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Should you wonder if pain can contribute to exhaustion or additional health problems, healthcare experts recommend not enduring pain for long durations due to its potential negative effects on our overall well-being. Research indicates that the consequences of pain exceed those related to cancer, heart disease, and diabetes combined. It is estimated that in the United States, about 50 million adults suffer from chronic pain, with nearly 20 million of them facing severe impacts. One of the major outcomes of persisting pain is the lack of sleep, which, consequently, may lead to further health concerns.

In fact, it is a vicious circle of causes and consequences, where chronic pain provokes less sleep, and the lack of sleep aggravates chronic pain syndrome. It can be hard to determine the root of the problem, thus making it difficult to heal.

No matter whether your pain is acute or chronic, you can experience sleep difficulties. However, there is a difference between them. Sharp pain can be sudden and severe, but it passes in a while, whereas chronic pain can last for more than six months and exist independently from the original cause, but it may have lower intensity.

Different Types of Sleep-Related Pain

Different types of pain and complications can impact your sleep.

Chronic Pain

Chronic pain lasts for more than six months and causes more pain on top of the original injury. Some examples of chronic pain include fibromyalgia, arthritis, pinched nerve, lupus, chronic fatigue syndrome, Lyme disease, gout, restless leg syndrome, Raynaud’s syndrome, and vascular pain.

Chronic pain affects your sleep habits in different ways. For example, those who have pinched nerve will have a difficult time finding a position that will not increase this pain. Treating your pain while sleeping depends on many factors, but ultimately, maintaining good sleep hygiene and managing the root of your pain are good practices that can help improve your condition.

Back Pain

Back pain is a common problem among people all over the world. Almost fifty percent of Americans report that they have symptoms of back pain, and the situation is very similar in other countries. The human spine protects the spinal cord, nerve endings and internal organs, provides structural support for the necessary upright posture and helps with movement. When the spine is unhealthy, it cannot perform, and because of that, you experience pain in your back. Individuals who suffer from this problem have pain that radiates down the leg, muscle aches, or pain that gets worse with standing, walking, bending or lifting. These symptoms affect sleep especially if you are sleeping on a mattress that does not provide proper spinal support as it will only increase the pain. If you don’t treat them, they will contribute to sleep deprivation.

Neck Pain

Neck pain happens because of many factors such as the narrowing of the spinal canal, arthritis, or disc degeneration, and it is not limited to the neck. You can experience shooting pains, leg weakness, numbness, or tingling in your limbs. Sleeping with neck and shoulder pain creates discomfort, which can damage your sleep quality. It is not recommended to sleep on your stomach, but if you must, it would be best to use thin and soft pillows. If you don’t want to wake up with a sore neck, the best position is back sleeping, and the best pillows for neck pain are memory foam models.

Hip Pain

Hip issues cause pain in the hip and groin area, while pains that you experience in the upper thigh, outer hip, and buttock area are the resulting ligament, muscle, and other soft tissue problems. The most common cause of hip pain is osteoarthritis that occurs because of joint inflammation. Sleeping with hip pain can make it difficult to find a comfortable position. It is vital to talk to your physician and get adequate pain management medicines and physical therapy. In some cases, a hip replacement or chronic pain rehabilitation programs may be needed. Also, you can try exercises that will strengthen your inner and outer thighs, or opt for a water workout.

Arthritis

Arthritis is a widespread condition that affects over 50 million adults. It comes in more than 100 forms, but it primarily affects the joints. The causes depend on the type of arthritis that you have, but the symptoms involve stiffness, pain, swelling, and decreased range of motion. Age and weight are significant causes of arthritis because your joints get older and weaker as you age or gain weight. Injuries that cause joint damage and infections are also common causes of arthritis, along with genetics. Having arthritis pain will make falling asleep problematic, and certain types of this condition can cause sensitivity to noise, motion transfer and temperature. However, getting more sleep and having good sleep hygiene will alleviate pain from arthritis.

Fibromyalgia

Fibromyalgia is the cause of widespread body pain that comes with other conditions such as arthritis, irritable bowel syndrome, or lupus. Among the symptoms of fibromyalgia are stabbing and shooting pains, severe pain, deep muscular aching, and stiffness. This condition causes sleep disturbances by interrupting your sleep with sudden brain activity that is typical in awakened state. To fight this condition and improve your sleep quality, you need to find ways to get psychological support for chronic pain, therapeutic massage, physical therapy or ways to destress.

Headaches

Researchers have found that every year over 36 million Americans report headaches and migraines. Migraines cause severe head throbbing, blurred vision, nausea, vertigo, fatigue, and light sensitivity. And if you have migraines, you are likely to experience sleep problems for as long as the symptoms last (which can even be days). Individuals that suffer from migraines often have insomnia, so having good sleep hygiene is a helpful way to reduce these problems. Of course, you also need to reduce the consumption of headache-triggering substances, such as coffee and alcohol, and drink plenty of water (just not before bed).

Endometriosis

Women who have endometriosis usually feel pain in the stomach or lower back area during, before or after their menstruation, or even during sexual intercourse. With this condition, irregular or heavy bleeding, along with fatigue and cramping pain, can cause sleep problems. Many treatments can help you with endometriosis symptoms, such as hormonal treatments and laparoscopic surgery. Be sure to consult your doctor before undergoing any procedure or treatment.

REM Pain

Rapid eye movement or REM is the sleep stage where parts of your brain are acting like you are awake. Scientists are still exploring REM sleep, but they have found that it is crucial for memories and dreams. However, REM sleep behavior disorder can cause you to have unpleasant dreams and act out by making noises like shouting, talking, laughing, or cursing or even punching around you. If you have narcolepsy or neurodegenerative disorders, you are more likely to have REM sleep behavior disorder. The same goes if you are taking specific medications or if you are a male over 50. The best treatment would be to take natural or prescription sleep aids that will improve your sleep. You might also want to safeguard things around you.

Pain From a Bad Bed

Having a lousy mattress can also drastically affect your sleep quality, while a good bed can help you. Sleeping on a good mattress can help you reduce pressure points on the shoulders, hips, the lower back region, and neck, alleviate aches and pains, and get proper spinal alignment, while a lousy mattress will increase the pressure on these areas and cause more pain. The weight of your body and the position you sleep in can be vital in finding the ideal mattress material and firmness.

We will now list the primary materials you have on the mattress market.

The most common mattress type is innerspring. These models are bouncier than others, but they are also very firm. Many people have complained that they are too firm, so if you need a firmer mattress, this would be a good choice for you.

Latex mattresses are models that have at least one layer of latex in the comfort area. Because of this structure, they provide excellent pressure relief, pain relief, and spinal support. For better comfort and feel, they can have many layers of latex with different densities. But they do not have edge support so that you can get sinkage around the edges.

Foam mattresses have close conforming to the body, and they provide great alignment for your spine and excellent pressure relief.

Memory foam models have extraordinary pain relief, but heavier people should get firmer models to prevent excessive sinkage.

Airbed mattresses are filled with air. You can deflate them to create a different feel on your body. They effectively absorb motion transfer, but they make noise that can cause some people sleep disruptions.

Hybrids are a combination of two or more components, like innerspring, latex, wool or foam. With their unique combination and structure, they give excellent edge support with minimal sinkage, but they are not a good choice if you need an extra-soft or extra-firm surface.

However, you should note that many companies have sleep trials with their products, so you will be able to try the mattress and find the right fit. Some companies even have trial periods, warranties and refund policies, so it will make choosing the right model cost-free. Be sure to check these details and read some guides before buying a new mattress.

Choosing the Right Pillow

One of the crucial things that should be at the top of your list is selecting the right pillow. The right pillow can aid or worsen your chronic pain. Thickness, material, and loft are vital factors for your choice of pillow. They determine if the pad will alleviate or increase your pain. There are also pillows that are made especially to help with certain chronic illnesses like back or neck pain.

Dealing with Sleep-Related Pain

Studies have suggested that lack of sleep is more likely to predict chronic pain than the other way around. So, it makes good sense to deal with the problem correctly, preventing it to from escalating and transferring to a higher level of health deterioration, since sleep hygiene can impact how we can deal with pain. Below are some of the practices we need to follow for the benefit of our health.

• The proper duration of sleep

It is estimated that adults need about 7 to 7.5 hours of sleep a night, but we don’t have to stick to this firmly. Instead, find out what amount works best for you.

• Time of going to bed

What most of the doctors suggest is to go to bed around 10 p.m. or at least before midnight, which is hard to achieve with the pace of modern life. But, we should definitely go to bed at the same time every night. There are sleep tracker apps we can use to maintain regular sleep habits, so we should profit from these benefits of the modern age.

• Avoiding noise

It is known that sound prevents us from having a quality sleep, so we should opt for a quiet place, or relay on the help of white noise machines to eliminate city noises or other background sounds.

• Proper bedroom conditions

Dark and cool bedroom is best for healthy and peaceful sleep. Just as the light sends a signal to our body that it should be awake and active, darkness helps our body to produce melatonin, a hormone produced in the brain’s pineal gland, often known as the “sleep hormone,” which sends a signal to our mind that it is time for rest. Melatonin influences sleep by sending a signal to the brain that it is time for snoozing, thus preparing our body for sleep by relaxing our muscles and reducing our body temperature.

• The role of bed

The bedroom is an essential part of your home, so it should only be dedicated to sleep, as opposed to what we usually use it for, like watching TV, eating snacks and similar bad habits. As for the walls, even though the colors of walls are subject to trends, they should be chosen with care. For example, light pink colors, shades of mauve, or deep purples, colors with violet undertones are a trend for 2018, but in order to be productive, we should color our bedroom walls blue, yellow, green, silver or orange. Based on the study of 2,000 British homes, Hotel booking site Travelodge concluded that those who slept in a blue bedroom were sleeping around 7 hours and 52 minutes every night because blue is associated with calmness, which reduced their blood pressure and heart rate. Shades of yellow produced 7 hours and 40 minutes of sleep, shades of green produced 7 hours and 36 minutes, shades of silver 7 hours and 33 minutes and shades of orange 7 hours and 28 minutes. So, pick your colors carefully, because your sleep depends on them. The worst colors were proven to be purple, brown and grey.

• Limit screen time

As much as we depend on mobile phones and tablets, these gadgets have no place in bedrooms. The screens trick our brains that it is daytime. Avoid using them an hour before bed.

• Bedtime routine

We are all creatures of habit, so sleeping is no different. Make your own routine by taking a warm bath, using aromatherapy, drinking warm milk or other practice you feel helps you sleep better. There are even some indications a banana helps.

• Living habits

Daytime habits are equally important. Sunshine during the day, eating well, exercising, and simply living a healthy life helps good sleep.

• Forbidden pleasures

Night time is no time for coffee and alcohol. They are stimulants and will not help you get good sleep. So, do not take them four to six hours before going to bed.

• Ultimately, relax

We all faced those moments of frustration lying in bed with eyes wide open. But, getting angry will not help. The best thing to do is to get up and do something relaxing, (such as reading a book) before going back to bed to give it another try.

Over the past decade, there has been a notable increase in research on sleep, primarily thanks to various organizations focused on underscoring the essential importance of sleep.

Unfortunately, despite all effort, it seems that the quality of sleep keeps dropping and sleep disorders become more and more common. Based on the latest survey, over 35 percent of Americans do not get enough sleep; the average number of snoozing is 6.8h. Compared to 1985 there has been an increase of 31 percent when it comes to people who sleep less than six hours.

A fun fact is that a century ago (in 1910) people slept around 9h on average.

Times have changed since then, but we can all agree that the importance of proper rest and sleep hasn’t. That is why many doctors and sleep specialists have decided to develop tests that can help them define disorders and understand them better.

Multiple sleep latency test is one of them.

What is the Multiple Sleep Latency Test?

Multiple sleep latency test is a helpful tool that doctors use to determine a sleep disorder where daytime sleepiness is the leading cause of disrupted sleep. It usually follows Polysomnography or PSG, which is an overnight test that monitors the sleep stages and patterns. PSG test can also help exclude sleep disorders including restless leg syndrome, sleep apnea and others.  

Some doctors decide to include tests like: 

• CPAP titration testing which helps to determine adequate pressure for those who use CPAP machine

• Split Night Study that helps doctors define if the person is suffering from obstructive sleep apnea
• MWT or maintenance of wakefulness test that measures how awake and alerts a person is while being an environment that is free from stimulations.

How Does MSLT Work?

After conducting a PSG, MSLT is scheduled during the day, but the patient must stop consuming antidepressants and stimulants a few weeks before taking the test.

On the day of the MSLT, the patient will have five naps lasting 15-20 min each and 2h apart. The goal of this test is -to see how fast the person will fall asleep during the daytime in an environment that is relaxing and quiet.  

This test also shows when the patient enters the stage of REM sleep. In most cases, people who do not have any disorder will not enter REM sleep while napping for a short time. The stage of REM sleep occurs after more than 1h during the night.

The nap takes place in an environment free from distractions, noise, and stimulations that can prevent them from falling asleep. For Multiple sleep latency test to work, a person must sleep at least 8h the night before, and should not be exposed to strong sunshine and exercise in the morning.

The equipment used for this type of test is similar to the one that is used for PSG. It consists of monitors and electrodes that collect data. Pieces of equipment include:

• Small cup wires attached to the scalp to measure brain activity
• Two elastic belts that go around your stomach and chest to regulate breathing  

• Electrodes with wires attached on your face and chin to follow the activity of the muscles and eye movement. The reason why they are attached to your chin is to follow possible teeth grinding.
• Nasal Cannula and heat monitor
• A microphone small in size to detect possible snoring
• Monitor that follows your levels of oxygen attached to your fingers
• Electrodes attached to your legs to track muscle activity
• EKG to track the rhythm and heart rate  

What Does MSLT Measure?

The primary function of this test is to determine the time people need to transit from awake to sleepy and how fast ones goes into REM sleep. The idea is that people who are sleepy will fall asleep more quickly compared to those with a sleep disorder.

For most people, it takes five to fifteen minutes to go into light sleep, but for people who have narcolepsy and idiopathic hypersomnia, it happens much faster. For patients with narcolepsy, it takes less than five minutes, while those who have idiopathic hypersomnia fall asleep in less than eight minutes.

People who sleep normally REM sleep usually occurs after one hour, and it is the same for idiopathic hypersomnia. But that is where IH and narcolepsy differ from one another. People with narcolepsy fall into REM sleep in less than fifteen minutes.

After the treatment, clinical neurophysiologist or sleep specialist read the results and then send them to the doctor that ordered this kind of test. It can take about two weeks to get the results.  

MSLT Cost

The cost of a multiple sleep latency test can vary depending on the sleep clinic. The ones that some hospitals provide are offering lower expenses compared to the ones in the sleep clinic. The price ranges from 600 dollars to 2200 dollars.

Many professionals respect this test because the results that it provides are consistent, but it does not offer a 100% diagnosis for any disorder mostly because normal sleep latency is yet to be confirmed. But on the other hand, it can provide valuable insight to symptoms of sleep disorders that cause seizures, sleep apnea and distinguish narcolepsy from idiopathic hypersomnia.

Since we mentioned many times PSG test and disorders like narcolepsy and idiopathic hypersomnia, we will provide you with some facts about it.

What is Polysomnography?

PSG or polysomnography is a test that is you take while you are sleeping. A doctor supervises you as you sleep, and record information about the pattern of your sleep and possible symptoms of sleep disorders. These are the things that will be measured:

• Eye movement

• Breathing and heart rate
• Levels of blood oxygen  
• The activity of the skeletal muscles
• Brain waves

Polysomnography notices the shift between non-REM and REM sleep. Non-REM sleep is separated into light and deep sleep. When you are in REM sleep the brain activity is very high. This is also the stage when dreams occur. In non-REM sleep, the activity of the brain is slower. A typical sleeper experiences 4-6 cycles each night.

As the sleep specialist observes your sleeping cycle, possible changes and how your body reacts to them, he/she can detect sleep disruptions and help you identify them.

How Does Polysomnography Work?

Major hospitals or sleep centers offer this kind of testing, and it occurs in the evening 2h before your sleep time (as we mentioned the night before MSLT). Since you will stay overnight, the center will provide you with a room similar to a room in a hotel. Of course, you can bring your own PJ and everything that is essential for your bedtime routine. A specialist observes the patient while sleeping, and because the specialist will hear and see inside the room, you will be able to consult during the night.

In order to measure stated parameters and record them, the specialist will have to put wired electrodes on your scalp, legs, chest, and temples. The sensors have patches that are adhesive so that they won’t fall off during the night and those sensors have thin wires that send information to a computer. Some sleep centers offer a possibility to record a video of that data. That way you and your doctor can review changes in the position of your body during your sleep.

To be fair, you probably won’t feel that comfortable enough to stay asleep as you would back home but don’t worry that won’t affect the results of the test.

Once you wake up the specialist will take off the sensors; you can leave and continue with your daily activities.

What is the Purpose of Polysomnography?

Polysomnography is used to monitor your sleep and determine when and why are your sleep patterns disrupted. During REM sleep,  the waves in your brain slow down drastically based on EEG.

In non-REM stage, your eyes do not move as much but after a few hours the brain waves speed up, and the REM stage begins where most dreams occur. You usually enter many sleep cycles, and a cycle between non-REM and REM takes about ninety minutes, but sleep disorders can disrupt that process.

The doctor might recommend this test if he or she thinks there might be a chance that you have:

• Narcolepsy – If you feel overwhelming daytime drowsiness and experience sudden sleep attacks.
• Sleep apnea – If your breathing occasionally stops during sleep.
• REM sleep behavior disorder – If you start to act out your dreams while you sleep.
• Periodic limb movement disorder – If you move your limbs uncontrollably similar to restless leg syndrome.

• Strange behavior while sleeping – such as sleepwalking or sleep talking
• Chronic insomnia – If you experience difficulty falling or staying asleep.

Idiopathic hypersomnia

This sleep disorder belongs in a category called Central Disorders of Hypersomnolence. The ICSD- 3 explains that most people with this disorder complain that despite regular sleep they feel sleepy during the day. Also, it makes waking up in the morning or after a nap harder.  

The difference between other sleep disorders and hypersomnolence is that other disorders are caused by disruption of sleep while this disorder does not have an external cause. However, even if a person sleeps normally, he or she cannot feel rested or refreshed.

The feeling of being sleepy can occur at any time like at work or while you’re driving which is why idiopathic hypersomnia can be dangerous.

Idiopathic hypersomnia symptoms: 

• Excessive daytime sleepiness
• The difficulty of waking up in the morning despite multiple alarms
• Sleep inertia – a state of feeling confused and disoriented after waking up
• Long naps after which a person doesn’t feel refreshed

• Memory problems and difficulty with attention and concentration.

Difference Between Idiopathic Hypersomnia and Narcolepsy

To understand the difference between IH and narcolepsy, it is best to use the MSLT. The first type of narcolepsy can be distinguished easily because cataplexy is usually linked to it. In the second type of narcolepsy, the cataplexy is non-existent. The multiple sleep latency tests can help understand the difference between those the two.

In people who have idiopathic hypersomnia and narcolepsy, sleep latency happens at a faster pace, but the difference is that narcolepsy patients have a shorter sleep latency of five or less minutes (that is eighty percent shorter than in other people).

Patients that have narcolepsy also have rapid experience of sleep onset REM stage. It is quite common for a person to experience sleep paralysis immediately, but in most cases, narcoleptics go to REM stage in less than 15 min. Unlike the people who have idiopathic hypersomnia have normal sleep onset REM period from seventy to ninety minutes.

Despite extensive exploration by humanity, much remains unknown about the human brain. Many mental health conditions and sleep disorders continue to puzzle us in terms of their origins and consistently effective remedies. However, we have been able to uncover some knowledge about its consumption of energy, though this understanding is either incomplete or not entirely accurate. An average adult’s brain, even while at rest, accounts for about 20% of the body’s total energy usage. This may appear out of proportion given its small size relative to the rest of the body, but considering the brain’s crucial role in processing and sending information via electrical signals, it justifiably requires a significant portion of our energy. Notably, as much as 75 percent of the energy the brain uses goes toward synaptic activity, which are the vital “communication pathways” linking neurons together or with other cells.

In this article, we will cover the energy consumption of the human brain during sleep hours, as well as where that energy comes from and related information. Along the way, we may mention several experiments on non-human species that led us to draw solid conclusions that apply to humans. The more you know about your sleeping energy consumption, the better you can plan your diet and overall lifestyle to stay healthy and improve your sleep quality.

The Basic Overview

An awake adult uses about 20% of their total energy on brain function, when all the values are averaged out, of course. A more detailed look reveals that 15 percent of our cardiac output (the amount of blood your heart pumps out per minute – for people weighing in at 70kg, this is roughly five liters per minute during resting) goes towards brain activity. At least 20 percent of our total oxygen supply fuels brain activity as well.

Additionally, 25% of all glucose utilization goes towards powering the brain. Glucose is possibly the most crucial energy source in our body, and it is stored primarily in our liver and skeletal muscles as glycogen, its polysaccharide form. Low blood sugar or low water levels are frequently treated with dextrose solution, which is a combination of glucose and water. This solution is on the World Health Organization’s Essential Medicines List (EML), a resource on the most practically useful medicines for a basic health system.

Depending on which sleep stage we’re in, our body distributes energy in different ways. During stage 2 and 3, meaning light and deep sleep respectively, our brain is far less active than while we’re awake. Meanwhile, the REM stage is characterized by brain activity with a close resemblance to when we’re awake.

There’s a common misconception floating around in layman conversations that our brain uses up more energy when we’re solving a particularly difficult task, or “thinking hard.” The truth is, the intensity of the task doesn’t affect the amount of energy the brain requires but depending on what you’re doing, different parts of your brain demand a higher percentage of the overall energy “bandwidth.” For example, if you’re trying to hold a conversation, then the area of the brain responsible for speech and forming sentences will spark into action. This localized energy increase isn’t massive – clocking in at around 8% extra energy at most. The more stimulation you send towards a specific area of your brain, the EEG delta power is higher in that area once the person enters NREM sleep, specifically stage 3 or as it’s normally called – deep sleep.

The Energy Conservation Theory

Many theories are circulating in the scientific world about why and how sleep as a process evolved in animals, including humans. One largely discarded theory (called the Inactivity Theory) explains how sleep was originally meant to put us in a sort of “stasis” during the time of day where roaming around outside would be risky due to the increased threat of dangerous predators. This self-preservation mechanism would force us to stay put in whatever hideout we found, even against our judgment. While this theory was rejected due to various gaps in its logic (such as “Why would we want to be unresponsive to the environment and immobile if we’re in danger from predators?), a similar idea has sprung up, called the Energy Conservation Theory.

This theory suggests that because humans of old couldn’t compete with the apex predators of their environment at night, they would prefer to search for sustenance during other parts of the day. The competition for energy sources (primarily food) would force them to rest and save their energy until they can resume their hunting and forage more safely when the most threatening carnivores are asleep or otherwise inactive. The evidence for this idea lies in how our metabolism changes during the night. While we’re asleep, body temperature is considerably lower, heart rate and breathing slow down. It is estimated that our metabolism as a whole is around 10% slower than while we’re awake. Therefore, it is easy to conclude that sleep evolved in humans (and other animals) at least partly as a way to preserve energy during a time of day when it is difficult or too risky to find sustenance. This theory does not discredit all the other research pointing out the physically and mentally restorative properties of sleep.

What Happens to the Brain While We Are Asleep?

Overall, studies show that the total energy expenditure (or EE for short) of our body doesn’t drastically change between sleep stages. Here’s an example that can help prove that – while our muscles are not active at all during the REM stage (as they’re essentially paralyzed), the brain’s increased activity makes up for that, evening out the energy usage. Conversely, the NREM stage boasts higher energy expenditure on our muscles while we switch positions (especially if the person suffers from periodic limb movement disorder or a similar condition), but the brain is less active overall.

On a similar note, scientists have discovered that sleep deprivation increases energy expenditure while we’re asleep. People dealing with sleep deprivation often file subjective reports about feeling cold. However, it’s hard to confirm whether this is simply because fragmented sleep leaves us in a waking state more often (as we expend considerably more energy while we’re awake) when we’re dealing with a noisy environment or one that is unsuitable in some other way. This study serves as further supporting evidence for the idea that one of the reasons sleep appeared in our evolutionary path is to conserve energy until we can find more food at a safer time of day.

One of the most revolutionary diagnostic techniques we can rely on during sleep research is positron emission tomography (or PET for short). It is deep in nuclear medicine territory, as it uses a radionuclide (a purposefully-created unstable atom that indirectly creates gamma rays) that is introduced into the body through the use of a radioactive tracer (a chemical compound where an atom has been replaced by a radionuclide for use in research and diagnosis). This method is used to monitor and track various metabolic processes by creating a detailed 3d model of the entire body for scientists to examine.

Let’s put it in layman’s terms: positron emission tomography is used for sleep research to discover which parts of the brain consume the most glucose during a given period while we’re resting. It is presumed that these parts of the brain are the most active, as they draw on our energy reserves the most. During REM sleep, for example, the most active and energy-hungry parts of our brain include the pontine tegmentum, the back portion of the cortex and the thalamic limbus. On the other hand, the prefrontal cortex and parietal lobe are dormant and consume way less energy.

The Brain’s Resting Process

New ideas and theories are proposed quite often in the world of sleep research. One of the most groundbreaking discoveries happened when scientists realized through experimentation that not every part of the brain rests at the same time and that different parts of the brain experience different sleep intensities. It isn’t a trait that’s specific to us as humans, mind you – other species have shown similar behavior during experiments. If you hook up a dolphin to an EEG, the readings will show that their cerebral hemispheres don’t exhibit high-amplitude delta waves at the same time during NREM sleep. The blood distribution to our brain is different between REM and NREM stages, solidifying the idea that different parts of the brain rest at a different time and intensity.

An example that’s been talked about is that of sleepwalkers. Sleepwalkers are often considered to be both asleep and awake at the same time. They retain the ability to move around objects and navigate their immediate surroundings similar (although not as effective) to a waking person, but they’re as unresponsive to various external stimuli as a fully asleep person. If every part of the brain rested and was inactive at the same time, this would not be possible.

By looking into the sleeping and awake state of individual cortical columns (which are thought to be the brain’s basic processing unit) in rats, it was discovered that each individual column switches from an awake to a sleeping state individually (you can visualize it as an “on-off switch”). If the rat as a whole is sleeping, a vast majority of these cortical columns were in their own sleeping state, but not all of them. The same applies when the rat is awake. While most of the columns show signs of being in the waking position, columns in a sleeping state can still be found and measured.

The behavior of these cortical columns is connected to the homeostatic process. As a rule, the longer an individual cortical column has spent in the waking state, the more likely it is to switch to a sleeping one. Following the rat example, if you make a test where the rat is trained to lick as a response to the stimulation of one of its whiskers, this response will be unreliable if the cortical column that is meant to process that stimulation is asleep. As a result, it is believed that a cortical column is the smallest brain unit that can exhibit sleep-like behavior. While these experiments were primarily done on rats, similar findings were discovered with humans involved, suggesting that this is at least a trait consistent in mammals, if not most animals in general.

This study process also contributes to the idea that NREM and REM sleep developed together as a way of helping the brain recover by allowing different parts of the brain to rest at different times. Given how the primary roles of these two stages differ in the sense of bodily and mental repairs, it’s not hard to see how this theory holds water.

What Happens During or After Brain Lesions?

There are no reported cases of complete insomnia after the patient experiences a stroke or other kind of brain lesion (and over a million brain lesion victims were inspected, so the numbers can’t lie at this point). If they survive as a whole, a sleeping rhythm is re-established among the surviving groups of neurons despite the overall damage caused to the brain. It leads scientists and sleep researchers to believe that sleep is a property of individual neuron groups, not necessarily of the brain as a whole. Additionally, if the blood supply is limited to any part of the brain, neurons will immediately shut off to maintain a base level of brain operation.

In evaluating sleep disorders, it’s essential to be aware of a patient’s habits throughout the day and night. Daytime tiredness can indicate a variety of health problems, including excessive daytime sleepiness (EDS). Therefore, understanding how sleepy a patient feels during the day helps in identifying the cause of their tiredness, allowing us to offer an accurate diagnosis and proper treatment.

The inherently subjective nature of some of these sleepiness quantification methods has been brought into question many times in the past. It’s easy for a patient to unintentionally misremember or exaggerate the severity of their symptoms when filling out a questionnaire. However, as subjective as their statements can be, the diagnosis success rate involving these sleepiness quantification methods continues to prove their effectiveness as a diagnosis tool. Additionally, their ease of use and accessibility make them easy to implement at various clinics and research centers, even if the budget doesn’t have room for more technologically advanced equipment.

In this article, we will list off the most commonly used diagnostic methods for measuring sleepiness, and explain how they work and how credible they are. Let’s get into it, one by one:

Pittsburgh Sleep Quality Index

Developed during the 1980s in the University of Pittsburgh’s Western Psychiatric Institute and Clinic, this diagnostic resource was created to prove a connection between psychiatric conditions and sleep disorders, the idea being that the sleep disorders can often occur as a direct consequence of a psychiatric condition. The development of the Pittsburgh Sleep Quality Index (or PSQI for short) is largely attributed to the work of Dr. Daniel J Buysse.

The PSQI is used primarily as a preliminary test to determine whether a patient requires more thorough and detailed sleep investigation, typically through the use of a polysomnogram. Part of what makes this tool accessible is the fact that no one involved needs any formal training, meaning you can potentially fill it out at home by yourself. It’s also not a time-consuming test, as the whole process takes around 5-10 minutes. The test consists of nineteen separate questions that all add up to form scores in seven categories. Here’s a brief list of categories so you can get a better idea of where this is going:

–          Sleep Duration

–          Subjective Sleep Quality

–          Habitual Sleep Efficiency

–          Sleep Disturbances

–          Sleep Latency

–          Daytime Dysfunction

–          Usage of Sleeping Medication

The separation of the results into these categories helps doctors eliminate unlikely illness candidates by understanding where the symptoms manifest in the patient’s daily life, which vastly improves the accuracy of their diagnosis. The Pittsburgh Sleep Quality Index has been incredibly useful at identifying possible sleep disorders (such as primary insomnia), especially in the case of depression-related conditions and self-reported sleeping problems. However, its usefulness as a tool for tracking patient progress during therapy has not been confirmed or praised, and it is quite lacking when diagnosing patients with dementia. The reliability and accessibility of the PSQI have been vital to its status as a frequently used clinical and research tool, and it has been translated into 56 different languages to this day.

Stanford Sleepiness Scale

Originally developed in 1972, the Stanford Sleepiness Scale (or SSS for short) is one of the oldest subjective scales still used to measure sleepiness today. It is very accessible to English-speakers around the world, as they can find it for free online. The process is very simple – the patient selects a value ranging from 1-7, representing how sleepy they feel during the day. The idea is that you can do this test multiple times to verify your level of fatigue, which helps doctors get an insight into your circadian rhythm and daily schedule.

One of the biggest benefits to the SSS is that it reminds the person about their sleep schedule and circadian rhythm very frequently. The fact that they have to fill it out multiple times per day means sleep health is never too far from their mind, and they are then more capable of providing other subjective input to help their doctor come to a good conclusion. Shift workers get extra benefit from this test as it can show them when they’re the most alert and ready to perform during the day. As a result of this convenience, many doctors use the SSS as an extra diagnostic option, coupled with other methods.

Over time, criticisms emerged about the effectiveness and reliability of the SSS. The two major criticisms both focus on the perceived lack of nuance that the SSS operates on. For one, the test does not differentiate between someone with a sleep disorder and a temporarily tired but otherwise healthy person. On top of that, the test implicitly oversimplifies sleep by overlooking all the details that can go into why a person is experiencing daytime drowsiness or similar symptoms. Due to this, it is rarely or never used by itself as a diagnostic tool, and serves more as a way to extract an accurate subjective report.

Epworth Sleepiness Scale

As one of the main diagnostic tools for detecting sleeping disorders, the Epworth Sleepiness Scale (or ESS for short) sees widespread use amongst both clinicians and sleep researchers. The ESS emerged around the early nineties, developed by Dr. Murray Johns at Epworth Hospital in Melbourne. When a patient begins this test, they’re given a questionnaire to fill out. This typically doesn’t take longer than ten minutes to complete, and it doesn’t require any formal credibility from anyone in how it’s used. The questions present common day-to-day situations and ask the patient how likely they are to fall asleep in those scenarios. Here’s the list of situations used for the ESS questionnaire:

–          Sitting and reading

–          Sitting and holding a conversation

–          Lying down in the afternoon

–          Sitting idle after lunch

–          Being a passenger in a car for over an hour

–          Watching television

–          Sitting in a public place, inactive

–          Stuck for a few minutes in traffic while driving

The answers are graded based on a simple point system. If the person is extremely unlikely (to the point where it’s practically impossible) to fall asleep in a given situation, they receive 0 points for that question. The maximum amount of points is 3, indicating that the person is highly likely to doze off at some point. When the test is complete, all the points are added up to a total score. Initially, test subjects with established sleep disorders were given this questionnaire and based on their answers and scores, the score of 10 points was declared an important threshold – people who score 10 or higher suffer from excessive daytime sleepiness.

This score won’t change during a single day, which means it’s not effective at keeping track of a person’s circadian rhythm. However, the ESS is exceptionally reliable as a monitoring tool once a patient starts receiving therapy or using medication. Because of its ease of use and accessibility, it sees common use amongst doctors and researchers alike.

Multiple Sleep Latency Test

The Multiple Sleep Latency Test (MSLT for short) is the most often used diagnostic tool when it comes to sleep disorder detection. It is frequently recommended by doctors everywhere as the results are impossible to misinterpret or get wrong. How it works is, a few weeks before the test, the patient is asked to stop using any medicine that could affect their sleep architecture, such as depressants, anti-depressants or stimulants – even coffee is off limits. Once this demand has been met, thorough polysomnography is conducted to monitor the patient’s sleep for one night. This is done in part to ensure that the patient sleeps at least 6 hours prior to the MSLT.

The next day, the patient comes to the sleep lab where they fill out a simple questionnaire. Depending on the sleep lab and the specific case they’re looking into, they may take blood and urine samples. Once that’s all done, the person either sits in a special chair or lies down on a prepared bed for the important part of the test. Electrodes are hooked up to their face, scalp, and chest, and they are told to take a nap. The napping period lasts about 20 minutes, after which the patient is woken up to recover for a while before trying again.

The idea behind this test is to measure how quickly a patient will fall asleep during “daytime naps” after getting enough rest the previous night. The quicker they fall asleep (the critical threshold is around 5 minutes or less for narcoleptic patients), the more likely it is that they are suffering from excessive daytime sleepiness (EDS). The thing about EDS is that it often comes packaged in with another sleep disorder. The combination of the MSLT results and the previously done polysomnography session is the most precise method we have of making an accurate diagnosis.

Overall, the MSLT is primarily used in diagnostics to detect narcolepsy, periodic limb movement disorder, sleep apnea, and idiopathic hypersomnia. Results are also useful when trying to detect sleep-related seizure disorders. The only downside to this test is the time and money investment it demands. Both the polysomnography session and the MSLT itself are typically conducted at a specialist sleep lab, and take up almost 20 hours combined. If you can afford this method, we highly recommend it.

Fatigue Severity Scale

The Fatigue Severity Scale (or FSS for short) was created in the late 1980s as a tool that can measure how much fatigue affects a patient’s daily waking routine. More specifically, it was made to monitor the fatigue experienced by people who are dealing with multiple sclerosis or systemic lupus erythematosus. The FSS sees use as a secondary tool for various therapy plans and policies, usually for patients with chronic diseases – but often for sleep research as well. Additionally, it’s used when dealing with patients who are afflicted with major depression.

The FSS functions based on a questionnaire (like many other methods in this article). There are a total of 9 questions in the form, each one having seven possible answers. The higher you go, the more strongly you agree with the question statement. Each answer can score up to seven points, and the points are added together at the end. The maximum score is 63 points, and a threshold of 36 points represents the presence of considerable fatigue. Most people who fill in this questionnaire get a score that is significantly below 36 points, meaning that the effect of fatigue on their daily routine is minor if it’s even noticeable. Arguments have been made that the threshold for indicating severe fatigue should be higher (roughly around 45 points), but no real changes have been made thus far.

Since its creation, the FSS has become one of the primary diagnostic and research tools for dealing with fatigue and multiple sclerosis, to the point where 50 percent or more studies on that topic have featured this scale. Its use is often linked to fatigue that occurs as a result of various disabilities, such as chronic illnesses. While it’s not as widespread as the Epworth Sleepiness Scale or the Multiple Sleep Latency Test, it has received praise for being a simple and reliable way to keep track of fatigue. Because the results are often internally consistent, this scale can be used to track progress while a patient is undergoing therapy. Over time, if the therapy is successful, it will start to show a significant reduction in daily fatigue impairment.

Plenty of individuals regularly struggle with getting insufficient sleep, a problem so prevalent that it’s frequently considered just another unavoidable consequence of work obligations or social activities. This lack of proper sleep can considerably reduce job performance, lead to increased impatience in interactions, and diminish overall efficiency. Moreover, it boosts the likelihood of getting sick, complicating matters even more. Alarmingly, many are oblivious to their sleep deficit, which poses grave risks, especially concerning safety on the roads and drowsy driving.

Preventing sleep deprivation entirely is practically impossible. Too many factors can contribute to it, and it’s very easy to get caught in a loop of inadequate sleep. The best you can realistically hope for is to minimize the effects of sleep deprivation and deal with underlying issues that cause it. We’ve made this article to offer as much information as you need to make lifestyle changes that can help you fight off sleep deprivation and avoid the plethora of risks and consequences that come along with it.

What Causes Sleep Deprivation?

The obvious answer is simply inadequate time spent resting. Adults need at least eight hours of uninterrupted sleep to achieve optimal performance the next day. However, it can be very hard to maintain a healthy sleep schedule thanks to our daily habits. Inadequate sleep can be a frequent problem even if the person is otherwise completely healthy, but the resulting sleep deprivation can cause completely unrelated health issues thanks to our now weakened immune system. We will list several common reasons people lose out on much-needed sleeping time so that you can look out for these behaviors or issues in your daily life:

–           Heavy intake of caffeine and other stimulants can disrupt your sleep schedule. If you drink enough coffee or tea or eat enough chocolate, it may prevent you from falling asleep when you need it the most. Alcohol helps you fall asleep faster, but its effects on your melatonin production and general immune system ruin the restorative properties of sleep.

–          Shift work is bad for your sleep-wake cycle. Working the night shift or constantly having to shuffle your schedule around while working changing shifts has negative consequences for your health. Being forced to sleep during the day can lead to drowsy driving and similar sources of danger.

–          Almost if not every sleep disorder will destroy your natural sleep rhythm. From disorders like nocturnal leg cramps that keep waking you up through pain, to something like obstructive sleep apnea or narcolepsy, you will often have to deal with fatigue at some point during the day. Not to mention that prescription or OTC (over the counter) medication meant to treat these disorders can cause further problems and keep you constantly tired.

–          Any hobby or social commitment that frequently tempts you to stay up late or reverse your sleep schedule (or anything like that) is damaging to your daily levels of rest. Try to organize your time, so you don’t have to sacrifice sleep to engage in your personal interests, or change your hobbies to something that lets you rest properly.

–          Staring at screens during intended bedtime is disastrous. Even your phone can be enough to sabotage proper melatonin production and keep you awake for way longer than you should be. If your schedule depends on you getting up in the early morning, this bad habit can lead to some serious fatigue levels, which affects how well you perform at work and so on.

Almost everyone can name additional causes in their lifestyle if they think hard enough. Because potential sleep disruption factors are everywhere, it pays to live in such a way that you’re not sabotaging yourself more than is necessary for work. Otherwise, you face:

The Consequences of Sleep Deprivation

Most of the consequences we will talk about have to do with how fatigue affects your daily life and your body. Depending on whether you’re facing a sleep disorder or not, additional problems may be added on top. If you experience major discomfort and you think the cause might be sleep-related, contact your primary care physician as soon as possible. Let’s look at the list of potential consequences:

–          Sleep schedule disturbance is a very common result of sleep deprivation. Whether you take a nap during the day and push your biological clock out of sync or you’re running on 6 or fewer hours of sleep, it could have a long-term effect on your sleeping habits which then causes additional problems. If you wake up frequently during the night as a result of sleep disorders or child care, your sleep architecture gets ruined. Sleep architecture is the natural progression of sleep through stages, and your body calculates its architecture. If you keep waking up constantly, you don’t get enough deep and REM sleep. Those stages are crucial for strengthening your immune system, consolidating memories and preparing your mind for the following day. Without them, even something like damaged muscle tissue (from intense exercise) takes longer to heal, causing aches and pains.

–          You become more prone to accidents as your mind isn’t in good condition. The Three Mile Island accident was partially attributed to sleep deprivation among the workforce, so inadequate sleep can clearly have catastrophic effects. Shift workers get it the worst, as their horrible sleep schedule makes them increasingly vulnerable to not just workplace accidents, but drowsy driving-related injuries and risks. Fatigue has immense negative effects on a series of mental faculties, such as your reaction time and attention to detail, how much information you get from your surroundings, how likely you are to take risks and be aggressive or irritated, etc. In fact, while you’re driving, not getting enough rest is equally as risky (and punishable by law) as drunk driving, that’s how severe it can be. Not every accident is lethal or even particularly dangerous, obviously, but if there’s even the smallest chance that your fatigue could result in a potential injury or death, it means you become a walking health hazard at your workplace, not just for you, but for everyone.

–          You become worse at solving many tasks, as a result of your fatigue’s effects on your mind. The effect can manifest in different ways. For example, in tasks where test subjects had enough time, their cognitive function slowed down, and they took way longer to perform their duty than usual. Because of your inability to focus properly, the longer a task goes on, the worse your performance can become. On the other hand, time-limited tasks pushed the subjects to make a lot more cognitive errors, leading researchers to believe that fatigue lessens our ability to handle the pressure of almost any kind. In one study, researchers tested the effects of sleep deprivation on people’s performance. 48 healthy subjects were made to sleep for 4, 6 or 8 hours, randomized. The tests they performed afterward showed a startling result; sleeping for 6 hours or less is almost as impairing as not sleeping at all for roughly two whole nights. As an example, drowsy driving is legally punishable if the driver hasn’t slept for 24 hours before stepping on the gas. But if a sleep duration of 6 hours or less is almost as bad as 48 hours of complete sleep deprivation, then you can encounter risks very easily even if you think you’ve slept enough.

–          You may experience involuntary microsleeps. Lapses in consciousness can sometimes go by completely undetected by you or surrounding people, but they can occur during incredibly dangerous moments and threaten the safety of both you and anyone in the vicinity, especially while driving. If these happen frequently, visit your doctor as soon as possible, because it may be linked to a myriad of sleep disorders, most notably narcolepsy.

–          Because your immune system is weakened, the risk of developing various illnesses and conditions grows exponentially. From the common cold to a whole host of sleeping disorders, most conditions have a nasty habit of further affecting your sleep schedule and the amount of rest you get from sleeping. Thus, a vicious circle forms. You don’t get enough sleep, which causes you to get ill. Your illness prevents you from sleeping properly, which can result in long-term problems.

–          Your mood gets ruined. People who are suffering from fatigue become much more irritable and aggressive. On top of causing reckless behavior, this mood change can negatively impact their social life and stress levels. Stress is one of, if not the main contributing factor to a variety of sleep disorders and other neurological conditions, some of which can also disturb your sleeping partner if you have one.

Sleep Deprivation and Its Effect on Children and Teens

While it may surprise some of you reading, children are actually more vulnerable to sleep deprivation than adults. At least 40 percent of kids in elementary school reported having some sort of sleeping problem. 10% of kids had excessive daytime sleepiness, and another 15% showcased bedtime resistance. Bedtime resistance is a term used for when your child stalls or avoids going to bed and has been a pediatric issue for a long time.

Around 50 percent of teens report having difficulties falling or staying asleep occasionally — 13 percent report having insomnia and similar issues. Sleeping problems cause lowered academic performance, disrupt their social lives and can even affect their self-image and likelihood of depression. Additionally, sleep deprivation has been shown to cause problematic behavior, both at school and home. Conditions like ADHD (Attention Deficit Hyperactivity Disorder) and learning difficulties have also been connected to a regular lack of sleep.

How Can You Detect Sleep Deprivation or Sleep Debt?

Sleep debt is what its name implies – a measure of how much you didn’t sleep when you should have. While not a disorder in itself, it’s linked to many health conditions. The best way to track how sleep-deprived you are is to visit a sleep lab. Sleep experts have a method called multiple sleep latency test. They measure how easily you fall asleep when forced to take a series of 20-minute naps. The idea is that a person with a lot of sleep debt banked up will have no issues quickly falling asleep, whereas someone with a healthy and regular sleep schedule will take way longer, usually around 15 minutes. This test is very effective at detecting sleep deprivation, and it’s often used to test for excessive daytime sleepiness or narcolepsy.

If you don’t have the time or money for a full sleep lab investigation, you can use a couple of tried-and-true home methods to get a solid idea. Some experts say that needing an alarm clock to wake up early enough for work (or any other relevant activity) is already a sign of sleep deprivation. You can resort to sleep tracking (usually by using an app or keeping a sleep journal) to take notes on how fast it takes you to fall asleep. The less time it takes to drift off, the more likely it is you have sleep deprivation issues. The same goes for daytime naps. If you’re a worried parent, make sure to talk to your child about their sleeping habits and how they feel. Otherwise, they likely won’t report sleeping problems themselves, unless it’s something that scares them or they’re sick.

Stepping into the role of a parent for the first time is often accompanied by significant stress. No matter the volume of parenting books and articles you read, there will be instances where you’re unsure of the next step to take. It’s a widespread feeling among new parents to worry about the adequacy of their parenting or the well-being of their child. Yet, experiencing such concerns is entirely normal.

Sleep in children can be particularly problematic. They often wake up during the night, they fight to stay awake and don’t want to go to bed, and that can result in one very long and sleepless night for you too. Children between the age of nine months and two years wake up two times per night on average. However, some may wake up as much as nine times each night, and cause a lot of concerns for their parents.

If your child is experiencing sleeping difficulties, they might have a Sleep Onset Association Disorder (SOAD). This disorder can develop when a child associates a specific environment or a person with falling asleep. For instance, a child is used to be nursed, rocked, or held before sleeping, and every time they wake up, they require this action to fall back to sleep. Sleeping in a sibling’s or parent’s bed, or falling asleep in a car are common as well.

It is estimated that as much as up to 50% of all the infants, and 15-20% of toddlers experience SOAD.

Parents unintentionally reinforce the behaviors that are associated with Sleep Onset Association Disorder. You might think that rushing in every time your baby wakes up, picking them up and rocking them back to sleep might be a good idea, but it is much more important to reinforce independent sleep in children. By helping your child to sleep independently, you will have more time to rest, and the quality of your child’s sleep will be improved as well.

How to Treat Sleep Onset Association Disorder in Children

If your child has a SOAD, it is crucial to encourage them to fall asleep on their own. Sometimes it can be hard to eliminate the associations your child might have with falling asleep, especially when it includes your intervention. Be prepared for a lot of crying in the beginning, and always keep in mind that doesn’t make you a bad parent. It is essential to teach your child how to sleep on their own as that will improve their sleep. It can be hard, but be consistent. Expect for a child’s temperament to worsen at first, but then it gets better after a short period. Some of the evidence-based techniques for treating SOAD are:

• Bedtime fading. This strategy includes temporarily delaying your kid’s bedtime and teaching them to sleep on their own. For instance, if your child usually takes about 30 minutes of fighting and crying, try putting them to sleep at least 30 minutes later. They will be more tired, and that will make them fall asleep easier. When the sleep onset latency (the time it takes to fall asleep) drops to 10 or 15 minutes after going to bed, move the bedtime routine a bit earlier every day until you reach the desired time. You should aim for 7:30 PM to 8:30 PM window.
• “Camping out.” It is another gentle routine that consists of gradually removing your presence from the child’s bedroom over time. This approach can result in less crying, but remember that this technique usually takes longer than some more strict ones. You start by being close to your child, and then slowly moving away every night. For instance, first you sit next to the crib, then you slowly position a chair a little further each night until you can stand at the door, and finally leave the room one night. Remember that your child might look for guidance and that you should provide comfort and make them feel safe. Keep the interactions brief with reassuring words and a light touch.
• The “cry it out” approach. The behavioral term for this method is extinction, and it consists of removing your presence from the child’s room entirely during sleeping hours. Remember that shutting the door and letting things play out until the morning can be very emotionally exhausting for your child and that we do not recommend this approach. Children need to feel safe, and you can do that by occasional visits to their room. First, you go out for shorter intervals, and then gradually make them longer until they can fall asleep on their own. Also, remember to check on your kid if they have been crying for more than a couple of minutes. You want to make them feel safe, but avoid turning the lights on or picking them up. Calm, reassuring words and a light touch will do the trick.
• The “excuse me” drill. This method is used on children that are older than three years, and can talk and already do some abstract thinking. While staying in a child’s bedroom, you should say “Excuse me” and then make up some excuse to leave the room. The more boring the reason is, the better. At the start, be gone just for a few moments, and then gradually prolong the time you are gone until they can sleep on their own. It is essential that you give them positive reinforcement when you get back, as that way they’ll feel good about themselves and falling asleep

You should also manage your child’s daytime naps so that they feel tired in the evening, and fall asleep more natural when they get to bed. You can introduce them to a transitional object that can help as well. Giving them a soft blanket, a stuffed animal or a doll can teach them to self-soothe, and fall asleep on their own.

Optimizing Sleep Hygiene in Children

Proper sleep hygiene in children will improve the quality of their sleep. It consists of:

• Establishing a regular bedtime routine. It will make sure that your child knows it is time to go to sleep and they’ll be more relaxed. Proposed bedtime routine includes eating a light snack, taking a bath, putting on pajamas, reading a story or singing a lullaby, saying goodnight and kissing them. Spending quality time before bed will make them feel safe and relaxed, which makes it easier for them to transition to sleep. A bedtime routine should take no longer than 30 minutes and should be a positive experience for your child.
• Setting a regular sleeping schedule. It means getting your kid to bed and waking them up at the same time every day.
• Don’t feed them too close to sleep. A light snack is okay, but avoid big meals before bed.
• Manage your child’s daytime naps, so the child is not wakeful or overly tired when going to bed.
• Do not allow your child to sleep in your or their sibling’s bed. Although this seems harmless, and shouldn’t matter if it’s not done too often, sharing a bed is shown to decrease the quality of sleep in children.
• Check your child from time to time, but don’t stay in their bedroom too long.
• Avoid giving them caffeinated drinks including coffee, ice cream, sodas, and dark chocolate.
• Light exercise is good for your child’s sleep, but it shouldn’t be done too close to their bedtime.
• Child’s bedroom should be kept dark, quiet and the temperature should be consistent through the night at around 68 degrees Fahrenheit.
• Keep the TV and other electronic devices away from their room.

Good news is that with proper sleep hygiene and usage of the techniques we’ve covered, your child should learn to sleep on their own, and their sleep quality should improve in no time. Don’t feel bad if they are crying at first and be persistent that is crucial.

Keep in mind that if your child is sick, you should take special care, and check on them more often. Also, if there are other sleep-related symptoms, you should visit a doctor. They can tell you if your child has insomnia or some other sleep disorder that can be found in children.

Sleep-related movement disorders, often referred to as SRMD, are characterized by unconscious, simple, and frequently repeated movements during sleep. These actions typically occur more often during the phase shifting between being awake and asleep. While these disorders are usually not critical, diagnosing and managing them can be complex. Specific disorders within this category, such as bruxism (grinding of teeth at night), may result in severe dental and jaw issues if left untreated. These conditions can also significantly stress parents of children who are dealing with them. It is essential to begin treatment promptly, even when the disorder appears to be harmless initially.

In this article, we will look at several sleep-related movement disorders to find out their potential risks and consequences, as well as how they’re normally treated. While the best idea is almost always to consult a doctor when dealing with these disorders, knowing the symptoms and causes yourself can help you understand their recommendations and also get some peace of mind, knowing that treatment options exist and the patient is less likely to suffer any long-term consequences. So let’s begin.

A General Overview of Sleep-Related Movement Disorders

The causes and contributing factors vary from case to case, although there is a consensus on how we can identify various sleep-related movement disorders. In most cases, a direct connection can be made between these disorders and the patient’s age, medical history or any medications they may be using at the time. For example, bruxism (also known as nighttime teeth grinding) primarily affects kids around age 6 or younger. After age 6, it subsides in the vast majority of cases. On the other side of the age spectrum, we have rapid eye movement (REM) sleep behavior disorder, affecting people older than 50.

Here’s the thing, however. Most if not all other sleeping disorders drastically increase the risk of becoming afflicted by a sleep-related movement disorder. Even if the original disorder isn’t the direct cause, the medication you take to fight against it could have nasty side-effects, including SRMD. Even medicine used to deal with depression, like SSRIs (selective serotonin reuptake inhibitors), can contribute to the risk. Other potential causes or contributors include heavy caffeine intake and stress.

As a consequence, the diagnosis process can get complicated. The doctors will want to know the patient’s full medical history and every bit of information about daily habits that could lead to increased SRMD risk. The most accurate way to find the causes is through a combination of the patient’s medical history and a detailed polysomnography procedure. It involves spending a night at the sleep lab, but the benefits are worth every second (and penny) invested.

Sleep-Related Movement Disorder List

We’ve covered the basics, but there aren’t many similarities between these conditions. It’s important to look at each one individually to get an idea of how you can solve your problem. In this article, the focus will be on the most common conditions, and we will cover their potential causes, risks and how they’re treated.

Sleep Bruxism

This condition is commonly known as nighttime teeth grinding. A distinction is usually made between child and adult bruxism. Around 30% of children aged 6 or under showcase this behavior. By the age of 13, this problem clears itself up in over 50 percent of cases. Once they reach adulthood, that percentage grows to around 90%. Think of it like bedwetting or night terrors – just a part of growing up for some children. Obviously, this doesn’t mean you shouldn’t take measures against it – regular dental check-ups are an excellent way to keep your child’s teeth safe from chipping or deformities. One of the main causes of nocturnal teeth grinding among children is the discomfort that comes with teething (the process where your child grows their teeth).

Adult bruxism is a different story. The main problem you run into with bruxism is that doctors don’t know for sure what causes it. Possible causes and contributing factors include stress, anxiety, genetics, and other sleep disorders (especially obstructive sleep apnea and rapid eye movement behavior disorder). Anxiety is the main potential cause, as 70% of adult bruxism patients give subjective reports that focus around it. Much like most sleep-related movement disorders, high caffeine intake or an alcohol or tobacco habit increases the risk of bruxism developing.

Unfortunately, there is no “cure” for nighttime teeth grinding. The best you can hope for is a set of methods that help neutralize or weaken the symptoms, so you or your loved one can sleep without worries. Before you seek out dental device or something similar, work on your sleeping habits and overall lifestyle. For example:

• Do exercises and activities that help you reduce stress, such as meditation, yoga or breathing exercises. Visit a sauna if you have the time or money. The more relaxed you feel in your day-to-day life, the less impactful bruxism symptoms can be
• Keep your jaw relaxed through massage, or by avoiding hard-to-chew food items and chewing gum. These foods put more strain on your jaw than usual which can cause or amplify the symptoms of bruxism.
• Remove or reduce the amount of alcohol, nicotine, and caffeine. This is much easier said than done, but these habits are a strong contributing factor for this disorder.

If you try these methods, and you still have to deal with unpleasant symptoms (such as jaw pain, changes in tooth shape, tooth pain, chipped teeth), it’s time to seek professional help. Luckily, dentists have a very reliable solution. They will take an imprint of your teeth and jaw, and create a custom-made protective set of jaw guards. These not only protect your teeth from the potential damage sustained through grinding, but they also reduce the noise, helping anyone else in the room sleep peacefully.

Nocturnal Leg Cramps

Nocturnal leg cramps are the name we use for a sudden calf muscle tightening during the night. This disorder is particularly common among pregnant women, but anyone can experience it. The probability of experiencing nocturnal leg cramps increases with age, as people above the age of 50 deal with it the most. Much like bruxism, there isn’t one specific cause you want to look for. These cramps could happen as a result of medication side-effects or metabolic diseases (such as hypothyroidism). Another common potential cause is simple dehydration. Endurance athletes often suffer from cramps, as they can’t reliably rehydrate during their trials.

The most impactful consequence of this disorder is that your sleep schedule and sleep architecture can get ruined because you keep waking up in pain. As a result, the impact is widespread, affecting your immune system, putting you at risk of drowsy driving and making you irritable and exhausted overall.

Treatment options are pretty simple. Increase the amount of potassium in your diet, whether by changing the dishes you regularly make or by taking supplements. Pregnant women will want to add magnesium pills to this combination. Make time in your schedule for regular muscle stretches and general exercise. Not only will this approach help you with nocturnal leg cramps, but it will improve the amount of energy you have to work with daily, and bring other general health benefits. Make sure you drink a lot of water, to prevent the risk of dehydration-induced leg cramps.

Periodic Limb Movement Disorder

Periodic Limb Movement Disorder (PLMD) is a condition portrayed by repetitive and involuntary limb movements during sleep. Don’t mistake this disorder for hypnic jerks, as those only occur at sleep onset, whereas periodic limb movement disorder is exhibited during sleep. The other disorder this might get confused for is restless legs syndrome (RLS), but RLS is characterized by a strong urge to move the legs due to a prickly sensation. While PLMD primarily causes legs, toes, and ankles to move, arms can be involved as well.

Because these limb movements happen during sleep and are completely involuntary, most people who suffer from this condition are unaware of it. However, if you’ve been dealing with this disorder for a while, you may notice fragmented sleep or daytime fatigue, or full-blown insomnia in the worst case scenario. An environmental hint you can pick up on is the position of your blanket and nearby items after you wake up. Your leg jerking can displace these things and tip you off that something is wrong.

PLMD affects roughly 4% of all adults. The probability is much higher for older adults (above age 65), at around 30%. This disorder often comes packaged in with another sleep disorder (usually restless legs syndrome, obstructive sleep apnea or narcolepsy), and can even be linked to other chronic conditions, such as diabetes or anemia. Unfortunately, we have not confirmed any guaranteed causes for periodic limb movement disorder, although there are solid theories. Genetic factors and iron deficiency are commonly linked to PLMD, as are a variety of genetic quirks. Because this disorder often comes bundled in with another condition, that condition is often considered the underlying cause, although not all of our research backs this up. The main methods of diagnosis involve a detailed analysis of the patient’s medical history and a full polysomnographic observation. Blood tests are often done to check the iron levels and similar values.

There is no real cure for periodic limb movement disorder, but there are measures you can take to alleviate some of the symptoms. While proper medication like gabapentin or dopamine agonists are necessary for the most severe cases (ones where the patient’s entire sleep rhythm is ruined by this condition), most people can resort to simple lifestyle alterations. A leg massage or a hot bath before bed can help out a lot, as can light exercise like quick walks. As is the case with most sleep disorders, you should avoid alcohol like the plague, and minimize your daily caffeine intake. If you take antidepressants, consult your doctor to make sure that your medication isn’t contributing to PLMD.

Hypnic Jerks

Everyone has experienced hypnic jerks (also known as sleep starts) in their life. Right as you’re about to fall asleep, a part of your body may suddenly jerk violently and startle you back into an alert state. Sometimes, many of these jerks can happen, one after another, for some time. Their intensity and frequency may vary, but it can get bad enough to cause people to be afraid to fall asleep. Most people rarely experience hypnic jerks, which is why it’s often not looked at as a disorder (despite being one). Children are the most susceptible, as sleep starts occur for them the most.

Contributing factors can vary from person to person, but they don’t stray too far away from the core offenders we’ve talked about already. Stimulants such as caffeine are a common contributing factor to almost if not every sleep-related movement disorder, as are things like iron deficiency. If you do intense exercise before bed, it increases the risk of hypnic jerks occurring. Stress is another well-known contributor, as are antidepressants (and their nasty side-effects).

Because of their relatively benign nature and commonplace occurrence, sleep starts are rarely treated properly. However, if a person’s sleep schedule and daily life are at serious risk from this condition, there are mostly reliable methods available. Iron supplements solve one of the most common problems in patients dealing with sleep-related movement disorders, while regular leg exercises (not right before bed) can lower jerk frequency and intensity. If the patient needs even more help, dopamine agonists are used, much like with RLS. Keep in mind that pregnant women should not be given dopamine agonists under any circumstances.

Unfortunately, a study conducted by The National Institute of Mental Health indicates that one in five Americans struggles with a type of mental health problem. The severity and length of these issues vary from person to person. Distressingly, just a small portion of these people are getting the necessary medical treatment.

Sleep disorders are potential symptoms of almost every mental disease. About 40% of people who seek medical help for sleeping problems, physicians discover they also have a psychiatric condition. On the flip side, it’s very rare to struggle with a sleep disorder without a mental health problem. Less than 20% of people with a mental health condition don’t have any sleep issues.

We could say that sleep quality can be used to measure the quality of our mental health. For this reason, psychiatrists always ask patients about sleep behaviors and habits when making a diagnosis. It is important to mention that sleep disorders often coexist with depression, panic disorders, ADHD, anxiety, schizophrenia, and bipolar disorder. Sleep issues associated with these mental health disorders make it more challenging to manage and alleviate the symptoms and to experience the benefits of medical treatment. Learn how mental illness and sleep disorders are connected.

The Relationship Between Mental Illness and Sleep

Poor sleep can be a symptom, but also a cause of mental illness. Sleep issues can contribute to the development of mental disease, prolong it and make it more difficult to cope with. As mentioned in the beginning, sleep disorders are commonly comorbid with other mental disorders. Insomnia is the biggest sleep problem psychiatric patients struggle with, apart from their condition. According to studies, 40% of insomnia patients and 45% of hypersomnia patients have a mental illness. People without mental illness have significantly lower rates of insomnia. The difference is so striking that nobody doubts the connection between sleep disorders and mental illness anymore.

You may be wondering how much sleep people with a mental health condition get? According to surveys, people who have mental illness often report their sleep is nonrestorative. They also struggle with midnight awakenings, falling asleep too late, waking up too early and waking up feeling fatigued.

Studies show that people with a mental health condition experience significant changes to their sleep architecture. Typically, they spend more time in lighter sleep that is less restorative, and less time in deep and REM sleep. Lack of sleep and the effects of sleep deprivation make it more challenging to manage and cope with the symptoms of their mental illness. Due to sleep deprivation, these patients are more emotionally sensitive, and irritable. They also may have a hard time to regulate their emotions, reactions and are prone to poor decision making. It’s easy to see how this mindset makes it rather hard to cope with the mental disease.

The worst thing is that mental illness and insomnia aggravate the effects of each other, creating a vicious cycle that once starts, pushes the patient in a downward spiral. This makes treating both conditions particularly hard. Let’s take a closer look at some mental diseases that are associated with sleep disorders.

Anxiety Disorders

Unfortunately, many US citizens struggle with different kind of anxiety disorders, starting from general anxiety, social anxiety and obsessive-compulsive disorder (OCD), to phobias, PTSD and panic disorder.

Anxiety is typically a reaction to stress, and stress, no matter how insignificant, affects the nervous system. Individuals suffering from anxiety experience stress on a more acute level, and it typically occurs due to obsessive or anxious thoughts or due to PTSD. Regardless of the cause of their stress, they cannot process it as a healthy person.

Their anxiety constantly keeps their nervous system alert and makes it very difficult to relax and unwind before sleep. When we are under a lot of stress, a stress hormone called cortisol significantly raises and prevents the production of the sleep-inducing hormone melatonin. The more stressed we are, the more cortisol is produced, further decreasing melatonin levels and making it almost impossible to fall asleep at night.

People suffering from anxiety are generally prone to experiencing insomnia or hypersomnia. Insomnia is the inability to fall or stay asleep. Many patients suffer from anxious thoughts or struggle with anticipatory anxiety toward certain phobia triggers which is so overwhelming that it makes it impossible to relax the mind and fall asleep in the evening.

When it comes to hypersomnia or oversleeping, patients often oversleep as a response to stress or simply exhaustion from insomnia. Insomnia and hypersomnia commonly occur together in many cases of anxiety disorders.

Apart from the two, nightmares are a common symptom of PTSD, and in them, the patient re-experiences and relives the trauma he or she went through in the first place. Those who have panic disorder may experience nocturnal panic attacks. A nightly panic attack typically wakes up the affected person who feels extreme panic or fear. The attack can also be accompanied by sweats, chest pain, and increase heart rate.

To treat anxiety-related sleep disorders, it’s best to practice psychotherapy, especially cognitive behavioral therapy (CBT). CBT is considered one of the best ways to treat insomnia and a variety of mental health issues. The principles of CBT include reframing your negative thoughts, educating yourself about healthy emotional responses, and learning to recognize the thoughts and behaviors interfering with your daily life and sleep. The point is to replace your negative reactions and thoughts with healthier reactions.

Depression

It’s estimated that around 16 million adults suffer from depression. People struggling with this mental illness typically have suicidal ideas, experience feelings of sadness and despair and lose interest in all the activities they previously enjoyed.

Individuals with depression commonly suffer from insomnia or hypersomnia. According to studies, insomnia is a major risk factor for suicide among the population. One study found that individuals with insomnia are 6 times more likely to develop depression, and those with both conditions are more likely to stay depressed. In addition to insomnia, people with depression may be prone to sleep problems such as hypersomnia or oversleeping, and obstructive sleep apnea (OSA). Around 40% of young adults and 10% of older adults with depression also suffer from oversleeping. When it comes to OSA, this sleep disorder is also a significant risk factor for developing depression.

Unfortunately, antidepressants used to treat depression can make insomnia even worse. Sometimes, antidepressant medications such as amitriptyline, trazodone, or mirtazapine can be used to treat insomnia. These medications are known as SSRI drugs. Antidepressant medicines can negatively affect insomnia by making the patient feel active and energetic which makes it difficult to fall asleep at night. However, these drugs can help the patient alleviate sleep maintenance insomnia, or ability to stay asleep at night.

In most cases, treating depression, especially in milder cases, makes insomnia go away. Similar to treating anxiety-related sleep disorders, to handle insomnia caused by depression, it is best to practice CBT. In case the person suffers for the seasonal affective disorder (SAD), light therapy, which involves sitting in front of a specialized light device for a set period of time each day, has shown great results. The goal of light therapy is to reset the patient’s circadian clock. Typically, the patient is exposed to bright light in the morning to help him wake up and prepare for the day, while early afternoon treatment helps them to stay awake and avoid hitting the hay too early.

Attention-Deficit/Hyperactivity Disorder

ADHD is a neurobiological disorder typically diagnosed in childhood. It’s estimated it affects 5% of children and that it can persist in adulthood as well. The disorder is characterized by behavioral changes and symptoms such as hyperactivity, impulsivity, and inability to focus.

Sleep problems associated with this disorder are mostly fragmented sleep. Insomnia occurs in 75% of patients, and some researchers believe this occurs due to a delayed circadian rhythm. Apart from sleep maintenance insomnia, these individuals also struggle with midnight awakenings.

Apart from insomnia, common ADHD-related sleep disorders include excessive daytime sleepiness, sleep-disordered breathing (sleep apnea), periodic limb movement and restless leg syndrome. Both PLMD and RLS are characterized by an urge to repeatedly move the legs while lying in bed or during sleep. The movements are so intense that the affected person finds relief only by jerking their limbs which makes falling asleep and resting pretty difficult.

Excessive daytime sleepiness is another common symptom of many ADHD- related sleep disorders. Due to their sleep problems, these patients are more likely to be tired during the day, even if they get the same amount of sleep as people without ADHD.

Unfortunately, the medications used to treat attention deficit disorder often cause sleep problems. Some ADHD medication has stronger effects on sleep. In case you suffer from ADHD and experience sleep problems, you should talk to your doctor and look for alternative solutions such as CBT. Cognitive behavioral therapy is a special method for treating various conditions, including sleep problems, by learning to develop healthy responses to your symptoms and changing your thought patterns and negative behavior.  When it comes to CBT for ADHD, the focus is to calm down the body and the mind and to alleviate hyperactivity symptoms. Stimulus control techniques and exercises that involve progressive muscle relaxation are also recommended. Other treatment options that showed great results are sleep restriction therapy, where therapists set a sleep schedule for their patient. For success, the patients must strictly stick to the schedule and spend only those hours in bed. Naps and sleep time outside of that schedule are not allowed. In case the patient has a delayed circadian rhythm, light therapy might be recommended. Lastly, if a patient is struggling with RLS or PLMD, using a weighted blanker may help to alleviate symptoms. The general rule is to use a blanket that weighs 10% of your body weight, plus 1 pound.

Schizophrenia

Schizophrenia is a severe mental illness that doesn’t affect many people. It’s estimated, one 1% of Americans have this mental disease. This psychosis prevents the patient to process reality, manage their emotions, and communicate with others. Severe hallucinations also accompany the condition. Sleep problems related to this mental disease include irregular sleep patterns and inconsistent sleep volume.

Patients who have schizophrenia tend to sleep at any point during the day or night. Scientists believe this is caused by a delayed melatonin release that shifts the circadian rhythm. When it comes to inconsistent sleep volume, patients typically don’t get enough sleep on a daily basis. Sometimes they are prone to insomnia, and sometimes they oversleep. Sleep problems also occur as a side effect of the strong medications they are taking.

In order to treat schizophrenia, psychiatrists use the first generation of antipsychotics, but also some atypical ones, such as clozapine, olanzapine, and quetiapine. The last three mentioned have positive effects on sleep, and typically help schizophrenic patients to sleep longer. Some medications help to improve their slow-wave sleep, while some increase REM latency, similar to SSRI drugs help people with depression. CBT can also aid in alleviating the psychotic symptoms of schizophrenia.

Bipolar Disorder

Bipolar disorder affects around 3% of US citizens. People suffering from this condition experience severe mood swings in behavior, energy, and mood. These swings also affect their sleep. If the person is in a state of mania, they will be full of energy and sleep very little. Even if they go long hours without snoozing, they won’t feel the need to sleep. When it a state of depression, the patient will probably experience hypersomnia or oversleeping. Irregular sleep patterns are also common in both states. Apart from the mentioned, bipolar disorder patients may also struggle with sleep apnea. Sleep-disordered breathing can sometimes spark another manic episode or make it hard to deal with episodes of depression. Whatever sleep issues these patient experience, it makes it generally more difficult to handle the symptoms of bipolar disorder.

Even in between their episodes, patients with disorder experience lower quality sleep, and have more difficulties falling asleep and staying asleep than healthy individuals. In order to treat bipolar disorder-related sleep problems, it is best to practice cognitive behavioral therapy or CBT-I, a type of treatment specially developed to treat insomnia. Sleep restriction and stimulus control have also shown great results.

Do you know that sleep takes up a whopping third of our lives? Yeah, it’s that big a deal! Skipping out on those precious z’s, for whatever reason, leaves us cranky and foggy the next day, wishing we hadn’t. You’ve been there, right? Waking up after a long night, regretting not hitting the hay earlier and counting the minutes until you can dive under the covers again.

Besides the obvious benefits that sleep has on our health, scientists have been wondering if sleep affects our memories and if it does, is it necessary for remembering new information.

During the initial studies, when sleep was shown to have a positive impact on memory, scientists thought that it was a passive role. Spending time resting meant that you were cut out from the environment and that there were fewer sensations to interfere with your memory. Newer studies showed that sleep plays an active role in the consolidation of memories, and while earlier studies focused more on the REM sleep and its importance, further studies highlighted the importance of deep (slow-wave) sleep.

We have learned a lot about sleep and memory from years of studying, but there is still a lot of research to be done.

Types of Memory

To process external information, store it as a memory and then be able to retrieve it, is a fundamental ability of all living creatures. This potential is needed so that all living things could adapt to the changing environment. We can say that a better memory is an adaptive feature that was supported by natural selection, and we see this storage of information on every level. For instance, if your immune system cells weren’t able to recognize some things, fighting off bacteria and viruses would be a lot less effective.

When it comes to humans, not all memory is the same. There are different parts of our central nervous system involved in remembering other kinds of information. Generally, hippocampus, amygdala, and neocortex play a central role in memory storage.

Depending on the involvement of different parts of our brain, there are two types of distinguished memory; declarative and nondeclarative.

There are two types of declarative memory: episodic memory that is referred to storing information about events, and context-based memories; and semantic memory that enables us to remember random fact and things that are independent of contextual knowledge. Declarative memories can be encoded even without our intention, but are exclusively retrieved by active, aware attempts. Episodic memories can be learned quickly, in just one try, in contrast to semantic memories that need repeated encoding.

Unlike declarative memories, nondeclarative ones can be obtained without the involvement of medial temporal lobe structures, and they rely on the different parts of the brain. Nondeclarative memories include procedural memories for motor and perceptual skills and certain forms of conditioning and learning. These memories can be obtained and retrieved without awareness, but the learning process is slow, and it usually requires many repeated attempts.

Distinguishing between nondeclarative and declarative memory can be quite tricky, as brain parts involved in both of these processes are communicating all the time, and that interaction is necessary for learning.

How Are Memories Stored?

There are three processes connected to memory: acquisition, consolidation, and recall. While acquisition and recall happen during waking hours, consolidation is mostly associated with sleep. Consolidation means moving short-term and easily lost memory, to better preserved long-term memory. The way that memory is preserved or erased is by strengthening or weakening neural synapses.

Initial studies focused more on the effect that REM sleep had on memory. Later on, it became clear that all three stages: light, deep and REM sleep were important for constructing memories. While light and deep sleep play a significant role in the embedding of declarative memories, REM sleep is vital for nondeclarative memories. Some even argue that the cyclical changes of these sleep phases are what makes memory possible.

Sleep is a perfect time for storing memories, as we are disconnected from our surroundings, and don’t have new information coming at all times and interfering. We are bombarded with information at any given moment, and our brain has to decide what’s important and store that somehow. The suggested model of consolidating information is known as a two-stage memory system. Firstly, we have a fast learning store (hippocampus), where the encoding of memories is quick and efficient. There is no more than one trial needed, but this information can quickly get lost when there is a new amount of information coming. Our brains had to find a way to overcome that somehow and store the memory for good. That happens slowly, as the data passes to long-term memory in neocortex. During our sleep, new memories are repeatedly reactivated, and that’s how they slowly get embedded in long-term knowledge.

The time for memory to go to long-term storage can vary between a day, and several months or even years. That depends on the acquired information and preexisting neural networks in our brain.

Sleep Deprivation and Memory

Sleep is essential for all of the processes related to memory. When you are sleep deprived, your concentration and cognitive ability are affected. That’s why it is hard to acquire new information when you are tired. Consolidation of memories is also affected, as less sleep means less time for memories to go to long-term storage. This way, information will stay in the hippocampal synapses, and it’s more likely to become affected by the new sensations and get lost in the meantime. Fatigued individuals find it harder to recall already stored information, so sleep deprivation affects memories on every level.

It is still not clear about all of the mechanisms that sleep deprivation affects memory, but it is suspected that adenosine build-up has a lot to do with it. Caffeine is showed to fight off the effects of adenosine successfully, and that is probably why so many students rely on coffee and energy drinks during their study sessions.

It seems that lack of sleep weakens some neural circuits, and that’s why our memory is affected. But don’t worry, our brain has an ability to reconsolidate memories, so during your next resting period, it will work hard on repairing those synapses.

People who have insomnia often have memory problems. That is another reassurance that sleep is the key element in remembering things.

Sleep and Learning

Electroencephalogram (EEG) is used for measuring brain activity. It gives us a good insight into what happens in our brain during sleep. EEG readings of Stage 2 of non-REM sleep show short bursts that scientists have name Spindles. Each spindle lasts for about a second, and there could be thousands of them each night. Spindles are correlated with the transfer of memory from the hippocampus to the neocortex and formation of long-term memory.

The density and number of Spindles are correlated with intelligence, and the number is observed to increase during the process of learning. As we age, the number of Spindles during our sleep declines, which is thought to have a connection with the cognitive decline in older people.

Light stages of sleep (Stage 1 and 2) are essential for motor memory. They also help the brain remain plastic to getting the new information. The light phases of sleep are usually shorter during the first part of the night, and then they become longer as you approach the dusk, so cutting short on your sleep may not be a good idea.

Naps are an excellent method to boost your learning abilities. They are especially beneficial to our procedural memory.

The Link Between Memory, Dreams, and Cortisol

Dreams have been a mystery for us for a long time. No one is quite sure why they happen and what can be their purpose, but some scientists have argued that they are playing a role in consolidating our memories.

During the waking hours and most likely REM sleep, the information flow is from neocortex to hippocampus. However, during the slow-wave sleep, the information flow is mostly reversed, but there are still some data coming to hippocampus from neocortex.

Dreams mostly occur during REM sleep, but they are shown to happen during other stages as well. It is just that these dreams are entirely different. Dreams connected to non-REM sleep are short, often episodic and are mostly memory based. That is why scientist argue that slow-wave sleep is maybe the most critical stage for memory consolidation. The neural circuits repeatedly reactivate, and that way your brain is strengthening the memories, while you experience dreams.

Dreams during REM sleep are entirely different; they are more chaotic, fragmented and can be far away from your memories and reality. That’s why some bizarre dreams happen, where you can fly off a building, or blink through different places on Earth in a matter of seconds.

Scientists suggested that the high level of cortisol as long with some other neurotransmitters can alter our memory and dreams. Cortisol is a hormone produced by the adrenal glands, located on your kidneys. It is created in times of stress, and it has an alarming function on your body. High levels of cortisol are shown to disrupt memory consolidation and as well as affect dreams. It is interesting how patients with high cortisol levels similarly described their dreams to individuals who have experienced some traumatic event. These descriptions, are often fragmented, bizarre and non-coherent.

While a lot about memory and sleep is still a mystery, scientists are doing their best to understand this phenomenon better. There is a large body of research being done in this field at the moment. While we are waiting for the results, one thing is clear; we need sleep to store memories. Sleeping well will improve your mood, concentration and give you proper motivation to deal with new stuff daily. If you are well rested, you’ll find it easier to learn things, and your brain will have more time to make sure that you don’t forget them.

If you want best cognitive results positive, stick with a regular bedtime routine, remove distractions from your bedroom, relax before going to sleep, and don’t forget to eat healthily and exercise regularly. If you have time during the day, consider taking a nap, as they can also be beneficial to you.

Sleep inertia is a natural bodily phenomenon that impairs your cognitive and physical functions when you wake up. It’s a condition that can impact almost everyone upon awakening, particularly during the shift from sleeping to being fully awake, especially if disrupted from a deep sleep before the sleep cycle has concluded. Symptoms of sleep inertia include confusion, drowsiness, and reduced physical coordination, with recovery time varying from a few minutes to a few hours after waking. Typically, it’s not considered worrisome as it is a common part of human biology and diminishes with time.

Symptoms and Causes

As we previously mentioned, the main symptoms are the feeling of grogginess, reduced cognitive and motor performance and difficulty executing tasks. Grogginess is a disoriented state where your mental activity and senses are dampened. Impaired motor dexterity and a decrease in cognitive ability is what increases the reaction time for any task or movement and causes low attentiveness. Apart from that, you can get deficits in spatial memory, heightened subjective fatigue and an increased desire to go back to sleep. Although we all have groggy mornings, every person wakes up differently. Individuals that are morning people rarely experience grogginess, while some have grogginess every day.

The symptoms usually occur after waking up, and this is the time when they have the greatest intensity. How long they last depends on multiple factors, and the time ranges from a minute to a couple of hours. The duration of sleep can have a significant influence on the severity of your sleep inertia. The most significant factor is the stage you are in before you wake up. Abrupt awakening during deep sleep generates more sleep inertia than awakening in the light sleep stage.

The cause of sleep inertia is known – it is the sudden awakening that occurs during your deep sleep or slow-wave sleep. It can also take effect when you have insufficient sleep duration because sleep deprivation also makes it difficult to wake up. Sleep inertia is most likely to occur if your awakening is timed much earlier than usual, like when you have to go to the airport or catch an early train. Waking up from deep sleep still leaves your body with high levels of melatonin that makes you feel sleepy. The more you sleep, the higher the melatonin level is. However, this does not happen when you wake up during your light sleep or non-REM sleep. Waking up at this stage of sleep slows down the heart rate, brain activity, and blood pressure, and you can be awake and become alert a lot quicker. There are also theories that suggest that the source of sleep inertia can be the buildup of adenosine, a neurotransmitter in the brain during non-REM sleep.

This occurrence can appear or get worse if you have any other sleep disorder, like delayed sleep-wake phase disorder or even sleep apnea.

The deferred sleep-wake phase is a disorder that creates a postponed ability to go to sleep with insomnia during the night. People that suffer from this have an unusually delayed major sleep episode that is connected to the dark phase of the solar cycle. Because of that, starting to sleep and waking up at an adequate time is very difficult with severe and chronic sleep restriction and deprivation. These night owls have problems sleeping because they are not able to fall asleep until late at night and consequently, they cannot wake up in the morning and tend to oversleep. The condition typically starts in teenagers and can continue into adulthood, and because it induces sleep deprivation, it can also lead to many other symptoms like insomnia, idiopathic hypersomnia or sleep inertia. Toddler sleep inertia is also present, but children grow out if in most cases.

Sleep apnea is a condition in which you have a temporary loss of breath while sleeping. During the night you get complete or partial obstructions which are blocking your airways. It splits your sleep into fragments and interrupts your sleep quality, and it often creates episodes of choking, gasping, teeth grinding, snoring, frequent urination, pauses in breathing insomnia.

When is Sleep Inertia a Problem?

An individual that is sleep deprived or gets waked from deep sleep, experiences sleep inertia in a more severe and longer period. In these cases, your ability to do any task or even see a mistake somewhere is very limited during sleep inertia periods. Many drowsy driving car accidents happen in the morning because of sleep inertia. A driver with sleep inertia is very dangerous since he has impaired motor and cognitive functions which severely affect the ability to drive a car safely. A study from 2006 showed that severe morning grogginess is actually more alarming than staying up all night. While both situations are precarious, it is important to remedy the bad grogginess before going to.

Sleep Inertia Treatment

Because sleep inertia is a big problem for some people, especially those who have to work extended shifts, a lot of research has been put into developing methods to help overcome this condition. People that work as emergency responders, medical professionals, or in the military need to have excellent cognitive ability and motor functions in order to respond to a call and help people in dangerous or hazardous situations, which is why they have increased the demand for a remedy.

Caffeine and adrenaline

The most common treatment we use for sleep inertia is caffeine and adrenaline. The adrenaline and caffeine stimulate the central nervous system which causes an increase in alertness and with a boost to your blood pressure and heart rate it also improves your concentration. Caffeine and adrenaline block the adenosine receptors, limit the effects of the adenosine buildup, stimulates the brain, increase your focus and reduce fatigue.

Caffeine is good at improving alertness and performance if you are stressed and sleep deprived. As a countermeasure for sleep inertia, caffeine is an efficient cure  But the tolerance and consumption of caffeine are very individual, and it can vary in its efficiency to minimize the effects of sleep inertia. Even though these help you function during the day, they are only a temporary fix of the consequences, and not sleep inertia itself, so they should not be used as a long-term remedy. Many reports have shown adverse effects with vast amounts of caffeine. Negative effects like increased anxiety and impaired sleep are common problems that people experience from high caffeine consumption.

Light

An excellent way to fight this condition is by exposing yourself to natural daylight. The natural sunshine you get with sunrise is a significant factor that minimizes the effects of sleep inertia. The light at dawn suppresses melatonin, a hormone that is in charge of regulating your sleep-wake cycles. Brief exposure to bright light doesn’t help immediately with sleep inertia, but studies have shown it can help reduce symptoms approximately an hour after waking up. Exposure to white light doesn’t help. Only natural daylight has been proven to aid sleep inertia.

Sleep and naps

Another way to reduce the symptoms of sleep inertia is re-entering sleep for a short period. When a person is tired and sleep deprived, a short rest can help minimize the effects sleep inertia has on you. However, more extended rests may induce reduced mental and physical fatigue, and even produce sleep inertia. However, small power naps might help you avoid it. 

To avoid sleep inertia, you need to wake up during your light sleep, also known as the quiescent sleep and non-rapid eye movement sleep. It is crucial to avoid waking up during deep sleep or the slow-wave sleep that happens around 30 minutes after falling asleep. If you’re taking a nap, you need to limit it to under 30 minutes, just before going into slow-wave sleep.

Sound and temperature

Sound and temperature are stimuli that are proven to be effective in helping with sleep inertia. The presence of mild sounds and a slight decrease in temperature of the extremities can minimize the symptoms and possibly reverse them. Sounds with lower frequency components than white noise can aid with sleep because they provide a constant, and auditory background which minimizes the impact of random noises on sleep initiation and promotes attentiveness in sleep deprivation conditions. A drop in temperature of the extremities can stop heat loss and promote the return of core body temperature to normal daytime levels.

Tips

 Optimizing both sleep quantity and quality is essential. Adults need from seven to nine hours of sleep to feel well rested and functioning. Not getting enough sleep impacts the length and intensity of sleep inertia, and sleep deprivation can even prolong it to several hours. A good approach to deal with sleep inertia is to time your morning alarm to the end of a sleep cycle that lasts around 90 minutes. The best time to set your alarm is seven and a half or nine hours after falling asleep. In order to better predict your wake time, you can’t use a fixed-time alarm because it’s difficult to predict in which sleep stage you’ll be in  the same time each day. Instead, you need to set the alarm for each night manually. If your fixed alarm clock wakes you up from deep sleep, you will end up feeling groggy all day because part of your body is still sleeping.

Conclusion

If you wake up abruptly, sleep inertia can last up to several hours, increasing your chances of making mistakes during any routine action. Apart from that, sleep inertia has many unpleasant and somewhat dangerous effects. Some of these effects are extremely risky for pilots, drivers, or any other shift workers.

The main effects are low performance and response time on tasks, lower productivity in the first half of the day and loss of concentration. Experiencing these symptoms leads to a reduction in memory ability and drowsy driving. Drowsy driving has been the root of approximately 20 percent of accidents, with an estimated 1.2 million crashes a year. It is vital not to operate any machinery or drive any vehicle during an episode of sleep inertia. With the limited reaction time and concentration, you will not be able to conduct any action.

Sleep inertia can happen regardless of the duration of sleep. Even a short nap can cause disorientation that can last up to twenty minutes. This situation can be extremely detrimental if you have to perform immediately after a rest. Individuals that are sleep deprived and nap longer can have severe disorientation and impairment.

Additionally, large amounts of caffeine you put in your body to suppress sleep inertia can affect your heart. A loud alarm clock can produce high levels of adrenaline, which also affects your heart.