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In our current era, the use of fear tactics to give out medical recommendations is becoming ever more prevalent. Alerts regarding health risks presented in the media have become as exaggerated as the latest celebrity scandals, complete with alarming warnings about certain dietary components allegedly causing cancer or other serious health problems. The difficulty in interpreting such warnings often stems from political agendas, which usually aim at discrediting a particular food producer or a similar entity. Nonetheless, considerable health dangers and their repercussions are still being ignored by the greater population.

Many studies have shown that short sleepers (people who get less than 7 hours of sleep each night) and long sleepers (people who sleep for more than 8 hours per night) face an increased risk of early death. If you look at the mortality rate chart shown in many of these studies, you will notice a repeating U-shaped pattern that spells it all out for you. In this article, we will look into these studies and examine the risk factors that can contribute to this early death statistic. This information will be able to help you plan your sleep schedule and general lifestyle to improve long-term health.

Note: Don’t be scared into thinking that short and long sleeping put you in guaranteed danger. Your medical history and individual physiological quirks, as well as your environment, are much more important factors to consider over whether you should be asleep for 7 or 8 hours. If you’re concerned, speak to your primary care physician.

The Concept of Relative Risk

Relative risk or risk ratio (both are abbreviated as RR, thankfully) is an epidemiological term used to describe probability. Epidemiology is the term for scientific analysis of studies and data, specifically related to the distribution and determinants of diseases and other health conditions in various populations. Epidemiologists try to narrow down specific risky behaviors that increase the chances of disease and other issues. The way the resulting information is presented may look convoluted and unintuitive at first, but it’s quite sensible. Let’s look at an example unrelated to sleeping:

You take two groups of people at a dinner event. One group is composed of vegetarians who avoid the steak portion of the buffet. The other group freely indulges in this steak dish. Thirty people eat steak, and 15 of those experience illness and nausea. Twenty people eat only the vegetable portion of the meal, and only 3 of them get ill. The relative risk ratio for the steak lovers is 0.5, while the vegetarians are facing a relative risk of 0.15. It means that people who ate steak were more than three times more likely to experience nausea compared to vegetarians. It points to the assumption that steak was the main cause of illness at the dinner event, although it cannot be considered irrefutable proof.

Separate potential factors can become “confounding factors,” meaning that they influence both the suspected cause and the outcome, which can muddy the research results and cause inaccuracies. Confounding factors and determinants are isolated and controlled through methods like stratification – sampling various subpopulations within the target population to find only the most relevant common factors.

In the context of sleep disorders or today’s specific topic (early death as a result of long or short sleeping), there is a list of common determinants to work with. If you’ve been reading any articles about sleep disorders, you can probably name a good handful of factors – stress, alcohol consumption, dietary habits, medical history, levels of exercise, etc. In this article, we’re looking at short and long sleeping as a possible factor that contributes to early death.

Study Results

The association between sleep duration and overall mortality has been shown in over 20 studies to this day. They all present the familiar U-shape pattern centered around the 7h sleep duration mark. While the mortality risk of regular sleepers is 1, short sleepers bump it up to 1.1, and long sleepers have a mortality risk of 1.23. However, it isn’t enough information to base a conclusion on, and the direct causes of those deaths should be examined. Sleep disorders are not considered a cause of death, but the weakened immune system you get can cause dangerous and potentially lethal health problems.

Let’s look at cancer and cardiovascular disease; two very common causes of death in the United States. Short sleepers have a relative risk of 0.99 when it comes to dying of cancer, meaning they’re only a tiny bit less likely to meet that end than normal sleepers. However, their relative risk of dying of cardiovascular disease is 1.06, a noticeable notch above average. Long sleepers have it the worst when it comes to these two conditions – their risk ratio for death by cancer is 1.21, and they have a relative risk of 1.38 for cardiovascular disease-related death.

Studies that deal with this sort of topic often function as a long-term monitoring process with questionnaires that get filled in by the subjects (often pairs of twins for convenience) each year or every couple of years. Because a lot of contributing factors for early death may exist in their lives, extra questions are included about their daily or weekly habits – things such as alcohol consumption, diets, levels of exercise, tobacco smoking, the presence of sleeping medication or any other significant drug that can influence the findings. Most studies tend to focus on cancer and cardiovascular disease.

The Allostatic Load Theory

The idea of the allostatic load has not exactly been widely accepted by the academic and medical circles thus far. However, it could be a key factor in explaining why abnormal sleep leads to increased mortality. The way it works is easy to understand on a basic level – allostasis is the process of achieving homeostasis. Homeostasis is a stable state of internal chemical distribution, and it is necessary for our body to function properly. A simple example is body temperature, where your body stops functioning properly if you go even slightly higher than the regular value.

The allostatic load is essentially the combined “wear and tear” your body experiences as it is exposed to chronic or repeated stress. Your nervous system responds to this stress in an intensified or fluctuating way, which has negative physiological consequences. Individual systems within the body respond to the overall state of the body, and the brain anticipates your needs and regulates the release of hormones and the processing of stimuli in advance to compensate. However, if the issue remains unresolved, the brain will continue pumping an increased amount of hormones, which isn’t healthy. One of these issues is sleep deprivation, and this idea goes a long way towards explaining why short sleepers have an increased mortality risk. Allostatic load is considered a key factor in many diseases and problems that a majority of seniors face. The longer a person is alive, the more wear and tear their body experiences, leading to health issues.

You’ll notice that most of this applies primarily to short sleepers. There is a different potential explanation for the increased mortality risk of long sleepers. The idea is that long sleep is most likely caused by one of a large number of potential underlying conditions. The fatigue that various illnesses cause can increase the amount of time a person spends asleep, and while the long sleep itself won’t be the cause of death, it is a warning sign that something much more dangerous (and likely undiagnosed) is happening under the surface. If the long sleep is diagnosed as hypersomnia, then the other conditions are considered co-morbid – meaning that they coexist with this sleeping disorder.

Changing Your Sleep Patterns

The idea of early death and mortality risks could cause some people reading this to get worried. After all, if someone is health-conscious and avoids harmful foods, then it is only natural that they would try to change their sleep schedule. However, it can be complicated to suddenly move your entire sleeping window to another part of the day, or force yourself to sleep more or less than what you’re used to. That’s why we recommend a series of steps you can take to fix your schedule without disrupting your normal daily routine and performance:

• Before attempting to make any sort of big changes to your lifestyle, keep a sleep journal for a couple of weeks. Sleep tracking is an excellent way to become more aware of how much sleep you’re getting, and get other relevant information. Try to keep this journal for a while even after you make alterations to your sleeping schedule, since the information may be useful later on.
• Consult your doctor about your plan. This step seems like a no-brainer, but so many people try things recklessly and get ill as a consequence. If your journal makes you suspect you have a sleeping disorder that’s causing you to sleep for more or less time than is ideal (which is 7-8 hours in this case), give them the journal, so they know what you’re dealing with. If they suggest a polysomnography session or other similar diagnostic tests, agree to them, since it’s crucial to know how you normally sleep and whether you’re dealing with a condition. Follow their diet advice or exercise recommendations, as these routines will help you live healthy even if they don’t directly affect sleep.
• Use an alarm or similar device to wake up exactly when you need to. Even if you’re unemployed or otherwise free to wake up at any time you want, investing in a smart alarm or a special lamp is a good idea. These alarms and lamps wake you up without instantly shocking you out of deeper sleep, usually through sleep stage detection or by slowly increasing the light in your room to emulate sunrise. Your circadian rhythm is governed by an internal biological clock that responds to light levels around you, so these lamps can help you feel refreshed when you get up.
• Manage your daytime naps. Short sleepers are sometimes tempted to take a quick daytime nap to “freshen up,” but this can disrupt their sleep schedule and do more harm than good. It’s good to be very tired before you hit the sack, as it can help you sleep for longer.

Chronic insomnia is extremely prevalent, with about 30% of the general population being affected. Struggling with sleep issues doesn’t automatically mean you should reach for medication, especially those over-the-counter types without consulting a professional! Insomnia can be quite disruptive and exhausting, even in milder cases. Should you find yourself dealing with its symptoms, it’s essential to seek advice from a healthcare professional before embarking on any treatment plan.

Things to Try Before Opting for Sleeping Pills

Before opting for pills, you should always try some less-invasive alternatives, such as natural sleep aids or CBT-I.  

When it comes to Cognitive Behavioral Therapy, this method of treating insomnia doesn’t involve any medications and instead focuses on improving your sleep hygiene and general wellbeing by reducing stress, setting up a sleeping schedule, etc.

If these still didn’t provide you with the so much wanted relief from insomnia (and you also tried other common-sense methods like limiting processed foods, caffeine and alcohol intake and getting more physically active) it might be time to look into sleep drugs and prescription medicine.

What Your Doctor Should Consider

When considering sleeping medication (or any medication really) for the first time, it is important to know exactly how it works and what are the possible side effects and complications for your health.  Before going into different drug options, your doctor will ask you some general questions to determine which course of action is appropriate for you. These will typically cover your medical history, age, sleeping hygiene, allergies and any other medication you might be taking.

After that, he or she will move on to your insomnia symptoms. In case your insomnia is secondary (caused by another medical condition), you will need to address the underlying condition.

It’s also important to determine whether you have issues with falling asleep (sleep onset insomnia) or staying asleep (sleep maintenance insomnia), as different medications target different problems.

Finally, your doctor should be able to prescribe a medication that potentially fits your needs, and schedule an appropriate follow-up, as most medications are meant for short-term use only. In case the first drug doesn’t work for you in the previously established period, make sure to report back to your doctor so he or she can adjust your therapy accordingly – don’t drop the whole treatment for some over-the-counter pill.

Types of Prescription Medications

There are a lot of different sleeping drugs out there, varying in their active substances, targeting issues, side-effects and form in which they are consumed. Some of them weren’t even primarily made to fix sleeping problems, but due to some fortunate side-effects, can be prescribed to treat insomnia. Most commonly used drugs can be divided into three groups: Benzodiazepines, Z-drugs and Other medications.

Benzodiazepines

Primarily used to treat anxiety, Benzodiazepines have also found common use in treating sleeping disorders by acting on benzodiazepine receptors in the brain. They belong to the group called Central Nervous System (CNS) depressants and work by decreasing excitability in certain parts of the brain, thus helping reduce both anxiety and insomnia symptoms. Two birds with one stone, now you just have to stock up on these, and you’re good, right? Well, no. Benzodiazepines work best when used for shorter periods, and aren’t as useful for longer-term problems. Partly, this is because your body gets used to the initial dose after two or three weeks, and the drug loses its use. So if you want to keep taking it, you have to keep increasing the dose (which alone is not advisable), and the same thing will happen. This effect is called tolerance.

Also, due to the addictive nature of the medicine – you start relying on it to feel normal. If you stop taking it abruptly after using it for over a month, you will experience withdrawal symptoms. These could be physical (inability to sleep, sweating, tremor, headache, nausea, sensitivity to light), psychological (odd sensations, panic attacks, anxiety, etc.) or both, and often beat the whole purpose of taking the drug in the first place. This can happen with overusing Z-drugs as well, and the symptoms could last up to six weeks after you’ve stopped medicating.

Some commonly used Benzodiazepines are: diazepam, estazolam, temazepam, triazolam, clonazepam, lorazepam, loprazolam.

Estazolam

–          comes in a tablet form, taken orally, usually in 1-2mg dosage

–          treats insomnia

–          helps with falling and staying asleep

–          has dependency potential

–       side-effects may include: headache, drowsiness, dizziness, weakness, constipation, agitation, slowed movements

Estazolam, or ProSom, is supposed to be taken at bedtime, or as needed when experiencing difficulty falling asleep, and isn’t recommended if you know you won’t be able to sleep for longer than  6 hours – even after you have slept the night, chances are you will still have difficulties waking up. Estazolam is not for pregnant women and people with liver problems.

Temazepam

–          capsule form, 15, 7.5, 30, 22.5mg

–          recommended dosage: up to 30mg

–          falling and staying asleep

–          should be taken for 7-10 days

–          possible side effects: nausea, vomiting, drowsiness, headache, fatigue

Another typical Benzodiazepine drug, Temazepam belongs in the hypnotic class, also known under the name Restoril. It’s meant to keep you asleep for at least 8 hours, so don’t be surprised if you wake up a bit disoriented and need some time to shake it off.

Triazolam

–          tablet form, either 0.125 or 0.25mg

–          recommended daily dose: 0.5mg or less

–          treats severe insomnia

–          helps with sleep onset but not with maintenance

–          dependency potential

–          side effects may include: drowsiness, nausea, headaches, lightheadedness, skin tingling, nervousness, problems with coordination

–          more dangerous side effects: rash, hives, itching, difficulty breathing, swelling

Triazolam is used on a short term basis to treat severe insomnia, although clinical studies have shown that it also reduces nighttime wakefulness. Common under the names Halcion, Apo-Triazo, Hypam and Trilam, this drug works by slowing brain activity, thus helping you fall asleep. The maximum dosage is 0.5mg per day, but smaller amounts are usually sufficient. If you experience any of the severe side-effects mentioned above, contact your doctor immediately.

Z-drugs

Zaleplon, zolpidem and eszopiclone/zopiclone are the three medications regularly grouped as Z-drugs because of their Z-names and similar function. They are primarily used to treat insomnia, and although they aren’t structured like Benzodiazepines, they affect the same parts of the brain to induce sleep. Z-drugs carry a slightly lower risk of abuse, but can also lead to dependence if taken for over three weeks, with same potential withdrawal symptoms as with Benzodiazepines. Their most common side-effect is drowsiness – many people reported being less attentive or “feeling like a zombie” while on a Z-drug.

Zaleplon

–          tablets, 5 or 10mg

–          Dosage: up to 20mg

–          helps onset sleep

–          can be addictive

–     some potential side-effects: numbness, loss of appetite, tingling in arms or legs, sensitivity to smell, headache, vision problems

Zaleplon (Sonata) is not indicated for sleep maintenance. It is a hypnotic, shown to help patients fall asleep, and FDA approved its use for up to one month. The recommended dosage is 10mg, for elderly and debilitated patients lower than 5mg. In some countries, Zaleplon is also available as Hegon, Zaplon or Andante.

Zolpidem

–          available in capsules of 5 or 10mg

–          recommended daily dosage: 10mg or less

–          indicated for patients with difficulties falling asleep

–          side effects: dizziness, lightheadedness, headache, drowsiness, fogginess

Commonly sold under the names Intermezzo, Ambien, Ambien CR, and Edluar, Zolpidem is a hypnotic drug that, much like Zaleplon, aids sleep onset issues and not maintenance. If you have troubles staying asleep, this one is not for you. Zolpidem has also been linked to CNS depression and has the potential for abuse.

Eszopiclone

–  comes as a tablet of 1, 2 or 3mg

–  recommended dosage: under 3mg

–  indicated for both sleep onset and maintenance

–  classified as hypnotic

– potential side-effects: headache, pains, unpleasant taste, dry mouth, heartburn, unusual dreams, short-term memory loss, decreased libido

Prior to the introduction of this drug, the FDA didn’t approve using hypnotics for a period longer than one month. Eszopiclone or Lunesta has been shown to be mostly non-habit-forming, although this is still discussed among professionals. This pill is classified as a hypnotic and meant to treat short-term insomnia. Don’t eat foods high in fats shortly before taking it, and make sure you are in bed maximum 30 minutes after. Otherwise, you may experience side-effects. It is not recommended for pregnant women.

Other Medication

Some prescription sleep medications that don’t classify under Benzodiazepines or Z-drugs, but are regularly prescribed to treat insomnia, are Ramelteon and Suvorexant.

Ramelteon’s main distinction from other commonly used sleep meds is that it acts on melatonin receptors in the brain instead of GABA receptors or benzodiazepine receptors. Melatonin is a hormone produced by the pineal gland in our brains that helps maintain a healthy sleep-wake cycle monitored by circadian rhythm, which helps us sleep through the night and wake up in the morning, triggered by daylight. Although still quite new to the market (FDA approved less than two decades ago), Ramelteon has shown to be a very reliable sleep pill without being addictive. One possible side effect is dizziness and recommended daily dosage is 8mg – meaning, one pill a day.

Suvorexant, or Belsomra, is classified as a sedative-hypnotic, but also an orexin agonist, which means it acts on orexin receptors in the brain. The US National Library of Medicine Institute of Health defines orexins as “recently described hypothalamic neuropeptides thought to have an important role in the regulation of sleep and arousal states.” Suvorexant comes in 10mg capsules, with recommended daily dosage being no more than 20mg. Side effects may include diarrhea, nausea, dizziness and dry mouth. It also has a potential for dependency, but lower than with Benzodiazepines or Z-Drugs.

Antidepressants with a sedating effect

We mentioned before that treating secondary insomnia without treating the underlying condition would be unwise. While that is true, there are certain situations where you could (at least temporarily) treat both at the same time, and one of those situations is the combination of depression and insomnia. Namely, some medication widely used to treat depression may help ease insomnia symptoms. These drugs are not FDA approved to treat sleep issues alone, but if insomnia is secondary to depression, using some antidepressants could be beneficial for both conditions. A few of these examples include Amitriptyline, Mirtazapine (Remeron) and Trazodone.

Mixing drugs

In short? Don’t do it.

Mixing prescription medication with over-the-counter medication is extremely dangerous, and mixing two prescriptions is just as bad, if not worse. Especially with something that has to do with your metabolic system, depending on how bad you mess up, it can result in a coma, even death. Your doctor has to be informed of your entire background before prescribing you a new pill. Otherwise, you are putting yourself at great risk.

Mixing drugs with alcohol is a terrible idea as well. When taken together, the sedative effect on your central nervous system is double, and short-term side effects could include:

–          impaired motor function

–          falling asleep while doing something that requires attentiveness, such as driving

–          blackouts

–          cardiac arrest

–          sleepwalking

If alcohol abuse is what induced insomnia in the first place, sleeping pills could be very risky.

Conclusion and Safety Considerations

Reaching for pills may seem easy, but could be very dangerous if not taken seriously. Out of the three groups of prescription medications, older and more tried out ones are Benzodiazepines and some Z drugs, but they can have some milder side-effects like drowsiness, decreased attentiveness or headache.  Perhaps more promising and seemingly less harmful would be Ramelteon, with no dependency risks, or even Suvorexant, but these drugs are still relatively new on the market, and not as vastly tested as the older ones.

There are many medications not highlighted in this article with different variations of traits covered here, but the key is to talk to your doctor and be open to some trial time before you find one suitable for you.

Pills don’t combine with other pills without expert advice, and pills with alcohol – never!

Lastly, if you are pregnant, breastfeeding, or have an existing condition such as kidney disease, arrhythmias, other heart or liver issues, low blood pressure – you might want to reconsider taking sleep medication altogether.

For many of us, the challenge of falling asleep at night becomes particularly acute when an important day looms ahead and we’re in dire need of a restful night. It’s incredibly aggravating to lie in bed, watching the minutes and hours tick by, without being able to succumb to sleep. The struggle feels even more intense knowing we need to rise early, making the inability to fall asleep even less welcome. This often leads to a cycle of anxiety and worry about facing the coming day on too little sleep – a concern that only makes the problem worse. For anyone struggling to meet their sleep goals and wants tips for falling asleep faster, here are a number of strategies that could help in winding down and preparing your body for a restful night.

Don’t Nap During the Day 

It can be quite difficult to resist daily napping, but it is something that you should try if you want to sleep on time in the evening. Many people feel sleepy and tired during the day, and they decide to take a nap so that they can feel better. Of course, daily napping has its benefits, such as improved alertness and well-being. However, according to some studies, excessive, frequent and late napping can affect sleep quality and even contribute to sleep deprivation. If you can’t go through the day without a nap, you should try to limit yourself to a short nap of around 30 minutes, but not in the late afternoon or evening. However, it would be a much better idea to eliminate naps altogether if you want to find out if they are affecting your sleep quality and duration or not. 

Avoid Using Electronic Devices before Bedtime 

Most of us like using our smartphones, watching TV or playing video games before going to sleep, but we are often not aware that this habit can disrupt our sleep patterns. It is vital to keep in mind that the use of electronic devices late at night is horrible for our sleep as they emit blue light. Blue light suppresses the secretion of melatonin, the hormone that regulates sleep-wake cycles. When we watch TV or use a mobile phone, it may be difficult for us to fall asleep and stay asleep. It is the best idea to put away smartphones, laptops, and tablets, and stop using them a couple of hours before going to bed. We need to disconnect all electronics if we want to improve our sleep quality and make sure our bedroom is free of distractions. Unfortunately, many people are addicted to these devices and can’t imagine an evening without using them. If you are one of them, you should at least use a blue light filter. Luckily, many smartphones and tablets have this feature, and thanks to it, the screen light will shift from blue to yellow, which is less likely to disrupt your sleep and keep you awake.  

Avoid Looking at Your Clock 

If you toss and turn at night trying to fall asleep, or you wake up in the middle of the night, one of the worst things that you can do is take a look at your clock. Having troubles falling asleep after waking up at night can be a bit difficult, but it is even worse when we become nervous. Watching the time on the clock pass by while we toss and turn can increase our stress and make it even more difficult to sleep. It is annoying to know that you have limited time for rest, and instead of sleeping, you are just lying there in bed doing nothing. If you want to do yourself a favor, you should hide your clock if you can’t resist looking at it. Don’t wait for too long to do this as over time your body will develop a routine. If you don’t stop it on time, you may find yourself waking up in the middle of the night every single night. 

Adjust the Bedroom Temperature 

Another thing that falls into the category of natural ways to fall asleep faster is adjusting the bedroom temperature. It is not easy to drift off to dreamland if you are too cold or too hot. Temperature preferences vary from person to person, and it is not possible to determine the right bedroom temperature for everyone. However, most sleepers prefer setting their thermostat to between 60 and 75 degrees, as they claim it helps them sleep the most comfortably. Of course, you should experiment a bit and find out what temperature level works best for you, but keep in mind that cooler bedroom can help you drift off to sleep. 

Listen to Soothing Music 

In case you are wondering how to fall asleep when not tired, soothing music can help. Listening to relaxing music can help us fall asleep faster at night, no matter if we are tired or not. Falling asleep to the right music can improve our quality and duration of sleep. However, only soothing music with a slow rhythm helps. Don’t expect to drift off to dreamland listening to heavy metal or rock. Relaxing music helps prepare us for sleep. We feel calmer when we listen to it, it slows our heart rate, breathing, reduces stress and anxiety, and triggers our muscles to relax. These biological changes mirror the changes that our bodies go through when falling asleep, which makes soothing music ideal for sleeping. According to research, listening to relaxing music before bedtime has a positive impact on sleep quality and it can even decrease the symptoms of depression. Also, it can assist in improving acute and chronic sleep disorders.  

Try Different Breathing Exercises 

If you want to know how to get to sleep when you can’t, another very effective solution is deep breathing. Breathing exercises can help us relax and direct our mind away from thoughts and worries that keep us awake. Taking slow and deep breaths can calm down our nervous system, relax us, and prepare our bodies for sleep. Deep breathing also provides relief from anxiety and stress and slows down our heart rate. In case you have troubles drifting off to dreamland because of the stress and different worries, you can choose from several breathing exercises that can help you. The best thing about them is that you can do them anywhere, at any time, and they can provide relief from stress before different important events, such as a meeting or an exam, not just before bedtime. 

Choose Comfortable Bedding 

If you want to get enough quality rest that you deserve, it is essential to be comfortable in bed. If it feels good to be in your bed, you will look forward to it every day. Having the right mattress can have a positive impact on your sleep quality and duration. On the other hand, if it is not comfortable, you may have a hard time drifting off to dreamland. Your mattress should match your needs and preferences. Different firmness levels of mattresses are available on the market, and you should make a decision based on your favorite sleep position, weight, and preferences. If you are a hot sleeper, you should opt for models with excellent cooling features. If you suffer from back pain or neck pain, it is a good idea to get a model with fantastic pressure relieving benefits. The choice of pillows is also vital, and it makes a difference between falling asleep almost immediately and tossing and turning. Pillows have an impact on the sleeper’s comfort, temperature, and neck curve, and you should choose them wisely. Different types of pillows are available with different features. You should also consider getting breathable bed linens if you want to sleep comfortably throughout the night. 

Exercise 

Engaging in physical activity is not only healthy, but it can also help us sleep better at night and fall asleep faster. Exercising increases the quality and duration of shut-eye as it stimulates the production of serotonin in the brain and makes you feel calmer and happier, and decreases the cortisol levels, which is also known as the stress hormone. Exercising during the day will also make you tired, which will reduce the chances of staying up late and not getting enough shut-eye. If you engage in physical activity of moderate intensity every other day, you will sleep better at night. However, it is crucial to choose the right time for exercising. Keep in mind that working out in the morning is the best, whereas working out in the evening is not a good idea as it can keep you awake.   

Limit Caffeine Intake 

Most of us grab a cup of coffee or consume caffeinated beverages to fight tiredness and improve our alertness. We especially need caffeine in the morning, when we get out of the bed and need something to wake us up and prepare for what awaits us during the day. Besides coffee, caffeine can also be found in energy drinks, sodas, cocoa, chocolate, ice cream, and more. It works by blocking sleep-inducing chemicals in the brain, increasing alertness and adrenaline production. When we consume it, it takes us several hours to remove it from our bodies. That’s why consuming foods and beverages that contain caffeine is not a good idea in the evening, and we shouldn’t consume them at least 6 or 7 hours before going to bed. Drinking coffee in the evening interferes with sleep quality and quantity.  

Read a Book 

Reading a book is an excellent option if you need help winding down before bed. It can help you relax in the evening and take your mind off worries and stress. However, you need to be aware that there is a difference between reading a paper book and an electronic book. Reading a paper book in the evening will help you wind down and sleep better, whereas electronic book will do just opposite as these books emit blue light that interferes with the melatonin secretion and makes it hard to fall asleep. If you want to relax and improve your sleep quality, you should try reading a paper book.  

Take a Warm Shower 

Taking a warm shower half an hour to one hour before going to bed can help you fall asleep faster. Our ability to drift off to dreamland depends on our internal temperature, among other things. A hot shower will warm up our body, and stepping into the cooler air once we get out of the bathroom will cause our body temperature to drop precipitously. The rapid decrease in temperature prepares our body for sleep and helps us drift off to dreamland faster.  

Sleep serves as an enchanting power source for our bodies, providing us with a boost of energy for the upcoming day when we manage to get those essential seven to nine hours of sleep each night. However, if your sleep is fragmented, resembling a sequence of brief naps rather than a full night’s rest, you’re missing out on the complete recharge.

Sleep fragmentation occurs in some people, and the problem with them is not falling asleep, that part usually passes without a problem; but staying asleep. People who typically experience it wake up many times during the night, and they have troubles falling back to sleep.

While sleep fragmentation is not classified as a sleep disorder, it is a definite symptom of many of them, including sleep maintenance insomnia, restless leg syndrome, narcolepsy, and more. Lack of sleep also leads to excessive daytime sleepiness and fatigue, morning headaches, impairment of memory, focus, and mood. When fatigue becomes chronic, it can lead to weight gain, elevated blood sugar, high blood pressure, and cardiovascular problems.

Why You Shouldn’t Overlook Sleep Fragmentation

Sleep fragmentation is described as many brief arousals during the night. These are not the typical microarousals that everybody experience during sleep. Microarousals are natural, and they occur during the transitions between sleep cycles. You don’t recall them later, and they don’t cause daytime fatigue.

Sleep fragmentation, on the other hand, involves awakenings that a person can recall in the morning. People who are experiencing them are often struggling to fall back to sleep, which leads to less sleep time and daytime fatigue.

Disrupted sleep is more than just annoying. It can lead to some severe health consequences including weight gain, cardiovascular problems, impaired mood, memory, and concentration. Scientists have observed that a night of fragmented sleep can lead to similar effects as skipping rest. That’s due to the less time spent in the deep restorative stage of sleep.

If you are regularly experiencing sleep fragmentation, you may be suffering from a condition called sleep maintenance insomnia. People who have this condition have no problem falling asleep, but they can’t stay asleep. There is also a condition called sleep onset insomnia, and where people have a problem falling asleep instead of maintaining it.

Experiments on animals have shown that sleep fragmentation can induce tumor growth. Lack of sleep also leads to increases oxidative stress in the brain so that sleep fragmentation can lead to increased insulin production and activation of some mechanisms that serve a protective purpose in brains.

Causes of Fragmented Sleep

Sleep fragmentation isn’t listed as a specific disorder, and while it is relatively common, its exact prevalence is unknown.

There are occasional situations when sleep fragmentation occurs. It can happen when you are feeling ill, and coughing or a sore back is keeping you awake. New parents also experience disrupted sleep, due to many wakings during the night, to care for their newborn. This kind of sleep fragmentation is entirely reasonable, and it doesn’t mean that there is anything wrong with the person. When the disturbances are over, sleep restores to normal.

Fragmented sleep can be a result of a sleep disorder, including sleep maintenance insomnia, restless leg syndrome, sleep apnea, and narcolepsy. Treating these conditions should lead to better sleep quality.

Sleep fragmentation can be a result of daytime habits as well. Poor sleep hygiene, alcohol and caffeine consumption, exercising too close to bedtime, and not timing or napping too much during the day. Improving those habits should restore your sleep to normal.

Some people sleep in two intervals during the night with a long wake period in between. That is not considered fragmented sleep, it is classified as a biphasic sleep, and a lot of people sleep that way.

Sleep Fragmentation Diagnosis

If you are experiencing sleep problems and have decided to visit a sleep specialist, they might use Sleep Fragmentation Index (SFI) to measure the level of sleep disturbances that you experience. The SFI is shown to be a quick and reliable method, and it compares your nighttime awakenings, shifts between sleep stages, and your total sleep time.

A doctor might instruct you to a stay at a sleep facility for an overnight study called polysomnography. Sleep technicians attach you to a bunch of electrodes that track your brain waves, heart and respiration rates, your chest, limb, and eye movement. Besides that, they observe you to see if there is any snoring or some other unusual behavior. Polysomnography is a golden standard when it comes to determining the quality of sleep, and it gives doctors all the information they need about your nightly slumber.

If you are not comfortable staying for an overnight study, they might ask you to keep a sleep diary for a week or two, as well as provide your medical history and medication use. Sleep diaries are easy to maintain, and anyone can do it. You write down different kind of information about your sleep including:

• The time you go to sleep each night
• How much it took you to fall asleep (sleep latency)
• When you wake up in the morning
• If you have experienced any disruptions during the night
• How rested you felt after waking up
• If you have taken any naps during the day
• How energized you were during the day

If that seems a bit complicated, they can also give you a small device that is worn around the wrist, and it tracks your movement and heart rate. This method is called actigraphy, and it is pretty useful in determining whether you are sleeping or not.

All of these methods will provide sleep specialists with enough information to determine the cause of your disrupted sleep and to prescribe you the right treatment.

Sleep Fragmentation Treatment

Treatment for sleep fragmentation usually involves treating any underlying sleep disorder that might be causing it; like narcolepsy, sleep apnea, and restless legs syndrome.

Melatonin supplements can be very useful in getting better quality sleep, and they can be bought over the counter in any pharmacy.

Changing your sleep habits and maintaining good sleep hygiene will improve your sleep quality. You should try doing the following:

• Allow yourself to get tired and sleepy. It means that you should better manage or completely avoid naps. Sleepy people are less likely to experience fragmented sleep.
• Exercise regularly but make sure that you don’t do it to close to bedtime as it can leave you laying in your bed wide awake.
• Set a sleeping routine, and stick with it. It means that you should go to sleep and wake up at the same time every day. Staying late, or sleeping in on weekends can seem like a good idea, but you should only do it if you are sleep deprived, and you need to make up for lost rest.
• Ban all the electronics from your bedroom. Screens emit blue light that can disrupt your circadian rhythms, and it can make it harder for you to fall asleep. That’s why you should remove the TV and laptop from your bedroom, and avoid looking at the screens at least an hour before bed.
• Remove any disturbances from your bedroom. Shut your windows and fix any leaking faucets you have in your home. If you can’t completely block the outside noise, consider using earplugs or white noise machine.
• Besides keeping your bedroom quiet, you should also keep it dark and set the temperature you prefer. Consider getting warmer color light bulbs, get a block out curtains if it’s needed, and pick the right temperature.
• Buy a comfortable mattress, pillow, and bedding. This can drastically improve your sleep, so think about replacing your old or uncomfortable items.
• Avoid drinking caffeine eight hours before bed. You should also avoid nicotine, as those are stimulants and they can keep you up at night and increase the number of nighttime awakenings.
• Avoid drinking alcohol a few hours before bedtime, and also don’t drink too much fluid before going to bed. Too much liquid will make you have to go during the night, and it might be hard to fall asleep afterward. Alcohol stimulates synthesis of a neurotransmitter called vasopressin. More vasopressin means less protein called aquaporin. The primary function of this protein is the transport of water through the membranes of our cells. When there is less aquaporin in our urinary tract, less water will be reabsorbed, and that means that we will have more urine to excrete. That is why drinking beer will make you go to the bathroom so many times.
• Consider getting a sleep tracker. These devices can be pretty useful in giving you some insight about your sleep. Wearable ones also have many more purposes, including fitness tracking, GPS and advice to improve your sleep habits.

Advice for new parents

Having a baby can be very stressful, and worsen the quality of your sleep. There are a few things you can try to get the best rest possible:

• Share night shifts with your partner. Someone can take the first half of the night, and the other can take the second. That way you’ll get some sleep, and be ready for a new day of parenting.
• Turn the baby monitor down. Babies often produce a lot of sleep noises, so responding to every sound won’t be beneficial for you or your baby’s sleep.
• Keep the lights off during nightly diaper changes or visits, as bright light may suppress the production of melatonin, the hormone responsible for your sleep.
• Develop healthy sleeping habits. Ban screens from your bedroom, exercise regularly and make a nice relaxing bedtime routine for yourself after you put your baby to rest.

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

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

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

Different Types of Sleep-Related Pain

Different types of pain and complications can impact your sleep.

Chronic Pain

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

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

Back Pain

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

Neck Pain

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

Hip Pain

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

Arthritis

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

Fibromyalgia

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

Headaches

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

Endometriosis

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

REM Pain

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

Pain From a Bad Bed

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

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

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

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

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

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

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

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

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

Choosing the Right Pillow

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

Dealing with Sleep-Related Pain

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

• The proper duration of sleep

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

• Time of going to bed

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

• Avoiding noise

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

• Proper bedroom conditions

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

• The role of bed

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

• Limit screen time

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

• Bedtime routine

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

• Living habits

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

• Forbidden pleasures

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

• Ultimately, relax

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

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

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

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

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

Multiple sleep latency test is one of them.

What is the Multiple Sleep Latency Test?

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

Some doctors decide to include tests like: 

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

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

How Does MSLT Work?

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

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

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

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

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

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

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

What Does MSLT Measure?

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

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

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

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

MSLT Cost

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

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

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

What is Polysomnography?

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

• Eye movement

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

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

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

How Does Polysomnography Work?

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

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

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

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

What is the Purpose of Polysomnography?

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

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

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

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

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

Idiopathic hypersomnia

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

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

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

Idiopathic hypersomnia symptoms: 

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

• Memory problems and difficulty with attention and concentration.

Difference Between Idiopathic Hypersomnia and Narcolepsy

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

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

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

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

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

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

Pittsburgh Sleep Quality Index

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

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

–          Sleep Duration

–          Subjective Sleep Quality

–          Habitual Sleep Efficiency

–          Sleep Disturbances

–          Sleep Latency

–          Daytime Dysfunction

–          Usage of Sleeping Medication

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

Stanford Sleepiness Scale

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

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

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

Epworth Sleepiness Scale

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

–          Sitting and reading

–          Sitting and holding a conversation

–          Lying down in the afternoon

–          Sitting idle after lunch

–          Being a passenger in a car for over an hour

–          Watching television

–          Sitting in a public place, inactive

–          Stuck for a few minutes in traffic while driving

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

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

Multiple Sleep Latency Test

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

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

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

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

Fatigue Severity Scale

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

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

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

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

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

The Basic Overview

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

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

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

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

The Energy Conservation Theory

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

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

What Happens to the Brain While We Are Asleep?

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

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

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

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

The Brain’s Resting Process

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

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

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

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

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

What Happens During or After Brain Lesions?

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

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

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

What Causes Sleep Deprivation?

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

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

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

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

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

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

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

The Consequences of Sleep Deprivation

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

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

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

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

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

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

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

Sleep Deprivation and Its Effect on Children and Teens

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

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

How Can You Detect Sleep Deprivation or Sleep Debt?

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

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

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

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

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

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

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

How to Treat Sleep Onset Association Disorder in Children

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

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

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

Optimizing Sleep Hygiene in Children

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

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

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

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