Category: news

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.

The debate regarding the minimum amount of sleep one needs has been ongoing for a long time, captivating the attention of both the lay public and scientific community. The main concern centers on the effects of reducing sleep time. At present, there are no direct studies that link the reduction of sleep hours (sleep reduction) with insufficient sleep, thus leaving the association between diminishing sleep time and missing opportunities for sleep unverified. However, epidemiological studies show that individuals who sleep too little or too much have higher mortality rates. In particular, short sleep is defined as less than 5 hours per night, whereas long sleep is more than 8 hours.

A study done by Penn State University showed that people with insomnia and short sleep had a higher risk of hypertension and diabetes. They also found that among people who slept less than six hours, men had a more significant mortality risk than women.

Other studies have also found that adults between the ages of 30 and 45 that sleep for short periods have a higher chance of having a metabolic issue that involves a combination of cholesterol problems, upper body mass index, and high blood pressure. Short sleep has also been linked to reduced cognitive functions, especially with middle-aged adults and seniors. Younger individuals have a lower risk of dying than older people, but they can also have certain consequences if they sleep less than recommended. Among the consequences is lower general health. However, longer sleep is not a danger for young adults. One study discovered that short sleeping provides a greater sleep debt which imposes a self-sleep restriction. Additionally, the shift-work sleep disorder is a condition that happens to people who have unique and particular work hours that affect their sleep and causes diminished rest times.

Short Sleeper Syndrome

Short sleeper syndrome (SSS) is a condition that involves sleeping for less than six hours each night. Adults should sleep for seven or more hours to feel rested in the morning. Those who have short sleeper syndrome can function properly during the day despite having less sleep. They do not have to take naps or even sleep more to recover from lack of rest. Individuals with this condition do not purposefully avoid or restrict their sleep, their minimal amount of sleep happens naturally every night. Their sleep pattern usually develops in childhood or adolescence and advances into adulthood.

Symptoms

People who sleep less than six hours a day and still manage to be functional during the day may be diagnosed with short sleeper syndrome. They can perform their duties at work or school despite the lack of sleep. Also, they don’t feel the need to sleep more on weekends or take naps during the day.

This syndrome is not considered a sleeping disorder, but it can have similar effects on our bodies in general, such as trouble falling asleep or staying asleep during the night, fatigue, frequent waking up throughout the night. Those symptoms should be shared with a doctor, who can, in order to make a proper diagnosis, subject you to the Morningness-Eveningness Questionnaire containing nineteen questions about the issue. Furthermore, in order to establish whether you function better in the morning or the evening, he may give you the Munich Chronotype Questionnaire, or instruct you to keep a sleep diary with precise information on how long you sleep at night, how many times you wake up, if you take naps during the days and so on.

Causes

There is some scientific evidence that suggests this syndrome is linked to a gene mutation. The University of Pittsburgh did a study in 2014 with identical twins that showed a smaller percentage of people has a gene for short sleep. The twins were compared, and the one with the short sleep mutation was able to outperform its sibling in simple cognitive tasks. The change within the gene enables individuals with the mutation to think and function with less sleep than others. However, scientists are still not able to understand the full complexity of our sleep and how genes influence it.

Diagnosis

So, there is a difference between having a short sleeper syndrome and not sleeping enough on purpose. This difference can be determined through certain laboratory testing such as actigraphy (where you wear a portable device on your wrist or ankle, measuring the level of activities during various phases of the day for one week) or polysomnography (where you are tested during sleeping in the lab, measuring brain waves, heart rate, oxygen supplies, etc.).

Polysomnography (sleep study)

A sleep study, also called polysomnography, is a suitable method of diagnosing short sleep syndrome. The study is performed in a lab specialized to study your mind and body while you are sleeping. The doctors observe you and watch all your data about oxygen levels, heart rates, brain waves, breathing rates and sleep patterns to see if you have a sleep disorder.

Actigraphy

To determine if you have the syndrome or no, you can wear an actigraph. It is a portable device that you wear around your ankle or wrist for a week and during that time the device measures the level of activities and the time of day when they happen. This method determines certain aspects of sleep such as the periods of wakefulness or sleep.

Treatment

Sleeping troubles need to be addressed with natural remedies, such as arranging dark, cool and quiet bedroom to help send a message that it is night time, according to our natural body rhythms. In that respect, the time for going to bed should be the same each day. For people working in shifts, there is a particular device called a lightbox, which resembles sunlight and can help such individuals perceive the night as a day.

Light therapy

Light therapy uses artificial light to help regulate sleep with a light box that makes full-spectrum light that mimics sunlight. This therapy is especially useful for individuals who need to synchronize a specific schedule and rest. The treatment has proven to be great for night shift workers to help them experience night as day.

Chronotherapy

There is also a cognitive behavioral technique called chronotherapy, which offers a precise sleeping and waking schedule to train our brains to observe the right rhythm. You need to follow a one-month schedule before making changes to your sleep. The goal of this therapy is to retrain your brain, avoid naps and create three-hour delays for your bedtime for at least six days before reaching the adequate amount of sleep.

Sleep hygiene

Your sleep hygiene is a combination of tools you need to use in order to restore restful sleep. An excellent way to maintain a healthy sleep is to start specific habits that will help you. These habits are especially beneficial for individuals who have troubles staying asleep or falling asleep. Some of the things you can do are:

1. Electrical devices should not be placed in bedrooms, or if necessary, should be placed at least a few feet away from the bed.
2. Alcohol, caffeine, and nicotine should not be taken some time before going to bed. Likewise, eating greasy food or sweets should be avoided.
3. Naps are not recommended in such cases, or at least not longer than thirty minutes.
4. Sunshine exposure during the day is favorable, as well as regular exercise, but not in the evening.

Short sleepers may not have to cure their syndrome since they do not necessarily have to be at risk. In fact, according to research, only 1% to 3% of people have this syndrome. Some findings indicate short sleepers can deal with the lack of sleep more efficiently than others.

Some very famous individuals in our history are known to have slept less, such as Leonardo da Vinci,  Nikola Tesla, Benjamin Franklin, Thomas Jefferson, etc. They believed that sleeping is a waste of time, preventing them from performing more. Tesla, for example, allegedly slept for two to three hours a day. He might have adopted a sleeping system called polyphasic sleep, which envisages sleeping 1.5 – 2 hours a day, taking a nap 15 – 20 minutes for every four hours awake. While this may be a way for great minds to save time, science does not back this method for other people, except maybe for those whose work is related to staying awake longer than usual.

Some professions tend to impose less sleeping, due to the amount of work to be done, or the level of responsibility. For example, actors have long shootings, so they need to spend 18 hours at the set, which leaves them 6 hours to sleep. Presidents usually sleep less than 6 hours, given the responsibilities they carry on their shoulders. Also, employees in healthcare, law enforcement, teaching, and journalism tend to sleep less, so maybe people who cannot function on short sleeping should avoid these professions.

People with insomnia, though, should face the problem and try to find the right solution, since their condition can lead to severe health damage. They should not mistake their disorder with short sleeping since there is a difference in how it affects them.

I apologize, but I’m unable to access or pull information from YouTube links. Nonetheless, I’m available to assist with any other inquiries or requests you may have!

Although getting enough sleep on a daily basis is the key to living our best life, most adults and teenagers are sleep deprived. Something like this is not a surprise as many people willingly choose to sacrifice sleep so that they can watch TV, scroll through social media networks, or spend more time with friends. These are all the consequences of a modern lifestyle. We simply decide to overlook the benefits that enough shut-eye provides so that we can do other things instead. We also often have work deadlines and various household responsibilities which can also prevent us from getting a good night’s rest that we deserve. 

Adults need between 7 and 9 hours of sleep per night so that they can be well-rested, productive, and concentrated. Unfortunately, according to studies, more than 33% of American adults fail to get enough sleep on a regular basis. We are all aware that the lack of sleep can have an adverse impact on our health and well-being, but we rarely do something to change it. Sleeping less than the recommended number of hours per day can increase the risk of various chronic conditions, such as diabetes, obesity, stroke, and heart disease. Although most of us are aware of all these risks, we still rather choose to watch TV or play video games instead of going to bed on time. However, the question that many people want an answer to is – is it possible to make up for lost sleep? Many people tend to sleep less than recommended and hope to make up for it during the weekend when they are not working and have more free time for themselves. But, can you make up for sleep deprivation by staying in bed longer on weekends? Can something like this erase the health consequences of the lack of rest? Of course, we will feel less tired when we get more sleep on weekends, but it doesn’t mean that it will satisfy our body’s need for sleep.  

Sleep Debt – What is it and How Can You Calculate it? 

If you are not sure what sleep debt is, here is a simple explanation – it is the difference between the amount of sleep that you need to function properly and the amount of sleep that you actually get. For example, adults should sleep between 7 and 9 hours at night, and if you get only 4 hours of shut-eye, you will be in debt. The first step to deal with sleep debt is to learn how to calculate yours. The first thing that you need to do is to determine how much sleep you need, as people’s needs vary a lot. Once you do this, you will be able to determine the difference between the ideal duration of rest and the amount that you are getting. When it comes to sleep debt calculator, the best way is to keep a sleep diary. In this diary, you need to write down the time when you wake up and go to sleep every day, if you woke up during the night or not, how long it took you to fall asleep and more. Keeping a sleep diary is the best way to track your sleep hours. When people don’t use diaries to calculate their debt, they may think that they are getting more sleep than they actually are. 30-45 minutes here and there doesn’t seem like a big deal that can affect your well-being, but when this small amount of debt starts building up, it can add up to hours and hours of lost sleep. Keep in mind that, the more debt you have, the harder it is to pay it back and make up for the loss of rest. Over time, this debt can turn into sleep deprivation, which will bring along different mental and physical consequences, including tiredness, aching body, weight gain, diabetes, inability to concentrate, impaired memory, irritability, anxiety, and daytime sleepiness. When we are sleep–deprived, we turn to coffee and energy drinks to fuel us up and help us get through the day. However, these things can only mask our lack of sleep, they won’t have a positive impact on our well-being. The only way to fight sleep deprivation and improve your health is to focus on sleeping at least 7 hours daily. That way, you won’t have to worry about rest deprivation having an impact on your health, mood, work performance, and more. 

Is it Possible to Repay Your Sleep Debt? 

Many people try to make up for sleep that they lost during the week on the weekends, or when they get a chance. However, when it comes to sleep debt recovery, the question remains – is it enough? Unfortunately, sleeping longer hours on weekends doesn’t mean that it will restore all your systems and erase the consequences of sleep deprivation. If you want to know how to repay sleep debt, you should be aware that it is possible, but it depends on the situation. If you only have short-term debt, you can repay it fairly easily. For example, if you get four or five hours of sleep for a couple of days because of an exam, an important work project or event, or some other reason, you can erase it by sleeping longer on weekends. Several hours of lost sleep are nothing that you can’t make up for, but it won’t happen in one go. You won’t erase this debt in one day; you’ll probably need two or three days.  

On the other hand, long-term sleep debt simply can’t be repaid. If you don’t sleep enough for weeks, or even months, nothing will help you repay your debt. Sleeping less than recommended for several weeks or more can build up to hundreds of hours of debt. You can’t expect to make up for months of sleep loss. The only thing that you can do is to try sleeping enough from now on and prevent the sleep debt from building up even further. Keep in mind that sleep has a vital impact on your health, and if you don’t sleep enough during the week, you should repay the debt as soon as possible, before it becomes long-term.  

How to Get Enough Sleep? 

If you want to prevent the sleep debt from building up, you should focus on getting enough shut-eye at night. It is crucial to get a proper amount of good night’s rest if you want to be healthy and function properly. Some of the things that can help you sleep more include: 

Establish a Sleep Routine 

One of the best ways to improve your duration of sleep is to establish a routine and stick to it. Of course, keep in mind that it is not possible to change the sleep schedule overnight. If you are used to going to sleep at 3 AM, you can’t expect to fall asleep at 10 PM. Instead of trying to follow the newly established schedule immediately, you should make gradual changes. For example, you should go to bed 15-20 minutes earlier than what you are used to. It means that, if you usually go to sleep at 3 AM, you should go to bed at 2:40 AM for a couple of days, then 2:20 AM for the next couple of days, and continue with this adjustment until you reach the desired bedtime, in this case, 10 PM. It will require some patience and commitment, but very soon you will be glad that you accomplished this. It will be easier for your body to adjust to these 15to 20–minute increments. After you adjust to the new bedtime, you should concentrate on going to sleep at roughly the same time every day, even on weekends. Also, you should wake up at the same time. If you remain consistent and stick to this routine, you will enjoy quality good night’s rest that you deserve. It is a much better idea to establish a schedule that will help you get between 7 and 9 hours of shut-eye daily than to sleep only a few hours per night and try to make up for it on weekends.  

Be Careful with Daily Naps 

If you feel very tired, you shouldn’t put up with it when you can take a nap. Daytime naps can be beneficial as they can help you feel less tired, improve your productivity and concentration a bit, and help you get through the day. However, although they can benefit you during the day, they can have an adverse impact on your ability to fall asleep at night. That’s why it is the best idea to take a 20 to 30–minute daytime nap, as if you sleep for a couple of hours, you may have troubles sleeping in the evening. Also, you shouldn’t nap too close to bedtime. The best period for taking a daily nap is between 2 PM and 3 PM. Additionally, although they are helpful, you shouldn’t rely on them regularly to help you with getting back on track and repaying sleep debt. They are only a short-term solution, and they can’t compare to sleeping at night. 

Create a Sleep Sanctuary 

If you want to increase your chances of getting enough shut-eye and avoiding sleep debt, you should turn your bedroom into a sleep sanctuary. Reserving your bedroom for sleep, intimacy, meditation, and other relaxing activities will have a positive impact on your sleep duration and quality. You should start by adding a comfortable mattress and a pillow to your bedroom. The right choice of these sleep products can mean a huge difference between getting enough quality shut-eye and having troubles falling asleep and staying asleep throughout the night. You should also choose the right colors for your bedroom, as some colors are calming and can stimulate sleep whereas others can have an opposite effect.  

Another thing that you can do is to banish your smartphone, TV, laptop, tablet, and other diversions from this room. Blue light from these devices can interfere with your sleep cycles and affect the production of melatonin. If you can’t remove them altogether from your bedroom, you should at least avoid using them a couple of hours before going to sleep. Finally, your bedroom should be dark and cool enough, as the warm temperature can prevent you from getting enough quality shut-eye and cause you to wake up during the night. 

There’s something truly wonderful about waking up refreshed, particularly on a weekend morning, and starting your day with a cup of freshly brewed coffee. It’s the joy that comes from a restful night’s sleep, setting you up to tackle the day’s challenges with both ease and excitement.

It is a known fact that sleep is essential for our wellbeing and it’s not just our subjective feeling. Science backs it up too. Research shows that our cardiovascular and immune system go through the process of restoration like other organs. Quality of sleep also affects the proper functioning of our nervous system. The little amount of it can cause drowsiness and mood swings. We can go on and on about these facts, but what if you don’t feel rested? What if despite all efforts to get enough sleep you still feel tired as if you haven’t slept at all?

That my friend means you might be experiencing a nonrestorative sleep.

Nonrestorative sleep is considered a sleep that has poor quality. Even though not all doctors and researchers can agree that it is a sleep disorder, this term keeps popping up in scientific literature and manuals for diagnostics, despite the fact that we don’t have an official definition of it.

People who experience nonrestorative sleep often complain that they feel fatigued and in pain. Also, their score is lower on the psychomotor vigilance test.

Although they don’t feel or notice it, their sleep is fragmented based on the results of polysomnograms that show micro-awakenings, but whatever is the cause of nonrestorative sleep it does not show up during testing and standard diagnostics.

Some experts conclude that nonrestorative sleep is part of the symptoms of insomnia, but it can also affect people who sleep normally, causing them to feel sleepy during the day.

Information about the personal experience of feeling fatigued even if the proper amount of sleep has been achieved without having a sleep disorder is the closest thing to a definition we have at the moment.

Since many aspects of NRS are still unknown, it is hard to determine the right therapy. More research is needed to understand it.

But let’s see how the information about NRS is connected with sleep disorders like insomnia, fibromyalgia and chronic fatigue syndrome.

Note  

Psychomotor vigilance test is a helpful tool to measure behavioral alertness of a person. It is a visual-based test that follows the speed at which someone reacts to stimuli that are visual. Standard PVT lasts about 10 minutes, but there is also a shorter option form 3-5 minutes.  

PVT is also a very successful method to measure sleep deprivation, misalignment of circadian rhythm in relation to behavioral alertness. Organizations like NASA have also taken this test while on training or in space to follow possible misalignments in circadian rhythm as well as potential sleep deprivation.

Nonrestorative Sleep and Insomnia

Recent research and studies have suggested that NRS symptoms can be different from symptoms of insomnia. One of them conducted a trial with over ten thousand individuals age 20 or above.  

They were all classified by the absence or presence of nonrestorative sleep and nocturnal insomnia syndrome. A connection was found between NRS and other sleep disorders such as sleep apnea, restless leg syndrome and snoring. Increased CRP levels, as well thyroid issues appeared to be associated with NRS.  

The information that was found suggests that there are considerable differences between nocturnal insomnia syndrome and nonrestorative sleep regarding comorbidity associated with other physical and sleep disorders as well as sociodemographic factors. Response to inflammation can possibly play an interesting role in NRS pathogenesis (disease development).  

Nonrestorative Sleep and Fibromyalgia

Nonrestorative sleep, or unrefreshing sleep as some call it, is considered to be connected to fibromyalgia but some studies show that it is linked to abnormalities in the chemistry of the brain as well as immune system. Those abnormalities can both be a consequence and a cause to fibromyalgia.

Research shows that low sleep quality is linked to many fibromyalgia symptoms including:

• Lack of pain recovery during the night
• Lack of feeling refreshed in the morning
• Cognitive impairment
• Tenderness increased
• Feeling stiff and fatigued
• Task and performance is at a low or poor level
• Distress that is psychological

Unfortunately, we do not entirely understand why people who have this condition feel unrefreshed. Of course, it is normal to conclude that pain impacts quality of sleep in many ways and many fibromyalgia patients say that even lying down on muscles that are excessively tender can lead to high pain. As they have a tendency to overheat and sweat excessively, sleep problems can occur more often.

Nervous system dysfunction can also play a big part in causing those sleep disruptions. According to recent fibromyalgia theory, the sympathetic part of the nervous system (the fight or flight mode) gets stuck which prevents the patient’s body to completely relax during sleep. It’s something similar to what parents who got their first baby experience as they are alert to help the baby whenever it cries. Just like the people with fibromyalgia are alert and continuously check the time when they are anxious that they’ll sleep in.

Some studies say that fibromyalgia participants had an abnormal heart rate which supports the raised sympathetic activity theory. Pain causes sleep disruptions, and lack of quality sleep causes pain, so it goes round and round.

Nonrestorative Sleep Treatment In Fibromyalgia

Some medication can alleviate the pain and improve the quality of sleep in fibromyalgia:

• Elavil
• Cymbalta
• Lyrica
• Savella
• Xyrem

The FDA approves Cymbalta, Savella, and Lyrica for this type of illness. Xyrem is a drug that has to be controlled strictly, and Elavil is antidepressant tricyclic.

Additionally, melatonin supplements can help relieve the pain and improve the quality of sleep but consult your doctor before deciding to use any of the stated medication.

Nonrestorative Sleep and Chronic Fatigue Syndrome

One of the main features of chronic fatigue syndrome (CFS/ ME) is that the quality of sleep is reduced which means it cannot relieve fatigue. Those are also symptoms of nonrestorative sleep. Researchers are still trying to get a better understanding of how nonrestorative sleep impacts CFS/ME.  

People with CFS/ME are mostly complaining that they always wake up feeling tired no matter the length of their sleep. Consequences of nonrestorative sleep are more than just feeling tired. Experts believe that it is caused by a problem in the regulation of our sleep – homeostasis. People with CFS/ME might have some sleep disorders, but many studies support the idea that intense and constant fatigue is due to homeostasis impairment and not from sleep disorders of a different kind.

One study that was released in Sleep Medicine Reviews shows that they didn’t find any evidence to support the theory that relief of fatigue in this condition can be achieved by comorbid treatment of sleep disorders.

Nonrestorative sleep can cause the following symptoms of CFS/ME:

• Cognitive impairment including low-level of concentration
• Excessive fatigue
• Sleepiness during daytime
• Hyperalgesia

The differences in sleep at people who have CFS/ME

• Abnormalities in brain waves during stages of sleep
• Less REM sleep
• Sleep duration is significantly shortened
• Possible autonomic dysfunction due to low heart rate variability

Autonomic dysfunction is a consequence of the ANS problem. If the parasympathetic and sympathetic are not in balance because of autonomic dysfunction, that can put a person in an increased state of awareness and arousal when it’s time to sleep.

Nonrestorative Sleep Treatment In Chronic Fatigue Syndrome

Unfortunately, researchers haven’t found the best way to improve the quality of sleep and alleviate excessive fatigue in CFS/ME. So far no medicine has been FSA approved for this disease. However, in 2010 one study showed positive results when it comes to narcolepsy Xyrem drug, but its usage should be strictly controlled, and most of the time it can be a challenge to get a prescription.

There are some other alternatives such as melatonin, but more studies need to be conducted to determine how effective it is. Some say that antidepressants and supplements help them sleep, but we do not have enough research material to support these claims entirely.

Sleep specialists recommend relaxing techniques as a way to improve sleep hygiene and habits. The most important thing is to find a reliable and experienced doctor that can help you by offering different types of treatment to alleviate nonrestorative sleep.

Since there aren’t many medicines that are reliable enough, let’s check out some helpful tips on what you can do today (or better tonight) that can help you sleep better.

How To Get More REM and Deep Sleep?  

There are many things that you can do to enter all essential stages of sleep with ease and consistency.  

• Exercise should be a priority – Studies show that activity on a regular basis can make a difference in REM sleep. You can add an extra twenty minutes of walk each day and then gradually increase the time, or try jogging, yoga, or swimming. However, you shouldn’t exercise before bedtime; the minimum gap between exercise and going to sleep should be around three hours to ensure that you can easily wind down.
• Stick to a bedtime schedule – You need to be aware of how vital it is to maintain the same sleep and wake up time. When you have a consistent schedule, your body will get used to it, and it will go to light, deep and REM sleep easier.
• Bedtime routine is a must! – Bedtime routine helps you unwind and prepare yourself mentally for sleep. Taking a hot bath may promote slow wave sleep.
• No alcohol and caffeine before sleep – It is best to avoid alcohol and drinks that contain caffeine. You should hydrate your body during the day and avoid consuming alcohol and caffeine at least 3h before sleep.
• Be creative when it comes to stress releasing methods – You might not be the creative type, but meditation, gratitude journal, and aromatherapy are methods that many people praise in terms of relaxation and stress relief.
• Consider changing your pillows if you have had them for a long time as they can cause discomfort.
• If you can’t sleep, don’t stay in bed. Get up and do something relaxing such as reading until you feel sleepy again.
• Minimize the light before bedtime because too much screen and outside light can make it difficult for you to relax.

Melatonin, a cost-effective and easily accessible solution you can find over the counter, seems to be the simplest and fastest solution to your sleep issues. Plus, being a natural substance, you’d think it’s safe, right? Yet, the truth can sometimes be more complicated than it appears.

In this video, I will help you understand all the ins and outs of melatonin, how it works in your body, and if taking its synthetic form can really help you sleep better. At the end of the video, I will recommend 3 natural and safer alternatives.

Watch this video before reaching for another melatonin pill!

What is Melatonin?

Melatonin is a hormone that regulates our sleep-wake cycles. This hormone is naturally produced by the pineal gland. However, in its synthetic form, or as a medication, it is used for the short-term treatment of sleep issues such as insomnia, jet lag or shift work.

Evidence that melatonin supplements are beneficial for sleep is unclear. Despite claims by supplement manufacturers, melatonin has shown mixed results as a treatment for any disease. It is not recommended for children, for women trying to get pregnant or breastfeeding mothers.

Two studies conducted in 2017 showed that melatonin helps you to fall asleep only 6 minutes faster, and stay asleep only 7 minutes longer.  Total sleep time in some participants wasn’t affected by melatonin pills at all.

How does Melatonin work for Sleep?

Melatonin’s main job in the body is to regulate sleep-wake cycles. Whenever the sun goes down, and the temperature starts to decrease, your body begins producing more melatonin, which signals the body to prepare for sleep. Light decreases melatonin production and signals the body to prepare for being awake. The human body naturally produces enough melatonin for sleep on their own. As we age, and especially once we reach age 54, natural melatonin secretion significantly decreases.

Without melatonin, it would be impossible for us to sleep in a normal and healthy way. However, this doesn’t mean that putting melatonin in a bottle and selling it in a form of a pill will help you solve your sleep issues. On the contrary, if you use it for a prolonged time, it may hurt your sleep, rather than improve it.

Before I explain to you why taking melatonin is a bad idea, I have to mention that you can easily buy these pills over-the-counter in the US and Canada. However, in the UK it is a prescription-only medication, and it is not FDA-approved for any use. In Australia and Europe, online sources and some studies we found suggest that melatonin is approved as a sleep aid only for people over the age of 54. (Just a brief reminder, after the age of 54, our natural melatonin production significantly decreases) However, other online sources indicate that you can obtain melatonin over-the-counter in Australia and some European countries such as Hungary and Netherlands.

Shouldn’t we be worried about these tight regulations in other parts of the world? It’s definitely something to think about.

Now, back to our main topic – although sold as a supplement, you should never forget that melatonin is still a hormone. It cannot replace or help with natural production; on the contrary, it can only further inhibit it.

How exactly? We naturally produce only 0.25mg of melatonin, and melatonin pills come in doses of 3mg which is 12 times higher than normal. When we are overdosing our bodies with melatonin, our body has to react and somehow get rid of all that excess. That’s where SCN comes in.

The suprachiasmatic nuclei (SCN) is a tiny region of the brain in the hypothalamus responsible for controlling circadian rhythms. The SCN, functions as a master circadian pacemaker controlling the timing of the sleep-wake cycle and coordinating this with circadian rhythms in other brain areas and other tissues to enhance behavioral adaptation.

The suprachiasmatic nucleus contains a bunch of different neurons that circulate back and forth to the different areas of our brain. The SCN also has melatonin receptors that circulate back and forth to the pineal gland and help regulate melatonin secretion. Normally, the signals from the receptors would be sent to the pineal gland in response to the environmental light/dark cycle. However, when we take melatonin pills (remember the dose is 12x higher than natural production), we instantly trigger a reaction, because the melatonin receptors in the SCN become overloaded. So, what happens next is that the receptors will signal the pineal gland to stop producing melatonin because we already have enough of it.  

This is how melatonin supplements inhibit natural melatonin production, and this is how you become dependent on it. By continuing to use melatonin you put your body in a negative feedback loop.

You might be thinking, okay natural production is slowed down, but I can regulate it with pills. However, doing so, you are also throwing off balance other hormones in your body. Let’s see how.

Homeostasis

Our body and hormones work like a finely-tuned machine. Hormones are responsible for key homeostatic processes in the body such as control of blood glucose levels and control of blood pressure. Throwing off only one hormone out of balance (in our case melatonin), will mess up the entire body and normal regulation of the internal conditions within cells and organs. The body always has to be in perfect hormonal balance. For example, if your testosterone levels reduce, estrogen levels may increase to restore the balance. The same happens when you use melatonin. When it goes high, another one is needed to balance it all out somehow.

When you have higher doses of melatonin in your body than needed, this means your body will need much longer time to clear it out. This also explains why you have a hangover effect when you take it. The sad thing is that some people are so used to this effect, that they don’t even know anymore how their life looks without it.

Is falling asleep only 6 minutes longer and staying asleep 7 minutes more than usual really worth all these risks and effects? Really not.

Also, the point of the entire story is that taking melatonin to induce sleep when the sleeping problems are not caused by a lack of it creates an opposite reaction. When there is too much melatonin in the brain, the synapses will become less responsive, which will cause more sleeping problems. In that case the effect of melatonin will be minimal – on average, you will get 8 minutes more sleep per night, and fall asleep on average 7 minutes faster. To really solve your sleep problems, you have to know what is causing them and address those.

Now back to homeostasis.

How Melatonin Affects other Hormones?

Scientists are not sure how exactly melatonin affects other hormones in our body, but new studies, aiming to find out more, are being conducted every day — according to research, overdosing leads to drowsiness and reduced core body temperature. Very large doses have adverse effects on the performance of the human reproductive system.

In experiments conducted by Japanese researchers and the University of California, Berkeley, was found out that melatonin switches on a recently discovered hormone called gonadotropin-inhibitory hormone (GnIH). GnIH has been found to have the opposite effect to the key hormone priming the body for sex – gonadotropin-releasing hormone (GnRH). Over time, switching off GnRH causes the gonads – testes and ovary – to shrink.

The good news is that the results of the study were observed on birds, but it is not unlikely that it doesn’t affect humans. We should be concerned because if melatonin can do this to one neuropeptide system, chances are high it can do it to any other.

Alternatives to Melatonin

So, what should we use instead of melatonin? Is there some natural sleep aid that is safe, and that can really help us to sleep better? Out top 3 alternatives are magnesium, theanine, and glycine.

Magnesium

Magnesium is a natural muscle relaxant that blocks the stress hormone cortisol in the brain, and as a result, produces a calming effect. On a chemical level, magnesium activates the parasympathetic nervous system, also known as the system responsible for getting you calm and relaxed.

It regulates neurotransmitters, which send signals throughout the nervous system and brain, and also supports the production of the hormone melatonin and gamma-aminobutyric acid (GABA) receptors. GABA is the neurotransmitter responsible for quieting down nerve activity. It is the same neurotransmitter used by sleep drugs like Ambien. By helping to quiet the nervous system, magnesium prepares your body and mind for sleep. So, instead of taking a shortcut, and using synthetic hormones, you should help your body naturally produce more melatonin.

L-theanine

L-theanine L is an amino acid that is found in tea leaves. L-theanine promotes relaxation and facilitates sleep by contributing to a number of changes in the brain, such as boosting GABA levels, lowering the levels of excitatory brain chemicals, and enhancing alpha brain waves.

The biggest benefit of this substance is that, at the same time, it increases chemicals that promote feelings of calm and induce sleep, while also reducing levels of chemicals in the brain that are linked to stress and anxiety.

L-Theanine helps to restore your wake cycle meaning you won’t have to worry about the hangover effect in the morning. The supplement doesn’t disrupt the natural stages of your sleep, and doesn’t produce a sedative effect; simply a relaxing one.

Glycine

Glycine (also known as 2-Aminoacetic Acid) is an amino acid and a neurotransmitter. The body produces glycine on its own, and we also consume it through food. This amino acid aids sleep by decreasing your subcutaneous temperature and cooling the body down. By reducing the body temperature, melatonin and GABA levels go up, which induces sleep and helps to improve its quality. Glycine also increases serotonin levels, and serotonin is vital for promoting the natural production of melatonin.

So, there were 3 different ways to fall asleep faster and stay asleep without using melatonin and becoming a hormone pumper.

Since the beginnings of human society, sleep has always been a mysterious event, a period of unconsciousness filled with dreams, and throughout history, people have endeavored to understand and elucidate the complexities and purposes of our regular descent into this state. Even with modern technology and advanced research facilities, scientists persist in their efforts to unravel the enigmas of sleep, consistently making new findings. Nevertheless, many facets of sleep are yet to be discovered and explained.

One of the most philosophical sleep questions remains, why do we sleep? It was listed as one of the 100 questions that are not answered by the American Association for the Advancement of Science (AAAS). Some of the sleep-related topics that remain unclear are causes of parasomnia, dreams, effects of long and short sleep, the function of REM sleep, hibernation, how our memory works, and many, many more. In today’s post, we are going to discuss a few of these sleep mysteries.

Why Do We Need to Sleep?

You may believe that sleeping is overrated but anyway you will have to sleep at some point since it is inevitable. If our body and brain are forcing us to fall asleep, then it must be a mandatory part of their normal functioning. We may sleep for three hours or nine hours and go on with our day feeling tired, but our body is somehow programmed that it needs those six to eight hours of sleep per night in order to function normally. But why does it take that specific period of time? Researchers have found out that that number of hours is the most optimal for us, and there will probably be no way to shorten that time.

Even though while we are sleeping we are not doing any activities except occasional movements, our brain, and internal body organs are highly active and perform many restorative processes, hormones are being released, heart rate and blood pressure are regulated, and so on. How exactly this occurs and why and how our body is programmed to function this way is still a mystery in some way. Scientists are aware that sleep and its restorative processes are key to our wellbeing, but they have not figured out how it all functions yet.  

What Causes Parasomnia?

Parasomnia stands for a group of sleep disorders such as sleepwalking, sleep paralysis, sleep aggression, nightmares, sleep-related eating disorders or REM sleep behavior disorder. Parasomnias include a wide range of undesirable movements, behavior, emotions, dreams or perceptions. Apparently, many of these disorders have a negative impact on sleepers daytime, but science is struggling to provide enough solid pieces of evidence about what can cause them.

It is believed that genetics play a key role since parasomnia usually runs in families, but for some types of parasomnia, even brain disorders can be responsible, for example for a REM behavior disorder. Many medications or other sleep disorders can also trigger parasomnia which affects around 10% of the US population.

People of all ages can experience parasomnia, but children are the most liable age group since the immaturity of their brain puts them at higher risk of parasomnia. Good news is that as children get older, this disorder usually disappears on its own without leaving any consequences on the children’s health.

How Sleep Impacts Memory?

Getting too much or too little sleep can negatively affect your memory, but how that happens and how can we determine the perfect amount of sleep? It is believed that recommended seven or eight hours of sleep can help you maintain a good memory later in life.

One study gathered information about the sleep habits of a group of women in 1986., and in 2002., and interviewed them three times after that about their thinking skills and memory. They find out that brains of participants who slept more than 9 or less than 5 hours per night had worse test performances than the ones from participants who were sleeping around seven hours each night. They also came to the conclusion that so-called undersleepers and oversleepers are usually mentally two years older than the sleepers who slept for at least seven hours per night.

People who are chronically sleep deprived are more likely to make mistakes, accidents, to forget what they need to do because their brain functions are slower. Some long term consequences of sleep deprivation include memory problems, although it has not been figured out how exactly are those two things correlated.

Some memories are based on facts, and some are episodic and attached to some events from our lives, while others are instructional (riding a bike, playing piano, etc.). In order for something to become a part of our memory, it has to go through these three stages:

• Acquisition – experiencing or learning something new
• Consolidation – once the memory of an event becomes stable in our brain
• Recall – the ability to access that memory in near or further future

Recall and acquisition both occur while we are awake, but sleep researchers believe that for consolidation of memory, regardless of her type, sleep is essential and required. Because without an adequate amount of sleep, our brain will have troubles with absorbing and recalling memories.

Some studies that included memory tests have shown that people who were sleeping the night before performed better in many fields.

Genetics and Sleep

Scientists believe that some sleep disorders are genetically transferred to family members and that our genes can determine the amount of sleep that we need. In a recent study, scientists were able to identify a human gene DEC2 that has an essential role in body’s natural sleep-wake cycle, and mutations of that gene can result with very short periods of sleep.

Researches were following sleep habits of a family with a mutated DEC2 gene. All family members were going to bed around 11 PM, and they would wake up on their own around 5 AM. This family had low sleep requirements, but surprisingly that did not have any negative consequences on their everyday functioning, that was their natural sleep cycle. It is considered that less than 5% of the US population has this unusual condition.

Sleep disorders that can run in families include dyssomnia, which stands for a wide range of sleep disorders including narcolepsy, sleep apnea, insomnia, and hypersomnia, or any other disorder that affects the ability to fall or stay asleep.

Circadian rhythm disorder interferes with our natural sleep and wake cycle, giving sleepers a hard time falling asleep and excessive daytime fatigue. Lately, circadian genes such as ARNTL1, CLOCK, NPAS2, and PER3 have been connected to bipolar disorders. But those together with parasomnias are still to be proven and examined.

Can Sleep Disorders Cause Vision Loss?

This question is a tricky one, but it has been proven that some disorders such as obstructive sleep apnea can hinder your vision abilities and lead to a total loss of vision. Sleepers with sleep apnea experience breathing stops multiple times during the night, due to that the oxygen level varies highly over the night, and those high oscillations in oxygen level usually impact our eyes and vision. Some of the vision problems that may come as an outcome are glaucoma, floppy eyelid syndrome, central serous retinopathy, and retinal vein occlusion.

Some studies have tried to link sleep deprivation with vision problems as well as excessive sleeping and sleep quality. The progress in this area of research can be meaningful especially for seniors who are most liable to problems with vision.

The Mysteries of Dreams

One of the most fascinating sleep mysteries is dreams, since the beginning of the time people were mesmerized with them, wrote dream books and tried to explain their meaning, but even today scientists cannot fully understand why do we dream, and what is happening while we are dreaming.

We all have dreams almost every night, and those vivid scenes sometimes can be related to the things that we experienced, or we were thinking about them. On the other hand, some dreams are completely irrational, confusing, and we cannot relate them to anything from our everyday life. Because they are so hard to explain, they are liable to superstitions and many questionable interpretations. Dream books are popular even today, and in them, all sorts of dreams have been interpreted and attached to some meaning or a message since people tend to believe that dreams are transferring some sings to us, or showing us the way we should go.

Scientific studies of dreams are called oneirology, and these studies are trying to find a connection between dreams and brain function. Around 60 years ago, sleep researcher Eugene Aserinsky was performing an overnight sleep study on his son, and he accidentally noticed rapid eye movements during sleep. Those eye movements were then connected to higher brain activity which annulled the long supported idea that the sleep is a passive condition. In another, pioneering paper from 1957. Nathaniel Kleitman and William Dement researched the connection between dream content and rapid eye movements. They woke up their participants during the REM stage and asked them to describe their dreams, and then they tried to connect those interpretations to the kind of eye movements (horizontal, vertical or mixed). The ones who have vertical eye movements reported scenes such as climbing a ladder and standing at the bottom of a cliff. The participant with horizontal movements described a scene in which people were throwing tomatoes on each other, while those with mixed eye movements were dreaming people that are close to them. After this pioneering study, evidence about the correlation between dreams and REM have not been consistent, but one recent study found that the patients with REM behavior disorder have coordinated eye and limb movements during the stage of REM.

Irregular sleep-wake rhythm disorder is classified among the distinct group of circadian rhythm sleep disorders, which interfere with the normal 24-hour biological cycle, leading to atypical sleep patterns. This circadian rhythm, or biological clock, refers to any biological process that follows a 24-hour cycle. Within your body lies an internal circadian clock that dictates periods of sleepiness and wakefulness throughout the day. In essence, your brain employs a perpetual timekeeping system that alternates between sensations of drowsiness and alertness at regular intervals. The metrics for measuring the circadian rhythm involve melatonin, a hormone released by the pineal gland, cortisol levels in the plasma – a hormone crucial for regulating a variety of bodily processes including immune function, stress reaction, and metabolism, and the minimum body temperature core.

The irregular sleep-wake rhythm disorder disrupts this rhythm and forces you to have a wide range of naps throughout the 24 hours without having a proper 7-9 hour sleep during the night. Individuals who suffer from this rare neurological condition do not have defined circadian rhythm, which means that they do not have a regular sleep schedule. Their sleep is divided into parts, and they get a total of 8-9 hours in a 24-hour period, but they do not have a steady sleep pattern. With the day naps they take, their nighttime sleep is usually divided, fragmented, and shortened. The naps differ in length, but it is typically a couple of sleep periods during the day that last from one to four hours. Their longest periods of sleep usually happen between 2 a.m. and 6 a.m. Over time, this condition leads to problems like daytime fatigue or difficulty to perform regular daily tasks.

Circadian rhythm sleep disorders

Circadian rhythm sleep disorders (CRSD) are a group of sleep disorders that affect your sleep quality by interfering with your circadian pattern. When you have this disorder, you are not able to control when and where you fall asleep. It means that you could fall asleep at work or school but be awake at night. Although you are not able to get enough sleep, your sleep quality is normal if there are no other disorders involved. Among individuals with healthy circadian rhythm, there are types of chronotypes. A chronotype is a disposition that allows the person to sleep at a specific time within a 24-hour period. Some individuals are either morning people who prefer waking up early or night owls who prefer to stay up late and wake up late. However, both groups have a normal circadian rhythm that involves waking up and falling asleep at the same time each day, and an adjustment period of a few days when changing their routine.

Symptoms

General symptoms of sleep-wake rhythm disorders include waking up frequently at night, difficulty falling asleep and waking up in the morning. People who have irregular sleep-wake rhythm disorder apart from these difficulties experience fragmented and shortened sleep during the night, morning grogginess, excessive daytime sleepiness, sleeping on and off throughout the day with frequent daytime naps or several sleep periods that last from one to four hours in a 24-hour period.

Causes

The cause of irregular sleep-wake rhythm disorder is still not clear. What is known is that this disorder is the result of a terribly functioning circadian rhythm. This problem involves a lack of exposure to daily light and age as well. As we age, our hormone levels decrease which can influence our circadian rhythms. However, this problem can occur much earlier if the person does not get regular exposure to light. The absence of light impact our internal clock and our body’s circadian rhythm is affected. The light provides cues, called zeitgebers, that are in charge of regulating biological rhythms, like sleep. Zeitgebers, which means time-giver, is a word Germans invented to define the signals that regulate our body’s circadian phases.

Additionally, changes in specific brain parts that regulate or participate in the regulation of the biorhythms can influence this condition. Apart from that, there is some research that shows a genetic factor influences disrupted sleep patterns that are present in irregular sleep-wake rhythm disorder, but researchers have not found a particular genetic link.

Risk Factors

The irregular sleep-wake rhythm disorder is very rare. It is still unknown how many people have it, but it usually happens to individuals who have a brain function problem or do not have a daily routine to follow. These people still get a normal amount of sleep, but the circadian cycle is lost. Individuals with constant changing work shift or those who travel and change time zones can also experience these symptoms, but these are different conditions like jet lag syndrome for travelers and the shift work sleep disorder.

Individuals with neurological conditions such as brain damage, dementia, Alzheimer’s disease, or mental retardation have a weak body clock and are at risk of developing irregular sleep-wake rhythm disorder. Of course, it does not mean that having these conditions will result in this disorder. It just means that it is easier for the problem to happen. It could also happen to people who do not have any neurological issue. People who don’t have contact with daily light are also at a certain risk because daily light is essential for resetting the sleep clocks of our bodies.

Diagnosis

This disorder impacts your responsibilities and relationships because you are bound to your home which can worsen the problem. Using medication or applying certain behaviors without a proper diagnosis can make the problem worse. To get an adequate diagnosis, doctors need to examine the symptoms that the patient claims he has and inspect the sleep patterns. To determine your sleep patterns, the doctor can ask you to do a sleep diary where you record your natural sleep and times of waking up. This diary will help the specialist see if there are any disruptions to the sleep patterns that match the symptoms of irregular sleep-wake rhythm disorder. Having at least three sleep periods in a 24-hour period is the most significant factor that doctors will look for. in your sleep diary. You may also need to rate your sleep using the Epworth Sleepiness Scale, which is used to measure daytime sleepiness with a short questionnaire where you answer eight different situations with numbers from one to three.

The sleep patterns can also be examined with an overnight sleep study called polysomnogram. This study records your heart rate, blood pressure, breathing, the oxygen level in your blood, brain waves, muscle activity, eye, and leg movements.

Another way to examine a patient is through a medical and neurological exam. The doctor can ask you to wear an actigraph, a non-invasive device used to document active and inactive episodes happening over a period of one week. An actigraph is worn on your wrist or around the waist, both during the day and night – you do not take it off. If your doctor suspects that a certain problem is the cause, you might need to do some blood tests or even an MRI or a CT scan.

Treatment

The treatment for irregular sleep-wake rhythm disorder is the same as with any other circadian rhythm sleep-wake disorder. Treatments for all circadian rhythm disorders focus on the sensitivity of your internal clock and its 24-hour schedule. The usual treatments include combining several behavioral and lifestyle changes like having good sleep hygiene, making a sleep routine, avoiding naps during the day, setting a comfortable environment and avoiding the use of stimulants. Additionally, you can undergo light therapy, melatonin supplements therapy or use sleeping pills. Once you have achieved a proper sleeping period, these therapies can be phased out.

Practicing Good Sleep Hygiene

An excellent way to treat your sleep disorder is to have good sleep hygiene and follow a sleep routine. The routine adds structure to sleep and develops a habit in your body to wake up and go to sleep at specific times. The first thing that you need to do is to make your routine directed at one main period of waking and one main period of sleeping. It means that you need to reduce the number of naps and daytime rest periods and increase the duration of each of the naps. Naps, long ones especially, can help minimize the sleep debt so that you won’t feel sleepy at night. It’s essential to keep sleep logs to track your routine and make sure you follow it properly. You can use apps for your phone that monitor your sleep or wearable and non-wearable sleep trackers.

As time advances, you need to follow a more strict bedtime, so you avoid the risk of relapsing into old sleep patterns that cause circadian rhythm disorders. A strict bedtime includes having an alarm that will wake you up in the morning every day (even if you do not have obligations that require you to get up at that time). You need to maintain a consistent wake-up time and sleep time to have the desired sleep-wake rhythm.

Use The Bed Only For Sleep And Sex

To properly follow a sleep routine you need to reserve your bedroom just for sleep and sex. It can be tempting to watch television or do some work in bed, but this creates associations to these things when you need to associate bed with sleep or sex.

Avoid Stimulants

Stimulants such as caffeine can be a great wake up method for mornings, but they should be avoided after 2 pm because they remain in the body for a long time and may keep you up at night. Among those stimulants are also nicotine that stimulates the adrenaline production and alcohol that can wake you up if you have it before bed.

Have a Comfortable Sleep Environment

Your bedroom needs to be a comfortable sleep environment. You should keep it dark, cool and quiet to be able to sleep easily. Brightly-light rooms can upset your circadian rhythm and noisy environments can keep you up at night. The bed itself needs to be comfortable without any sagging or lumps that can wake you up. It might be best to consider investing in a mattress that promotes sleep and fits your needs.

Light Therapy

Apart from making lifestyle changes, there are therapies you can take to reset your internal body clock. Doctors can prescribe light treatment to patients to treat irregular sleep-wake rhythm disorder. This therapy involves exposing patients to bright levels of light for a period. This exposure is safe, and it should adjust the circadian rhythm of your body and enable earlier sleep at night. It is done in the morning to promote wakefulness during the day. Any bright light should be avoided a couple of hours before bed.

Melatonin Supplements

Changes that come with age include a shift in hormone levels that have a role in irregular sleep-wake rhythm disorder. Using melatonin supplements can help promote better and regular biorhythms and sleep patterns. But people who have neurological issues should take this therapy carefully, and people with dementia must not use these supplements.