, it can help them get through tough times and overcome the problems that they encounter. Also, very often, those suffering from depression have troubles sleeping, and a pet’s presence can alleviate this. Allowing your pet to sleep in your bed can also help relieve you of stress. Many people can’t seem to fall asleep in the evening because of all the stress that they are facing. Having a pet nearby provides relief from stress, and it makes sense to have your pets around at night too. As a result, if they are close to you, you will be able to relax, which will have a positive impact on your quality and duration of sleep.  

Pets Give Us Warmth 

Most people love the sense of warmth while sleeping, which explains why we use comforters and blankets. Many individuals can’t fall asleep without a blanket. Luckily, pets are comfy creatures, have warm bodies, and tend to curl up as close to owners as possible, and in a way, they act as a small bed radiator. Although something like this may not be ideal during the summer, it is perfect for other seasons, especially winter, and it is excellent for those who live in a cold climate as their animal’s warmth can feel fantastic. 

You Will Feel Safe 

Another benefit of sleeping in the same bed, or at least in the same room as your pet is that you will feel much safer. People are most vulnerable when they are sleeping because they have no idea what is going on around them. It is especially true for those who are not awoken easily by different disruptions. However, if you have another presence watching over you while you are sleeping, you will feel safe. This increased sense of security especially applies to sleeping with dogs. Dogs have a sense of protection and excellent hearing, and if they notice an intruder or hear something strange, they will start barking and warn you about the potential danger. It is crucial to keep in mind that most break-ins happen during early morning or late at night, which is when most people are asleep. Luckily, thanks to your furry friend, you will know if something is wrong. 

It Will Be Easier to Get Up in the Morning 

Let’s face it, around half of us are morning people and can get up early with ease, while the other half are not this type. If you fall into this second category, you probably hate the sound of an alarm clock and don’t look forward to getting up early in the morning. Hitting the snooze button is a favorite activity of most people of this type, and they tend to stay in bed for as long as possible. They want to rest in bed until it is about time to get up and get ready for work. If you are one of them, sleeping with a furry friend can help you. Pets play a vital role in motivating you to get out of the bed. Very often, dogs will lick you, put their paws on you, or try something else to wake you up as soon as they are ready to go outside to pee, and you will need to leave your bed. Something like this will give you the motivation to kick off the covers unless you want them to make a mess in your bedroom, and get outside instead of lying in your bed until the last moment. 

You Will Bond With Your Pet 

Some animals, especially dogs, love sleeping in a pile or alongside their owners. Sleeping in the same bed as your dog will bond you. Animal owners want to make their pets happy, and one of the ways to do so is to allow them to rest in a bed. Your pet will want to be as close to you as possible almost all the time, and if you allow them this, it will strengthen the bond between you. 

As you can see, there are several reasons why people share their bed with pets. It can be very beneficial both to animals and owners. However, something like this can also have its drawbacks. 

Disadvantages of Sharing a Bed with Your Pet 

Some of the dangers of sleeping with dogs and other pets include: 

You May Sneeze a Lot 

Some people own a pet although they have allergies. If you have allergies, you shouldn’t even have a pet, but if you do, sleeping with it is something that you should definitely avoid. However, even if you don’t have allergies at first, it doesn’t mean that you won’t develop them at some point. If you have been allowing your cat or dog to sleep in your bed for a long time, and all of a sudden you can’t handle dandruff, you should break this habit. In this case, sleeping with cats, dogs, and other animals can be quite unpleasant. 

You are at Risk of Parasites 

Although letting your pet sleep in your bed brings health benefits, it also has certain health risks. Of course, it only happens if you don’t take the necessary steps to keep your pet healthy. Sometimes, animals have ticks, fleas, different worms, and other parasites, and if you let them rest in your bed, you are at risk of all these parasites ending up in your bedroom.  If you are wondering “what if my dog sleeps with me and has fleas?” the answer is – your pet should stay out of the bedroom. Luckily, you can avoid it by taking your pet to regular vet visits and making sure it is parasite-free. 

They May Sleep on Your Face 

This disadvantage applies to cats as they often find weird places for resting. Sometimes, cats find the perfect sleeping spot right on the head of their owner. If it is not possible, they may at least try to sleep as close to your head as possible. In some way, it is cute that they want to sleep next to you, but it is not pleasant to wake up with a cat on your head. 

Accidents are Possible 

Sometimes, pets can pee on the bed, especially if they are still young and don’t know what they should and shouldn’t do. The downside of sleeping with your puppy is that they are prone to peeing, but it can also happen to older dogs and other types of pets as they get closer to the senior animal age. They may not be able to hold it if they are old, and as a result, accidents may happen. Also, dogs are occasionally prone to throwing up, which is another thing that you don’t want to wake up to in the morning. However, keep in mind that these things don’t happen very often. Many animals have never peed in the bed.  

It Can Affect Your Intimacy 

Another disadvantage is that it can contribute to marital difficulties. If your spouse doesn’t want to share a bed with a pet, you need to consider his or her wishes. Also, if you let your pet sleep in the bed, it can have an adverse impact on your intimacy. Proximity and physical touch are vital when it comes to maintaining the connection as a couple and being intimate. If your pet sleeps between you two, it will increase the distance between you and your spouse. However, you can avoid this problem by letting your cat, dog, or a different animal to sleep at the bottom of the bed, or on one side, but never between you and your partner. 

Now that you know more about the benefits and drawbacks of letting a pet sleep in your bed, it is time to make a decision. However, most pet owners will continue to sleep with their furry companion, no matter the potential disadvantages. 

Useful Tips for Sleeping with a Pet 

If you decide to let your pet sleep in your bed anyway, here are some tips that can help you: 

• Set the Rules – It is vital to establish some rules before letting a family pet in your bed. You can determine which part of the bed you plan to let your beloved pet sleep on, and make sure that they don’t rest on other areas of the bed. 
• Create a Schedule – If you want to sleep comfortably throughout the night, you need to create a schedule and stick to it. Your pet should know when it is time to play, eat, and exercise, and that night is for sleeping only. That way, you won’t have to worry that you will be awoken to engage in a play session. Additionally, you should make a potty run close to your bedtime so that your pet doesn’t have to go during the night.  
• Get the Right Mattress – In case you want your dog or cat to sleep in the same bed, you need the right mattress that is large enough for all humans and animals. Qualities that you should look for are limited motion transfer and excellent edge support. Latex mattresses and memory foam models are the best choices. 
• Don’t Let Your Pets Sleep Under the Covers – If you decide to share your bed with a furry companion, you need to keep them above the covers. 

In the first few months, many parents experience sleep deprivation, while newborns mostly engage in sleep. The pattern of infants waking up and then going back to sleep can complicate parents’ ability to assess whether their baby is receiving enough rest. Sleep, together with nutrition, is essentially vital for a baby’s needs. It is during this period of quick growth and development that sleep provides the essential period for recovery, rejuvenation, and growth.

We have all heard the “sleeps like a baby” phrase, which implies that babies sleep really well and that they easily fall asleep, which is something with what many parents would probably have to disagree. In today’s post, we are going to share a few tips for parents to help them establish a safe and healthy sleep routine of their baby.

Will I Ever Sleep Again?

If you are reading this and you are a sleep-deprived parent, to console you first, yes, you will get your sleep back, someday. While trying to establish baby’s sleep pattern, many parents will spend many, and by many, we mean weeks and months of sleepless nights, except those few who got lucky with a quiet and sleepy baby, which is so rare that it is almost a myth. Although parents were aware that sleepless nights are going to become a part of their life, nothing can really prepare them for that, because in reality, being awake because your baby cries and screams at 3AM is far from staying up all night and binge-watching favorite tv shows.

But, eventually, it will all settle down when babies get to that point when they can establish a sleep routine and schedule. The reality is that babies demand full attention, commitment, and for new parents, it can be hard to put someone else in the center of their lives and adjust to someone else’s needs, even though that someone is their child just because that is not the way we are used to functioning.

Even when a baby starts to sleep on a schedule, that does not mean much more sleep and free time for parents, because they will probably have to use that time to do all the chores around the house, laundry, cleaning, etc. But as hard as it sometimes can be, all parents know that it was all worth it.

How Much Sleep do Babies Need?

All babies need a lot of sleep, up to 18 hours per day, but that varies a bit throughout the first year, so we are going to go into detail and present you the optimal sleep routine for baby’s first year. Many parents cannot wait that their baby starts sleeping for the whole night, but younger babies need feeding more frequently so they cannot connect many hours of sleep. As babies grow and their stomachs develop and hold more, and they start to sleep for longer stretches. When establishing newborn sleep routine, babies should be placed to sleep before they are actually fully asleep, for example when you notice that the baby is yawning and the eyelids are fluttering, because babies need to learn to self soothe and fall asleep on their own. We would like to remember parents that every baby is different, and so are their sleep patterns, that is why parents should not stress about the fact that their baby is not doing everything by the book or if she is not making progress as quickly as some other babies.

• 0 – 6 weeks – this is a very hectic phase of adjustment for parents and newborns, sleeping is irregular, it is too early for any type of sleep schedule, babies are awake usually when they need feeding or changing since they can stay awake approximately for 40 minutes consecutive. This is a so-called sleep-eat-poop phase, and babies generally sleep for 15 to 18 hours total each day.
• 2 – 3 months – at this time parents can start their baby sleep training. Babies are able to stay awake longer in between the naps, around 1.5 hours, and parents are learning more about baby’s sleep habits. Babies will need from 14 to 16 hours of sleep, and some might even connect between 3 to 6 hours of sleep during the night.  Parents should schedule their bedtime around 8 PM, but not later than 10 PM.
• 4 – 6 months – this is a transitional phase, and babies have different ways of getting through it, some will reduce their daily naps to only 2, some babies will experience sleep regression, while others might be sleeping tight during the whole night. If your baby is still unable to pull a full night of sleep, you need to know that you are almost there, since this is a period when babies start connecting more sleep hours during the night. The transition from bassinet to a crib can be tricky, but also the changes in sleep cycle itself are affecting on the baby too. Babies should sleep from 12 to 15 hours in total, and they can stretch their nighttime sleep up to 8 hours. Bedtime should be around 8 PM.
• 6 – 10 months – this is a stage when some babies are still struggling to connect more than 4 hours per night, while others are sleeping whole night for more than a month, and that is ok too, because like we said, babies are different, and they do not have to do all things equally at the same time. It is important to stick to their routine and eventually they will sleep for those magical 8 hours. They will spend around 11 to 15 hours sleeping, with maybe one or two naps during the day, but make sure that the naps are not postponing their bedtime which should stay around 8 PM.
• 10 – 12 months – here is the part when babies sleep patterns start looking more like the adult ones, well, except for the naps. Most babies will sleep during the night, play and explore during the day, maybe have a nap or two and that is it. The only potential challenge could be sleep regressions, which many babies experience around their 10th month. Many milestones, changes of environments and routine or separation anxiety can be the cause of setbacks or sleep regressions at this age. But, regardless of that, as babies approach their first birthday, they will be sleeping 11 to 14 hours, with one or two hour-long naps during the day.

Safe Sleep Environment for Babies

Babies are particularly sensitive, and their sleep is very fragile, so parents need to make sure that they have proper conditions and a safe environment for their baby. American Academy of Pediatrics (AAP) often prescribes new safety wise regulations for babies and baby products, so make sure to check their recommendations. Since babies cannot talk, it is sometimes hard for parents to understand baby’s needs although they are all pretty basic and simple, so here are some things on which parents should pay particular attention when it comes to safety.

• Sleeping surface – mattresses for babies need to be firm and supportive because soft and cozy surfaces are potential risk factors, when babies start turning on sides, stomach or moving, soft surfaces may prevent them from rolling back, block the airway and cause suffocation or SIDS.
• Crib – babies should not share a bed with their parents; they can safely sleep in a bassinet or crib, which are designed with their needs and safety on the mind. Sleeping between parents, or in arms of one parent can lead to accidental suffocation and many other complications.
• Sleep position – it is always recommended to place babies on their back since it is the safest and healthiest sleep position for them. It also helps with the prevention of SIDS since in this position airway is not blocked. But, while babies are awake, they should also have their tummy-time supervised by parents, since spending too much time on their back may lead to the flat head syndrome.
• Toys and pillows – although they are cute and playful, cozy pillows, stuffed animals and plushy toys should not be placed inside of baby’s crib, they are another potential blocker of airway and cause of SIDS.
• Pacifier- start using the pacifier only if your baby was breastfeeding for at least a month, to avoid confusions or create a preference for the pacifier. Place it in the infant’s mouth before once you put them to bed, if the baby does not want it, do not force it. Pacifiers, as well as breastfeeding, have been associated with a lower risk of SIDS.
• Temperature regulation – it can be hard to tell what is the optimal temperature for babies or the amount of clothing since parents tend to exaggerate and care a little bit too much sometimes. Overheating can occur while the baby is sleeping and it is another cause of SIDS. Do not go over the top with layers on baby, it is important that the pajamas are comfortable, use one layer of sheets or a blanket as a cover, and make sure that the room temperature is optimal.

Sleep Mistakes that New Parents Make

Parenting can be harsh, especially if you are having your first child, many changes are happening, and some situations are hard to manage. To help out, we are going to suggest what you should avoid by listing some common mistakes that new parents usually make.

• Sleeping with a newborn in arms – this is a huge no, it does not matter if you are in your bed or napping on a couch in front a tv, by doing so you will put your baby at high risk of dropping down or suffocation which is one of the leading causes of SIDS which stands for sudden infant death syndrome.
• Sleeping in a car seat – since for babies is so easy to fall asleep, while you are driving home, doing some errands around the town or traveling, babies will snooze in their car seat. And you might think that that is a good thing, well, it is better than crying anyway, but you should not let the baby stay too long in the car seat for a few reasons. The first one is the angle of a car seat if it is too upfront baby’s head can fall forward and block her airway, and the second risk is developing positional plagiocephaly which is actually a flattened head syndrome.
• Bumper sets for cribs – while shopping for your baby you have probably seen many crib designs, colors, followed by even more colorful bumper sets for cribs. Although it seems reasonable to use bumpers since they are softer than the typical wooden rail, they are also a possible cause of SIDS, and their sale is even banned in some states of the US.
• Room-sharing – sleeping in the same room with a newborn baby in its bassinet or crib is recommended, but no longer than the first six months. Many parents do not have enough space in their bedroom to fit a crib, bassinets are smaller, but they are used only up to six months, and some babies sleep better when they are alone, without any potential noise or movements around them. Once your baby gets older or becomes a toddler, it will be much harder to teach her how to sleep in a separate room, and you might have to use the notorious sleep training called cry-it-out method.

Many people find themselves attempting to catch up on sleep after spending numerous late nights awake. Perhaps you’ve dedicated many hours to work, stayed up late working on a project, or had to handle emergencies during the night, and now, you’re looking to recoup those missed hours of sleep. However, the reality is that sleep doesn’t function like a bank account where you can simply deposit and withdraw at will. It’s not possible to fully recover lost sleep. You might be able to get a little extra rest to help keep you going, but that’s pretty much the extent of it. Continue reading to learn why the idea of catching up on sleep is more of a myth than truth and understand what that implies for your health and well-being.

If you usually sleep for seven hours but for some reason you need to stay up one entire night, it will have consequences on your day, causing you to be less productive than usual, along with some physical effects that sleep deprivation causes. Because of all this, you might think getting more sleep the next night will fix everything. You will recover almost all of your deep sleep and a part of your REM sleep, but you will not recover your light sleep. Additionally, people might want to get more rest during their days off, to make up for the lost sleep, but there is no need to sleep the weekend away.

The limit for human wakefulness is around ten days, depending on the situation and the person. After that, the person goes to sleep and sleeps longer than usual, but without sleeping all the lost time. If you sleep for 7 hours each night and skip one night, you will want to sleep 14 hours the following night. But that is a terrible plan. Sleeping for 14 hours will do nothing. Your body is already compromised, and there is no way to make up for the entire amount of sleep. Instead, you can add an hour or two to make up for part of the shut-eye you lost.

Randy Gardner set the record for the longest time being awake at the age of 17. In 1965 he was awake for 11 days without getting any sleep, while under observation by researchers. After that, he slept for 15 hours straight on his first night of sleep and 11 hours on the second night. This is how you technically catch up on sleep, but it doesn’t really exist – you can not get the lost sleep back. The adverse health effects you get by skimping on sleep are not something you can reverse by overloading yourself with rest.

Negative Effects

Researchers have shown that routine sleep deprivation contributes to many health risks like diabetes and weight gain. Many studies have studied participants in a sleep laboratory by limiting them to a few hours of sleep to examine carefully the adverse effects that sleep deprivation can have. Participants in these studies experienced weight gain and metabolic disruption, both of which increase the risk for certain illnesses like diabetes. The recovery during the weekend after a week of not getting the adequate amount of rest had some benefits. But again, those benefits are easily wiped out when you go back to the same sleep-deprived schedule after recovery. These benefits of catch-up sleep are gone the moment you get back to the same routine, and your body and performance are severely affected the longer you maintain a schedule like that. While the benefits are short-term, the health risks are long-term. These studies aim to reinforce the fact that sleep is not a balance sheet where you can make up what you lost before. When rest deprivation is caused by sleep apnea, insomnia or any sleep disorder, it is a good idea to recover some of the shut-eye you lose until you feel normal again.

Our body has the natural ability to heal itself during sleep, even if there is sleep debt. By nature, the body tries to recover the lost REM and deep sleep as much as possible, but it is often at the expense of other sleep stages. The general opinion among experts is that seven to eight hours of sleep are the adequate amount for an individual. Of course, this can vary depending on genetics, health problems, and lifestyle. Some people can feel great after six hours of sleep, while others can feel terrible after eight.

Some of the symptoms you might experience due to lack of sleep are headaches, memory problems, inability to focus and concentrate, impaired vision and motor skills. If sleep deprivation continues these symptoms will get worse, and you can get chronic inflammation and be at an increased risk of illnesses like heart disease, diabetes, or even early death.

Research about Catch-Up Sleep

Pennsylvania State University did a study in 2013 that tested if a weekend of sleep could help with reversing the symptoms. They tested the subjects to see their levels of cortisol, attention spans, daytime sleepiness, and inflammation. The daytime sleepiness was increased during the period of sleep restriction and then decreased after two nights of recovery sleep. The same thing happened to inflammation. The cortisol levels were the same during the period of sleep restriction but decreased after recovery sleep, which meant that the individuals were sleep deprived. However, the levels of attention and concentration severely dropped during those six sleep restricted nights and did not get better with three nights of recovery sleep. This result lead the researchers to conclude that extended recovery sleep impacts our biological factor, but our concentration needs more time to recover from multiple nights of sleep restriction or deprivation. But, these results were only short-term, and this study did not uncover the long-term effects. The key to recovering from too little rest is to get back your natural sleep pattern and follow it. For severe sleep deprivation, it will take a few months of recovery and catching up on sleep will be necessary.

A study of rest deprivation done by the University of Chicago had a similar situation. Their volunteers developed high levels of cortisol (stress hormone) and high blood pressure. Additionally, this study provided information that the volunteers produced only half of the usual amount of antibodies to a flu vaccine. They also showed signs of insulin resistance, which is a condition that leads to type 2 diabetes if not treated. However, all of these problems were reversed when the students made up the lost hours of shut-eye. The Chicago study helped explain the impacts of chronic sleep debt, such as the risk of heart disease, diabetes, stroke, and obesity.

Advice for Avoiding Sleep Deprivation

As we mentioned before, our bodies have the natural ability to get back as much deep and REM sleep as possible. Adults need seven to nine hours of sleep per day; anything less will have an impact on your overall health. Falling behind sleep for ten hours or more requires you to gradually make up that lost time during the week by adding two or three hours to your usual sleep time. This requires you to go to bed earlier than usual and if possible squeeze in some extra time in the morning. While you work on this, you need to incorporate some good sleep habits that will improve your sleep quality, and your health as well.

Better sleep hygiene

Sleep hygiene is a combination of tools used to help restore restful sleep. It requires you to implement good sleep habits and maintain them, as they are beneficial for individuals who can’t stay asleep and fall asleep.

Have a regular sleep schedule

To properly orient and maintain your sleep rhythm you need to set a schedule that will include fixed times for going to bed and waking up. Make sure you have at least seven hours of rest per night. As time passes, your body and brain will by default feel tired or wake up at these times out of habit. For better implementation of the schedule, you can add activities that will later trigger your brain and body into going to sleep, for example, you can take a bath, brush your teeth, read a book, turn off your TV, phone, tablet and other devices.

The bedroom needs to be an optimal sleep environment

You need to create a sleep sanctuary. The bed needs to be reserved for sleep,  intimacy, and relaxation. No watching television, no stressful reminders, and unnecessary stuff. The bedroom needs to be a relaxing environment that is dark, cool, and quiet. Keep in mind that electrical devices do not belong in bedrooms, and if it is necessary for them to be there, you should place them at least a few feet from the bed. To block unwanted sounds you can get earplugs or a white noise machine, and for the light, you can get a mask or blackout curtains that will keep your bedroom extremely dark.

Reduce stress levels

You need to reduce your stress levels if you want to minimize the strain on your nervous system and heart. Daily exercise can help to burn off excess energy and stress. Also, as we previously mentioned, you need to avoid using any electronics an hour before bed because of their blue light that can provide the same effect on your brain as sunlight does.

Exercise

Daytime exercise is an excellent way to make your body tired, which will make it easier for you to fall asleep and stay asleep during the night. But do not exercise too late in the day, because the adrenaline can keep you up at night. You should aim to work out in the morning in order to expose yourself to daily light and start your day with an extra energy boost.

Eating healthy

Eating healthy food has been shown to promote sleep, and sugary junk food is terrible for sleep. By eating healthier, you will consume extra vitamins and proteins that will be beneficial when night comes. However, you need to be careful when you eat food and don’t eat or drink a few hours before bedtime. Especially avoid junk food, caffeine or alcohol. Alcohol may cause mid-night or early awakenings, while caffeine will keep you awake. Additionally, the consumption of nicotine and smoking can also have a severe and harmful effect on your sleep.

Naps

Taking naps during the day is not recommended in these cases. If there is a need for a nap, it should not be longer than thirty minutes. Night owls and night shift workers have a higher risk of developing sleep debt and usually try catching up on sleep they cannot possibly recover. Because of this, they nap for an hour or two, trying to supplement the missed hours, but these naps can interfere with your ability to sleep at night and completely reverse your sleep schedule.

Today, changing careers, inventing new positions, and crafting the perfect job is more feasible than ever. The sleep research sector is booming, primarily due to a wide array of individuals grappling with sleep disorders, turning sleep health into a thriving industry worth millions of dollars. This surge in interest has led numerous Universities to open their sleep research facilities, resulting in a significant increase in sleep clinics across the country. A pivotal moment in 2013 saw the University of North Carolina grant the first Bachelor of Arts degrees to a new generation of neuro-diagnosticians and sleep researchers, highlighting the growing fascination and investment in the field of sleep studies.

Since sleeping is related to health, usually some medical or health-related educational background is required, but some positions do not require a bachelor’s degree, or you need to do specialization only, it all depends on your previous education. If you are not thinking about pursuing a professional career in sleep, or you have a degree in something else, and you are done with scholar education, but you are still intrigued by the sleep-related jobs and want to get involved there are still some available options.

When people have a problem, especially when it comes to their health, they tend to find out everything about it, they go in-depth, do the research, read the books, and the best part is that they are also experiencing it in practice, so they are not staying stuck in theory. Sleep disorders are one of those things since they are so common among Americans that they have become almost a part of our lifestyle, somehow it is getting harder to avoid them, and the numbers are alarming. That situation opened the door to a whole new medical field, and although sleep disorders have been known and treated for centuries, the situation today is extreme, and that resulted with the topic that we are discussing here today.

Get Paid to Sleep

It sounds like a dream job, doesn’t it? It is not a joke, and although you can hardly consider this as a regular 9-to-5 job, you can occasionally get paid for sleeping in sleep centers. Many universities and hospitals need participants for their examinations and experiments in various sleep-related studies, and many of them are willing to pay their participants a decent amount of money for it. However, even though it is called a sleep study, sometimes you might need to do the opposite and stay awake for quite some time. The University of Colorado, for example, pays well and often has open calls for participants willing to do a sleep study.

Since today there are numerous sleep clinics in every bigger town, it is easy to get the information and apply for your dream job. Some studies need people of certain age, gender, or there are some other specific requirements that participants need to fulfill. Usually, the clinic will send you a questionnaire, and then they will inform you if you fit in their current research. Make sure that you are getting paid because some sleep studies offer compensations, whereas others are a voluntary type, which is ok if you are willing to do it just to see how it works for free.

Once you are accepted for a sleep study, there are numerous psychological and physical exams in front of you before you start a sleep study because researchers need to make sure that you are able to stay in a sleeping lab room for quite some time, for days even and that you can handle being isolated majority of the time. What can be challenging about this “job” are some demands that can be annoying, for example, you might have to stay in one sleeping or sitting position for a long time, it depends on the study, so make sure that you are able to perform it before you sign anything. Also, you will probably have to wear IV for a part of the study, electrodes will be attached to your head, and sometimes even rectal thermometers are included as a mandatory thing. While you are being isolated in a lab, you will not have access to your smartphone or computer, no clocks will be around you, no windows in the room so that the doctors can determine when daytime and nighttime are for you, so it can be boring and mentally exhausting even though you are not doing anything. And since some of these studies last up to a month, do not rush yourself into it because you are attracted to the money, start with short period studies from 2 to five days to see if you can make it and is it all worth it at the end. Payday is the best part of it because, to be honest, there was not much hard work for that money.

Options for Professional Career in Sleep

If you are interested in this area of research, a great way to check it out is to get an internship during college. Various internships are available and most common ones are internships in sleep research or science, dental sleep medicine, behavioral sleep medicine, and many others. Here we are going to list a few most common career paths which require proper educational background for people who are interested in involving themselves into sleep-related job fields.

• Sleep scientists are doctors specialized in sleep-medicine with a board certificate coming from one of these fields: internal medicine, anesthesiology, pulmonary medicine, pediatrics, neurology or psychiatry. They either work as professors at universities or in sleep clinics, but many are opening their own private practices too. Their job is to diagnose and treat sleep disorders.

When it comes to former education, after a bachelor degree, they need to get an MD or DO degree, and also do a residency and specialization or fellowship in sleep medicine.

American Academy of Sleep Medicine (AASM) is the only professional organization for sleep scientists.

• Sleep respiratory therapists are working with people who have breathing issues that affect their sleep quality; usually those with sleep apnea. Most sleep respiratory therapists work in sleep clinics or hospitals, and they are working with patients, training them on how to use the CPAP device properly. They need to have at least an associate’s degree, but a bachelor’s degree in some health or medical field is also highly desirable. Besides their degree, they have to get a certification for a respiratory therapist (CRT) or registration (RRT), and a sleep disorder specialist certification (SDS).

National Board of Medical Care is the professional organization for sleep respiratory therapists.

• Polysomnographic technologists or sleep technologists are working in sleep laboratories at clinics for sleep disorders. They work under the direction of a doctor who is a sleep specialist and usually operate with the equipment used for sleep studies and monitor patients during the study by following their heart rate, oxygen level, breathing, brain waves, and eye movement. They gather and record all the data from a sleep study and pass it to the doctor who then analyzes everything and sets a diagnose. Sleep technologists have to be trained to perform various sleep studies at sleep clinics, such as parasomnia exams, polysomnography, and multiple sleep latency tests, but besides that, they should also be able to help patients with sleep apnea and get them to know how CPAP works. A possible downside of this job position is that it is usually a night work in shifts from 10 to 12 hours, three or four times per week. When technologists become more tenured and experienced, they may get more working hours during the daytime or be promoted into managers.

Polysomnographic technologists usually supervise sleep technicians, who are in most cases on the way to get their associate’s degree or are in the process of specialization and they need six months of training. After an associate’s degree, sleep technologists usually get CAAHEP or A-STEP accreditation. This job position is probably the “easiest” one to achieve, but it is estimated that the educational requirements for this position are going to increase in the following few years.

American Association of Sleep Technologists (AAST) is a professional organization in charge of this sector.

• Managers or directors of sleep centers have to be certified as sleep technologists, and they can perform operations in centers for sleep disorders. They usually work during the daytime, taking care of the staff, hiring new people, managing policies and procedures, but they are also in charge of making sure that all patients are treated well and that sleep technologists and staff are following all the steps of a procedure properly. Associate’s degree is a minimum, but a bachelor’s degree is more preferable for this job position. Some additional certification that may be beneficial are sleep disorders specialist (SDS), certificate in clinical sleep health (CCSH), registered sleep technologist (RST), registered polysomnographic technologist (RPSGT).

American Association of Sleep Technologists (AAST) is a professional organization in charge of managers for sleep centers.

• Sleep health educators usually work in centers for sleep disorders, and they have the knowledge and expertise about any sleep disorder diagnose that their clinic provides and they are aware of all the aspects of sleep technology. They communicate with patients and provide them with all the information to help them prepare for their examination. Also, they are working in cooperation with doctors and staff but setting the diagnose or recommending treatments is not their primary role. They are focused on explaining all the terms and conditions to the patients and getting their compliance with the treatment. For this job position a bachelor’s degree is required and a certificate for clinical sleep health (CCSH). Associate’s degree can be accepted only if it is combined with some of the following proofs of specialization: sleep disorders specialist (SDS), registered polysomnographic technologist (RPSGT), registered sleep technologist (RST).
• Neurodiagnostic technologists work together with neurologists, sleep specialists and scientists to monitor and examine the data collected from the nervous system. They usually work at hospitals neurological departments, sleep clinics or private practices, managing long term monitoring, electroencephalography or intraoperative neuromonitoring tests. Also, they apply the electrodes to the patients and monitor them during the study, and later share the data with a physician. For this position, people need to after graduating high school or GED complete an associate’s degree program, or obtain a CAAHEP with a primary focus on either neuroanatomy, physiology or anatomy.

American Society of Electroneurodiagnostic Technologists (ASET) is the professional organization for neurodiagnostic technologists.

• Sleep neurologists are specialized in brain damages, disorders related to nervous system and spinal cord. Neurological disorders are the cause of many sleep-related issues such as insomnia, fragmented sleep, restless leg syndrome or sleep apnea. Sleep neurologists have to be trained in neurology and sleep medicine since their job is to use EEG equipment in diagnosing sleep disorders, perform MSL tests or polysomnograms, and to use psychological screenings and questionnaires for recognizing symptoms.

Education wise, neurologists need to obtain a bachelor’s degree in biology or health field, then they need to go to medical school, complete an internship, fellowship, and residency, and in the end, to get a certification from the board. American Academy of Sleep Medicine is a professional organization in charge of sleep neurology.

• Behavioral sleep medicine specialists can work as professors at universities or at sleep clinics dealing with patients who have sleep disorders. It has been proven that some psychological disorders such as depression or ADHD can trigger sleep disorders, which makes the diagnosing process harder and the treatment itself. Cognitive therapy works in a way that it helps patients to understand and adjust their emotions when it comes to sleep to reduce anxiety and fears. The focus is on changing the patient’s habits that are hindering their sleep. After obtaining a bachelor’s degree, the next step for behavioral specialists is a PhD PsyD doctorate degree and a postdoctoral fellowship, and of course, the certification from the board.

Society of Behavioral Sleep Medicine is a professional organization in charge of this field.

There are several terms used to describe sleep enuresis. One widely known term is nocturnal enuresis, which differentiates between daytime and nighttime wetting. However, the term most parents are likely familiar with is bedwetting. Bedwetting remains a common issue among most children until they are around 7 years old, after which the incidence of bedwetting dramatically declines. It’s typically not a cause for concern for parents when children wet the bed, unless the child is older than 8 years.

It may not always be easy to handle the problem of sleep enuresis. The parents have a responsibility to monitor the situation and intervene where necessary to help their child reach a level of physical maturity where their bladder muscle becomes strong enough to handle enough urine to keep them clean in bed. It is essential for this guidance to be conducted without making the child ashamed of something they cannot control. For this reason, we have filled this article with information about how sleep enuresis works and how to deal with it efficiently and without fuss. Let’s get into it.

How Does Sleep Enuresis Work?

One of the alternate names spells it out quite well: involuntary urination, in this case during the night while the person is asleep. There are two main types of sleep enuresis to consider when it comes to causes – primary and secondary sleep enuresis. Primary enuresis is the most common type, as it is characterized by the person having had that issue since birth. This is typically what you’d see in children, who start wetting themselves as babies. This category of bedwetting is traditionally caused by the brain’s inability to wake the child up at night for a quick bathroom trip, or the bladder itself not developing enough to be stable during the night. Luckily, both of these issues are easily outgrown given enough time.

Secondary enuresis happens much less often, which is why it often goes overlooked. It is a condition that can pop up anywhere from six months to several years after the person develops the ability to control their bladder properly. Despite normally being seen as an issue only children (and through them, their parents) face, bedwetting affects around 1-2% of teens in the United States. If a person older than the age of 6 or 7 has sleep enuresis problems, it becomes necessary and important to consult a doctor.

There are multiple potential causes of sleep enuresis. The key word here is “potential,” as not even researchers can clearly outline the exact causes in most cases. Still, we have a list of possible causes and contributing factors that can affect children and adults. Knowing about these factors is important for providing proper care for the person dealing with involuntary urination. Here’s the list:

• Hormonal problems can cause sleep enuresis. There is a special compound called antidiuretic hormone (ADH) whose job it is to significantly lower our urine production while we’re asleep. However, some people simply do not produce enough of this hormone, which can cause involuntary urination.
• Bladder issues can be common across the board when it comes to different age groups. Children don’t have properly developed bladders until at least age 5, which can (and often will) lead to nocturnal enuresis. For children especially, a common cause can be the brain’s inability to interrupt sleep when it comes time for a midnight bathroom trip (we say midnight because involuntary urination often happens only 2-3 hours after the person falls asleep). The bladder communicates that it’s full to the brain, but the response isn’t adequate. Adults and teens sometimes simply have small bladders, which cannot hold that much much urine before they automatically lose control and relieve themselves.
• Genetics can sometimes make a difference on their own. Studies have shown that teens who experience sleep enuresis tend to have a parent who had the same problem at their age.
• Psychological issues are a recently-established potential cause of bedwetting. Stress, in particular, has been linked to increased urges to urinate, which can translate into nocturnal enuresis according to some experts.
• Medical conditions such as constipation, diabetes, urinary tract infections (UTIs) and urinary tract abnormalities or deformities can all cause secondary sleep enuresis. The latter is characterized by problems in the structure and functionality of the person’s urinary tract. It is one of the leading causes of secondary sleep enuresis for teens and adults. More severe conditions such as bladder cancer or prostate cancer often cause bedwetting, too.
• Sleeping disorders and problems can cause nocturnal enuresis. Certain conditions can prevent the person from waking up when they have to relieve themselves, even if they would normally be able to do so. Depending on what the underlying disorder is, different solutions are available for this. However, some sleep medication can also make it harder to wake up and urinate properly, along with other potential side-effects.

Diagnosing Sleep Enuresis

The best and most practical course of action when dealing with sleep enuresis (whether it’s you, your child or another family member) is to simply consult a doctor as soon as possible. They are way more prepared to offer an accurate and helpful diagnosis and set the patient on the right path in terms of treatment. Depending on the patient’s age (note that sleep enuresis typically isn’t diagnosed in children under the age of 5) and other potential parameters, different diagnostic methods can be used. In general, however, you should expect to see one or more of the following options:

• A basic physical examination is almost guaranteed to take place when someone is inspected for signs of sleep enuresis and general urinary issues.
• A neurological examination
• Urine sample analysis and urologic examination
• In some cases, a full ultrasound inspection of the patient’s kidneys and bladder may be necessary. This method can help uncover conditions such as bladder cancer for adults.

No matter which of these methods are used, a detailed medical history is also required. The doctor will ask you about your (or your child’s) urinary patterns, sleeping patterns, past medicine use, allergies, etc. Additionally, they will ask about daily stress and anxiety levels, since those mental problems can contribute a lot towards involuntary nocturnal urination. Give as much detail as you can, because all of it helps reach an accurate diagnosis.

Treating and Coping With Sleep Enuresis

Fortunately, the vast majority of treatment options for involuntary nocturnal urination have no significant side-effects aside from occasional sleepiness. Depending on who’s being treated, many methods usually boil down to behavioral planning and timely interventions by others in the household. Medication is only prescribed as a last resort in most situations. Let’s look at the most common methods used to treat patients with sleep enuresis, especially children:

• Because bedwetting often occurs in the first couple of hours after the person falls asleep, someone else in the house can either set an alarm or stay awake long enough to wake them up right before they normally have a tendency to wet the bed. Some alarms use a “bell and pad” system to automatically detect moisture in the patient’s sleeping clothes or on the bed under them, and wake them up upon registering enough moisture. The ultimate goal of this method is to train the person to automatically wake up early enough to relieve themselves in the bathroom properly.
• Establishing a strict and reliable sleeping routine can do wonders for the person dealing with sleep enuresis. It is important to include regular bathroom trips in this routine. If you combine this method with the previously mentioned alarm systems and assistance waking up, you can prepare yourself, your child or another loved one to wake up properly to relieve themselves.
• Avoid drinking a ton of liquids before bed. A no-brainer, perhaps, but it’s often hard to notice exactly how much water or other drinks you consume, as they’re a deeply ingrained part of our daily routine. It’s a common habit to have a glass of water right before bed, to avoid dry mouth situations that can cause minor discomfort. Try to avoid this habit.
• Parents of bedwetting children can establish reward charts and introduce healthier meals that promote dry nights and reduce the risk of involuntary urination. Rewarding your child for waking up to go to the bathroom can increase how often they follow that behavior pattern, even if they’re not aware of it.
• If all else fails, doctors may prescribe some medication. One of the best options is a manmade dose of antidiuretic hormone (ADH), which can compensate for the potentially reduced ADH production level in the body, and force the body to produce less urine, preventing sleep enuresis.

Treatment is one thing, but there are ways to simply improve the bedwetting situation and help your child through it emotionally. One pitfall that a lot of parents fail to avoid is that you should never, under any circumstance, criticize, scold or punish your child for wetting the bed. They cannot control their bladders properly, so the problem is out of their hands, so to speak. Being too strict can seriously hurt the trust your child has for you, as it can feel like you’re punishing them for something they didn’t do. Be comforting and friendly when talking to your kid about bedwetting, and help them avoid feeling ashamed or embarrassed. You (and your spouse) are the only people this child can rely on, so be understanding. Also, avoid talking about their problem in front of other people, especially if the child dislikes those people for whatever reason (for example, sometimes a family member will tease your child in a friendly way, but that joking manner may not be interpreted as such by the child, causing mistrust and avoidance).

You can make a clever investment and buy disposable or reusable absorbent underpants. These can save you a lot of effort cleaning up messes that occur as a result of bedwetting and don’t interfere with the functionality of moisture alarms.

A considerable number of people are plagued by insomnia, with about 20% of adults in the United States frequently battling it. This issue casts a wide net over various aspects of life, affecting job performance, immune system health, and even one’s emotional and mental state. The root causes of many sleeping problems are often shrouded in mystery, making it hard to find effective solutions. The side effects of commonly prescribed drugs can worsen symptoms or introduce new problems, adding to the challenge. Thus, those struggling with insomnia are increasingly exploring non-pharmaceutical alternatives in hopes of sidestepping the harsh side effects that could negatively influence their professional and personal lives.

Sleep restriction therapy (or SRT for short) is a part of cognitive behavior therapy for insomnia (CBT-I), a revolutionary treatment procedure that can be conducted without the use of risky medications. The concept for SRT is based on the idea that excessive time spent in bed can often perpetuate or amplify insomnia. By making a very strict sleep schedule and lowering the amount of time spent in bed (without going under five hours for obvious health-related reasons), we can work our way to higher sleep quality and quantity in the long run. Think of it like diet plans or exercise – sleep restriction therapy takes time and dedication. In this article, we will go over the basics of CBT-I and its components, focusing on sleep restriction therapy as a core method of dealing with insomnia without using prescription medication. Let’s get into it.

Cognitive Behavior Treatment for Insomnia (CBT-I)

The purpose of CBT-I is to change the patient’s behavior patterns and habits that help perpetuate or amplify insomnia. These habits include poor sleep hygiene, bad lifestyle habits, hyperarousal and so on. This technique can be used without or alongside medication treatment, although as always, meds carry the risk of very inconvenient side-effects that could be counterproductive for the whole therapy process.

Before any treatment procedure is initiated, the patient should have their sleep patterns evaluated, or document them themselves. This usually involves sleep tracking methods like keeping a sleep journal, as it’s very important for the patient to take note of everything in their life that could contribute to insomnia. These things can include stress from work or environments, too much time spent in front of screens, a bad diet plan, overstimulation from caffeine and similar sources, etc. If there is another condition that acts as the underlying cause of insomnia, it’s crucial to be aware of it.

Once all of these factors are taken into account, treatment can begin. CBT-I consists of several methods that all work alongside each other to improve the patient’s sleeping habits and remove misconceptions about sleep that can influence their decision-making. These methods include:

–          Stimulus control, a regime where the amount of things the patient uses their bed for is limited to sleeping and sex, and daytime napping is forbidden. Additionally, the patient is instructed to move to a different room if they stay awake in their bed for fifteen minutes or longer. This is done to prevent the mind from associating their bedroom with stress and frustration.

–          Sleep hygiene education, an approach where the patient learns about sleep-ruining habits and behaviors. They get educated on the consequences of heavy caffeine intake, alcohol consumption, exposure to TV, smartphone or computer screens before bed, and other factors. By knowing how to arrange a good sleeping environment (including how to create an ideal sleeping temperature and noise management) and properly wind down at the end of the day, the patient can maintain a healthier sleep schedule.

–          Relaxation exercises vary from method to method, but all have the same purpose: to help the body relax throughout the day, especially as bedtime starts approaching. Depending on the person in question, these exercises may include yoga sessions, self-hypnosis, meditation, breathing exercises, progressive muscle relaxation, etc. Most relaxation exercises require no financial investment to perform and can be a healthy habit even if you’re not dealing with insomnia.

How Sleep Restriction Therapy Works

The main goal of sleep restriction therapy is to reduce the amount of time insomniacs spend in bed without sleeping. One of the main concerns sleep experts and therapists have is that excessive time spent tossing and turning can create a mental connection in the patient that connects their bed to frustration and anxiety. The bigger the percentage of time spent sleeping while in bed, the higher the sleep efficiency. To this end, it may be best to shorten the sleeping period to improve that efficiency.

As a whole, sleep restriction carries several benefits that help the patient over time. Because their nocturnal sleep window is reduced significantly, they become tired earlier in the day. While this can cause certain problems (which we’ll discuss later), it means that the patient is always tired and sleepy when it comes time to go to bed. Sleep onset latency is reduced considerably, which is one of the primary goals of SRT and CBT-I treatment in general. Much like with stimulus control, their newfound ease of falling asleep will help their brain make a positive association between their bed and relaxation, severely reducing the amount of anxiety the patient experiences in bed.

Being very tired right when they should go to bed helps people maintain a sleep schedule. A strict time-frame for sleeping is healthy for the body because it helps stabilize one of the most important processes our bodies are governed by – the circadian rhythm. Our brain has what amounts to a built-in biological master clock, and all of our hormonal secretions, metabolic functions, etc. are regulated and managed by this clock. Unfortunately, it is very easy to ruin our circadian rhythm through factors like alcohol consumption, heavy exercise before bed, stress, etc. The demographics with the biggest risk here are shift workers or long-distance drivers and pilots – these people either have to change their sleep schedules drastically to serve the needs of their occupation, or they (and their potential passengers) are particularly susceptible to the dangers of drowsy driving while on the road or in the air. Fragmented sleep is one of the main causes of daytime fatigue, as the affected person doesn’t spend enough time in deep sleep or REM sleep. These sleep stages are responsible for a large portion of physical and mental repairs, as the immune system, tissue repair, and memory consolidation primarily occur at this point in the sleep architecture. SRT is very effective in dealing with fragmented sleep – think of all those moments where you sleep like a log after dealing with fatigue all day. Your sleep becomes more restorative as a result of this therapy method.

The step by step process is fairly simple. The patient is instructed to maintain a sleep journal, usually starting several weeks before SRT begins properly. Through that sleep journal, the doctor receives information about the realistic number of hours the patient spends asleep each night. If they sleep only six hours but spend more than that amount of time tossing and turning in bed, then the sleep period is set to just under six hours (but never under five hours), to maximize initial sleep efficiency. The schedule is arranged, so the patient always goes to bed and gets out of bed at the same predetermined times. The patient is forbidden from taking naps or going to bed earlier than what was established.

Once their schedule is set, the patient must stick to it while working on the sleep journal. If the person estimates that their sleep efficiency is over 85 percent (meaning that at least 85 percent of their time in bed is spent sleeping) for a given week or two, the sleep period is increased by 15-30 minutes for the following 1-2 weeks. Should their sleep efficiency ever drop below 80%, the doctors will decrease the patient’s allowed sleeping time to correct that problem. A sleep efficiency value of 80-85 percent results in another week or two without changes. Over time, this technique is expected to not only improve sleep efficiency but help the patient sleep healthily throughout the night, as their insomnia symptoms get resolved.

Sleep Restriction Therapy Downsides and Risks

While its effectiveness has been noted many times, sleep restriction therapy isn’t without its share of controversy and critique. Most of these criticisms focus on the negative effects of sleep deprivation and excessive daytime sleepiness on the patient’s daily life. The fatigue that comes as a result of insomnia doesn’t normally go away during this therapy plan, which can put the patient in danger during their work commute or at their workplace. Drivers and pilots are particularly unsuitable for SRT, as their jobs require a very high level of vigilance and awareness – something that cannot coexist with fatigue. Shift workers can also find it incredibly hard to stick to one predetermined sleep schedule due to the nature of their unstable work hours. During studies, subjects have dropped out solely out of concern that their work performance and other aspects of life would be ruined by extra sleep deprivation.

Some sleep labs may set an initial “time in bed” value as low as 4-4.5 hours. Studies have concluded that going under five hours can create serious deficits in the patient’s attention span, cognitive sharpness and immune system, which is why some experts propose a mandatory lower limit of five hours. Anything less than that makes the person a liability at work and in traffic if maintained as a regular sleep schedule.

However, no connection has been drawn between SRT and increased daytime fatigue thus far (assuming the patient was given a sensible initial sleep window). This method rarely forces a patient to sleep for less time than they normally would – it only decreases how much time the patient spends in bed without sleeping. Additionally, the fatigue tends to disappear from the patient’s life slowly, as their insomnia starts to subside.

Note: If you experience unforeseen negative consequences of sleep restriction therapy, inform your doctor immediately. They may recommend an alternative treatment method or some natural sleep aids since those are much safer than the prescription medication you may be trying to avoid. Be thorough and dedicated when writing information down in your sleep journal, since your doctor will need anything you can give them.

Sleep Restriction Therapy and Depression

Depression is a potentially crippling mental health condition, and sleeping problems are some of its core symptoms. There is a reason that a lot of depressive people get tested for sleeping disorders – the two go hand-in-hand. When a doctor suspects their patient may have depression (which is important to know when diagnosing further problems), they often pose questions about the person’s sleeping patterns. Both insomnia and hypersomnia are possible outcomes of depression.

A vicious cycle can form in depressed people. As we’ve established, depression can result in all manner of sleeping problems, and those sleeping problems cause daytime fatigue. This fatigue negatively affects the person’s performance at work and their ability to socialize and stay energized or motivated. The mood drop that results from these problems fits in perfectly with how depression affects a person’s self-image and outlook on life, which can directly or indirectly contribute to further sleeping problems, repeating the cycle.

The consolidation of sleep achieved through SRT helps alleviate some of those problems by eliminating fragmented sleep. As a result, sleep restriction therapy is often used as a short-term depression reliever while a more concrete and thorough mental health care plan is constructed.

Falling asleep can appear to be the easiest thing to do, especially following an exhausting workday. Yet, there are numerous factors influencing our sleep beyond just steering clear of caffeine or setting an early morning alarm. Sleep is an essential aspect of our lives, so much so that we sometimes take its significance for granted until inadequate sleep habits begin to erode our daytime productivity and overall wellness. Sleep is indeed vital for our health, impacting almost every aspect of our physiological functions. Ignoring our sleep needs can result in serious health issues, affecting our immune response, metabolic processes, and mental well-being. Regrettably, the negative impacts of insufficient sleep often don’t receive the attention they deserve until they are unmistakably obvious.

It isn’t helped by the fact that sleep research, until the end of the 19th century, didn’t have many methods available for experimenting and extending the sparse knowledge we had at the time. Only with the discovery of EEG (electroencephalography) in the 20th century was this ice broken, and many other revelations followed, setting the ground for sleep science to develop. That is why this area is still very much considered new and has yet to be unlocked.

Two-Process Model

The two-process model of sleep regulation is an important sleep research posit explaining what goes on in our bodies during the 24-hour time frame, making us feel energized and awake at some points, drained and fatigued at others. It’s based on the interaction of our two bodily processes – sleep-wake homeostasis (S) and the circadian process (C) – working simultaneously and dictating our sleep length, quality, and it’s timing. Before explaining how exactly these two combine, let’s take a look at what each of them is.

Sleep-Wake Homeostasis/Process S

Homeostatic processes throughout the body are basically in charge of small-range maintenance, each in their own respective area. One homeostatic process, for example, is in charge of thermoregulation; another one monitors the salinity level in our blood, etc. The sleep-wake homeostasis, or process S, is a sleep-dependant process, in charge of generating a sleep drive in your brain, making you progressively more and more tired as the day passes by to ensure you fall asleep after enough time has passed. When you do fall asleep, the process is set off and gradually declines until you wake up. This sleep pressure seems to be connected to the NREM (non-rapid eye movement) phase of sleep, characterized by slow wave activity (SWA) in the brain. Because of this, SWA is perceived as one of the markers of process S in the brain. Another sign of sleep pressure or hypnogenic build-up is a molecule called Adenosine. Sleep drive has been shown only to decrease while in the NREM stage of sleep, other stages do not offset it entirely.

Circadian Rhythm/Process C

Certain timing of feeding and sleeping patterns is present in all animals, including humans. The circadian process, or process C, is simply put our internal, biological clock. It is a sleep-independent process that controls the body’s alertness levels and keeps check of our feeding time, brain wave activity, heart rate, oxidative stress, immune responses, hormone production, etc. It is situated in the small section of our brain’s hypothalamus known as suprachiasmatic nucleus, right above the optic chiasm, which consists of over 20000 neurons that respond to light. Process C looks over our 24-hour schedule; synchronizes our sleep rhythm with external cues, mainly light levels, to make sure we sleep when it’s dark and wake up in the morning, while also regulating other internal processes accordingly. It intervenes if the sleep drive gets too high during the daytime – without it, our sleep patterns would be completely random, unrelated to external stimuli, and more prone to polyphasic sleep. Circadian rhythm is assumed to be controlled by a circadian oscillator, and it’s markers in the body are melatonin secretion, core body temperature and plasma level of cortisol.

Two-Process Model in Action

These two processes constantly coexist and override each other during different times of the day. A normal day (meaning, after a good night’s sleep, and without activities that require attentiveness late at night) would look something like this:

You wake up and slowly pick up your daily pace. Sometime after lunch, your energy level drops a bit. Maybe you even take a nap, which freshens you up just enough so you can push through the rest of the work, wrap up your to-do list and call it a day. Later, comfortable and finally in bed, sleepiness takes over, and you quickly doze off.

This example shows the two-process model working regularly. Both of these processes have a peak and an ebb during the 24-hour cycle. The morning, after we shrug off sleep inertia, is typically when our mental capability levels at their highest. Process S slowly starts picking up and builds pressure as the day goes by. Circadian rhythm maintains this pressure and keeps it in check, so as to help prolong our time awake until nightfall when it enables melatonin production and induces sleep. Plainly explained, Process S peaks right before you fall asleep, and is at its lowest right before you wake up. Process C is at its ebb when you fall asleep, and peaks sometime midday.

What this essentially means by extent is that process S and process C might gang up on you when you are trying to stay awake after not sleeping for an extended period. Such a situation isn’t uncommon when working at a shift job. Case in point: After being awake the whole day, a surgeon, the only one available at the time, has to operate at 5 A.M. The sleep drive in his brain is over the roof, and the circadian rhythm isn’t making it any easier to keep his eyes open, insisting that it is nighttime and he should be sleeping. This sleepy cloud can seriously compromise our abilities and put us at risk of injuries and accidents, not to mention cause sleep deprivation issues if it happens on a more regular basis.

However, there are also times where the two processes work against each other, usually prompted by a sudden change in our surroundings or a stretch of our wakeful state beyond the regular sleep schedule.

When the Processes Collide

The perfect example is jet-lag; changing time-zones so suddenly leaves your body confused for up to a few weeks. As a result, as tired as you may feel, your circadian rhythm refuses to let you rest at night because according to recent experience, it’s not supposed to be night. It hasn’t yet successfully tuned your internal clock to match the day-night rhythm of the zone.

Another testimony to these two processes clashing occasionally occurs when you come home in the early morning after pulling an all-nighter and find it impossible to fall asleep. Once again, it’s process C, letting you know that you missed your shot because the night is over. Although it can create quite a struggle sometimes, this strict internal clock sometimes covers for you, helping you stay awake during the day even after a slim sleeping session the previous night, or fall asleep at night even though you weren’t feeling very tired.

It’s important to remember that process S and process C function together to balance your sleep habits and aren’t independent, which is perfectly displayed in the fact that the clock genes (which control circadian rhythm) have a role in the homeostatic process as well. They are connected, and both required in order to provide fulfilling rest. If the circadian process becomes too strong, it can prevent you from catching up on sleep after being deprived. In the other direction, sleep deprivation can also weaken the circadian process. This Two-Process Model is helpful to navigate our sleep-wake cycle and predict daytime vigilance levels, but a lot of other factors also come to play when it comes to our general sleep and well being.

Ways you Might be Making it Difficult on Yourself

Although this model is very helpful in understanding what happens in our brain in different stages of the day, you have probably realized by now that you cannot rely on your body to be impeccable in every situation and fix problems it didn’t cause. There’s almost always something else interfering with the system externally and making things more complicated. Some of these factors have a sedative effect on you, some offset sleep, and most of them you have either heard of or are guilty of yourself.

– Irregular sleeping schedule. Maybe you switch shifts often; maybe just willingly postpone sleep to watch a show, then take long naps to try and make up for it. When this scattered behavior happens often, it can take a toll on your body. Your circadian rhythm desperately tries to make sense of what you are doing, causing you to feel tired pretty much all the time and not letting you sleep when you want. To avoid this effect, try sticking to a plan of going to bed at the same time every night, and waking up the same every morning. To fit this in your weekly schedule, find the earliest time you must wake up, maybe 7 A.M. on Wednesday for that 8 A.M. class, and then wake up at that time every other day as well. That way, your circadian clock will work to your advantage, plus you will guarantee not feeling lost in class on Wednesday.

• Caffeine intake. A cup of coffee in the morning is fine. A cup in the evening, or a few cups throughout the day, will have a negative impact on your sleep. Caffeine blocks adenosine, a neuromodulator that is believed to play a part in inducing sleep. This is why coffee helps energize you in the morning, but leave it at that, and certainly avoid it later in the day.
• Certain drugs and alcohol. Drugs like antihistamines, melatonin, marijuana, and alcohol all have a sedative effect, which might trigger sleep at first, only to disrupt it later and affect the REM stage, leading to a poorer overall quality of sleep. Other than this, many of these substances are highly addictive, and you would be best advised to avoid them altogether.
• 
  Physical activity. A double-edged sword. Sort of. It is not unheard of for people to be crazed with straining exercises and training at all costs, but the more prevalent problem in adults is being in a prolonged sedentary state. Humans aren’t meant to be stuck in one spot for too long. If you spend a lot of the time sitting, at a desk job or you don’t like participating in sport, many health problems can occur. All that energy you get from sleeping and eating has to be used in some way, and if you don’t move it enough, your body will find its own outlets. The sedentary state has been linked to anxiety and depression, along with high blood pressure, obesity, cardiovascular disease, and even premature aging. Working out doesn’t just benefit your looks. It is a powerful stress relief, which ensures better sleep and mental hygiene. That brings us to…
• Stress. Stress and lack of sleep form a vicious cycle. Too much stress leads to endless health issues and makes it hard to calm down and fall asleep at night. Poor sleep then leads to more stress. No amount of sleep can balance out living in survival mode for an extended period, so you will have to identify your biggest stressor and deal with it. Even if you can’t fix all of your problems, which is not unusual, you can learn how to cope with them better, ensuring better health and sound sleep.

It is estimated that autism spectrum disorder (ASD) impacts around one percent of individuals globally. The last decade has seen not only a significant increase in ASD diagnoses but also a heightened awareness of the condition, sparking a keen interest among researchers to explore it further, especially its connections with mental health issues and sleep disturbances. Studies have shown that between 50% and 80% of those living with ASD, both children and adults, suffer from sleep problems. These issues can be attributed to several factors, including the effects of ASD itself, medication side effects, interactions between different medications, or the presence of other co-occurring conditions that exacerbate the problem. Sleep disturbances are most prevalent among those on the more severe end of the autism spectrum, who struggle with either initiating or maintaining sleep throughout the night. Insufficient sleep can aggravate common ASD-related behaviors like aggression, short attention spans, hyperactivity, and anxiety. This, in turn, can lead to increased daytime challenges and diminished performance in educational or vocational environments.

In this article, we will cover the precise sleep difficulties frequently faced by people with ASD, some appropriate treatment options and longer-term coping advice to remove some of the due stress and make these issues more manageable. But before all that, let’s get a bit more familiar with what ASD actually is.

What is Autism Spectrum Disorder?

Autism spectrum disorder is a lifelong condition that interferes with how people perceive life, form relationships and communicate with those around them. Despite many attempts at researching and identifying it, the exact cause of ASD is unknown; it is believed to occur resulting from a combination of complex genetic and environmental factors. People with ASD have specific needs depending on how debilitating their disorder is, and, albeit a cure doesn’t exist, with the appropriate amount of support, they are able to live long and fulfilling lives.

ASD is almost always diagnosed in the patient’s early childhood. Children under four years old already display symptoms that single them out from other children. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), one of the most renowned manuals on mental health disorder diagnosis and treatments worldwide, a patient can be diagnosed with ASD if fulfilling the following criteria:

• ‘Persistent deficits’ in communication and social interaction that occur in multiple settings. It includes not being engaged in social interactions, having poor verbal and nonverbal communication skills (unawareness of other people’s personal space, being sensitive about their own personal space, rejecting social invitations, reacting negatively to being hugged or when being asked to do something, avoiding eye-contact, differentiating between facial expressions when communicating, not picking up on the tone of voice or sarcasm in back-and-forth communication, etc.), displaying some nervous tics, etc. Adults and children with ASD aren’t fully capable of understanding, cultivating or differentiating relationships with others.
•  Restricted, repetitive behavioral patterns in speech (repeating a phrase or word group, or impersonating speech), repetitive body movements (rocking in place, clapping hands, etc.), fixed daily rituals and routine use of some objects in a specific way; being very inflexible about these patterns and reluctant to break from them. These symptoms are frequently accompanied by increased or decreased sensitivity to sensory stimuli like smells, light, noises, colors, etc. and fixation on certain subjects of interest.
• Symptoms must be or have been present during the early development period. As mentioned before, a child who has an ASD will display symptoms as early as in their second year. Symptoms include specific behavior patterns, maybe lining up toys based on their color, using toys in an otherwise different way than a so-called “neurotypical” child might, being reluctant to socialize, preferring to play alone, communicating in learned phrases rather than combining words to form new sentences, etc. Even when people are diagnosed later in life, the symptoms of their particular disorder must have been present all along.
• The symptoms are not ‘better explained’ by the presence of another condition. An accompanying condition in addition to ASD, like an intellectual disorder, is not irregular, but it is important to distinguish the two as distinctive, with separate diagnostic criteria.

The spectrum is a tool used to determine how debilitating the disorder is in an individual by evaluating how much support they need to navigate everyday situations. A person with a disorder classified as “high functioning” requires less help and is, with some difficulties, capable of handling day-to-day life, as opposed to a person whose disorder is classified as “low functioning” on the spectrum — this end groups people whose disorders are more extreme and can’t manage without very substantial support.

There are four categories of ASD that most people affected can be grouped in:

• Asperger syndrome. Many people with this syndrome are high-functioning. Symptoms include hypersensitivity, fixation on certain subjects of interest, inability to recognize some gestures in communication.
• Autistic disorder – usually classified somewhere in the middle between the high and low end of the spectrum.
•  Childhood disintegrative disorder (CDD) – severe, lower end disorder, diagnosed most commonly in children of under four years old. With a very small socializing and cognitive ability window, children with CDD often develop seizure disorders.
• Pervasive development disorder, not otherwise specified (PDD-NOS) is a term used for diagnosing any disorder that didn’t fall into the three previous categories; people diagnosed with PDD-NOS can be placed anywhere on the spectrum, with displayed symptoms from the most severe to the mildest of all the disorders.

How Autism Spectrum Disorder Affects Sleep

People with ASD frequently experience difficulties with sleep. Some of the common ones include:

• Issues inducing sleep
• Sleep maintenance issues
• Hypersomnia
• Increased daytime sleepiness
• Anxiety around bedtime
• Difficulty waking up in the morning

The root of these problems is always linked or directly induced by the person’s specific disorder, with some common, overlapping causes such as the following:

• Medical conditions or problems, the most common one being neurological – epilepsy. Seizures can cause major and sometimes frequent sleep problems. Acid reflux and diarrhea are often in people with ASD as well, making them wake up during the night, delay going to sleep, and the quality of sleep is disrupted.
• Mental health disorders, such as depression, anxiety, and attention-deficit hyperactive disorder (ADHD) are common in children and adults with ASD. These conditions are often accompanied by secondary insomnia or some other sleep disorder because they make it difficult to calm down and fall asleep; even if the condition in point didn’t inherently cause sleep problems, any medication potentially used to subside it could also affect sleep.
• Side-effects of ASD medication, for example, selective serotonin reuptake inhibitors (SSRIs) or antipsychotics, often include excessive sleepiness during daytime, and anxiety or restlessness in the evening, depending on the type of medication. It makes it harder for people with ASD to onset sleep or avoid being exhausted.
• Atypical circadian rhythm and melatonin production. The circadian rhythm is in charge of timing our sleep to match the dark-light periods of the day. Impairment of circadian rhythm, along with irregular secretion of the hormone melatonin, greatly influences a person’s sleep pattern, duration, and overall quality. A lot of people with ASD have an atypical circadian rhythm, causing them frequent sleep difficulties.

People who live with ASD already have a harder time navigating their daily life than people who don’t have this disorder. Heightened stress in itself means they often require more sleep to be able to function to their best ability. Lack of sleep can further the struggle they go through, and over time issues with sleep can develop into disorders.

Insomnia, the difficulty falling and staying asleep is the leading sleep disorder reported among people with ASD, with the incidence rate for adults being up to 90%, and 66% in children. Among children, parasomnias (night terrors, nightmares and enuresis) are also very prevalent, with the added diagnostic difficulties of the child’s inability to explain these occurrences and their own distress or fear. Upon waking up from such an episode, many children will get up and play or do something else instead of going back to sleep.

The link between ASD and other sleep disorders is highly debated among mental health and sleep specialists.

Treatment Options for Sleep Issues Related to ASD

Sleep medication is often prescribed to treat sleep onset and maintenance issues. Benzodiazepines, Z-drugs and other pills are all FDA approved for insomnia treatments, but the majority of them have some serious side-effects. The dependence potential, especially for children, is one strong reason for people with ASD to avoid sleeping pills altogether. Even for people without this disorder, sleep medication is not advised unless necessary, and under special circumstances; pregnant women, people with liver problems, high blood pressure and some other medical or neurological conditions, along with people who take other medication would all be ill-advised to take sleeping pills. Some people who have ASD might fall under this category as well, for two reasons:

1.    Along with the dependency risk, other sleep medication side-effects might increase some of the ASD problems like acid reflux.
2.    People who live with ASD often already take some medication to ease their condition; adding other pills shouldn’t be a quick choice, as the interaction of the two can potentially cause severe complications.

These points should be carefully considered before opting for sleep pills.

Instead, the treatment will probably first involve cognitive behavioral therapy (CBT). Children with ASD are often very strict about their routines, so a well-planned sleep routine might be useful. This routine might include changing into PJs, brushing teeth, using the bathroom, laying in bed and switching off the lights. While attempting this with a child, it is important for the parent to be very clear with what is going to happen; using visual aids to help explain the process to the child, limiting the number of steps and positively reinforcing the child when a step is followed through can be very useful in establishing the routine.

Additionally, light therapy might help with sleep. Exposing the child to bright light when they wake up can help raise their alertness levels during the day.

If the child doesn’t respond well to the first two methods, pharmacological treatments can be considered. A doctor might prescribe:

• Melatonin – children with ASD often have a decreased melatonin secretion in their brain, so a boost can help induce sleep. Risks and side-effects are low compared to sleep medication, but some nausea or dizziness is possible;
• Dietary supplements like valerian root, iron, some multivitamins, etc. are sometimes helpful for onsetting and maintaining sleep. The possible harmful effects are even lower than with melatonin.

Finally, if nothing stated above works, the parents of a child with ASD might consider prescription medication. Because of the smaller relative risks compared to common prescription medication, the only pills indicated for children are the following:

• Clonidine. An antihypertensive pill that treats ADHD and tic disorders, Clonidine can be used before bed to onset sleep. It carries a lower dependency risk than Z-drugs and other common sleep drugs
• Mirtazapine is an antidepressant used to relieve insomnia and anxiety but has potential side-effects like suicidal thoughts, so it’s not recommended for adolescents and some other patients.

Treatment for adults with ASD, although also starting with CBT, might include some stronger medication as well. It is vital to discuss all options with a specialist before deciding on anything, and unless otherwise advised, don’t take over-the-counter pills.

Sleep Management Suggestions for People Living with ASD

Treating sleep disorders and issues is important, but staying free of them is impossible if proper sleep hygiene isn’t kept. Below are some ideas on how to make bedtime less of a struggle for people with ASD:

• Avoid stimulating substances like alcohol and caffeine, especially in the evening. These will either keep you awake or disrupt your sleep later on.
• Don’t eat foods high in sugar or fat shortly before bedtime. Opt for healthy, more balanced meals with lots of vegetables and fruit whenever possible.
• Use the bed only for sleep. Associating it with many different activities might confuse the brain and delay sleep onset.
• Turn all electronics off at least half an hour before going to sleep to boost melatonin secretion and better sleep.
• Don’t nap in the late afternoon, and for longer than half an hour.
• Make the bedroom an inviting, relaxing place. Check if the temperature isn’t too low or too high and if the mattress is comfortable; declutter it as much as possible, keep your smartphone or tablet in another room, install lights that can be dimmed, pick a cool, calming color palette for the walls.
•  Keep a sleep log. Use drawings, writing or any method you feel comfortable with to describe your sleep patterns, dreams, any changes in when you fall asleep or how many times you wake up during the night. It will also be useful for a doctor during future visits.

If you’re typically adept at getting your much-needed rest but have recently started experiencing the “advantages” of pulling an all-nighter, you may be surprised to find yourself feeling unexpectedly lively or joyful after skimping on good sleep. It’s well-acknowledged that symptoms such as fatigue and sleepiness usually follow insufficient sleep, yet a fascinating and lesser-known side effect can actually induce feelings quite the contrary. Euphoria, characterized by happiness, excitement, or a sense of well-being, can be triggered by various daily activities. However, it’s important to recognize that certain neurological conditions and medications are also known to prompt or cause feelings of euphoria.

The first all-nighter after a while usually provides that extra buzz on the day after, research show that we owe that to the increased level of dopamine. That can potentially be the way in which our brain is trying to fight off sleepiness and function as normal as possible on the day after a sleepless night. But, the brain’s defense mechanism only masks the real problem for a certain amount of time; once the effects of dopamine increase vanish, the fatigue will strike down on us hard.

This sudden mood boost has even been considered as a short-term treatment for depression. There have been some indications that the symptoms of depression can decline for around 40% to 60% after a whole night of wakefulness. However, that is not a recommended way of treatment in any case, since sleep deprivation can cause more severe problems while ostensibly solving one.

One Sleepless Night

You do not have to be chronically sleep deprived to experience consequences of poor sleep, and sometimes it is hard to pay off just one night of sleep debt. Sleeping is important for many reasons, while we are resting, our body is working and performing multiple restorative processes which all help us to function on the next day. Since we are a sleep-deprived nation, many of us are already used to the fact that we sometimes need to sacrifice a night or two in order to do something on time or just to binge-watch a tv show. However, the reason why we continue to do that even though we know that losing sleep is not good for us is that we know that we can make it, we know that somehow we can survive and stay awake on the day after a sleepless night.

Some days are harder than the others, but yet there are those days when we stay up all night, and with the first rays of sun we feel good, no fatigue, no yawning, nothing, we just go out and do whatever we need to do that day. And no, that is not a sign that you have become resistant to sleep deprivation, or that you are so used to it that it has become normal. Feeling good, motivated and powered even though you did not shut your eyes for even five minutes is also a side effect of sleep deprivation.

Researchers from Berkeley and Harvard Medical School examined the brains of young adults and found out that their brains got a boost of pleasure after a sleepless night. When our brain functions normally it finds a sweet spot on the mood spectrum, but a brain of a sleep-deprived person will switch to one of two extremes, and neither one of them is considered good for decision making. This study also pointed out that professions such as doctors or pilots, people who take important and risky decisions on a daily basis, are especially at risk of making bad choices with fatal consequences if they are sleep deprived.

Intrigued by the fact that many patients with diagnosed clinical depression feel better and positive after a sleepless night, researchers used MRI to see what is going on inside of the brains of people who pulled an all-nighter, compared to those who were sleeping the last night. A total of 27 young adults aged from 18 to 30 years participated in this research, various images were shown to them, and their task was to rate them as positive or neutral. The group of all-nighters gave more positive feedback on the pictures, while the ones who were well rested gave a more moderate score. That shows that the participants who were awake for the past 30 hours have an overall more positive attitude towards basically everything, but that was impacting their judgmental abilities and hindering their objective point of view.

Brain scans of all-nighters showed that there is a higher activity in their mesolimbic pathway which is a brain circuit driven by dopamine, and dopamine regulates our positive feelings, motivation, cravings, addiction, etc.

After a night of good sleep, our frontal lobe regions are highly connected to the dopamine reward regions, but when we stay up all night, a disconnection occurs between the prefrontal cortex and mesolimbic pathway. This leans on the previous conclusions and researches of this team, which have also shown that sleep deprivation shuts down those regions in our brain which are in charge of decision making and planning while activating some more primal neural functions in the amygdala region.

Another study from 2012. also tried to inspect what is happening in our brain after a wholly sleepless night. Since dopamine has two main types of receptors, they hypothesize that the D2 receptor controls wakefulness. So, their question was, what is causing the decrease of D2 receptors when people are sleep deprived? Their first guess was that the increased release of dopamine was responsible for that because when some receptors are overstimulated, they leave the membrane. A group of volunteers was kept awake the whole night, while the other group was sleeping tight, so the next morning they checked the D2 receptors in the striatum, area full of dopamine. They realized that D2 receptor binding was much lower in the brains of sleep-deprived people, so does that mean that tiredness causes increased release of dopamine, which as a consequence has a decrease in D2 receptors? Or do the receptors decrease for some other reason? Most probably it will still remain a mystery, the researchers tried to test their theory one more time and treated their participants with methylphenidate which increases dopamine to see will it gave them higher dopamine release in well-rested participants than sleep deprivation. But, there was no significant difference, which means that the decrease of D2 receptors is not caused by the higher release of dopamine due to sleep deprivation. Their second guess was that adenosine, which is a neurochemical that promotes sleepiness. Caffeine increases wakefulness by counteracting the adenosine receptors, and one of the areas included in these effects is striatum, which is very high in dopamine. So their next mission is to see how adenosine and dopamine interact in the brains of sleep-deprived people.

Changes in receptors can also be linked to some risky behavior and impulsiveness which usually follows sleep deprivation. Although those changes in D2 type of receptors are visible, there is still no scientific explanation that can tell us why do they happen.

What is Dopamine?

Dopamine is usually widely associated with some positive conditions such as bliss, euphoria or motivation, but is it a thrill pill, happy hormone or something else?

Just like, for example, serotonin, dopamine is one of the hundreds of different brain chemicals called neurotransmitters, released by the brain cells. Dopamine is created by neurons when an enzyme called tyrosine hydroxylase gets combined with tyrosine, which is an amino acid. Neurotransmitters are in charge of controlling many body functions and transferring signals from the brain through the body. Although dopamine has been found in many animals, humans have three times more dopamine-producing neurons than most of the primates.

Dopamine has a key role in many body functions, such as sleeping, learning, movement, mood, attention, memory, etc. It is essential to know that dopamine will affect you positively only when its level is optimal, inadequate level or dopamine deficiency can even cause some negative outcomes, and one of them is depression. On the other hand, an increased level of dopamine makes us act and feel like we are on drugs since people experience something similar to losing their touch with reality.

Dopamine Effects

Researcher James Olds performed some of the earliest experiments inspecting dopamine back in the 1950s and 1960s. He experimented with rats, and find out that when their brains receive electrical stimulation at a certain area, they will keep performing some action over and over. At first, scientists suspected that dopamine somehow causes pleasure, and since people who suffer from depression usually had a lower level of dopamine in their brains, it supported their assumption that less dopamine means less pleasure. But, research from the 1980s proved that theory wrong. It was another experiment on animals, this time, their dopamine cells were dashed by drugs, but the animals still enjoyed the taste of sugar, according to their faces. They came to the conclusion that dopamine is not responsible for causing pleasure, but it does impact the way how pleasure affects our brain.

When we experience some pleasure, such as eating our favorite cake, our brain releases more dopamine, which will make you feel good about it, and that is why dopamine is often connected to addiction. Dopamine is the reason why we feel that urge to satisfy our cravings. And, we all want to feel good all the time, who does not, but some people seek illegal substances that increase their level of dopamine in an unhealthy way. Many recreational drugs stimulate the release of dopamine in our brain, causing addiction because the dopamine produced as a result of drug usage has a more long-lasting and intense effect than a piece of cake or anything else. When you finish your piece of cake, that intense feeling of pleasure will quickly start to fade, but with drugs it does not stop once you are done with your act, it gets you high and out of control. Now here is the part when it all goes down for drug addicts since constant use of drugs makes changes in their brains. Due to the over the top dopamine production, the brain starts to shut down some of the dopamine receptors, but the brain is still used to expect that pleasure caused by drugs, so in order to achieve the same amount of pleasure, addicts use more and more drugs. But the process of shutting down the receptors slowly takes that feeling away from them, causing the condition called anhedonia, which is a state when nothing feels right. Low level of dopamine receptors is responsible for impulsive and risky behavior, but that is not only connected to drug addicts, many gamblers or extreme sports aficionados are also risk takers due to their naturally smaller number of dopamine receptors. People who have a fewer amount of these receptors also have a problem with the regulation of released dopamine.

Can Sleep Deprivation Cure Depression?

This is a somewhat bizarre treatment for depression which was tested and proven decades ago. It has been shown that sleep deprivation rapidly alleviates symptoms of depression in up to 50% of depressed people, but there is still no reasonable explanation why it works for some people and for the others does not. Around 200 years ago, a German psychiatrist, Johann Christian August Heinroth, was testing sleep deprivation as a treatment for a condition then called melancholia. Since this phenomena became a huge field of interest for many psychologists, this treatment or process was established as a so-called Wake therapy, and it quickly became as popular as treatments with antidepressant drugs.

The main disadvantage is that symptoms of depression recur quickly, even after a day, since its effects are not long lasting. Regardless of that, researchers of this treatment for depression have come up with some new data, a study from 2015. found out that sleep deprivation impacts the same receptor for mood regulation as the ketamine and tricyclic antidepressants.

People who suffer from depression should never start this therapy randomly or on their own since sleep deprivation will never be a viable therapy for clinical depression. A sleepless night will provide that short-term experience of euphoria, but for those people who are suffering from depression, once the feeling of pleasure starts to fade, their coming back to reality would be even harder. Hopefully, ongoing research will give us more information on how sleep deprivation affects depression, and create a drug that can replicate its effects, without losing precious sleep time.