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.

Numerous individuals struggle to obtain enough quality sleep during the night.Nowadays, sleep issues are becoming more common, a phenomenon often linked to modern lifestyles. In our 24/7 culture, experiencing sleep difficulties is becoming the norm. Yet, these challenges can have detrimental effects on our health and our life’s overall quality. It’s universally understood that sleep is essential for human beings, yet many overlook its importance and fail to prioritize it. Lacking adequate sleep makes it unrealistic to expect good health, vitality, efficiency, motivation, and more. 

In case you have troubles sleeping, but can’t seem to figure out what the cause of these problems is, you should consider keeping a sleep diary. It is an excellent way to track your quality of sleep and habits that may have an impact on your ability to get a decent amount of rest. If you track your habits and see how they influence your duration and quality of shut-eye, you will figure out if you need to make any changes to your lifestyle in order to sleep better at night. 

Keeping a sleep diary can help you figure out what is keeping you awake. Many people can’t seem to fall asleep, or they wake up frequently at night because of the bad habits, such as drinking too much water, eating heavy meals in the evening, drinking coffee or other caffeinated beverages before going to bed, skipping exercises, and more. A sleep diary helps you record information about your sleeping and waking times, sleep quality, and more, over the course of a few weeks, depending on you. It can help you pinpoint if you are waking up or falling asleep at a similar time, what you did during the day, what you consumed when it comes to food and beverages, and more. Over the period of a few weeks, you will be able to notice a pattern, if there is any, between your habits and sleep. As soon as you notice what causes your sleep issues, you will be able to do something about it. 

Keeping a sleep diary is an excellent way of getting insight into your sleep patterns and problems. You should start keeping it as soon as you realize that you have a sleep issue. It can also help you later if you decide to visit a doctor, as having evidence of your sleep-wake pattern can assist in giving the right diagnosis and treatment. 

Things to Record in Your Sleep Diary 

If you have troubles sleeping, information from your sleep diary can help both you and your doctor figure out what is wrong with you. It can contain basic information such as when you went to sleep and when you woke up, or more detailed information as well. Here are some things that you should consider writing in your sleep diary: 

• When you went to bed 
• After how long you fell asleep 
• When you woke up 
• When you got out of bed 
• Duration of sleep 
• Quality of sleep
• If you woke up by an alarm clock, spontaneously, or because of a different disturbance
• Number of times you woke up at night
• Number of alcoholic drinks you had and when
• Number of caffeinated drinks and when you consumed them
• The time and the type of your evening meal
• Time of your last food and beverage intake before sleep 
• Start and end time and duration of daily naps 
• Alertness level in the morning
• Time, name, and dosage of drugs or medications you took 
• Stress level before bedtime
• Time and type of exercise you had during the day
• Activities you performed the last hour before going to bed
• How you felt during the day
• Things that disrupt your sleep, if any, such as troubles breathing, insomnia, snoring partner, and more 

If you start recording some or all of these things over the course of a couple of weeks to several weeks or more (it depends on how long it takes you to notice a pattern) you will learn more about how different things can affect your shut-eye. For example, you will notice if exercising during the day helped you improve your sleep patterns or no, if you started falling asleep earlier than usual, if giving up on heavy meals, alcohol, and caffeine in the evening improved your night’s rest, etc. All in all, you will learn how different factors impact your sleep quality and duration. You don’t need to be a highly trained professional to be able to get insight from a sleep diary, find patterns and make useful observations. 

You can take a pen and a piece of paper and write everything down yourself, or you can find a sleep diary online and download it. A sleep diary worksheet will help you track your sleep. Another option is to download a sleep diary app to your smartphone.  

Reasons to Keep a Sleep Diary 

Some of the reasons to consider keeping a sleep diary include: 

You Will Have a Better Idea about Your Sleep Patterns 

Although many people suffer from sleep-related disorders, troubles falling asleep and staying asleep are not necessarily a consequence of these disorders. Sometimes, sleeping troubles are merely a result of bad habits. If you tend to drink too much coffee in the afternoon or evening, you probably won’t be able to drift off to dreamland easily. Consuming alcohol and heavy meals before bedtime can also disrupt your patterns and cause you to wake up frequently. If you drink too much water in the late evening, you will probably have to go to the bathroom during the night, and this action will prevent you from having an undisrupted sleep. As you can see, these and similar voluntary behaviors can have a negative impact on your shut-eye. Luckily, you can correct your habits by making small adjustments in your behavior week after week, until you finally start getting enough quality rest and wake up well-rested and full of energy in the morning. 

You Will Help Your Doctor to Give You a Proper Diagnosis 

If you decide to keep the diary for a few weeks, make some changes in your habits, and still don’t see any positive results, it is time to visit a doctor. During a consultation, you can present your sleep diary to a sleep specialist as it will make things easier. Sometimes, doctors can give the wrong diagnosis as all of us make mistakes from time to time, and they could recommend the wrong course of action for your problems. For example, some people have sleep apnea, but doctors recommend treatment for insomnia. One of the most common reasons for misdiagnosis is patient reporting. People mention some symptoms that they consider more important, and don’t mention other symptoms, which can contribute to misdiagnosis. When patients mention troubles staying asleep, mood disturbances, and tiredness, doctors rather assume that it is insomnia as patients fail to mention snoring and pauses breathing. However, a sleep diary can give your doctor a detailed insight into your problems that can mean a difference between the right and the wrong diagnosis. Details are more important than many people realize, and even the little things can cause sleep difficulties. Also, if you keep a diary, you won’t have to worry about forgetting to share something critical about your habits and patterns with your doctor. Sometimes we simply forget things and don’t remember to tell them, even if they are important, and writing it all down will prevent something like this. 

You Will Notice the Improvement Easily 

No matter if you decide to do everything on your own and start changing your habits, or you visit a doctor for help, thanks to a sleep diary it will be easier to monitor the improvement. If you stop drinking alcohol and coffee in the evening and replace heavy dinners with light meals, you will notice whether these things have had a positive impact on your sleep patterns or not. Also, if your doctor gave you a treatment for sleep disorders in a form of therapy or medications, you will soon know if it is helping. It is much easier to notice the improvement in your rest quality and duration if you write everything down than if you try to remember it.  

Multiple Sclerosis (MS) affects roughly 400,000 people in the United States and about 2.1 million individuals worldwide. This disease impairs the central nervous system (including the brain and spinal cord), interfering with the nerves that facilitate communication throughout the body. Consequently, the flow of messages via neurons is obstructed, making it challenging for the body to perform movements efficiently.

The most frequent symptom of MS is fatigue. The problem with this is that it can mask some sleep disorders that fatigue can be attributed to, like insomnia, restless legs syndrome, parasomnia and sleep apnea. To make things even worse, poor sleep quality can lead to worsening of the MS symptoms, as quality sleep is needed for muscle restoration, sharp cognitive functioning, mood improvement, and many more.

Although people with MS experience some symptoms, it isn’t a deadly disease. However, it can lead to depression, lower quality of life and shortening of lifespan. There are many different treatments available that could help ease the symptoms a little bit and maybe even slow down the progression of the disease, but unfortunately, there is no cure.

What is Multiple Sclerosis?

MS is a neurological disorder that affects a person’s immune system. Because of not functioning the way it is supposed to, the immune system attacks myelin, a material that makes a layer around your neurons. Myelin serves as a protective layer of neuron’s bodies called axons, and it also contributes to the faster distribution of electrical impulses throughout the body. Myelination is a crucial feature of neurons in vertebrates that allowed them to conserve energy and space, and to increase conductivity by far. Due to MS, the myelin is broken down, causing nerve damage and scar tissue, which makes it difficult for signals to travel across the body and tell it to perform the needed functions.

Symptoms

Symptoms can vary between people, and not everyone is affected the same way. People who suffer from MS experience physical, mental, and emotional symptoms that can affect sleep. Also, a condition in some individuals may get worse with time, while others have periods of improvement and worsening. Most people experience:

• Fatigue
• Difficulty walking
• Muscle weakness or numbness
• Sexual dysfunction
• Generalized pain
• Lack of bowel and bladder control
• Lack of balance and coordination
• Problems with vision
• Difficulty focusing
• Impaired memory
• Depression
• Reduced mood

A lot of people also experience some problems with their sleep. That can lead to a series of sleep disorders like:

• Insomnia
• Sleep apnea
• Restless legs syndrome
• Hypersomnia
• Nocturia
• Narcolepsy

Risk Factors

It was estimated that the prevalence of MS in the United States in 2012 was around 15 in 10,000 people. While the cause of MS is still not known, some people are at a higher risk of developing it:

• Women are two to three times more likely to develop MS than men
• Caucasian people are twice as likely to suffer from it that people of the other racial backgrounds
• People who live in the northern hemisphere are more prone to developing MS than people who live near the equator
• Smokers are at a higher risk than those who don’t smoke
• People with some viral infections may be more inclined to MS, or the infection can worsen the symptoms
• Specific genes are correlated with the disease, around 200 of them
• Obesity also increases the chances of MS

There is research being done in different fields to try and understand MS a little better. Immunology, epidemiology, and genetics are all studied to find a cure for MS, or maybe even prevent it in the first place.

Environmental factors also impact the development of MS. It is shown that people who live further from the equator are more likely to have it. To confirm that it is the environment that is responsible for that, it is recorded that people who migrate from the area of a higher risk to the place in the tropics before the age of 15, acquire the chance of MS of a new location.

There is growing evidence that vitamin D plays a role in MS as well. Low levels of vitamin D have been identified as a risk factor for MS. As exposure to sunlight is the biggest source of vitamin D, researchers believe that it fits with a narrative that people who live further of the equator are more prone to having MS. People in the tropics are exposed to more sunlight, and they naturally have higher levels of vitamin D produced.

Diagnosis

People usually start to see the symptoms of MS between the age of 20 to 40. Because some of the signs are similar to some other disorders, medical professionals need a series of tests to determine whether you indeed have MS. The doctors will go through your medical history, a neurologist will need to examine you, and you’ll go through various tests including magnetic resonance imaging (MRI), spinal fluid analysis, and evoked potentials test that measures the activity in your brain. For a specialist to make a diagnosis, they need to find evidence of damage in at least two different areas of the central nervous system (CNS), to find evidence that this damage occurred at different times, and to rule out any other possible diagnoses.

Treatment

Unfortunately, there is still no cure for MS. There are, however, different treatment options for easing the symptoms, including prescription drugs and therapy.

Lower levels of vitamin D have shown to increase the risk of MS, and moving to a sunnier place may help with the symptoms. The research with vitamin D supplements show different results, and while some showed some benefits, others didn’t find that link. There is more research needed to detect if vitamin D supplements do indeed help.

The primary goal of prescription drugs is to slow down the destruction of myelin and nerve damage, thus preventing the worsening of the symptoms.

Physical therapy has shown benefits in improving muscle strength and balance. It also improves coordination, so moving around and everyday life tasks can become a lot easier. Some patients find using a cane or a walker to help them move around very useful. Also, talking to a psychologist can help people who struggle from MS-related mental drainage and depression.

Sleep Disturbances in Patients With Multiple Sclerosis

Many of the MS symptoms cause sleep disturbances, and problems with sleep can additionally increase the severity of MS symptoms. Patients with MS are three times more likely to suffer from fragmented sleep and are twice as likely to report inadequate sleep. The improvement is needed in the detection of sleep disturbances in people with MS, and also the education of patients to report sleep problems.

Most common sleep disorders in people with MS are:

• Fatigue affects as much as 90% of people with MS. It is different than usual sleepiness, as it can’t be relieved with sleep. People tend to wake up feeling fatigued, and they don’t feel the refreshment that rest should provide.

• Insomnia can be due to muscle pain and discomfort, depression, or some other MS-related symptom. Sleep onset insomnia is described as difficulty falling asleep, while sleep maintenance insomnia is characterized by the inability of a person to stay asleep — individuals with MS experience both of these.

• Restless legs syndrome (RLS) is described as a strong urge to move lower limbs, due to pain, discomfort or a sensation that resembles stabbing of needles. Walking or stretching can help relieve these sensations, but because people with MS can sometimes have a hard time moving, these symptoms can be severe.

• Obstructive sleep apnea (OSA) is a breathing disorder that can potentially be very dangerous. Due to the blockage of the upper airway, there can be a complete stoppage of airflow called apnea, or it can be partially, and it’s called hypopnea. Snoring is the most common symptom and researches thing that OSA is highly undiagnosed and that it affects 1 in 15 people.

• Hypersomnia is the condition opposite of insomnia. People who experience it sleep for too long, or they can spend too much time in certain sleep stages. People with hypersomnia can nap too much during the day, which can lead to insomnia.

• Narcolepsy is characterized by suddenly falling asleep during the day. These episodes can last from a few moments to more than 30 minutes. This can be very dangerous as it could happen while driving or operating heavy machinery, and it can lead to severe accidents. There is currently no cure for narcolepsy.

• Nocturia is a condition where a sleeper has to go and urinate multiple times during the night. That can lead to fragmented sleep and disrupted sleep cycle. As one of MS symptoms is reduced bladder control, it can be a trigger for nocturia.

Depression is another symptom of MS, and it can additionally worsen sleep problems. If you think that you are suffering from a sleep disorder, you should visit a doctor. They will most likely do an overnight sleep study called polysomnography, to determine if everything is okay with your sleep.

MS and Fatigue

Fatigue is the most prevalent symptom of MS, and as much as 90% of people with MS report experiencing it at some point. They usually experience general tiredness throughout the day, or they can feel exhausted after some activity, such as walking.

There are a few theories about the case of MS-related fatigue. One is that the weakened immune system is responsible for it. Cytokines are molecules that are responsible for cell communication during the inflammation. People with MS have been observed to have higher levels of cytokine, which could be a potential cause of fatigue.

Other theories focus on the brain, and its inability to properly communicate with the rest of the body. Because of that, it needs to spend more energy, which could be at least a partial cause for general tiredness.

MS and Sleep Apnea

Obstructive sleep apnea (OSA) affects people with MS a lot more than healthy people. While the prevalence of OSA in the general population is estimated to be around 3%, it goes up to 20% in the MS patients.

One of the causes for that is higher obesity rate in people with MS. Because of the general tiredness, they are less likely to move and exercise, and that is one of the causes for adding extra weight. Extra fat can block the upper airway and cause OSA.

Even if people with MS are not overweight, they are still more prone to central sleep apnea. Because of the lack of brain communication, throat muscles may cause dysfunction, and that can lead to the cessation of airflow.

Snoring and waking up short of breath are the most common symptoms of sleep apnea, so people who are regularly experiencing them should consult their doctor.

MS and Restless Legs Syndrome (RLS)

RLS is characterized by the strong urge to move your legs during rest to relieve pain or discomfort that you feel inside them. It is much more prevalent in people with MS than in the general population, and women are more likely to develop it.

Some individuals with MS also experience periodic limb movement disorder, which is described as involuntary muscle twitching during sleep.

Sleeping Tips for People With Multiple Sclerosis

Improving your sleeping habits can help you ease some of the symptoms and get better quality sleep.

• Set a regular bedtime routine and stick with it. Going to bed and waking up at the same time can help your body rest better.
• Create a sleep environment that fits you well. Your bedroom should be dark, quiet, and cool. You can consider getting one of the sleep product to make your sleep easier like: low profile beds, bed rails, rope ladders, grab handles, floor pads, waterproof mattress and bedding, weighted blanket, or CPAP machine. Most of these should help you with getting out of bed or changing position, or they should help you keep in place, and not falling out of bed. Low profile beds and floor pads will make sure that even if you do fall out, you don’t hurt yourself. A weighted blanket can help relieve some of the symptoms related to RLS, while CPAP is a therapy used for treating sleep apnea.
• Try to eat healthily and to exercise regularly. These will help ease some symptoms, and also make sure that you don’t gain extra weight. Limit fluid intake in the evening if you have a problem with frequent bathroom nighttime visits.
• Manage your naps. They can be very helpful to get additional rest and feel less tired, but make sure you don’t do it too late in the day, and also don’t nap for longer than 30 minutes.
• Don’t be afraid to seek professional help. Whether you need counseling to help with your depression or some other medical advice from your doctor, don’t be shy and ask them anything. They’ll surely do everything in their power to give you the best possible information.

In the modern age, electronics are an integral part of our daily existence. It seems nearly impossible to navigate a day without engaging with smartphones, televisions, video games, and various other devices that not only entertain us but also connect us with our loved ones and our work. These devices have become so embedded in our daily practices that many individuals find themselves taking them to bed. A survey conducted by the National Sleep Foundation uncovered a startling fact: 95% of respondents confessed to using a smartphone or another electronic device during the hour before sleep. Alarmingly, three out of four parents permit their children to take at least one electronic device to bed with them.

When it comes to sleep and technology, it has even significantly influenced the mattress industry and enabled the development of smart mattresses, online availability and more variety than ever before. Thanks to the internet and numerous apps, sleep products have become easily accessible and affordable to every budget. Apart from smart beds that react to the sleeper’s body temperature, thanks to technology, we also have numerous personal sleep trackers at our disposal. Lastly, technology helps you find useful articles like this about how to sleep better.

Although technology has many benefits to our sleep, it can severely interfere with it. For example, regularly using electronic devices, and especially before bedtime, can negatively affect your sleep quality and sleep time. Consequently, when tech interferes sleep, it also impacts how well you function during the day.

Read on to learn how technology truly impacts sleep, how it affects children and adults, and how to power down and get a good night’s sleep without tech gadgets that we are so used to using.

How Tech Devices Impact Sleep?

The biggest problem tech devices are for sleep is the level of blue light they emit. Blue light is present in all modern technology, starting from smartphones and television, to computers, e-readers, and even fluorescent lighting.

Blue light – Blue light has one of the strongest and brightest wavelengths, which means it intensively pierces the photoreceptors in our retinas. When our brain senses blue light from an electronic device, it perceives it as sunlight and may assume it’s daytime. This is bad because melatonin production is regulated by natural sunlight, and its production is essential for normal functioning of our circadian rhythm. Normally, melatonin levels increase in the evening and make us feel drowsy. In the morning, melatonin levels decrease making us feel more alert. However, due to blue light exposure, our levels our melatonin may also increase at night, making us feel refreshed and alert instead of sleepy. When melatonin release is delayed, it’s much harder to fall asleep, and logically, stay asleep.

Noise – Apart from blue light emission, our favorite tech gadgets also disturb our snooze time in other ways. For example, electronic devices often come with a cacophony of beeps, chimes, and sounds that may easily disrupt our sleep environment. Starting from social media notifications to emails and calls, you can definitely recall a time when a noise from your phone woken you up in the middle of the night or early in the morning. The solution to this problem is easy – just turn your phone ringer off or turn on the “Do Not Disturb” option when you go to bed. According to our survey, most Americans forget to do this, and around 10% of them report waking up in the middle of the night, a few times a week due to a sound their smartphone makes. It’s an interesting fact that even when your phone is on silent, the strong vibration may wake you up. Studies have also found that electromagnetic cellular and Wi-Fi signals may disrupt your sleep quality.

Increased anxiety and cortisol levels – Certain technology, especially our smartphones, may deliver content that is stimulating and stressful. For example, reading work emails late at night has shown to increase your anxiety and cortisol levels. Watching action movies or playing an intense video game activates the “fight or flight” response in your brain which also increase your cortisol levels, and at the same time, delaying melatonin production. The point is that your favorite gadgets, although it may not seem like it, prevent you from unwinding and relaxing before bed, which is important for falling asleep.

Young adults particularly have a hard time separating themselves from their phones. A survey conducted in 2016 shows that young adults feel insecure when they are separated from their phones and that this makes them so anxious that bot their smartphone usage and nighttime awakenings increased. We can say that young adults are basically addicted to technology and their phones.

Passive and Interactive Activity

The type of device you use, the way you use it, as well as for how long you use it can all affect how it disrupts your sleep quality. For example, playing video games before bedtime or texting can affect your sleep more than passive use of technology such as watching Netflix or television. However, passive use should also not be taken lightly. Some studies show that using your phone for 2 hours on maximum brightness significantly slows down or completely delays melatonin production.

What tech is the most dangerous for sleep? The answer is your smartphone. Smartphones and tablets can be especially hazardous because we hold the screens much closer to our eyes than other devices, such as televisions and computers. A Harvard study showed interesting results – people who use e-readers opposed to people who read paper books, need 10 minutes longer to fall asleep. This fact alone is not concerning because there is not a big difference. However, e-readers also released only half the amount of melatonin than normal, and spent significantly less time in REM sleep.

Simply put, no matter what type of electronic device you use before bedtime, the longer you use it, the less amount of quality sleep you can expect.

Does Technology Affect Children’s Sleep more than Adults?

Unfortunately, technology may create bigger sleep problems for children than adults. It also may have adverse effects and consequences beyond sleep, such as affecting their academic performance, and general wellbeing.

According to some studies and surveys, teens who text after bedtime, even only once a week, experience significantly higher levels of daytime sleepiness, and sleep approximately half an hour less than teenagers who don’t use their phones past their bedtimes. Teens who tend to text at night also sleep shorter and have a hard time falling asleep.

When children are sleep deprived, they have a hard time to focus, process and memorize information. They are also at higher risk of poor health. The adverse effects of technology on children’s sleep is particularly problematic because the use of numerous tech gadgets and electronic devices is normalized from early age. Kids basically grow up with smartphones, internet, and computer, and they are used to living in a world full of electronic devices. Due to this, many kids use technology to unwind before bed. For example, they engage on social media, watch TV, Netflix or play video games. As you may conclude, kids and young adults basically use technology as a sleep aid. Children don’t see technology as something that hinders their sleep but on the contrary, something that benefits it. Kids that believe technology such as smartphones helps their rest, often go to slumber later, sleep significantly shorter than they should in their age, and may suffer from excessive daytime sleepiness.

Some children don’t prefer technology, but it’s still forced on them. For example, most homework is nowadays done on computers or online, and since homework is done after school (which sometimes last until late afternoon) kids are basically forced to sit in front of bright electronic devices for hours. Extracurricular activities and other priorities may also make it hard to squeeze homework in earlier hours during the day.

Tips for Reducing the Negative Effects of Technology On Children’s Sleep

Here are some ideas and suggestions you could use to counteract the adverse effects of technology on your kids’ sleep.

Be a good sleep role model – as you undoubtedly know, your child looks up to you for guidance from the first day they were born. Guidance refers to all areas in life, including developing healthy sleep habits. If you don’t practice healthy sleep habits, it’s unlikely your child will do the opposite. So, it’s vital to be a good sleep role model to your kids, and encourage them to follow your footsteps. For example, if you don’t want your kids to use electronic devices before bed, you should also remove your phone, TV, and computer out of the bedroom.

Get your kids in the habit of reading before bed – Encouraging your children to read from early age is beneficial to them on multiple levels. Studies show that children who start reading from early age have better emotional intelligence and enjoy the cognitivist benefits all through their pre-teen years. Reading before bed is also a great way to unwind and prepare yourself for sleep. So, make sure your child uses a book and not his smartphone to relax before snoozing.

Explain the effects – Your kids may not like the fact you are forcing them to separate themselves from their phones and computers. Rather than forcing your children to use technology less than usual, you should educate them how it affects sleep, and why it’s essential to avoid electronic devices before bedtime.

Prioritize sleep – kids, especially teens, usually have a very challenging school schedule to follow, and since many parents fear it won’t be enough to get them into the best college, they don’t react even when they noticed their children are obviously overbooked. If your kids struggle with their schedule, you have to remove one or two of their activities and make sure there is enough room for proper and restorative sleep. Help your kids with their homework, and try to find ways to make things a bit easier for them.

How to Power Down for a Better Night’s Rest

Not getting proper sleep regularly is a problem that should be taken seriously. The effects of deprivation will severely deteriorate your life quality and affect every aspect of your life, starting to school and work to putting a strain on your social life. Here are some tips to get a better night’s rest without the use of electronics.

Remove electronics from the bedroom – This is the first thing you have to do if you want to avoid the negative impact technology may have on your sleep. Apart from making sure you are not disturbed by blue light or electronic devices noise, this will also help your brain to see your bedroom as a place for sleep. Your bedroom shouldn’t be a place for work or socializing.

Stop using blue-light devices an hour before bed – It’s as simple as that. To sleep better, just stop using your smartphone, e-readers, computers, tablets and other tech an hour before bedtime. If you don’t know how to unwind without those gadgets, you should try reading a book or a magazine, or listen to an audiobook, podcast or some relaxing music. You can also talk to your household members, take a shower or meditate a bit.

Reduce tech use in the evening – if possible, it is best to limit your electronic devices use in the evening because it stimulates your brain and may make it harder to fall asleep. This includes playing video games and scrolling through social media.

Set your sleep schedule – once you set your sleep schedule and decide to go to bed, simply turn on the “Do Not Disturb” mode, and ignore all text and emails until morning. An important part of following your sleep schedule is to go to sleep and wake up at the same time every day, even when it’s your day off. Combining this with other healthy sleep habits such as limiting your caffeine intake in the evening and avoiding unhealthy foods will also help you to snooze better.

Use “night mode” – if you have to use technology at night and in bed, at least set your phone and apps to night mode. Night mode typically uses red light instead of blue light, so your screens will be dimmer and less intense on your eyes. If you are using some old devices that don’t come with this feature, invert the color settings, so your background is black with white text. It is also possible to download apps that will do this for you. Lastly, dim the brightness on your devices and keep it far away from your face as possible (ideally 14 inches away).

Use tinted glasses – tinted glasses are yellow or orange and reduce the amount of blue light you perceive when using your computer and smartphone, especially at night.

Limit your exposure to light at night – apart from avoiding blue light from your screens, you should also limit your exposure from other light around your house. Dim the lights in the evening in your home and If you live on a street with a lot of light pollution, use blackout curtains for your bedroom.

Get a great mattress – one of the best ways to motivate yourself to go to bed earlier is to turn your bedroom into a place you can’t wait to fall asleep in every night. By getting a comfortable and cozy mattress, choosing a soothing bedroom color and decorations, you are halfway done. Make sure your room is quiet, dark and comfortably cool, and your sleep sanctuary is ready to use!

Do you ever find yourself lying in bed wide awake, deep in the night, staring at the clock as it ticks away, doing mental calculations on your phone, and thinking, “If I fall asleep right now, I can still get X hours of sleep”?

We all know this story too well. The truth is, our sleep pattern often gets disrupted due to our work, obligations, and even if we try to go to bed “on time” we often spend more time in bed rather than being asleep. But what is interesting is that many people often mistake light sleep for being awake. This is because your cognitive abilities might still be active, and as you drift out and into light sleep, your mind is still processing some information, though chances are you won’t remember them later.   

Light sleep is still better than no sleep, but unfortunately, it does not provide the restorative effects that our body needs, which is why experts recommend trying techniques specifically developed for treating symptoms of insomnia, like sleep restriction in combination with CBT-I. 

What is Sleep Restriction Therapy? 

Sleep restriction was first invented in 1982 by Dr. Spielman and his colleagues in order to focus more on the efficiency of sleep and decreasing the time that a person spends in bed. It is based on the idea that deprivation of sleep will boost your sleep drive and keep you asleep. It might be a challenge for people who struggle with insomnia, but when we consider the fact of misinterpretation of being awake and being in light sleep, it is worth a shot.  

Another goal of sleep restriction is to break the connection that your mind is making between bed and wakefulness. As time passes and you are not able to fall asleep in bed, the conditioned stimulus for being awake will be your bed. To understand better the conditioned stimulus and conditioned response let’s illustrate it: 

If you ever had food poisoning, you might already know where I’m going with this. Imagine that you ate a taco and for some reason it made you feel sick after a short time. Now every time you think or smell taco (conditioned stimulus), you will associate it with feeling sick or wanting to vomit (conditioned response). 

For the second one, imagine you get attacked by a dog while riding a bike. Now every time you are near the place of the attack (conditioned stimulus) your brain will automatically connect it with the attack; hence you will feel fear (conditioned response) as you pass it. The list can go on; the point is that our subconsciousness can do wonders and we shouldn’t underestimate it.
 

How Does Sleep Restriction Therapy Work?
 

The first thing that should be done is to estimate three primary factors of sleep: 

1. Usual sleep duration 

1. Wake up time during the workday 

1. Sleep efficiency  

An example will help you to create a mental picture of how sleep restriction works (roughly). Let’s talk about Bob. Bob is an office worker (a typical 9-5 job). He usually wakes up at 7 am and goes to bed at 11 pm. But here is the catch, Bob has insomnia, which means he sleeps around 5 hours or less. To implement sleep restriction therapy, the first step is to limit his time in bed. Meaning, if he sleeps 5 hours, he should be in bed for 5 hours, going to bed at midnight and waking up at 5 am. It might seem harsh, but after a week or two the time spent awake during the night will decrease and increase sleep efficiency, but more on that later. 

The best way to follow that pattern is to keep a sleep diary. 

1. Usual Sleep Duration 

The first couple of weeks use the sleep diary to keep track of your sleeping pattern, when do you go to bed when do you wake up, when do the sleep disruptions occur, etc. Once you have collected the data, calculate how many hours of sleep you get on average each night by reviewing your sleep diary. The easiest way to calculate it is simply by adding the number of hours during the whole week and then dividing by 7 (the days).  For instance, if you have slept for 38h in one week dividing it by 7 gives you the average number of 5.4h a night. 

1. Schedule wake up time that works for you 

Since you will spend less time in bed, your waking up time will probably be slightly earlier than usual. Based on your choice you should schedule your optimal bedtime. You can do that by calculating backward, compared to the time you would wake up. In the previous example, we had 5.4h of average sleep per night. Adding 30 extra minutes as a start would lead us to about 6h allowed in bed. That means if you chose to wake up at 6 am, you should go to bed at 12 am. Sometimes it can be challenging to stay awake until chosen time but try your best to follow the schedule because that kind of sleep deprivation will limit the time awake in bed, and it will make you will fall asleep quicker. 

1. Sleep Efficiency 

As with most new situations, it will be a bit difficult to get used to it, but as you track your sleep at the end of your first week, you’ll notice that it’s gradually improving. Naturally, there will still be some disruptions. Also, at the end of the week, you should calculate the efficiency of your sleep. You can do that by calculating the number of hours you spent asleep and dividing that with the number of hours you spent in bed in total. Going back to the mentioned example, let’s say you spent the whole 6h in bed, but due to disrupted sleep or sleep latency, the real amount of sleep varied from 4-5.5h. It means you spent 44h in bed while getting approximately 34.5h of quality sleep. The percentage of sleep efficiency is around 78. 

That percentage determines whether you should add more or deduct time spent in bed which you adjust every week. 

• If the sleep efficiency is greater than 85 percent and you feel that you need more rest to function properly during the day, you should add 15-30 minutes to your allowed time in bed.  
• If sleep efficiency is less than 80 percent, you should decrease your time in bed by 15-30 min., but you shouldn’t spend less than 5.5h in bed. 

• If sleep efficiency is between 80 and 85 percent, you should continue with the current schedule.  

*All deductions and increases in TIB should be supervised and determined by clinician or therapist of your choice.  

For best results combine sleep restriction therapy with CBT-I and make sure you are supervised by a therapist who has experience with this type of treatment. Another benefit of having a therapist is that he/she can help you if you experience some side effects. Sometimes people who have bipolar disorder can feel moody due to sleep restriction. Others might feel that their seizures are getting worse. With the help of an expert, those side effects can be controlled or even avoided. 

It is hard to say how long you should implement this therapy strictly as it all depends on your progress. It can all be modified to minimize the symptoms of sleep disorders that can cause disruptions and help you get the best sleep quality to function in your day to day life properly.
 

Tips for Stimulus Control 

These tips are designed to help your brain connect bed with sleep instead of associating it with wakefulness. 

• Regular wake up time – It will help our circadian rhythm get stronger and regulate wakefulness and sleep.
   
• Wind down before bedtime – Relaxing activities like reading or listening to music can help you prepare for sleep, and it may help you fall asleep quickly as those activities slow you down.
   
• Go to bed when you feel sleepy – It will make you fall asleep faster but don’t confuse fatigue and sleepiness. Fatigue is when you are feeling like your energy is low and sleepiness is when you cannot stay awake (like when you doze off while watching something on TV).
   
• If you cannot fall asleep, and toss and turn in bed instead, try getting out of bed and going back when you feel sleepy. Use that time to do something that will relax you and promote the sleepy feeling.
   

• Try to avoid long naps during the day – Power naps that last up to 30 minutes are an excellent way for you to feel refreshed without disturbing nocturnal sleep. 

Central sleep apnea is a sleep-related disorder that impacts respiration. Those suffering from this condition experience instances during the night where their breathing ceases, causing a reduction in oxygen levels, potentially leading to severe health complications. Central sleep apnea (CSA) occurs when the brain doesn’t properly communicate with the muscles that control breathing. This is different from obstructive sleep apnea (OSA), which involves the blockage of airflow due to a physical barrier.

Central sleep apnea is often connected to some underlying neurological or cardiovascular conditions, and it is more frequent during non-REM sleep. CSA can be an indicator of a severe illness affecting the lower brainstem, a part of your central nervous system that controls breathing patterns.

CSA can increase the risk of diabetes, stroke, obesity, heart-related conditions, and high blood pressure. It also increases the chances of accidents while driving or working, which can endanger your safety.

We’ll look into the common symptoms of central sleep apnea, what causes it, and how doctors diagnose and treat this condition.

Symptoms

Central sleep apnea shares some symptoms with other sleep disorders, especially obstructive sleep apnea. Most commons symptoms are:

• Frequent nighttime awakenings accompanied by shortness of breath
• Difficulty falling or staying asleep (insomnia)
• Shortness of breath is usually relieved by sitting up
• Excessive daytime sleepiness (hypersomnia) and fatigue
• Morning headaches
• Difficulty learning and concentrating
• Mood swings
• Chest pain at night
• Snoring

While snoring is typically a symptom of obstructive sleep apnea, it can be an indicator of CSA. CSA caused by Parkinson’s disease or some other neurological conditions can have other symptoms like:

• Difficulty swallowing
• Change of voice
• Changes in speech patterns
• General weakness

You should consult a medical professional if you experience any of these symptoms, especially shortness of breath that can wake you up, pauses in breathing during sleep, difficulty staying asleep, or excessive daytime drowsiness. Falling asleep can be particularly dangerous if it happens while you are working or driving. Sometimes, it is easier for your partner to notice some of these symptoms, so ask them to observe you for a short period during the night, and watch out for anything unusual.

Causes and Risk Factors

Central sleep apnea is caused by bad communication between the brain and muscles in charge of respiration. Brain’s signals are not interpreted well, or there are no signals, and that leads to hyperventilation (rapid breathing) or hypoventilation (slow breathing). Both of these alter the amount of carbon dioxide and oxygen in our bodies, which then affects the brain stem, a part of our central nervous system that is in charge of breathing.

Several factors can put you at risk of developing central sleep apnea:

• Stroke, structural brainstem lesion or brain tumor. These brain conditions affect the brainstem and its ability to regulate breathing. Any other conditions that affect this part of your brain increase risk of developing CSA.
• Heart disorders. People with congestive heart failure and atrial fibrillation are at a higher risk of developing central sleep apnea.
• Opioid use. Opioid medications can increase the chances of getting CSA as well. Watch out for pain relievers like morphine, codeine, oxycodone, hydrocodone, fentanyl, tramadol, meperidine, and hydromorphone.
• High Altitude. Sleeping at a higher elevation than what you are generally accustomed to can cause central sleep apnea. The symptoms stop when you get back to your usual altitude.
• Sex. Men are more likely to develop CSA than women.
• Age. CSA is more frequent among older people over 65 years old, probably because they have disrupted sleep patterns and other medical conditions that are likely to cause CSA.
• CPAP therapy. Some people who have obstructive sleep apnea can develop central sleep apnea due to the use of continuous positive airway pressure (CPAP) machine. This condition is known as complex sleep apnea because it is the combination of central and obstructive sleep apneas. This problem is solved by the continuous use of a CPAP machine or trying a different treatment of positive air pressure therapy.

Different Types of Central Sleep Apnea

• Cheyne-Stokes breathing. This type of CSA is commonly associated with stroke and congestive heart failure. The condition is identified by the increase and then decrease of airflow and breathing effort. Stopping of airflow can happen during the weakest breathing effort. This type of CSA is primarily observed in many who are 60 or older, it is rarely seen in women, and it doesn’t seem to be inherited.
• Drug-induced apnea. Certain medications such as some opioids like codeine, morphine, and oxycodone can cause irregular breathing patterns and induce central sleep apnea.
• High altitude periodic breathing. When being at a higher altitude, Cheyne-Strokes breathing pattern might occur. Due to changes in oxygen levels with higher elevation, your breathing patterns can vary between hyperventilation and hypoventilation. This condition seems to affect men more, as they are more sensitive to changes in oxygen and carbon dioxide blood levels. Some people will experience symptoms when sleeping at 15,000 feet (about 5,000 meters) or higher, while anyone resting above 25,000 feet (7,600 meters) will experience this condition.
• Complex sleep apnea. This condition appears in some people and is caused by continuous positive airway pressure (CPAP) therapy. It’s called complex because it is a combination of central and obstructive sleep apneas.
• Idiopathic (primary) sleep apnea. This condition appears to be very rare, and its cause is unknown. It mostly affects middle-aged and seniors, and men are more prone to developing this disease. There might be a tendency for inheritance, and some neurological conditions such as Parkinson’s may increase the risk.
• Medical condition induced central sleep apnea. This type of CSA is rare, and it occurs in patients with medical conditions that include kidney and heart problems, and abnormalities in the brainstem.

Central Sleep Apnea vs. Obstructive Sleep Apnea

Central sleep apnea is different than obstructive sleep apnea. OSA is caused by some obstruction in the airway during sleep. Brain signals are standard, and an effort to breath is intact, but the problem is mechanical.

CSA is a condition in which the brain doesn’t emit right signals, so the muscles that are in charge of breathing don’t function the way they are supposed to. There is no effort to breathe, and it results in apnea.

CSA is a lot less common than OSA. It is estimated that around 20% of all people diagnosed with apneas suffer from CSA.

Diagnosis

The doctor will review your medical history, medication use, and existing symptoms. They might ask you to keep a sleep diary for a week or two so that they have better insights into your sleeping patterns. You’ll include a series of information in a sleep diary, such as:

• What time you went to bed every night
• What time you got up in the morning
• How many times you woke up during the night
• Whether you feel well-rested after waking up
• If you took naps during the day
• How energized you felt during the day

If your situation is complicated, they’ll most likely refer you to a sleep specialist for further diagnosis. Sleep specialists often collaborate with cardiologists and neurologists, and they’ll require you to stay at their facility for an overnight sleep study called polysomnogram.

Polysomnogram includes a series of tests that measure your brainwaves, breathing and heart rate, airflow and blood oxygen levels, eye movement, muscle activity and snoring. You might have a full or split-night sleep study.

In a split-night sleep study, you are observed during the first half of the night. If central apnea symptoms are persistent, sleep technicians will hook you up to a continuous positive airway pressure machine during the second part of the night. That way, they can track how you respond to the therapy, and adjust it if it’s needed.

Polysomnography will also make it easier for doctors to rule out other sleeping conditions that may have similar symptoms but require different therapy. Sometimes, they’ll order an MRI scan of your brain and heart, to better understand any underlying conditions you might have.

Treatment

There are several treatment options for CSA, and they might include:

• Lifestyle changes. Some treatments used to treat OSA can benefit CSA patients as well, such as losing weight if necessary, avoiding alcohol and nicotine, sleeping on your side instead of your back, using nasal sprays to treat congestion, avoiding sleep deprivation and sticking to healthy sleeping habits.
• Continuous positive airway therapy. CPAP is usually the initial treatment used for OSA and can be quite useful in treating CSA as well. The treatment includes wearing a nasal or a full face mask that is hooked up to a CPAP machine. It supplies pressurized air, and it prevents your upper airway from closing while you are asleep. It is essential to stick with your doctor’s advice on CPAP therapy, and you should inform them if you have any problems with it.
• Treating associated medical conditions. Treating other diseases that may be affecting your sleep apnea will make the symptoms of CSA improve as well.
• Reducing opioid medication. If it’s your medication that is causing CSA, your doctor may gradually reduce the dosage of that medication.
• Adaptive servo-ventilation (ASV). If the CPAP therapy wasn’t successful, you might be given ASV. Like CPAP, it delivers pressurized air to the patient. But, unlike CPAP, it regulates the pressure during inspiration and expiration on a breath to breath basis. That makes it easier for patients, as they can sometimes have problems breathing out during CPAP therapy. ASV regulates breathing patterns, and it might even deliver a breath if you haven’t inhaled in a certain amount of seconds. ASV is not recommended for people who suffer from symptomatic heart failure.
• Bilevel positive airway pressure (BiPAP). Like CPAP, BiPAP also delivers a continuous flow of pressurized air. But that pressure is lower for breathing out. Unlike ASV, the amount of pressurized air is fixed, rather than variable. BiPAP can also be instructed to deliver a breath if you haven’t taken one in a certain amount of seconds.
• Oxygen therapy. Supplemental oxygen therapy while sleeping might help with central sleep apnea. There are various devices available on the market.
• Medications. Certain medications can be prescribed if you are not responding well to positive airway pressure. They help to stimulate breathing and acetazolamide and theophylline are the most common ones. They can also be used to prevent CSA in higher altitudes.

Central sleep apnea can be a dangerous medical condition if not treated well. If you notice any symptoms, pay a visit to your doctor, and they’ll know what to do. Even if you are not suffering from central sleep apnea, they might discover some other sleep disorders that are causing you problems. They’ll treat you accordingly and help you get a better night’s sleep.

Sleepwalking, scientifically termed as somnambulism, is a type of parasomnia, which itself is a category of sleep disorder. This phenomenon is characterized by individuals engaging in activities such as sitting up, standing, or ambulating while in a state of sleep. Events of this nature are predominantly early-night occurrences happening during the NREM (Non-Rapid Eye Movement) sleep stage, usually within the first one to two hours after the individual has dozed off. Such parasomniac activities may cause concern among other members of the household. The propensity for sleepwalking is notably higher in children than in adults, and it is expected that the majority of affected children will naturally cease to experience these episodes by the time they reach ten years old. In adults, instances of sleepwalking are frequently misdiagnosed as manifestations of other underlying sleep disorders or medical conditions.

Sleepwalkers may injure themselves or damage their environments. Due to this, this sleep disorder is considering dangerous. People struggling with this parasomnia sometimes trip, fall or even urinate during one of their episodes. One episode of sleepwalking typically lasts around 5-10 minutes.

Isolated episodes of sleepwalking are also possible, and they don’t indicate a serious problem that requires visiting a doctor or starting treatment. Only recurrent sleepwalking is classified as a sleep disorder.

If you are living with a sleepwalker, it’s very important to protect him or her from potential injuries.

Symptoms

As mentioned in the beginning, sleepwalking episodes typically occur early in the night, usually only one or two hours after falling asleep. It never happens during naps, and when it comes to frequency, it can occur rarely or very often. One episode lasts several minutes, usually not longer than 10 minutes.

How does a sleepwalker look like? A person suffering from somnambulism may get of bed and walk around or just sit up in bed and open his or her eyes. Sometimes they can make small hand movements. Their eyes may look glazed or glassy, and they often stare with their eyes open and with a blank expression. They typically don’t communicate with others or respond to questions, but in some cases, they may react inappropriately or say things that don’t make sense.

They can move quietly around the house or run, trying to escape from something. Often, they move well around familiar objects but are prone to falling down the stairs or tripping over an obstacle.

It’s also not uncommon for sleepwalkers to go into the kitchen and start snacking. Somnambulism is often linked to sleep-eating, a separate sleep disorder that is characterized by eating or drinking several times during the night and especially during sleep time. Since sleep-eaters aren’t entirely aware of what they eat, they could be at risk for getting injured or poisoned, since they snack or drink non-food items like cigarettes, toys or even cleaning fluids.

It is very difficult to wake up a sleepwalker from one of his or her episodes. After being awakened, the affected person may feel confused, disoriented and fatigued. Due to fatigue, they may have problems functioning optimally during the day. Somnambulism sufferers typically don’t remember experiencing an episode in the morning. Apart from sleepwalking, patients can also experience sleep terrors.

A person who is sleepwalking can sometimes also do one or more of the following things:

•    Do routine activities such as talking, getting dressed, eating
•    Leave the house
•    Drive a car
•    Engage in unusual behavior, such as urinating in a closet
•    Jump out a window
•    Engage in sexual activity without awareness
•    Get injured (by falling down the stairs or tripping)
•    Become violent (more often after suddenly waking up, than during an episode)

Causes

Sleepwalking is classified as a parasomnia, and all parasomnias are characterized by undesirable behavior or experience during sleep. Somnambulism is a sleep disorder of arousal, meaning it occurs during N3 sleep or the deepest stage of NREM sleep. Another disorder that often occurs with sleepwalking is sleep terrors. The condition is more common in individuals who spend more time deep sleep stages.

For centuries, sleepwalking was associated with psychiatric disorders such as hysteria, or with some psychological problems, such as a guilty conscience. One of the most popular sleepwalking depiction can be seen in Shakespeare’s MacBeth, where Lady MacBeth plays out actions related to her own guilt.

Today, science has disproved these centuries-old myths. Numerous things can cause somnambulism, and there are also factors that contribute to the development of this condition, such as stress, sleep deprivation, fever, sleep interruptions, sleep schedule disruptions, traveling, and so forth.

The parasomnia can also be triggered by other conditions that disturb sleep, such as sleep-related breathing disorders (such as sleep apnea), RLS (restless legs syndrome), GERD (gastroesophageal reflux disease), heart rhythm problems, nighttime asthma, nighttime seizures, PTSD, and so forth.

Taking certain drugs, such as hypnotics (used for relaxation or sleep), neuroleptics (used for treating psychosis), stimulants (used to boost activity), and antihistamines (used for treating symptoms of allergy), and certain medications used for psychiatric disorders can also trigger somnambulism. Substance abuse and alcohol can also contribute to sleepwalking. Some individuals report drunk sleepwalking or sleepwalking while intoxicated.

Risk Factors

There are two major risk factors for somnambulism – genetics, and age. Studies show that sleepwalking runs in families, and it’s more common to struggle with this sleep disorder if one or both of your parents experienced it. When it comes to age, as we mentioned in the beginning, sleepwalking occurs in children more often than adults. In adulthood, the condition will more likely be related to other underlying health conditions.

Complications

Sleepwalking itself doesn’t always have to be a concern. However, sleepwalkers can sometimes injure themselves or others due to their behavior in sleepwalking episodes. Injuries typically occur when sleepwalkers walk near furniture or stairs or wander outdoors (noctambulism). Some of them may jump out of a window or get into their car and start driving. People suffering from somnambulism may also eat something inappropriate.

Due to prolonged sleep disruption, sleepwalkers may experience increased daytime sleepiness, which can further lead to school, work or behavior issues. Due to embarrassment, they may also experience problems with their social relationships.

Lastly, sleepwalkers can injure others or disturb their sleep.

How Common is Sleepwalking?

According to a Stanford study, 10% of people experience sleepwalking at some point in their life, and 3.6% of adults experienced sleepwalking in 2018. Like all other parasomnias, somnambulism is commonly experienced by children aged from 6 to 12. It’s also more common in boys than girls. Since in most cases sleepwalking occurs with sleep terrors, some researchers believe the two disorders are connected.

Diagnosis

In order to diagnose sleepwalking, doctors don’t generally have to perform special tests or sleep studies. Taking your detailed health history and inspecting your sleep patterns and habits is often sufficient. Doctors also always check if your somnambulism is caused by an underlying sleep disorder or other medical condition.

Occasional episodes of sleepwalking shouldn’t worry you because they typically resolve on their own. However, it’s a good idea to mention this to your doctor during a routine exam.

You should see a doctor if your somnambulism episodes have the following characteristics:

•    They often occur (more than one to two times a week or several times a night)
•    They lead to dangerous behavior or injury
•    They cause significant sleep disruption either to you or your household members
•    If you struggle with excessive daytime sleepiness
•    If the episodes appear for the first time as an adult
•    If they continue after your child’s ten years  
•    If they affect your overall quality of life

Sleepwalking Treatment – How to Stop Sleepwalking

You have probably heard that you should never wake up a sleepwalker. However, this is a myth, and in case your partner or child sleepwalks, it’s very important to try to wake him or her or carefully guide the affected person back to bed.

The first thing you have to do is to make sure the sleepwalker’s environment is safe, and that they are safe (since some of them can wander out or try to jump out of a window). Sleepwalkers often go to bed on their own after some time, but it’s better to gently guide them or carefully wake them up. It’s very important not to wake up the person abruptly or to physically restrain them (unless they are in danger). Doing so can make them lash out and act violently.

Waking a person out of the episode is very helpful because it prevents them from experiencing another episode when going back to sleep. However, when one deep sleep cycle passes, a new sleepwalking episode may occur in a new one.

As mentioned, children outgrow sleepwalking on their own and treatment is therefore not necessary. Improving your sleep hygiene and sleep habits can help you alleviate some symptoms of sleepwalking, especially fatigue, and excessive daytime sleepiness.

Here are some essential sleep tips you should practice to prevent sleepwalking:

•    Bedtime routine – as you undoubtedly know by now, a bedtime routine is not only useful for children, but also to adults. Since episodes can be triggered by stress and anxiety, giving yourself some time to relax and unwind can be very beneficial. To relax and prepare yourself for sleep, we recommend taking a warm bath or reading a relaxing book.
•    Sleep/wake schedule – create a sleep and wake schedule that works you, and try to stick to it every day.
•    Bedroom environment – make sure your bedroom is perfect for sleep. It should be dark, cool and quiet. Your mattress should be comfortable and able to provide quality support.
•    Limit fluid intake – avoid coffee and other caffeinated beverages because they can severely disrupt your sleep.
•    If your partner or child sleepwalks at the same time most nights, gently wake them up 15 to 30 minutes before they would normally sleepwalk to prevent the episode from occurring.
•    If your child is affected, establish a regular bedtime routine for it, and promote healthy sleep habits.

Apart from improving your overall sleep hygiene, you should also avoid stressful situations and anxiety, modify your sleep environment so it’s hazard free, and empty your bladder before sleep. Some therapist practice hypnosis for alleviating stress and anxiety that contributes to experiencing sleepwalking episodes. Medications, such as benzodiazepines, should reduce the intensity and frequency of sleepwalking episodes.

To treat sleepwalking, your doctor might prescribe one of the following drugs:

•    Prosom – a sedative that will help you to fall asleep faster, stay asleep longer, and wake less frequently during the night.
•    Klonopin – an anticonvulsant that is often used to calms the brain and nerves. It is used to treat seizures and panic attacks. This medication could reduce sleepwalking frequency by decreasing the amount of electrical activity in the brain.
•    Trazodone – an antidepressant that increases the levels of serotonin in the brain, and it’s used to treat depression, anxiety, and some sleep disorders developed due to stress.

Lastly, cognitive behavioral therapy (CBT) or hypnotherapy may also be recommended.

How to Prevent Sleepwalking Accidents?

As mentioned before, in order to prevent accidents, you must keep the areas of your home where a person may sleepwalk safe and hazard-free. You should remove any harmful objects that may cause the sleepwalker to trip over and fall. It’s also important to keep the windows and doors locked to prevent wandering out of jumping out of a window (noctambulism).

In case your child struggles with this parasomnia, don’t allow him or her to sleep on the top of a bunk bed. Fitting safety gates at the top of the stairs is also recommended. Lastly, it’s vital to warn babysitters, relatives or friends who look after your child at night that he or she may sleepwalk. Also, you should explain to them how to react and gently take them back to bed or wake them up.

Lastly, it’s a good idea to set an impromptu alarm by attaching a bell to the sleepwalker’s bedroom. The bell should jingle in case the sleepwalker opens it. It might wake them up or wake you up – in both cases, it will help the affected individual get back to bed sooner.

The Bottom Line

It is very important to know that somnambulism is not harmful to your health. However, since it puts you at risk for hurting yourself and others, you should still take it seriously. Children in most case outgrow the condition on their own, while in adulthood, it’s typically caused by an underlying medical condition.

If you or your household members sleepwalked once or twice, it’s not a big deal. However, if somnambulism becomes frequent, you should see a doctor, and determine whether the condition is idiopathic or caused by an underlying health condition. No matter whether a cause exists or not, sleepwalking is still manageable and treatable. By changing your sleep habits, improving your sleep hygiene, experimenting with natural sleep aids and even taking prescription medication, you can manage this weird nighttime phenomenon, and get the good night’s rest that you need.

By now, you’re probably familiar with the concept of sleep stages. At first glance, understanding this concept might seem complex since to the untrained eye, people sleeping might not appear significantly different from one another. Nevertheless, tools like the electroencephalogram (or EEG, for short) have revealed that sleep involves a complex interplay of brain activity that was not fully appreciated before. We have started to understand how deeply the recovery processes of the body are connected to certain phases of sleep, and the way various factors and conditions can interrupt this delicate equilibrium, possibly leading to health problems down the line.

In this article, we will be focusing on explaining light sleep. It represents stages 1 and 2 out of the three non-REM (NREM) stages we’re aware of. We used to separate NREM sleep into four stages, but recent research developments and consensus have “combined” stage 3 and 4 into one. Light sleep makes up about 50 percent of adult sleep time, although it can get longer depending on age and other factors. In some ways, light sleep can be seen as a preparation phase for deep sleep and REM sleep, and it’s much easier to wake someone in the lighter stages. Let’s look into the details.

A Brief Overview of Sleep Stages

It’s important to understand how a regular sleep cycle works. Light sleep is hard to analyze on its own, as its connections to other sleep stages determine its functionality and properties. A healthy body is capable of calculating the ideal sleep architecture for itself, which is why medication side-effects that extend a specific sleep stage or cut it short can easily compromise your health. Let’s look at and summarize the four distinct stages of sleep that form each sleep cycle.

Stage 1 only lasts a short time (around 5-15 minutes usually, taking up about 3% of your overall sleeping time) and doesn’t repeat during other cycles. During this stage, you’re transitioning from a waking state to a sleeping one. As your body prepares for stage 3 (deep sleep), your breathing and heart rate go down, as does your body temperature. You become less responsive to any external stimuli as your consciousness slowly drifts away. At some point (it can be quite hard to tell) you enter stage 2. Your eyes make slow rolling movements, as you’re not very far into your first sleep cycle.

Stage 2 is the main topic of this article. Your body temperature drops further in this stage, and your breathing and heart rate follow suit. Eye movement stops, and your brainwaves slow down significantly. This stage occupies roughly 50% of your sleeping time, although the cycle distribution may vary, as REM sleep becomes more and more prevalent over the course of a night. While it’s not stage 1, it’s still fairly easy to wake you up in this stage. This stage of light sleep comes with signature brainwave patterns, called spindles and K-complexes. We will cover them in more detail later on in the article.

Stage 3 is simply called deep sleep. During this time in your sleep cycle, you are almost completely disconnected from the stimuli in your immediate environment, making you much more difficult to wake up. Your muscle movement relaxes considerably, and your breathing and heart rate slow down even more – you barely move at all in stage 3. Dreams do not occur in this stage, but it is still quite important for healing your body. Your organs and blood are cleansed of toxins, and your tissues are rebuilt. In regular sleeping conditions, stage 3 occupies around 20% of total sleep time.

Stage 4 is REM sleep. Another name for REM sleep is “paradoxical sleep,” as the brainwaves and certain other processes within the body resemble what a waking person would display on the readings. Certain parts of the brain are even more active than when you’re awake, but others are dormant. This stage is where memories are consolidated, and your mind is “sharpened” for the coming day. Part of the reason people with sleeping problems don’t perform well mentally during the day is that they don’t get enough REM sleep. Initially, it takes around 80-100 minutes to enter this stage, and from then on it’s a regular part of your cycles, becoming longer and longer until you wake up.

Where Light Sleep Fits In – Signature Brainwave Patterns

Light sleep can sometimes be considered the “filler” stage as it will last as long as it needs to while deep and REM sleep aren’t happening. It doesn’t mean its functions are trivial or irrelevant. During light sleep, the brain transfers memories from short-term storage to long-term storage. Think of it as making a “memory backup,” much like you would with important files on your computer. As a result, stage 2 sleep is crucial for trying to learn anything. It is achieved through the activity of sleep spindles.

Sleep spindles are at the core of why light sleep is so beneficial to our mind. They are specific brainwave patterns that define stage 2 of our sleep cycle. The name spindle comes from how the brainwave looks when you examine the EEG reading. It is a quick burst of oscillatory activity that is widely theorized to represent brain arranging or experiencing a transfer of electrical energy. Not every spindle will appear the same on an EEG reading. They can differ in location and frequency, as well as their association with slower waves. The main potential reason is that spindles occur as a result of different processes in the brain, although we don’t have enough research to determine which processes those are. Aside from memory consolidation, these spindles are widely associated with cortical development. The amount of spindle activity (or sigma power, as spindles are also known as sigma waves) has been correlated to an individual’s intelligence, specifically their performance IQ.

Spindles can occur at almost any part of the brain, but any given spindle is localized to the part of the brain where it pops up. They appear more often as light sleep is initiated or right before it finishes, and the frequencies can depend on which section of the brain receives the activity. The frontal part of the brain produces slower frequencies (around 10-13Hz) than the centroparietal part (13-15Hz).

Without getting into further detail, it’s pretty clear why the hypotheses about spindles have formed. If light sleep is responsible for memory consolidation and learning, these brain waves could very likely be the direct cause or method. But there’s one more brainwave that defines light sleep, and if you’ve been experiencing disorders like restless legs syndrome or obstructive sleep apnea, it may be especially relevant.

K-complexes are almost the opposite of spindles when you look at the EEG reading. Instead of being rapid bursts of oscillation, they’re slower, larger in their fluctuations, and serve a different purpose. They react to external stimuli that usually come from the room or even further outside. A spindle typically follows a k-complex brainwave, and this is interpreted as the brain exerting effort to keep the person asleep. Anomalies and disruptions in how these waves form are closely linked to disorders such as epilepsy, obstructive sleep apnea, and restless leg syndrome.

According to some recent research, the frequency of spindle production (meaning how often you experience them, not their specific frequency on the EEG reading) affects how difficult it is to wake you up during stage 2. While light sleep takes its name from the idea that it’s very easy to rouse someone from this state, there are variations from person to person. The more often you experience spindles, the harder it is for you to be disturbed while sleeping, which leads many people to believe that spindle production frequency is directly linked to sleep quality overall.

In general, light sleep is the only state that doesn’t have a recommended minimum duration. It is very rare for an adult or teenage person to spend less time in stage 2 than is necessary. Because light sleep has to be “cleared” first before you can enter deep and REM sleep, it’s much more likely that a person will spend an excessive amount of time in stage 2. Sleep disorders and environmental factors that may wake the sleeper up shift the balance drastically in favor of light sleep, denying the person crucial restorative processes that characterize deep and REM sleep.

How Are Light Sleep And Age Connected?

Depending on a given person’s age, they can have vastly different EEG readings during sleep, mostly related to the activity of spindles and k-complex brainwaves. Sometimes light sleep is barely involved at all. For example, babies spend very little if any time in light sleep. Sleep spindles that define this stage don’t develop at all until around 6-8 weeks after birth. K-complex waves take much longer to develop properly, first showing up at around five months of age.

Meanwhile, older adults tend to spend most of their sleeping time in light sleep. They often deal with an issue called fragmented sleep. As a result, they keep waking up in the middle of the night, and get an insufficient amount of deep and REM sleep, ruining their sleep architecture entirely. Deep sleep is the main sleep stage when it comes to your body repairing itself and improving the immune system. REM sleep is the primary stage for mental repairs such as memory consolidation, and it’s also where your mental clarity and sharpness get restored for the following day. As a result of this dynamic, older adults who spend a vast majority of time in the light stages tend to feel adverse effects on their body and mind, as the crucial restorative portion of sleep never occurs for them, or is drastically less efficient. It is theorized (and research is slowly confirming these theories) that this dysfunctional sleep structure directly leads to problems like Alzheimer’s or dementia.

Light Sleep VS Light Sleepers

We want to quickly clear up a possible misconception here. When a person is called a “light sleeper,” this doesn’t mean they’re currently in stage 2 or that they experience more light sleep than usual. Instead, people refer to how easily you can wake someone up. A light sleeper is someone who is more susceptible to being disturbed and awakened by external stimuli, thanks to their lower spindle production frequency. A deep or heavy sleeper is the opposite, being harder to rouse and having a higher spindle production frequency. While we can define light and deep sleep by how easily someone can be woken up, these traits still vary from person to person and change with age. Because a senior sleeper spends more time in light stages on average, they may be easier to wake up even if they were originally a heavy sleeper.

Light Sleep And Napping

Deciding how long you want to nap doesn’t have to be tied to your daily work schedule only. Depending on how much fatigue you’re experiencing and whether you’re looking to rest after an intense study session, you can optimize your nap time to achieve the best results. As a rule, the longer you sleep, the harder it is to feel truly energized when you wake up from your nap. However, a slightly longer nap (around 90 minutes at most) is excellent for helping your newfound knowledge settle in. Conversely, if you’re only looking to get rid of some fatigue, a quick (15-20 minutes or less) nap is a better choice. Light sleep is all you need to have a refreshing nap.

**Depression** often sneaks up with sleep issues, such as difficulty falling asleep, frequent wake-ups, or even oversleeping. Not every soul battling depression will wrestle with their sheets, but many do. Doctors peek at your sleep habits to pick up hints about your mental well-being. Here’s the twist – depression and lack of shut-eye can worsen each other, twirling in a challenging cycle. You’re on the brink of exploring what depression truly involves, its impact on your slumber, strategies to combat it, and advice for catching those elusive Z’s amidst mental turmoil. You’ll definitely want to hang tight till the last word.

What is Depression?

According to research done by the CDC, over 7% of US citizens suffer from moderate or severe depression. The symptoms of this mental illness vary, but most patients experience the following:

•    Feelings of sadness and despair
•    Suicidal thoughts
•    Difficulty concentrating
•    Lack of energy
•    Lower libido
•    Low self-esteem
•    Weight loss or weight gain
•    Daytime sleepiness
•    Insomnia
•    Loss of interest in activities the affected person previously enjoyed

Symptoms of depression are persistent and may change every aspect of one’s life, starting from work and friendship to satisfying your basic needs such as eating and sleeping. People with depression often have trouble being productive at work or in school, and their social and romantic relationship may also be compromised. Sleep issues are one of the most common reasons depressed people seek professional help.

Types of Depression

Major Depressive Disorder – As the name might suggest, this mental illness is characterized by extreme depression. The affected person feels very sad, hopeless and has suicidal thoughts. The patient rarely feels happy or satisfied. When it comes to sleep problems, these patients experience insomnia and excessive daytime sleepiness.

Dysthymia – This is a milder form of depression. All the symptoms remain the same, but they are just less intense. Apart from disrupted and fragmented sleep, these patients also struggle with hypersomnia.

Bipolar Disorder – People struggling with bipolar disorder experience mood swings that oscillate between extreme highs and lows. The person may be either highly motivated, energetic, and excited or extremely sad, tired and hopeless. When their mood is positive, the excitement often prevents them from falling asleep at night. When they are feeling sad and tired, they typically oversleep.

Seasonal Affective Disorder (SAD) – As the name suggests, SAD is a type of seasonal depression. This mental disorder often occurs in winter months. Rarely, it can occur during warmer months and in summer. Common symptoms are insomnia, daytime sleepiness, and worsened mood. It’s very interesting to mention that this disorder is most likely caused by the changing levels of sunlight, which affect the circadian rhythms of the patients, messing both with their emotions and sleep. The disorder is effectively treated with light therapy.

Who Is at Risk for Depression?

One of the most significant factors for depression is stress, genetics, emotional trauma or loss. Depression can affect some people more than others, and according to certain studies, women and adults in middle age are more prone to this condition. These two groups are also more common to experience insomnia.

The Vicious Cycle of Depression and Sleep Deprivation

As mentioned in the beginning, depression and insomnia are comorbid. Depression and negative thoughts make it harder to fall asleep at night, while sleep deprivation only further worsens mood, and makes the affected person even more emotionally sensitive than before. It’s already hard to regulate the emotional volatility with depression, and sleep deprivation only makes things even worse.

Due to lack of sleep, depressed individuals don’t have enough and will to stay motivated, engage with others, go to work or even satisfy their basic needs such as eating. People who are depressed often self-isolate, which can lead to more sleep issues, because loneliness is associated with fragmented sleep.

Lastly, even if you are not depressed, lack of sleep and sleep deprivation over time increase the risk of depression. A study published in the Journal Sleep confirmed that children with both insomnia and hypersomnia are more likely to be depressed for longer periods of time. There is also a strong correlation between insomnia and major depressive disorder, especially in young adults. Lastly, research shows that teens who don’t get enough sleep are more prone to depression and suicide.

Now let’s take a look at how depression affects sleep and causes various sleep disorders.

Changes in REM sleep

Electroencephalogram tests of patients with depression show they have a longer sleep latency, spend significantly less time in deep sleep, shift REM sleep to earlier in the night, and often experience sleep maintenance insomnia, meaning they are prone to waking up during the night.

Electrical activity the brain exhibits during REM sleep is very similar to that in people with depression. Also, patients with depression have their first REM sleep much earlier during sleep than healthy people. If the depression gets worse, REM sleep further shifts and occurs earlier than normal. In severe cases, the sequence of sleep stages is completely disturbed, and first REM sleep occurs before the first deep sleep period.

Scientists still don’t know why rapid eye movement activity is increased in patients with depression. So far, researchers have noticed that patients with major depressive disorder have high activity in the ventromedial prefrontal cortex and low activity in dorsolateral prefrontal cortex section of the brain. When we take a look at the sleep architecture of a healthy individual, and one with depression, we can conclude that depressed people sleep shorter, experience decreased REM latency, and struggle with sleep maintenance insomnia.

Insomnia and Depression

Insomnia is characterized by a difficulty to fall or stay asleep. This sleep disorder is pretty common, and according to statistics, every third person struggled with insomnia at least once. As mentioned in the beginning, people with insomnia are 10 times more likely to develop depression. Some people with sleep issues don’t suffer from clinical depression but show some of its signs. This is understandable, as being unable to sleep frustrates the affected person. Most chronic insomniacs believe they will never sleep normally again. Also struggling with excessive daytime sleepiness the following day easily affect almost every aspect of your life and reduces its general quality.

Researchers still don’t know how exactly depression and sleep disorders are linked. However, they have found neurochemical links between the two – corticotropin-releasing factor. This neuropeptide is elevated both in people who suffer from depression and those who struggle with insomnia.

Other Sleep Disorders and Depression

Hypersomnia – as you may logically conclude it is the opposite of insomnia, and characterized by oversleeping. It occurs in 40% of young adults with depression.

Sleep apnea – this condition is characterized by short breathing interruptions during sleep. The affected person literally stops breathing for a few seconds. This condition interrupts the sleep cycle and may lead to sleep deprivation, even if you don’t wake up at night because of it. Sleep apnea and depression are also comorbid. The association is particularly strong among adult men.

Restless legs syndrome – this is another sleep disorder that occurs with depression. RLS is characterized by feeling intense and unpleasant sensations in the lower limbs when you lie down. The feeling is often described as being pierced by pins and needles. The only way the affected individuals find relief is by jerking their legs. As you might guess, this makes falling asleep very hard, and it contributes to the development of insomnia and sleep deprivation.

Treatment for Depression-Related Sleep Disorders

If you are struggling with depression or depression-related sleep disorders, getting a good night’s rest can help you alleviate the symptoms. Standard treatment for depression combines psychotherapy and medications.

When it comes to psychotherapy, the most popular choice is CBT or cognitive-behavioral therapy. This type of treatment is focused on helping the patient recognize the negative or destructive thought patterns and replace them with more positive thoughts and behaviors. The patient is trained to respond differently to a negative situation or thought, and to develop new ways of thinking and behavior. A sub-type of cognitive-behavioral therapy, called CBT-I is specifically designed to help people with insomnia.

When it comes to medications, there are different drugs for insomnia and depression. However, it’s interesting to mention that both conditions can be treated with antidepressants especially selective serotonin reuptake inhibitors (SSRIs). People suffering from insomnia also find relief when taking these drugs. In case, a patient is struggling with idiopathic hypersomnia, he or she needs a stimulant – something completely opposite of sleeping pills. Due to this, it’s very important for doctors to accurately diagnose the condition and evaluate whether people with sleep disorders may also have depression and whether they are a good candidate for anti-depressant medications.

Apart from psychotherapy and medications, light therapy and CPAP therapy may also be useful to alleviate some symptoms of depression.

Light Therapy

Light therapy psychotherapy and medications, depression and depression-related sleep disorders can also be treated with light therapy or even CPAP therapy. Light therapy is a very effective form of treatment for SAD or seasonal affective disorder. It can also be used to treat insomnia or hypersomnia.

Light therapy is very simple. The patient needs to sit in front of a special light box that produces 10,000 lux of bright light similar to the sun. The special light box is typically used in the morning or at night to help the patient wake up or stay up (in case they struggle with excessive daytime sleepiness). Light therapy devices can also come in the form of wake-up lights, sunrise dawn simulating alarm clocks, and wearable visors.

CPAP therapy is used in case the patient suffers from sleep apnea. Continuous positive airway pressure devices are very effective for treating obstructive sleep apnea, and may also alleviate some symptoms of depression in individuals with co-morbid depression. Patients with OSA and depression should be very careful about taking sedative medications because these can worsen the symptoms of sleep apnea.

Tips for Getting Better Sleep with Depression

By improving your sleep hygiene and developing healthy sleep habits, you can significantly alleviate the symptoms of depression and depression-related sleep problems. Let’s take a closer look at some essential sleep tips and advice you should follow.

Keep a sleep diary – if you believe you suffer from depression or a comorbid sleep disorder, keep a mood and sleep diary for two weeks and take it to your doctor. It’s important to note when you go to bed, how long it takes to fall asleep when you wake up, did you wake up at night, and how much time you spent asleep. Note your level of sleepiness and fatigue through the day, as well as your mood changes. Changes in your diet, libido and thought patterns (for example, being very negative or constantly anxious) may be signs of depression.

Turn your bedroom into a sleep sanctuary – As we mentioned numerous times before in our articles, the bedroom should be used only for sleep and sex. Everything else, from watching TV to working should take place elsewhere. By ensuring you use your bedroom only for the things you should, your mind will start associating the environment with rest and peace, and won’t perceive it as a place of worry, stress, anxiety or social activity. Ideally, your sleep environment should be quiet, dark and reasonably cool. Make sure you remove all the unnecessary electronics out of there, and if there if the room is too bright in the morning (or in the evening due to street light), use blackout curtains. Lastly, invest in quality and comfortable mattress.

Stick to a regular sleep schedule – a regular bedtime is not only good for kids but also or adults. Try to go to bed and wake up every day at approximately the same time, even when you have a day off. You may struggle a bit in the beginning, but don’t worry if you can’t immediately fall asleep. Your goal is to stick to the schedule and eventually your brain, and circadian rhythm will catch up. Basically, as you once did with your kids (if you have them), you are training yourself to sleep and wake up in the morning more naturally.  

Avoid napping – naps are allowed only if you are very tired during the day. However, it’s best to limit them to 20 or 30 minutes. Napping longer than that can be problematic because you risk transitioning into deep sleep.

Create a bedtime routine – depression can produce worrying thoughts that enable you to fall asleep peacefully at night. To ease your mind of worries and relax, create a simple bedtime routine that includes relaxation techniques, meditation or deep breathing exercises. Taking a warm bath or reading a good book will also help. If you still have troubles to unwind, write your thoughts down in a worry journal, and release them out of your head. If you are anxious, write a to-do list for tomorrow to organize your day in advance.

Enjoy the sunshine – natural sunlight is very healthy for your sleep-wake cycle, and it’s also great for improving your mood. Enjoy the sun by exercising outdoor or just by taking a walk with your friends. Sunlight will give you energy, and make you feel better and less tired during the day.

Eat healthier –food high in sugar or fats can easily mess up with your sleep, as well as stimulating substances such as caffeine, and alcohol. By eating healthier and drinking plenty of water, you will also sleep better.

Stay calm – training your body to sleep is not easy, and takes some time. Therefore, it’s important to stay calm if things don’t work out immediately. Every person is different, and what works for someone else, may not work for you. It’s important to keep trying until you find what suits you. Over time, sleep will naturally come.