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Every process on our planet operates in a cyclical manner. This ranges from the regular alternation of day and night to the shift in seasons; it all seems to follow a pattern of repetition. Every form of life has adapted to these environmental changes, possessing innate timers which are capable of operating independently yet also adjust in harmony with external signals. The Sun acts as the primary environmental trigger, with the majority of organisms timing their behaviors in alignment with the rhythmic cycle of daylight and darkness.

Circadian rhythms are described as repeating patterns that occur daily. The term is coined from the Latin “circa” meaning “around,” and “diem” meaning “day.” Most living things have an internal clock that is controlling every activity based on these rhythms. Only a small portion of organisms that live in coastal regions are synced to lunar days and don’t follow this pattern. Instead, they depend on the Moon and its gravitational impact on tides. A lunar day is a time it takes the Moon to finish the rotation around its axis compared to the Sun. It is slightly longer than the day, and its duration is 24 hours and 50 minutes.

Let’s take a closer look at how this circadian system works, the different factors that can impact it, and what you can do to boost it and use your biology to improve other aspects of your life. 

How Does Our Internal Clock Work?

The master clock is located in the suprachiasmatic nucleus (SCN), which is a part of the hypothalamus, a region that plays a role in regulating many vital functions like body temperature, appetite, thirst, sleep cycle, sex drive, emotions, blood pressure, heart rate, and many more. If we were to describe what hypothalamus does, we would say that it is in charge of keeping the homeostasis, the principle on which all organisms function. Homeostasis represents the dynamics of the body that uses various feedback mechanisms to keep everything in balance. It doesn’t mean that the state of your body is always the same, but that it is within specific parameters.

The SCN is the size of a pea, and it contains around 20,000 small neurons that send signals to other parts of the brain to regulate sleep/wake cycle, hormone production, body temperature, and other functions. Each neuron exhibits a near 24-hour activity rhythm, which suggests that the clock mechanism works even on a cellular level. When these brain cells are individually grown in a Petri dish, they each follow a 24-hour rhythm, but when they are incorporated in the SCN, they all synchronize together. In the experiments where researchers would remove the SCN in mice, the animals that are otherwise active at night and sleep during the day, show little to no preference in these activities. Their activity didn’t seem to follow a pattern and was random through both day and night. 

This biological clock needs to check its accuracy each day and to do that it uses external stimuli, mostly the sunlight. There are specific photoreceptive ganglion cells in the retina of the eye, which are entirely different than rods and cones that are in charge of generating pictures of the world around us. These cells contain a light-sensitive pigment called melanopsin, that is most sensitive to blue light. Exposure to daylight stimulates a pathway from these ganglion cells, and send a signal about the time of the day so that our biological clock can adjust. Interestingly, most blind people can sense these stimuli, since these photoreceptors can recognize daylight even through closed eyelids. The signals are sent via the optic nerve to the SCN, and it then regulates itself accordingly.

Our internal clocks don’t need light to function, and the circadian rhythms exist even if the person is cut off from the daylight completely. However, the length of day and night varies during the year, and with different geographic locations, so light in addition to other external cues like temperature and meals, serve to synchronize with your environment and prevent small timing errors. Without this feedback, the circadian system could become unbalanced and cause some problems. For instance, shift workers can never fully adapt to their irregular sleep patterns and face many health problems simply because artificial light is not as efficient in resetting the circadian clock in these people. It has been shown that increasing natural daytime lighting in elderly care homes can significantly improve mood disorders, sleep patterns, and can reduce cognitive decline. That is why scientists suggest that everybody should spend some time outside in natural light, as it appears to have many benefits.

Other secondary biological clocks are located throughout the entire body, and they can be found in the heart, liver, kidneys, pancreas, intestines, lungs, lymphocytes, and skin. They are affected by other cues other than light, such as meal times and environmental temperature. The SCN receives feedback from these secondary clocks and uses the information for further synchronization and coordination. Chronobiology is a relatively new discipline that found practical use in the medical field. It turns out that the effectiveness of treatment can significantly increase if it’s applied at the right time, depending on the involved organ.

Circadian Rhythms in Animals

Other living beings on Earth experience the very same natural rhythms that we do. From single-celled bacteria, through plants, to other animals, every organism seems to have an internal clock that regulates its activity. That became evident with the first simple experiments that took place in the 18th century. Curious researchers decided to put plants in the dark to see what would happen, and it turned out that plants tried to adjust to new conditions, but also kept some of the previous activities that otherwise wouldn’t occur during the night. 

The modern-day research of circadian rhythms is mostly done on fruit flies (Drosophila). We have learned a lot about how different genes, biochemistry, and environment all impact the internal clocks. 

In birds, mammals, and reptiles, the central biological clock is located in the hypothalamus, while other organisms don’t have this brain part, so it is located somewhere else, or the rhythms are regulated on the cell level in bacteria. The light is sensed with eyes, or pineal gland in some animals. It is located at the top of the head, and it can also perceive light stimulus and send the information to other parts of the brain. 

Animals need these signals to adjust their activities. For instance, rodents are active during the night, and they use their strong sense of smell to forage for food. Many predators like owls and felines are also active during the night, and they hunt rodents and other animals that are active at that time. Animals that mostly rely on their vision use daytime for their activities. Herbivores eat throughout the whole day and then rest during the night, as they can’t see as clearly, and they would be easier prey for predators. Interestingly, squirrels are most active at dusk and dawn, and they avoid overexposing both during the day and night.

A presence of light is essential for circadian rhythms, but it also signals changes in seasons, and most animals combine it with other environmental cues such as temperature to prepare for mating, hibernation, or migration. That ensures they survive the unfavorable period, and leave the offspring when the conditions are most suitable for their survival.

It is interesting how different animals adapted to conditions where the light is not an adequate stimulus. For instance, deep sea and cave-dwelling fish don’t experience sunlight in their environment, and their internal clocks seem to be operating on its own without being based on the presence of light. Also, reindeer and other animals that live in polar regions with long daylight periods during summer, and exceptionally long nights during winter, seem to be independent of this day/night cycle. 

Genetic Background 

Many different genes that play a role in maintaining circadian rhythms have been identified in recent years. It is no surprise that they are mainly active within the cells of the SCN, but they are also found in other tissues of our bodies. Scientists estimate that around 15% of our genes operate on a 24-hour cycle, and CLOCK, CRY, TIM, PER, and BMAL have been identified to play an important role in the process of sleep. Although scientists are still not sure about all different mechanisms through which they regulate sleep, research in this field is very active. It is known that mutations in these genes are closely linked to several different sleep disorders.

Research of different genetic markers in all organisms discovered something interesting. Even though mammalian clock genes are similar to those of most living things, there is one group that stands out. There is still no connection between genes that regulate circadian rhythms in cyanobacteria, which leads to the conclusion that these systems have evolved independently at least two times. However, there is more research needed to shed light on what is happening there, so we look forward to discovering more about it.

Unexpected Consequences of Circadian Rhythms

Many processes in our bodies occur rhythmically. Our internal clock regulates when to go to sleep and wake up, controls alertness, food intake, temperature regulation, organ functioning, and hormone production. Some other processes are linked to circadian rhythms, even though it might not seem like that at first glance:

• Giving birth usually occurs at night, because the evolution has timed hormones to trigger labor at this time. There is a simple explanation behind this, a mother and her newborn are probably less vulnerable in the dark as they are not as visible to predators, which increases their chances of survival. Even though modern day humans don’t have this problem, it appears that deliveries after midnight are still more frequent.
• Blood pressure spikes in the morning, which generally has the effect of waking us up and promoting alertness, but it also increases the chances of heart attack and stroke. 
• Allergies are often worse in the morning. As much as 70% of allergy sufferers report more symptoms such as sneezing and runny nose in the mornings.
• Asthma attacks are also more prevalent at dawn. One of the possible explanations is that the cortisol levels are very low at that point, which is a steroid hormone that plays a significant role in battling inflammation.

These and many other discoveries lead to the development of chronotherapy, which aims to use natural rhythms to predict the best time to take medications for maximal effectiveness.

Circadian Rhythm Disorders

Several different conditions limit the body’s ability to get sufficient rest. People with circadian rhythm disorders suffer from the lack of sleep, too much sleep, or simply not resting enough at the right time. Their internal clocks are off for some reason, and that can lead to a series of consequences. Here are the most common circadian rhythm disorders:

• Delayed sleep phase syndrome (DSPS) is relatively common, and some estimations show that around 15% of teenagers in the United States suffer from it. People with it usually have 3 to 6 hours delay of sleep onset time. Naturally, they also wake up later. They are getting sufficient sleep, it’s just that their internal clocks are not synchronized with the environment, and they follow their schedule. This behavior is usually frowned upon, and people with DSPS are often labeled as lazy and unmotivated. Because their rhythm is different than what is socially acceptable, they often fail at fitting in their responsibilities. By sacrificing sleep, they can risk the development of insomnia, and people with DSPS often suffer from depression and anxiety disorders.
• Advanced sleep phase disorder (ASPD) is pretty much the opposite of DSPS. People affected by this condition usually experience sleep onset between 7 pm and 9 pm, and they wake up around 3 am. Since this schedule fits in what is socially acceptable, these individuals usually don’t experience as much backlash as people with DSPS, but social alienation can lead to depression. There is a strong genetic link behind this disorder, and people suffering from it have a 50% chance of transferring it to their offspring. 
• Non-24-hour sleep-wake disorder affects the synchronization of the body clock with the environment. Affected people usually have slightly longer than the usual 24-hour day/night cycle, with the gradual expansion. They have trouble falling asleep most of the time but can get a good quality sleep a few times a month when their clock aligns with the photoperiod, and they can feel temporary relief.
• Irregular sleep-wake rhythm is characterized by the complete absence of regular sleep patterns. There is no prolonged sleep period during the night, and sleeping times seem sporadic and random. This condition is extremely rare and is usually in correlation with certain neurological disorders like Alzheimer’s, mental retardation, dementia, and brain damage.
• Shift work sleep disorder affects people working at night and those who are always rotating shifts and don’t have a steady schedule because of it. These people are often sleep deprived, have a higher chance of developing insomnia, and experience excessive sleepiness during waking hours. They are also at a higher risk of having a driving or work-related accident because of the drowsiness and decreased concentration.

The disruptions in circadian rhythms can be a consequence of traveling through several time zones. Jet lag can affect everybody, and people usually have trouble adjusting to a new schedule for several days. Other factors include pregnancy, medication, changes in daily routine, mental health problems, menopause, medical problems like Alzheimer’s and Parkinson’s disease.

Disruption of Sleep/Wake Cycle and Mental Health

Everybody who has missed a night or two of sleep knows that it affects the ability to function the next day. Lack of sleep affects your mood, it makes it harder to concentrate, memorize things, and decreases your work and academic performance. Long term effects go far beyond feeling moody and distracted.

The disruptions of circadian rhythms can affect our physical and mental health. Sleep deprivation is linked to the increased risk of developing anxiety, bipolar disorder, and depression. Increased activity during the resting hours and inactivity during the day have the strongest connection with the higher risk of mood disorders, slower reaction times, and worse subjective feelings of well-being.

Unfortunately, it looks like more and more people are experiencing both mental health problems and sleep disruptions. The faster way of life has got us all chasing around, and sacrificing precious rest to do as many activities as we can. Here are some things you can do to sync your internal clock with the environment and enjoy better sleep, health, and the subjective feeling of well-being:

• Try to maintain a stable sleep schedule. Going to bed and waking up at the same time can help your brain realize when to rest and when to be active. 
• Create a relaxing nighttime routine that will help you unwind and fall asleep faster. You can try reading, meditating, or listening to music. Ban the electronics from your bedroom, and keep it dark, quiet, and cold, to promote a distraction-free environment.
• Control your light exposure. Walking outside the first thing in the morning will get you some sunlight, and it should help your clock restart. Consider spending some time outdoors in the natural light each day for the best results. You can try getting smart light bulbs at your house since you can adjust the light they emit. That way, you can dim them and set a warmer shade in the evening to let your brain know that it is time to go to sleep. That should boost the production of melatonin. Avoid screens at least a couple of hours before bedtime as they emit blue light that can confuse your brain into thinking that it is the morning, which is the time to be active. 
• Try to exercise daily. Only 20 minutes of moderate exercise can do wonders for your sleep and overall health, so try to incorporate it into your everyday routine. Don’t do it too close to bedtime, as it can make it harder to fall asleep since it takes some time for your body to cool down.
• Enjoy a balanced diet with whole grains, lean protein, and plenty of fruits and vegetables. It is best to create a schedule for your meals as well; consume them in a 10-12 hour window and then leave 12-14 hours for your body to rest and repair. Avoid nicotine, alcohol, and caffeine in the second part of the day since these stimulants can disrupt your sleep.

The majority of individuals have faced difficulties trying to fall asleep at some time. Research indicates that approximately 70 million people in the United States are affected by sleep disturbances. In today’s world, our days are filled with activity, our responsibilities have increased more than ever, leading to high stress levels that adversely impact our sleep quality.

If a person has constant difficulty falling asleep or staying asleep enough to get rested, it might be a symptom of chronic insomnia. There are several ways to prevent or recover from this condition. Recent research suggests that hypnosis can be one of the better treatments for insomnia, as it is natural, and generally good for physical and mental health. Read on to find more about insomnia and how hypnotherapy may help with this condition.

The Importance of Good Night’s Sleep

Quality sleep positively affects every aspect of our lives, and sleeping less than our body requires can lead to serious health problems. There is evidence that shows that bad sleeping habits can even shorten our lifespan. Heart problems may arise if we are constantly tired. Lack of sleep can also affect how we deal with the world around us. We are more likely to get angry and not be able to control our emotions properly. Because our focus decreases, we are more prone to accidents and have a harder time adapting to stressful events. Although not as essential, our social life can suffer as well. When we don’t get enough sleep, we appear less physically and socially attractive to others.

If you have sleep problems, reaching for sleeping pills is not always the solution. In most cases, sleep medications help you to fall asleep by making you feel drowsy. As a consequence, you won’t feel refreshed in the morning, but rather as you were run over by a train. Before reaching for sleeping pills, it’s better to try some natural treatment options such as herbal supplements and teas, CBT-I, or even hypnosis.

What is insomnia?

Insomnia is one of the most common sleep disorders, and people who suffer from this condition have problems falling asleep or staying asleep long enough to get rested. Waking up too early and not being able to go back to sleep can also happen. Common symptoms include difficulties concentrating, fatigue, and trouble with performing everyday tasks.

Based on what causes it, this sleep disorder can be primary and secondary. Primary insomnia is not caused by another condition, while secondary insomnia occurs as a symptom of another health problem or condition. Insomnia can also vary in how often it happens and how long it lasts. It can be short, and only occur occasionally, for instance, the night before or after some stressful event. This condition is called acute insomnia. 

On the other hand, chronic insomnia can last several nights in a row over at least three months. If this happens, treatment is recommended because it can be a sign of other medical or psychological issues. Knowing what causes sleep disturbance is vital as it will help with treating it correctly. 

Scientists believe that one of the causes of insomnia is a problem with the sleep and wake cycle in our brain. For instance, when our brain is supposed to enter the sleep cycle, we stay awake. Additionally, the wake cycle lasts significantly longer than normal, so we don’t feel the need to sleep even though our body is tired.

Medical conditions are some of the most common causes of secondary insomnia. Among leading causes are chronic back pain, arthritis, asthma, heart disease, endocrine and gastrointestinal problems, etc. If any of these conditions cause sleep problems, it is recommended to inform a doctor as there may be a way to alleviate the symptoms and improve your sleep. Some medications can also lead to sleep disorders as a side effect.

Psychiatric conditions such as depression, anxiety, and emotional discomfort can cause insomnia that ranges from mild to severe. Mental disease and insomnia are usually linked, and symptoms of one condition can worsen the symptoms of the other.

What is Hypnosis?

The origin of the name hypnosis comes from a Greek god of sleep “Hypnos.” Even though it means “put to sleep,” the state that is induced by hypnosis is not sleeping. It is sometimes referred to as hypnotherapy as it usually involves a researcher or a health professional working with a patient. This type of alternative therapy is used to improve the patients’ state of mind through increased focus, relaxation, and attentiveness. Patients are awake during these sessions, but they are less aware of what is happening around them and more responsive to suggestion. 

When it comes to inducing hypnosis, most people think of swinging watches that make them slowly drift to sleep, but in reality, it is less exciting. Hypnotherapists perform verbal cues that patients listen to and get drawn into a trance-like state. These cues are usually spoken in a soft voice and help patients enter a state of deep relaxation. When hypnotized, patients have increased suggestibility, which means that they are more likely to respond to any suggestions made by the therapist. As hypnotherapy heavily relies on the placebo effect, some people are more suggestible than others. When successful, hypnotherapy shows results within a few sessions, and some of its positive effects can last a lifetime. Even though hypnosis can be a great help, it is recommended to use it as an additional tool to improve other therapies. 

Can Hypnotherapy Help With Insomnia?

If you suffer from more severe sleep disorders, like chronic insomnia, the best course of action is to consult your physician. This way, you can find out if your problems are a symptom of another medical condition. If it turns out you have chronic insomnia, your physician may recommend other therapies like CBT-I. Cognitive behavior therapy (CBT) is one of the most effective ways to treat insomnia, and it consists of several different therapies, including a type of hypnosis. The effects of CBT can be further improved when combined with hypnotherapy. Ask your doctor to refer you to a good hypnotherapist with experience in treating insomnia, and ask for additional resources that can help you learn more about this type of therapy. 

When visiting a hypnotherapist, one of the most crucial things is the willingness to participate in the session and do what you are told. Telling yourself that it will not work or having any doubts can make the process more difficult. As hypnosis is similar to meditation, it is essential to be relaxed as much as possible. The difference is, with hypnosis, you are in this state with the purpose of changing thoughts or patterns. When it comes to insomnia, hypnotherapy is used to train the unconscious mind to sleep naturally and with ease. Those who have long-term insomnia usually feel anxiety when they need to fall asleep, making it even harder to do so. Through hypnosis, a therapist will try to help you deal with this unconsciously by generating more positive associations towards sleep. This is done by using positive words while hypnotized to describe your sleeping experience. For instance, “rest,” “tranquility,” and “peace” are known to work well. Your mind will stop treating sleep negatively, and it will be easier to get enough rest. If someone has problems falling asleep occasionally, these problems are often caused by high levels of stress and inability to relax your mind. Therefore, hypnotherapists usually use a step-by-step process that helps gradually reduce conscious thoughts.

Even though it has not yet been medically proven that hypnosis helps with insomnia, many studies have been performed claiming that this type of alternative therapy helps with sleep disorders. Research has shown that problems with restless legs syndrome (RLS), insomnia, sleepwalking, and night terrors have been reduced through hypnotherapy. Hypnosis can have a positive impact on your rest in several ways. For instance, Swiss researchers reported that participants who were hypnotized experienced sleep of much better quality. They spent more time in the deep sleep stage, slept longer, and were more well-rested. Different research has shown that those who visited a hypnotherapist and participated in sessions several times a week were able to fall asleep faster. A study that was performed in 2007 had promising results. Participants received only one session, and a month later, over half of them reported the improvement of their condition. 

Because of its positive results, and the fact that it is a natural treatment, hypnotherapy can reduce the symptoms of this sleep disorder. Full recovery is possible as well, with both acute and chronic type. If you want to achieve the best results, you should combine it with other therapies.

Can Self-Hypnosis Help With Insomnia?

One of the best things about hypnosis is that it is simple, and almost anyone can lead themselves into this state. Although sessions with a therapist are recommended for more severe sleep disorders, acute insomnia can be dealt with by using self-hypnosis techniques.

There are several ways of self-hypnotizing. It is usually done by following already established programs for inducing self-hypnosis. You can also listen to a guided recording. These programs and recordings are available online, so there is no special preparation necessary to try this. 

Most self-hypnosis programs have similar steps that need to be taken to reach a state of deep relaxation and be subjectable to hypnosis. First of all, it is crucial to find the most comfortable position, and your sleeping position is usually the best choice. Next, your eyes should be closed, and you need to relax your mind and body. It can be helpful to try to imagine tension and stress leaving your body. Afterward, you can use different breathing techniques. The program you follow will usually have a guide that will assist you. If not, you should breathe deeply and rhythmically. Take around 3 seconds for each inhale and exhale. Finally, you will need to recite a script that will help you fall into a relaxing sleep. When you wake up, you will feel refreshed and rested.

When it comes to recordings for self-inducing hypnosis, they commonly contain a guided audio or video session. These are often recordings of some of the best hypnotherapists giving advice and strategies on how to enter a state of deep relaxation. When you succeed, a therapist will use softly spoken words that should help you fall asleep. For instance, phrases like “yawn,” “peace,” and “let go” work best. Even though it sounds simple, these words are what helps transfer your unconscious mind from meditation-like state to sleep. All these recordings are relatively short, as they last up to 15 minutes. 

If your insomnia is not too severe, and you visit a hypnotherapist, he or she might give you a script that you can work with from the comfort of your home. You can also ask a professional to recommend some techniques for meditation and self-hypnosis because they can be useful for many other things. For example, they can help reduce work-related stress, relax your body after intense physical exercise, or help you improve your emotional health.

In conclusion, if you can clear your mind of thoughts and lead yourself into deep relaxation, self-hypnosis will probably help you with insomnia. Although it might be harder with more severe cases, reducing anxiety with these techniques can at least improve some aspects of dealing with this sleep disorder. 

Can Hypnosis be Used on Children?

Children can also be affected by various sleep disorders or just have occasional problems with falling asleep. Since there are no sleeping pills for children that are FDA approved, other therapies need to be used. Changing their sleep hygiene can prove helpful, and if not, CBT can be very successful. Children who have some type of insomnia can also combine these therapies with hypnosis. Hypnotherapy can also be helpful by itself. There is evidence that younger people, children especially, enter the state of hypnosis more easily than those past adolescence. Furthermore, some studies show that children have been successfully treated with hypnotherapy from various problems, including headaches, night terrors, and even insomnia. 

Takeaway

Even though there is still only a limited number of studies that show positive results of hypnosis, hypnotherapy is a promising new way of dealing with insomnia.

The important thing is not to get discouraged if it doesn’t work right away. Solving your sleeping disorders with hypnosis requires commitment and willingness. Sometimes, positive results can manifest after more than five sessions. Moreover, to fully recover from insomnia, treatments may need to last several years. Hypnosis is one of the most natural ways to get yourself to sleep without any side effects.

Narcolepsy is a long-term brain disorder that interferes with the ability to control sleep and wakefulness. Those who suffer from it usually experience profound tiredness throughout the day, regardless of how much they slept the previous night. This level of sleepiness is extraordinary, akin to having sleep episodes that the individual cannot fight off, leading to instances where they might fall asleep briefly or for prolonged periods.

People with narcolepsy experience changes in the architecture of their sleep, especially in REM stages. Rapid eye movement (REM) sleep usually occurs every 60 to 90 minutes in people with regular sleep cycles, but in those affected by narcolepsy, it can happen only 10 minutes after falling asleep. Additionally, people may experience cataplexy, which is described as the weakness of muscles that enables a person to move while awake. This state is similar to the paralyzing of the muscles that happen during the REM stage, but since the brain has lost the ability to regulate sleep and wake cycle, it can randomly occur during wakefulness.

It is estimated that 135.000 to 200.000 people are affected by narcolepsy in the United States. However, some experts believe that the condition is underdiagnosed because it is often mistaken with psychiatric disorders, and that the number can be much higher. It affects males and females equally, and the first symptoms usually appear between the ages of 7 and 25.

The goal of this article is to educate people on the causes, symptoms, and the treatment of narcolepsy. Affected people go through many relationship, work, academic, and social problems because of the sleep attacks, and that can often lead to the feeling of embarrassment and impaired mental health. 

Types of Narcolepsy

There are two main types of narcolepsy:

• Type 1 or narcolepsy with cataplexy. It is characterized by a sudden muscle weakness that enables a person to move. Strong emotions often trigger these events, and they can be dangerous if they happen during certain activities such as driving. The main symptom of this type 1 narcolepsy is daytime sleepiness, but people can also experience sleep hallucinations and sleep paralysis. Individuals affected by this most commonly have low levels of brain hormone hypocretin.
• Type 2 or narcolepsy without cataplexy. It is also characterized by excessive daytime sleepiness, but unlike type 1, there are no sleep attacks and cataplexy. People with this condition often have less severe symptoms and normal levels of hypocretin.

A disorder known as secondary narcolepsy can arise from an injury to the hypothalamus, a brain region that plays a significant role in regulating sleep. Besides the standard symptoms, these individuals can also experience severe neurological problems and sleep for prolonged periods each night (more than 10 hours).

Symptoms

The symptoms start in early life, in most cases in the teenage period. Unfortunately, it is a lifelong condition, but it doesn’t necessarily get worse with age. Some symptoms improve over time, especially if the person follows the guidelines for narcolepsy management. The excessive daytime sleepiness is present in all the patients, but all other symptoms are only experienced by 10 to 25 percent of affected individuals. Symptoms include:

• Excessive daytime sleepiness (EDS) is present in all individuals, and it’s the most obvious symptom. EDS is persistent even if the person seems to get enough sleep during the night and feel well-rested in the morning. Unlike with other sleeping disorders, EDS in narcolepsy manifests through the sudden urge to fall asleep, and these sleep attacks come rather unexpectedly. In between these events, a person has normal levels of alertness, especially if they are partaking in an activity that requires their close attention.

• Cataplexy is defined by a sudden loss of muscle tone that leads to muscle weakness and inability to move while the person is awake. It is often triggered by strong emotions such as anger, fear, excitement, laughter, or stress. The onset of cataplexy can be years after the start of EDS, and while some people can only experience a few attacks in their lifetime, others may have many each day. In a small percentage of cases, cataplexy can be the first symptom to appear, and these people are usually misdiagnosed with a seizure disorder. Most of the attacks are on the mild side, where the person feels weakness in limited muscles in their body, and it quickly passes after a few moments. In most severe cases, the affected person’s whole body can collapse, leaving them unable to move, speak, or even open their eyes. But what distinguishes cataplexy from other seizure disorders is that people remain fully conscious even during the most severe attacks. These episodes can last anywhere from a few seconds to several minutes, and they can be terrifying, but in most cases are not dangerous if a person can sense them and find a safe place to collapse.

• Sleep paralysis is described by the temporary inability to move or speak while falling asleep or waking up. It usually lasts from a few seconds to a few minutes, and it is similar to REM induced paralysis, only a person is awake during this event. It resembles cataplexy, and the only difference is that it occurs at the edges of sleep. These events can be pretty scary and troubling, and some people can be mentally affected for an extended period after the episode. In most cases, people fully recover after they are regained the ability to move and speak. 

• Hallucinations are present in a small number of people, and they can sometimes accompany sleep paralysis. Hallucinations can be very vivid and frightening, and while in most cases they are primarily visual, other senses can be involved as well.

• Fragmented sleep and insomnia. Individuals with narcolepsy are very sleepy during the day, but at night they often experience difficulties staying asleep. Sleep maintenance can be affected by vivid dreams, sleep apnea, acting out while dreaming, periodic limb movement, and it can lead to the development of insomnia.

• Automatic behaviors. Individuals affected by this condition often experience microsleeps during the day that usually last a few seconds. A person briefly falls asleep while doing some type of activity, and they continue doing it without being conscious or aware of the action. That mostly happens with routine activities such as writing, typing, and driving. After they wake up, they have no recollection of their actions, but they can recognize them by the impaired performance. If they were writing, their handwriting could degenerate to the point of no recognition, the text they were typing doesn’t make sense, or they might get lost while driving, or even worse, have an accident. After people wake up from these episodes, they usually feel refreshed, and their fatigue and sleepiness disappear for a short period.

What Causes Narcolepsy?

There are several known causes of this disorder. Almost all people with type 1 narcolepsy have lower levels of a brain hormone hypocretin (orexin), which plays a vital role in regulating REM sleep and promoting wakefulness. Low levels of hypocretin do not describe type 2 narcolepsy, and its causes are not well understood. And even though we know that the balance of this naturally appearing hormone dictates the development of the condition, we are not entirely sure how it all works and why it happens. Several factors cause lower hypocretin levels, and they include:

• Autoimmune disorders occur when the person’s immune system doesn’t function properly, turns against itself, and then attacks healthy cells and tissues in the body. Since the cause in most cases is loss of the neurons that produce hypocretin, it appears that it is linked with abnormalities in the immune system. 
• Hereditary factors seem to play a significant role as well, as around 10% of narcolepsy patients report to have a close relative with similar symptoms. However, most of the cases are sporadic, meaning that there is no family history of the disease. That probably means that the person could be genetically predisposed to developing the condition, but that it also depends on the environmental factors.
• Brain injuries can cause narcolepsy. Usually, when the hypothalamus is affected, symptoms can develop. Tumors and other diseases that affect this region can have the same effect.

Related Conditions

Idiopathic hypersomnia is a condition that falls into the same category of sleep disorders as narcolepsy (hypersomnias). It is characterized by episodes of extreme sleepiness that have no identifiable cause. It is different than narcolepsy because the patients never develop cataplexy, and they don’t have sudden sleep attacks. Many individuals experience prolonged periods of rest (more than 10 hours), and excessive sleepiness can disrupt many aspects of life. Standard treatment includes behavioral therapy and certain medications.

Obstructive sleep apnea is a sleep-related breathing disorder that is described by the temporary interruption and cessation of airflow. It is caused by the blockage in the upper airway, and the person affected by it often wakes up during the night short of breath and painting. The most visible sign of sleep apnea is loud snoring, and others include excessive daytime sleepiness, sleep fragmentation, irritability, poor concentration, and impaired cognition. Obesity and neck size are the most common causes of this disorder, and if untreated, it could lead to high blood pressure, and increased risk of heart disease, stroke, and diabetes. Luckily, positive air pressure therapy is very effective in treating obstructive sleep apnea.

Kleine-Levin syndrome is a rare disorder that mostly affects teenage males, and it’s characterized by the behavioral changes such as an increased sex drive, the need for excessive amounts of sleep (over 20 hours a day), and overeating. When awake, affected people seem very disoriented, show irritability, lack of emotions and energy, and may experience hallucinations. These episodes last for days or weeks, and then a person goes into a few months of normal behavior. The cause of Kleine-Levin syndrome is not known, and weirdly, in most cases, the condition disappears later in life.

Excessive daytime sleepiness is a symptom of many other disorders, including hypothyroidism, depression, delayed sleep phase syndrome, periodic limb movement disorder, and many others. Brain tumors, head trauma, cerebral arteriosclerosis, psychosis, and uremia can cause symptoms that resemble those of narcolepsy.

Diagnosis

The diagnosis of narcolepsy consists of a comprehensive clinical study that has the goal to rule out other disorders that could be a potential cause of occurring problems. Since symptoms of narcolepsy appear in many different conditions, the diagnosis is not that simple. A physician will take a close physical exam, and also talk about the patient’s medical history and symptoms. They might ask them to fill out a sleep diary for a week or two, where a person can keep track of their sleeping habits. That includes sleeping and waking times, night disruptions, daily energy levels, nap, activity, and others. This data gives doctors more perspective and can help them plan the next steps.

An overnight sleep study called polysomnography is required to determine the cause of sleep disturbances. It is done in a specialized facility where the sleep technicians measure brain waves, respiration, heart rate, body and eye movement, snoring, and muscle tension, while you are sleeping. They can also determine characteristics of REM sleep that should begin after 60 to 90 minutes after falling asleep, but with narcolepsy, it happens approximately 15 minutes from the beginning. 

A multiple sleep latency test often happens the day after the sleep study. It measures the time it takes people to fall asleep during the day. Usually, there are 4 or 5 opportunities, and people with narcolepsy appear to fall asleep more easily. Also, they will achieve REM sleep during short naps, which is something that other people don’t experience.

Cerebrospinal fluid analysis is helpful with diagnosing narcolepsy, as low levels of hypocretin in a cerebrospinal fluid almost always indicate this disorder.

Treatment

Unfortunately, there is no definite cure for narcolepsy, and people affected by it go through their lives trying to manage the symptoms. Luckily, excessive daytime sleepiness and cataplexy can be both controlled with medications, and with additional lifestyle changes, symptoms became reasonably tolerable.

Medications include:

• Modafinil. It is a central neural system stimulant, and it’s usually the initial treatment for this disorder. It is a popular choice since it has fewer side effects and it is less addictive than other stimulants. Modafinil improves alertness and reduces daytime sleepiness in the majority of people.
• Sodium oxybate. It is also known as gamma hydroxybutyrate (GHB), and it reduces cataplexy and daytime sleepiness. Since it is a strong sedative that is taken twice a day, the distribution of GHB is strictly controlled.
• Amphetamine-like stimulants. These drugs are usually prescribed to treat excessive daytime sleepiness when Modafinil doesn’t prove useful. They come with more side effects such as irritability, shakiness, heart rhythm disturbances, sleep disruptions, and because of that, they need to be closely monitored. People taking these stimulants should always be careful since the amphetamine is risky for potential abuse.
• Antidepressants. They are usually used to treat cataplexy, sleep paralysis, and hallucinations. Two main classes of antidepressants are used: tricyclics and selective serotonin and noradrenergic reuptake inhibitors. These drugs produce fewer side effects than amphetamines, but some may include impotence, heart rhythm irregularities, and high blood pressure.

Lifestyle Changes

Medication treatment works for most of the patients, but it is always recommended to combine with certain changes in life habits. These strategies can help manage occurring symptoms:

• Taking scheduled short naps when you feel the sleepiest. It should prevent sudden sleep attacks from happening and increase energy and alertness during wake hours.
• Maintaining a regular sleep schedule. Going to bed and waking up at the same time every day can help people sleep better. Even if you get the urge to sleep in on the weekends, try to fight it.
• Creating a relaxing bedtime routine. It helps to calm down before going to bed, and it can help people fall asleep faster. You can try reading a book, taking a hot bath, meditating, breathing exercises, or listening to relaxing music. Also, make sure to remove any distractions from your bedroom. Keep it dark and cold to minimize nighttime arousals and sleep fragmentation.
• Exercising daily. A short 20 minutes of moderate exercise can help you sleep better and avoid gaining excess weight. Be sure to do it at least 4 hours before going to bed, as exercising later can be counterproductive, and leave you unable to fall asleep.
• Eating a balanced diet and avoiding large meals before bed. Also, people shouldn’t drink alcohol and caffeine at least 6 hours before bedtime and should avoid smoking altogether.

Safety precautions are essential for people with narcolepsy, especially when driving. Taking medication regularly and following other guidelines that a medical professional prescribed is vital, and minimizes chances of accidents. 

A person’s mental health can suffer when they have troubles maintaining work, intimate, and social relationships. People not familiar with this condition can find sleep attacks humorous, or see them as a sign of laziness, which can negatively affect people suffering from it. That is why the Americans with Disabilities Act require employers and schools to adjust the schedule to the affected person. They might be able to take scheduled naps and perform more demanding tasks when they are most alert. Educating others about narcolepsy is also useful so that these people don’t feel embarrassed or discluded. Additionally, numerous support groups offer emotional support and practical advice to help individuals cope with this disorder.

In a perfect world, everyone would maintain a well-balanced diet, engage in regular physical activity, and enjoy eight hours of slumber each night. However, the demands of daily life often prevent many individuals from reaching these objectives. The lack of time frequently leads people to opt for quick, less healthy fast-food options over preparing nutritious meals. With the majority of our waking hours consumed by work, and additional tasks to complete, it’s easy to convince ourselves there’s no opportunity for exercise. Moreover, in an effort to accomplish everything, many end up cutting back on sleep, which can have detrimental effects over time.

Lack of sleep has many negative effects. Sleep deprivation leads to numerous health conditions, impaired memory and performance, inability to focus, weaker immune system, and the continual practice of poor sleep hygiene can lead to the development of many sleep disorders.

Insomnia is one of the most common sleep disturbances, and it is estimated to affect around 30% of the general population. It is defined by the inability to fall (sleep onset), or stay asleep (sleep maintenance insomnia). An occasional night of poor sleep can happen to anyone, but if it becomes frequent, you should probably pay a visit to your medical provider to check if there is an underlying condition that’s causing sleep problems.

Continue reading to learn more about insomnia, how it develops, what are the risk factors, what you can do to prevent it from happening, and what the treatment looks like for the affected people.

Insomnia Symptoms

Even though it affects around one-fifth of the population, most people experience transient or short term insomnia. Symptoms usually last from a few days up to three months at most. The cause of these short term sleeping difficulties is generally accounted to periods of high stress, acute illness, a short term medical issue that requires surgery or hospitalization, or a significant life event. Regular sleep patterns usually restore when the situation is resolved. 

An excellent example of transient insomnia is the rebound effects when a person ceases to take sleep aids. These medications are used to help your internal clock adjust to the night and day cycle, and when you stop using them, your brain has to reset your sleep pattern on its own, without any supplements. You can help it by spending some time outdoors in the natural light during the day, as well as by dimming the lights in the evening to boost the production of a sleep-promoting hormone called melatonin. The rebound effects can last up to a few days, depending on a person, and then your sleep rhythm should go back to normal.

Chronic insomnia affects a smaller part of the population, and it troubles people at least three times each week, for a period longer than three months. Besides the environmental factors, it seems that genetics play a significant role in the development of chronic insomnia as well. The most frequent symptoms include:

• Daytime sleepiness
• Fatigue and low energy levels
• Memory impairment
• Inability to focus
• Poor work and school performance
• Loss of motivation
• Irritability and mood swings
• Impulsive or aggressive behavior
• Lack of balance and coordination
• Frustration about sleep

Health Risks of the Lack of Sleep

Sleep experts recommend 7 to 9 hours of sleep each night, but it appears that one in three Americans is getting less than six hours on average. This trend can have serious health consequences that affect every aspect of your life.

Sleep deprivation can leave you feeling cranky and unmotivated. You feel too tired to work efficiently and participate in your daily activities. On top of that, your performance is affected, and you can’t seem to be able to concentrate and deliver like you used to. To make things even worse, your ability to make rational decisions declines, which leads to more unhealthy choices like smoking, drinking more alcohol, and eating junk food. With a lack of motivation to exercise, unhealthy diet, and increased stress, insomnia can lead to more severe health effects.

Chronic sleep deprivation raises the risk of diabetes, obesity, high blood pressure, stroke, and heart disease. It also appears to be connected with numerous mental health disorders, such as depression and anxiety. Lack of sleep also leads to weakened immune systems, which leaves you more prone to the common cold, inflammations, and infections. Impaired judgment can play a role in the development of alcohol or drug abuse. 

In rare cases, insufficient rest can be even more dangerous. A chronic lack of sleep leads to daytime drowsiness, which can result in the appearance of microsleeps. These events are short bursts of sleep that usually last several seconds. They are involuntary, and anyone who has briefly snoozed during a lecture has experienced them. Although they seem harmless, if they happen when the person is driving or operating heavy machinery, there could be fatal consequences. During microsleep, your brain doesn’t respond to the external stimuli, and you are not aware of what is happening around you for a few moments. People are generally bad at recognizing when these events will occur, or they choose to ignore it, which is even worse. Drowsy driving is responsible for more than 100 thousand car crashes, 1500 fatalities, and 40 thousand injuries each year in the United States. 

What Causes Insomnia?

Insomnia is a condition that affects people of all ages. It is estimated that around 30 percent of adults, and about the same percentage of children and teenagers suffer from it. However, it is a little more prevalent among women and people aged 65 or older. 

Developing this condition is connected to many underlying disorders, and treating it depends on each case. Transient and short term insomnia is often the result of specific circumstances that create a stressful environment and disrupt regular day to day living. Resolving the situation usually leads to the cessation of symptoms.

Development of chronic insomnia is affected by three factors: hereditary, repetitive behaviors, and different triggers. In most cases, the results are a combination of more than one of these factors.

You can’t run from your genetics, and it seems that it has a significant part in the development of sleep disorders. Some people simply have a lower threshold for nocturnal arousals, which means that they are easily woken up by sound or movement. If the arousals are somewhat frequent, they lead to fragmentation of sleep, and it can develop into insomnia. Unfortunately, there is little a person can do to limit this, and people who are easily woken up should aim to eliminate night disturbances from their bedroom so that they can enjoy a sound, restful sleep.

Other people are prone to certain medical conditions that can affect a person’s sleep quality, like:

• Chronic pain
• Restless legs syndrome
• Sleep-related breathing disorders
• Neurological disorders like Alzheimer’s and Parkinson’s disease
• Depression
• Anxiety
• Kidney disease
• Bladder dysfunction
• Gastrointestinal Reflux Disease (GERD)
• Arthritis
• Cardiovascular disease
• Lung disease

If another disorder is causing your sleep problems, the first step is to treat that underlying condition. The proper management should eliminate or lessen the symptoms that are interfering with a person’s nightly slumber.

Certain triggers can initiate or make sleep difficulties worse in people, and they include:

• Injury
• Acute illness
• Stressful life events
• Positive or negative emotional experiences
• Medications and stimulants

While not all of these factors can be controlled and eliminated, the use of cognitive and behavioral therapy can lessen the magnitude of the triggers, and help us understand how to deal with, and overcome them. The removal is easier with the medications as there are usually different alternatives on the market. Some drugs that can increase the risk of insomnia as a side effect are:

• Stimulants (Caffeine, amphetamines, ephedrines including Aderal)
• Antidepressants (Prozac, Paxil, Zoloft, Lexapro)
• Steroids
• Narcotic analgesics (Codeine, Oxycodone, Oxycontin, Percocet)
• Decongestants (Pseudoephedrine, phenylephrine)
• Pulmonary (Albuterol, Theophylline)
• Cardiovascular (β-blockers, diuretics, lipid-lowering medication)

The use of stimulants like caffeine, nicotine, and alcohol can additionally disrupt sleep. That is why health professionals are suggesting limited consummation of alcohol and caffeine during the day, and all sleep experts agree that you should restrain from using any stimulants at least six hours before bedtime.

Diagnosis of Insomnia 

Depending on the complexity of the situation, discovering underlying factors can be challenging. First, your physician will review your medical and medication history to see if he or she can spot anything unusual that could be causing sleep problems. Next step is talking about your sleep habits and doing a physical exam to look for any signs of medical conditions that could be the cause of insomnia. They might even order a blood test to determine if everything is alright with your thyroid gland.

Also, a physician can ask you to keep a sleep diary for a week or two. It is a log of your sleep behaviors that should include things like the time you go to sleep and wake up, how long it takes you to fall asleep, if you experience any night disruptions, if you feel well rested in the morning, if you are napping during the day, and more. You should also keep track of other habits that could be affecting sleep like diet and exercise. This detailed information helps them get a more comprehensive view of the situation so that they can prescribe you the best possible treatment, which often includes overall lifestyle and sleep habit changes and in some cases, a short use of medications. 

If the cause of your sleep problems isn’t clear, or your physician suspects that there is some other sleep disorder in question such as restless legs syndrome or sleep apnea, they may refer you to do an overnight sleep study called polysomnography. This procedure is done in specialized facilities called sleep clinics, where the technicians take numerous tests to determine the cause of your sleep disruptions. 

When you first come in, they’ll ask you to fill out several questionnaires like the Pittsburgh Sleep Quality Index, to evaluate your situation. The way these tests work is that there is a certain threshold and if your score passes that, it is an indication that you may have a sleep disorder. After you are done, it is time for the actual sleep study. A sleep technician will hook you up to several machines that measure your brain waves, heart rate, breathing patterns, snoring, eye and body movement, and more. With this detailed data about your sleep, sleep experts can then assert your situation, give a diagnosis, and recommend further treatment.

Different Therapy Options

Based on the individual situation, a doctor can suggest several different approaches to battle with sleep problems.

Behavioral treatment (CBT-I)

These approaches are based on changing behaviors surrounding sleep, which can include internal thoughts and impressions about sleep, creating a pleasant bedroom environment, and doing activities that should improve sleep routines. The goal is to root out all negative and create positive associations that should help with insomnia.

CBT-I is a type of therapy where you are trying to address the recurring thoughts and behavioral patterns that hurt your sleep, with the help of a professional. This method is mostly used for chronic insomnia, as people usually develop frustrations with nighttime rest because they spend so much time trying to fall asleep without success. The goal is to undo this and make healthy, positive associations. This usually takes time, and standard CBT-I involves hour-long weekly sessions over 6 to 12 weeks. The treatment includes the use of sleep restriction, stimulus control, relaxation training, biofeedback, cognitive control, and sleep hygiene training. 

Stimulus control refers to strengthening positive associations between the bed and sleep. Since people with chronic insomnia get frustrated with the inability to fall asleep, a single thought of going to bed can make them anxious. This method requires using your bed only for sleep and intimacy. Everything else like watching TV, reading, scrolling social networks, and answering work emails, should be done somewhere else. If you are using stimulus control should only go to bed when you are feeling sleepy, and if you can’t fall asleep for 20 to 30 minutes, you should get up and do a relaxing activity until you get tired again. Over time, your brain will learn to recognize your bed as the place for nightly slumber, and it will take you a lot less to drop off.

Sleep restriction limits the time you spend in bed each night. The way it works is that you look at your sleeping habits and set a time you spend in bed each night. For instance, if you usually take 8 hours, but only spend 5 of those sleeping, then the limit is set at 5 hours. The goal of this initial restriction is to cut down the time needed to fall asleep so that you don’t spend hours lying awake and getting frustrated. When the falling asleep becomes easier, you gradually expand this time, so that you can get a sufficient amount of sleep.

Relaxation and biofeedback include different methods of meditation and breathing exercises that help calm the mind and body. Biofeedback is achieved through the use of specific devices that let you know your state of relaxation by notifying you about your blood pressure, body temperature, heart rate, or muscle tension. That way, you can use meditation and breathing techniques to get back to the calm state.

Cognitive control refers to the use of psychotherapy to change the negative thoughts and attitudes towards sleep. Therapists use different methods to do that depending on the individual, but you should know that this usually takes some time, so the best you can do is to be open and patient.

Some doctors may prescribe different medications to treat insomnia. Most of them are used for one to four weeks and are not intended to be taken for more extended periods. They are usually used in combination with other treatment methods. The most commonly used ones are benzodiazepines, including Diazepam (Valium), Clonazepam (Klonopin), Alprazolam (Xanax), and Lorazepam (Ativan). Some over the counter sleep aids can include Antihistamines, Benadryl, and Melatonin. 

Improving Sleep Hygiene

One of the essential things for battling insomnia is to change some of your lifestyle habits and establish good sleep hygiene. That includes:

• Going to bed and waking up at the same time every day. That way, your internal clock will be set in a way that your brain knows exactly when is the time to fall asleep, and when it should be active.
• Creating a comfortable sleep environment. Your bedroom should be dark, and you should keep a thermostat somewhere between 60 and 67 degrees Fahrenheit. Also, block any auditory distractions by using earplugs or white noise machine.
• Ban all electronics from your bedroom, and avoid screen time in the last hour before going to bed. Displays emit blue light that can trick your brain into thinking that it is daytime, and that can suppress the production of a sleep-inducing hormone called melatonin.
• Stay active and enjoy some time outside in the natural light. Exercise is essential for proper sleep, and you should aim for at least three sessions each week to fully enjoy all the benefits. Just keep in mind not to do it too close to bedtime, as it can be counterproductive.
• Eat a balanced diet with lots of fruits and vegetables. Also keep away from stimulants such as alcohol, nicotine, and caffeine, especially later in the day.

Popular Insomnia Content

Insomnia affects a large number of individuals, with many experiencing it at some point in their lives. Those dealing with insomnia or other sleep-related conditions often find it challenging to fall asleep, remain asleep, or might wake up frequently during the night. Additionally, some people face the problem of waking up too early, which can lead to decreased productivity, irritability, diminished memory, daytime tiredness, and occasionally, a decreased enjoyment of life overall.

Although it’s perfectly normal to have a restless night here and there, not getting enough quality sleep on a regular basis can be hard on your health, both mentally and physically. For some people, insomnia is a lifelong problem. For others, the issue is temporary, lasting days, weeks, or even months before sleep patterns return to normal. Thankfully, there are several alternative medicine solutions that can help people who are suffering from sleep disorders.

What Causes Temporary Insomnia?

Temporary insomnia can last anywhere from a single night to several weeks. Many things can bring on this problem, but the most common cause is stress. Illness or temporary pain from some sort of injury can also bring on periods of insomnia. Sometimes the problem is caused by something in the environment, such as sleeping in a new place, too much light, or too much noise. 

And, of course, changes in the sleep pattern, such as working a different shift or jet lag, can also bring on periods of temporary insomnia. If you are experiencing temporary insomnia, it’s essential to be aware of daytime fatigue that could lead to accidents on the road at your job.

What Causes Chronic Insomnia?

For most people, temporary insomnia will usually resolve itself. However, temporary insomnia can develop into a chronic issue if the cause of your inability to sleep is not addressed. In more severe cases, chronic insomnia may be the result of mental or emotional disorders, including extreme stress, depression, and anxiety.

Other health conditions, like sleep apnea, breathing problems, hormonal or digestive disorders, and even heart conditions, can cause chronic insomnia. Drug and alcohol abuse and overuse of stimulants like caffeine and tobacco are also common causes. And finally, poor bedtime habits, like keeping the television on when you’re trying to fall asleep or not having a regular bedtime schedule, could also be the cause.

Using Herbalism and Supplements to Relieve Insomnia

There are several herbs and supplements that are recommended for the treatment of insomnia. Herbs and supplements are a great alternative to conventional sleeping pills because they are usually non-addictive, and they don’t generally leave you feeling drowsy when you wake up in the morning. 

Here are some herbs and supplements to consider trying if you are suffering from chronic or temporary insomnia:

• Valerian: Valerian has been used as a remedy for insomnia for centuries. It doesn’t work for everyone, but for many, it is just as effective as conventional sleeping pills. If you decide to try this herb, take it about one hour before you go to bed for best results.
• Magnesium: Magnesium is a mineral that not only helps with insomnia, it’s also essential for heart and brain health. It also quiets the body and mind, so you can fall asleep more easily.
• Passionflower: Passionflower is an herbal remedy that’s often recommended for the treatment of insomnia. It’s especially useful when it’s paired with other natural remedies.
• Glycine: The amino acid glycine may be beneficial to those suffering from insomnia because of its effect on the nervous system. It has been shown to lower the body temperature, which signals to the body that it’s time for sleep.

Aromatherapy for Insomnia Relief

“If you’re having racing thoughts and difficulty settling into a restful sleep, insomnia may creep in,” says Yinova Center Chinese Medicine expert, Kate Reil. Kate is an acupuncturist and herbalist who often incorporates essential oils into an overall treatment plan for patients suffering from insomnia. She goes on to say that essential oils can be used for easing feelings of anxiety and promoting deep sleep.

Here are some essential oils to try:

• Lavender: Lavender is useful for calming and has been reported to have anxiety reducing effects that are similar to Valium, without the dangerous side effects. Try placing a few drops of the oil onto our pillow before you go to sleep.
• Orange: Orange essential oil is recommended for calming the mind and balancing emotions. Try it combined with cedarwood and lavender in a diffuser at bedtime.
• Bergamot: This essential is excellent for regulating emotions and harmonizing your mood.
• Clary Sage: Clary sage is known to relax muscles and regulate hormones. For a relaxing bath that will help you fall asleep, try adding 10 drops of clary sage to your bathwater along with two cups of Epsom salts. Epsom salts can give a boost of magnesium, which is also helpful for sleep disorders.
• Cedarwood: Cedarwood has a grounding and calming effect. To calm anxiety before bedtime, try rubbing a few drops of cedarwood oil into the soles of your feet.

Relaxation Techniques to Relieve Insomnia

Relaxation techniques can help you fall asleep more quickly, sleep longer, and feel more rested when you wake up. They should be used about 20 or 30 minutes before bedtime, and there are several different techniques you can try.

One of the easiest techniques to try is visualization. All you do is get in a comfortable position and imagine a calming scene. Try to include all of your senses. For example, if you’re at the beach, think about the way the breeze feels on your skin, hear the waves, smell the salt water, and picture the waves in your mind. The more vivid you visualize the scene, the more effective it will be.

Yoga is beneficial for insomnia because it includes several relaxation techniques, including stretching, meditation, and deep breathing. A study done by Harvard showed that people who do yoga every day for eight weeks fall asleep faster, sleep longer, and don’t wake up as often during the night. Try searching online for a gentle nighttime yoga routine and do it every night about half an hour before bedtime.

Massage Therapy for Insomnia

Studies done by the Mayo Clinic show that massage therapy is beneficial for reducing the stress that can lead to insomnia. Massage can help people sleep more deeply and restoratively. Massage can help boost the production of the hormones melatonin and serotonin, which are both critical for quality sleep. It’s a smart, drug-free option that can be used over the long term to help with both short-term and chronic insomnia.

Many physicians are beginning to recognize the value of alternative medicine for treating insomnia. Conventional sleeping pills are beginning to take a back seat to safer, more natural therapies. A multi-dimensional approach that addresses the patient as a whole may improve the outcome for patients who are hesitant to turn to pharmaceuticals.

Sleep plays a crucial role in our well-being, and healthcare experts are emphasizing the need for greater awareness regarding its importance. It’s common knowledge that diet and exercise significantly impact our health, yet it appears that adequate sleep should also be considered equally important, standing alongside these two as a vital component for leading a prolonged and fulfilling life.

With people today leading more stressful lives, it is no wonder that there is an increasing number of sleep disorders and headaches. It seems that these events are somehow connected, as it is not rare that they appear at the same time. Many insomnia patients often experience migraines that additionally make it harder to fall asleep. That poses an important question that looks like the famous “chicken and egg” problem. Is it the headaches that cause sleep disruptions, or are they simply a symptom of these disorders? The truth is somewhere in the middle, as our bodies are incredibly complex, and it seems that there isn’t an easy answer to this question.

One thing is sure, headaches are widespread, and they affect more than 50% of the population on any given year. Everybody has experienced it at some point in their lives, but those unfortunate ones have to deal with it a lot more often than the rest of the population. It appears that around 3% of people have chronic headache, meaning that they experience it for more than 15 days each month. That can be truly disabling, especially when you take into consideration that most of the times, doctors don’t know what is causing them. 

There are many available medications for potential treatment, and the effectiveness of each one depends on the individual. Some people find certain drugs to be miracle cures, while others regard them as not helpful at all. If you are experiencing headaches regularly, and they seem to affect your everyday life, you should speak to your medical care provider. They can do closer examinations to try and determine what is causing them and propose the right treatment.

In some cases, simple lifestyle changes can go a long way, and they can be extremely helpful in eliminating or lessening these painful events. Let’s take a closer look into the connection between adequate rest, sleep disorders, and headaches, and see what we can do to prevent them from happening.

Types of Headaches

There are many types of headaches, and health professionals recognize more than 150  different ones. They are divided into two main categories, primary ones that are the condition itself and are not caused by some other event, and the secondary ones that can occur due to some other disorder, head trauma, or substance abuse.

Primary Headaches:

• Migraines: People experiencing them feel the intense throbbing pain on one side of the head. It can be accompanied by heightened sensitivity to light, smell, and sound, with the feelings of nausea and sometimes vomiting. Some other disruptions may arise like numbness, muscle weakness, pins and needles sensation, difficulty speaking, flickering lights, or partial loss of vision. Migraines tend to last up to 3 days, and they are reoccurring. Unfortunately, most people who are experiencing them have these episodes throughout their whole lives, while the frequency can vary from once a year to several times a week. The causes of migraines are not fully understood, but they appear to be more common with people who have some disorders like depression and epilepsy, and they also seem to run in families. Some other triggers may include stress, anxiety, hormonal changes, sleep disruptions, dehydration, skipped meals, some drugs, and more. To treat them, physicians prescribe certain medications for the attacks, as well as suggest making lifestyle changes that should help with the prevention.
• Tension headaches: They are very common, and all people experience them from time to time. They are characterized by a dull, persistent pain on both sides of the head. People may also experience a feeling of pressure behind the eyes and the sensitivity to light and sound. Although the severity of these events can vary, they usually last up to several hours, and shouldn’t keep people from their regular activities. The cause of these events is not entirely known, but some triggers include stress, anxiety, dehydration, skipped meals, poor sleep, loud noise, lack of exercise, bad posture, and eye problems. It seems that they are also more prevalent among people suffering from depression. Treatments include medications and lifestyle changes that aim to remove all the potential triggers.
• Cluster headaches: They are described by a very sharp, unbearable piercing pain around or behind one eye. For some reason, they are six times more likely to develop in men than in women. These severe events can be accompanied by a watering eye, swollen eyelids, blocked or runny nose, increased sensitivity to light and sound, and restlessness. The attacks come without warning, and they often take place at the same time each day, usually in the part of the night just before the dawn. The cause of these events is unclear, but it seems to affect smokers and regular alcohol drinkers more. Treatment aims to reduce these occurrences, and doctors usually prescribe certain medications for that. In some severe cases, they might suggest surgery.
• Exertional headaches: They occur during strenuous physical exercise and can be caused by running, jumping, lifting weights, sexual intercourse, or intense coughing and sneezing. They manifest as a throbbing pain throughout the whole head and are usually short-lived. Over the counter (OTC) painkillers should take care of them, and you should always make sure to do the adequate warm-up exercises before any intense activity.
• Hypnic headaches: These mostly occur in people over 50 years old, and they are more prevalent among women. The episodes are characterized by a mild pain on both sides of the head, that usually appears at the same time each night, which got it a nickname of “alarm clock” headaches. It can last up to three hours, and symptoms may include sensitivity to sound and light, and nausea. Unfortunately, causes and triggers of these events are not known. Some researchers speculate that since the elderly are getting less slow wave sleep, which is essential for proper brain restoration, it is somehow connected with these events, but the proposed mechanisms are yet to be described. The leading treatment choice is surprising – caffeine. It is a brain stimulant that doctors usually recommend avoiding too close to bedtime, as it is known to disrupt sleep. But in these cases, it appears to be useful, and people can take it in the form of tablets, or they can drink coffee in the evening.

Secondary headaches:

• Medication-overuse: These painful events resemble migraines or tension headaches and are caused by the withdrawal of certain medications such as opioids, triptans, and acetaminophen. They can be accompanied by nausea, vomiting, increased heart rate, restlessness, anxiety, and sleep disturbances. 
• Sinus headaches: Sinusitis or the swelling of the sinuses causes these headaches, and it is usually the result of infection or allergy. The symptoms consist of dull aches around the eyes, cheeks, forehead, and can sometimes spread to the jaw and teeth. They often go hand in hand with thick green or yellow nasal discharge, blocked nose, fewer, light sensitivity, and nausea. Treatments include painkillers, nasal decongestants, antihistamines, and corticosteroids in the case of allergy, and antibiotics if the infection is the problem.
• Caffeine-related: Consuming more than 400 mg of caffeine per day, which is around four cups, is harmful to your health and can induce migraines. Also, withdrawal after some time of heavy consumption can have the same effect and can also be accompanied by poor mood, irritability, fatigue, nausea, and difficulty concentrating.
• Head Injuries: You should always seek professional help if the head injury seems to have caused unconsciousness, confusion, memory loss, seizures, vision or hearing problems, and vomiting. Usually, a headache will develop soon after the event, but in some cases, it can develop months later, making them difficult to diagnose.
• Menstrual headaches: In women, migraines are often linked with periods and are related to the change in hormone levels. They can also be caused by oral contraceptives, pregnancy, and menopause. 
• Alcohol: Everybody has experienced a hangover at some point in their life, with a throbbing pain on both sides of the head that seems to be worsened by movement, bright light, and loud noises. The risk of getting a hangover can be reduced by drinking in moderation, not doing it on an empty stomach, and consuming water between beverages and before going to bed to ensure proper hydration.

Sleep and Headache – The Connection

Sleep is essential for proper functioning, and lack of sleep can lead to numerous health conditions, impaired memory, inability to focus, poor work performance, and more. The internal clock in our brain is responsible for deciding when to rest and when we should be active. It is all part of circadian rhythms, which are cyclical changes that we go through every day. Our brain adjusts this clock by perceiving external stimuli like light and temperature. It then releases different neurotransmitters and hormones like melatonin, that tell the rest of the body to go to sleep.

It is clear by now that there is some connection between sleep and headaches. For instance, migraines usually appear between 4 am and 9 am, which might suggest a mechanism that correlates with sleep or circadian rhythm or both. Sleep deprivation, as well as sleeping too much, are among the most common triggers of these events. Also, shift work and jet lag can be common triggers, which suggest the influence of both circadian systems and sleep. 

Cluster and hypnic headaches appear almost exclusively during the night slumber, which additionally strengthens the idea of this close relationship. Migraines and insomnia usually appear together, and they are more likely to affect people who have suffered mild head injuries, as a part of post-concussion syndrome. 

Morning headaches usually go hand in hand with other symptoms like daytime sleepiness, and they are often a clear sign of an underlying sleep disorder like obstructive sleep apnea. Also, people with narcolepsy are more prone to migraines than the rest of the general population, and so are the individuals with restless legs syndrome. Night terrors and sleepwalking are somewhat more common in migraine sufferers, especially children. 

The balance between sleep and wakefulness is essential for keeping our bodies in optimal state and maintaining homeostasis. That may explain such a close relationship between headaches and sleep. Some researches suggested that the migraines are our body’s way of telling us that something is wrong. When you are not getting enough sleep, and you are faced with a sharp pain that disables you from doing anything, it might force you to slow down and catch up on your rest. Additionally, when you sleep in too much, migraines can keep you up at night, preventing you from falling asleep, which could lead to the restoration of balance between rest and activity.

Common Sleep Disorders

Insomnia is the most common sleep problem for people suffering from migraines. It refers to difficulty falling (sleep onset) and staying asleep (sleep maintenance insomnia). People usually wake up in the morning with a headache and not feeling refreshed. That leads to daytime fatigue, poor attention, inability to concentrate, lack of motivation, and impaired overall functioning. Sometimes a nap can help contain a daytime migraine, but that can later lead to difficulties falling asleep, so it’s a two-edged sword. If you suspect that you have insomnia, you should pay a visit to your medical provider. They can run a series of tests to determine the reasons for your sleep disruptions, and with the right treatment, your migraines should disappear as well.

Obstructive sleep apnea is a condition where something is blocking the upper airway and preventing regular ventilation. The most apparent symptom of this disorder is snoring, which occurs when the air is running over a relaxed tissue that then vibrates and produces that familiar sound. Sleep apnea contributes to disrupted sleep patterns as people often wake up in the middle of the night gasping for air. Sleep fragmentation leads to waking up with the morning headache, and people usually feel sluggish and not at all well-rested. Luckily, this condition is successfully treated with positive air pressure therapy, and all the symptoms, including migraines, should improve with regular use of prescribed treatment.

Teeth grinding can lead to waking up with a headache and sore jaw. If it is not treated, it can lead to a temporomandibular disorder, and chronic teeth grinding, which is also known as bruxism. Most common causes of this condition are excessive stress and poor sleep, and simple lifestyle adjustments, and the use of a mouthguard can improve symptoms and prevent migraines.

Improving Sleep Hygiene

If your symptoms are persistent and are preventing you from doing your daily activities, you should visit your doctor. They can carefully examine you and determine the cause of your problems, and advise further treatment accordingly. However, there are some things you can do on your own to improve many aspects of your life, including sleep quality, productivity, and fewer headaches. 

• Create a regular bedtime routine. You should try to go to bed and wake up at the same time every day. Most people like to sleep in on weekends and try to catch up on the lost sleep, but that doesn’t seem like a good idea. Instead, try maintaining a schedule where you will regularly get 7 to 8 hours of rest every night, and try to resist the urge to sleep in on the weekends. That way, your brain will know exactly when is the time to go to sleep, and when it should be active, which will lead to less time spent falling asleep, lifted energy levels during the day, and no daytime sleepiness.
• Understand your body’s need for rest. Adults should get between 7 and 9 hours of sleep each day. Don’t hesitate to take a nap, but don’t do it too late in the afternoon, and keep in under 40 minutes. If you sleep for longer, you are risking to enter deep sleep and feel disoriented after waking up, and that has an opposite effect on boosting productivity, which should be a goal of every nap.
• Incorporate exercise in your weekly routine, as it can boost the production of melatonin and help you enjoy more restorative sleep. Even a light 30-minute walk can go a long way, but it seems that moderate exercise has the most benefits. You should try to be active at least three times a week, and you can even try some weight lifting, as it seems to have some extra benefits. Make sure not to do it too close to bedtime though, as it can be counterproductive, and leave you awake in bed, unable to fall asleep.
• You should always aim to eat healthily. Fruits and vegetables should be the main focus of your meals, and you should cut down on alcohol, nicotine, and caffeine consumption, especially close to bedtime. They are stimulants that can disrupt your sleep, and cause more problems.
• Create a pleasant sleep environment free of any distractions. Your bedroom should be dark, cold, and noise free. You should ban all electronic devices from your sleeping area, and leave it just for that. Avoid using your smartphone or laptop before bed, because it emits blue light that can trick your brain into thinking it is the morning, and it can stop the production of melatonin, which can lead to poor sleep. 
• Try to spend some time outdoors in the natural light, as it can help your brain understand better when it is daytime, and adjust your internal clock accordingly. 

The human brain is among the universe’s most intricate entities, with researchers globally dedicating themselves to deciphering the mysteries of our cognition. Initially, ancient philosophers and thinkers posited that the heart was central to controlling the body and spirit. However, it was only after some time that the critical role of the brain was acknowledged, ushering in the age of neuroscience.

Our central nervous system (CNS) is pretty much in charge of everything we do. Whether it is a simple hand movement, perception, and processing of the internal and external stimuli, or more complex thinking and planning, there isn’t a single thing you can do that doesn’t include your CNS. Your brain works all the time, and it is only during sleep when it takes some time to do a little maintenance, but your brain is still very active.

Since scientists have realized the importance of our nervous system, they have been working very hard to gain a little understating of it. The neuroscience has come a long way since its beginning and the first description of neuron in the 19th century, and today we know a lot about how our brain functions, and how it communicates with the rest of the body. However, there are still some mysteries. As it was profoundly put by the English philosopher Emerson Pugh: “If the human brain were so simple that we could understand it, we would be so simple that we couldn’t.” But that doesn’t mean we shouldn’t try. 

Electroencephalography (EEG) was invented in 1924 by Hans Berger, and it represents a technique that measures the activity of the brain. It does so with electrodes that detect electrical impulses, and based on that, neurologists have learned a lot about how our nervous system works.

Brief History of Electroencephalography

The brain exploration using EEG has been going on for almost a century. It is an excellent screening method that is directly linked to neural activity. It is based on the fact that neurons communicate using electrical current, and when many are firing at the same time, electrodes can detect those signals, and we can start to look for the occurring patterns. That is how we detected brain waves, which are described as oscillatory neural impulses.

It all started with the Italian scientists Luigi Galvani in the 18th century. He showed that the electrical impulses could be used to flex a frog’s hindquarters. The current would excite the nerves, which would lead to muscle contraction. That was the turning point in understanding neuroscience, as there is no science class today where they don’t show the experiment with the frog, and how the muscles can contract if the electric current is applied. A German physician and physiologist, Emil du Bois-Raymond expanded the knowledge about electricity and cells as he was the first to describe the fundamentals on which the nerves communicate, known as the action potential. That meant that the cells in our brain and body were not only able to send and receive chemical signals but the electric ones as well. This seems to be a faster way to send information, and neurons work mostly based on that.

All of these discoveries led to the beginning of the brain electrical recordings, similar to today’s EEG. They were done on animals by Richard Catton. He attached electrodes to the brain hemispheres and showed that the electrical impulses changed when the animal behavior was different. Unfortunately, his findings weren’t such a hit, but he did lay stage for what was coming. 

A German psychiatrist Hans Berger is considered a father of the EEG. He performed his first human experiment in 1924, and five years later, he published his findings and presented the technique in a form that is very similar to the way we do it today. By the mid 20th century, the EEG was already used to describe alpha and beta waves, and there were a lot of experiments looking into the effects of different drugs on the brain.

Today, the EEG is cheaper and easier to use than ever, and it is a useful diagnostic tool for many conditions like epilepsy, stroke, brain abnormalities, sleeping disorders, tumors, and more. 

Brain Waves

Different patterns of neural oscillations are called brain waves. They are detected and described by EEG readings and based on the state of mind and activity, there are several different types:

• Beta waves can be detected while we are in the wake and active state. They occur when we are engaged in an activity, but interestingly, also when we observe other people’s actions.
• Alpha waves are characteristics of wake but a deeply relaxed and calm state. People engaging in meditation are often experiencing them.
• Theta waves happen mostly during the light stages of sleep. These transitional stages from wakefulness to deep slumber seem to have many benefits for our brains and bodies. It appears that this period of theta waves is connected to the integration of memory and that people who spend more time in the light stages of sleep have a higher ability to recall information.
• Delta waves are the lowest in frequency, and they are reserved for the deepest, most restorative sleep. It is clear by now that scientists have described sleep architecture based on the different brain waves that occur during the night. Because of that, Stage 3 is also called deep, or delta wave sleep. It is essential for the proper functioning of the body and mind, and during this period our brain does the needed housekeeping, and our muscles are repaired.

Besides these four basic types, there are a few other brain waves described, as well as other neural occurrences. For instance, sleep spindles and K-complexes are both found in the light stages of sleep, and it appears that they play a crucial role in the embedding of new information into our heads.

Other than general activity, EEG can also interpret which areas of the cortex are responsible for processing a different kind of information at any given time. For instance, the occipital region is responsible for visual stimuli, so this area will be active during the screening if you are looking at a picture or flashing light. The parietal cortex is responsible for motor functions and processing information that is essential to us. The temporal region is responsible for speech production and language processing, while the frontal cortex makes up the most significant part, and it is essentially responsible for what keeps us human. It is accountable for our behavior, ability to plan, and it helps us maintain control and analytically think about ourselves and the world around us.

Why Would You Need an EEG?

This method is used to diagnose several brain disorders. For instance, if the epilepsy is present, there are rapid spiking waves during the seizure episodes. It can also be used to locate brain lesions, which can be a result of certain tumors or a stroke. EEG is used to diagnose any other disorders that may affect neural activity and brain waves, such as Alzheimer’s disease and some psychoses.

The EEG can be used to evaluate the brain damage caused by various traumas, drug intoxication, or comatose state. It can also be used to track the blood flow through the head during specific surgical procedures. Since we are mostly interested in the field of sleep, it is important to state that EEG is an essential tool at diagnosing different sleep disorders. That happens during the overnight study in a special facility, but more on that later.

If your medical provider has instructed you to take EEG, don’t worry, as this procedure is harmless and causes no discomfort. It is a non-invasive method, meaning that the electrodes don’t penetrate your skin, but rest on the outside of your head, and there is no risk of getting an electric shock. 

There are certain risks of having a seizure for people who are suffering from epilepsy. Due to the nature of these tests, you may have to breathe deeply and look at the flashing light, which can trigger these events in some people. However, don’t worry, as the technicians are fully trained and should contain the attack immediately. Other risks are mainly connected to the use of certain medications, and that is why you should always discuss that with a medical professional before taking the test. Other factors can interfere with the EEG results, and they include:

• Low blood sugar levels caused by fasting
• Bright or flashing lights
• Drinking caffeine
• Excess eye or body movement during the tests
• Oily hair or the presence of hair products

How to Prepare For The EEG?

Your medical provider will usually talk you through all the preparation you need, but here is a list of things that you may be asked to do before the testing:

• You will be given a consent form you need to sign to confirm that you are giving permission for the procedure. You should read it carefully, and ask questions if something doesn’t seem clear. Your medical provider should be happy to explain any details that might be confusing to you.
• You must wash your hair the night before, or on the day of the procedure. Don’t use conditioner or the other hair products like gels or hairspray, as they can affect the results of the tests.
• Talk to your medical provider about the medications and supplements that you are using. In most cases, they will advise you to continue with it, but in a few rare instances, they might direct you to stop using certain ones.
• Avoid consuming any foods and drinks that contain caffeine for 8 to 12 hours before the procedure. That includes coffee, sodas, teas, and energy drinks.
• Avoid fasting the day before the tests, as low blood sugar levels may influence the results.
• If you are taking EEG as a part of the sleep study, your medical provider will probably tell you that you need to reduce your sleep during the night before the test. You are usually advised not to sleep for longer than 4 to 5 hours during that night. 
• Based on your medical condition, your doctor may request other specific preparations, so be sure to discuss it with them.

What Does an EEG Look Like?

The procedure may vary based on your condition and the practices of your healthcare provider. But it usually looks something like this:

• You will be asked to relax on a reclining chair or a bed, while the sleep technician measures your head and marks the places where he or she will attach the electrodes. They might scrub these spots with a special cream to remove any excess dead cells and improve the readings. 
• After that, they will attach electrodes to your scalp using a special adhesive paste. Sometimes they use elastic caps fitted with electrodes instead. Wires go to the instrument that amplifies your brain waves, and then it’s all recorded on the computer. 
• The test usually takes up to one hour, and during that time, you are supposed to stay motionless, relaxed, and with your eyes closed. The recording might be stopped from time to time, to let you re-adjust the position if you don’t feel comfortable. 
• After the initial readings in your resting position, the sleeping technician may ask you to perform various tasks. They can instruct you to read a paragraph of text, look at a particular image, breathe deeply and rapidly, or look at the bright or flashing light. 

The video is taken during the whole process so that they can compare your movements with the readings to get more accurate results. If you are instructed to get an EEG as a part of your sleep study, it will look a bit different.

Overnight Sleep Studies

To detect any sleep disorders, your medical provider may instruct you to take an overnight sleep study called polysomnography. It is done in a special facility called a sleep clinic, where you will be subjected to a series of tests including the EEG.

Before the screenings, you will be instructed to keep a sleep diary for a week or two. There, you will note your everyday sleeping behaviors like the time you went to bed, the time you woke up, how long it took you to fall asleep, if you had any interruptions during the night, and how rested you felt the following day. All of this is important to the sleep specialists, as they can detect any behavior that can be causing sleep problems, and then adjust the tests accordingly. 

When you enter the sleep clinic, they will first ask you to fill several questionnaires that should include the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. These tests serve to measure the overall sleep quality, and if the final results pass a certain threshold, it indicates a possible presence of a sleep disorder.

Then, it’s the time for actual polysomnography. Sleep technicians will connect you to many devices that will monitor you while you are sleeping. They include EEG that measures your brain wave activity, as well as other machines that track your heart rate, breathing patterns, nocturnal eye and body movement, snoring, and more. The medical professionals will then combine these results with the tests you have taken beforehand to make the right diagnosis and prepare you for the next steps. 

Usually, the polysomnography lasts until the morning when you will be discharged from a sleep clinic until your results are done. In some cases, this overnight study is stopped in the middle of the night as the doctors are already ready to give the diagnosis. That is mostly in the case of sleep apnea, and then for the second part of the night, sleep technicians can hook you up to a positive air pressure machine that is the part of your treatment. This way, you get the diagnosis and the plan of treatment during the same night.

What Happens After The EEG?

After the procedure, doctors trained to analyze EEG will need to take a look at your reading. It usually takes a team of medical professionals to interpret the results and then send the information to the doctor that ordered these tests. Sometimes a neurologist can give you some basic data about your readings on the spot, right after the exam. But you will more often have to wait a few days for a report and detailed results.

A doctor can instruct some additional exams to the EEG, like the MRI head scan. That can give them more details about what is causing your problems if the EEG screenings are not sufficient. 

Based on the results and your medical condition, your healthcare provider will plan the next steps and the treatment plan. You shouldn’t be afraid to ask them anything about your health or treatment. Don’t hesitate to ask them to suggest some credible sources where you can read about the condition that is causing you problems, and learn more about it. Make sure to follow the treatment plan they prescribe you and give them the feedback on how successful it is so that they can adjust it if necessary.

Do you ever notice your mood fluctuating with changes in the weather or as different seasons roll in? Many individuals report feeling gloomy during prolonged periods of unpleasant weather, particularly as fall approaches. Might there be a scientific explanation for this phenomenon? Historically, humans have been attuned to changes in the weather, with the earliest documentation tracing back to ancient Rome. Hippocrates, around 400 BC, was the first to note that various diseases seemed to be linked to shifts in seasons. However, it wasn’t until the late 1990s that the American Psychiatric Association officially recognized this condition. Currently, it’s estimated that this disorder impacts 4% to 6% of the population.

Meteoropathy is also considered a disease, type of weather-related pain, but it refers to a shorter period of time, and isolated pain in particular body parts, on the other side, seasonal affective disorder refers to the condition which lasts much longer, for months even, and it is attached mostly to winter and autumn season. 

If you have been down and grumpy all winter, it could be because of SAD, so stay tuned to find out more about the symptoms and other useful things.

Seasonal Affective Disorder Facts

SAD affects people who do not have any previously diagnosed mental problems, and they feel well during most of the year, but they tend to feel depressed or experience symptoms of depression throughout one particular season, usually winter each year. Although the term “winter blues” is often used when referring to this disorder, SAD is more than that, and it can even occur during the summer months. 

Even though a lot of experts were skeptical, this is now a recognizable and not so rare condition whose official status was changed and redefined from just a mood disorder to a more specific one by adding the “with seasonal pattern” suffix, which defines it more closely. 

Ten million Americans are affected by it, and approximately another 10 to 20 percent of the US population has a milder form of SAD. Interestingly, this is a condition that strikes women four times more often than men. When it comes to age, people who are between 18 and 30 years old are most liable to it. 

Many tend to neglect or not to take these symptoms seriously, but some people experience symptoms so severe that they hinder their daily functioning and lower the quality of their lives, and even 6% of them requires hospitalization. Although people with SAD usually do not have any other health problems, a lot of them has some close relative with a diagnosed psychiatric disorder, in most cases (55%) that is severe depression, but alcohol abuse is also frequent. 

Winter depression or SAD is pretty common among people who live in the Nordic countries, the first records of it go back to the 6th century when a Goth scholar named Jordanes described the people of Scandinavia in his Getica. In the US, the first proposition for an official diagnosis came at the end of the 20th century, when a psychiatrist and scientist Norman Rosenthal moved to New York from sunny South Africa. He first noticed the changes in its mood, and started experimenting with the exposure to artificial light, and noticed the improvement, which made him a pioneer in this field.

Causes

Like with many other disorders, the exact cause remains unknown, despite continuous ongoing research and effort. There are some theories, but they are not wide enough to reach to the root of the problem, but then again, it could be that many different things are capable of triggering this condition. We always expect from medicine and science to give us exact and concrete causes, or answers, but when it comes to conditions such as this one, expecting one precise and unique answer could be illusory.

According to one theory, SAD occurs due to the increased production of melatonin in our body during winter days. Melatonin is a hormone in charge of our sleep-wake cycle, and it is produced in the brain’s pineal gland. As the night falls, the production of melatonin rises, reaching its peak in the middle of the night, while in the morning with the sunrise, its level goes down. Since the dark surroundings can stimulate the production of melatonin and prepare our mind and body for sleep, a lot of scientists noticed the natural connection with shorter and darker days during the winter and blamed them for winter blues and lethargy.

The same thing is with another hormone called serotonin, which is a brain chemical, a sudden drop of it affects our mood significantly; hence, scientists believe that it can be connected to SAD. Less exposure to sunlight can lower the level of serotonin and trigger depression, but it also reduces the production of vitamin D, which also plays a crucial role in the activity of serotonin. In a lot of cases, lack of vitamin D is clinically connected to signs of depression.

Animals who hibernate represent the extreme example of this condition, and their activity is completely diminished during the winter months due to the lack of sunlight, food, and change of surroundings. There are species who do not hibernate, but they go through some changes during the winter in order to survive and accommodate better.

Symptoms

In the vast majority of cases, symptoms will start showing during the late autumn or beginning of the winter, and they will naturally go away with spring. But, although it is much less common, the reverse case is also possible, meaning that some people experience SAD during the summer months. With the wake of spring, their symptoms rise and become more severe during the summer, in the autumn they should be okay again. Regardless if you are a summer or winter type, the symptoms of SAD should appear at the same time each year. 

Some of the most common signs of SAD include:

• Feeling depressed almost all the time, each day
• Low life energy
• Lack of interest in the things you use to enjoy
• Appetite changes
• Issues with establishing a sleep routine
• Struggling to concentrate
• Feeling of hopelessness, worthlessness, guilt, etc.
• Thinking about death and suicide

Since the symptoms of summer and winter SAD are specific and different, we decided to share both lists separately; however, both types can also experience some of the common symptoms of depression, for example, the feeling of guilt, helplessness, loss of interest, etc. From the below-listed symptoms, you will notice that some signs are opposite, and go from one extreme to another, which shows how we all are prone to the things we cannot control, such as seasons.

Winter SAD Symptoms:

• Oversleeping
• Low energy and a constant feeling of tiredness
• Cravings for high-carb food and a gain of weight

Summer SAD Symptoms:

• Problems with falling or staying asleep, in most cases insomnia
• Lack of appetite and loss of weight
• Anxiety or agitation

How to Diagnose SAD?

Due to the high number of similar mental health disorders, sometimes it can be challenging to diagnose SAD because it has a lot of the same symptoms as some other types of depression, but it is also a lot of times misdiagnosed as mononucleosis, hypoglycemia, or hypothyroidism.

The process of setting a diagnose includes several evaluations and tests, and the most common combination of them consists of:

• Physical exam. The very first step in diagnosing SAD is a physical exam, followed by some thorough questions about the patient’s health since in a lot of cases depression is a manifestation of some other, underlying mental health problem.
• Laboratory. All kinds of lab tests come in option, from the initial blood test to the thyroid function one, if the doctor considers that it is necessary. 
• DSM 5. DSM stands for Diagnostic and Statistical Manual of Mental Disorders, in which the criteria for SAD are descriptive, and in a lot of cases, doctors will reach for this guide in order to be sure they are setting the right diagnosis.
• Psychological questionnaire. To detect any signs of depression doctors will ask a series of questions about your mental health, feelings, thoughts, to try to find any possible symptoms of depression, and even give you to fill a questionnaire, which will help them determine whether or not it is SAD.

Treatment

Treating this disorder is not easy, and there are several ways in which you can alleviate the symptoms, so be prepared that you might not find the solution in your first attempt. If waiting for spring seems too long and unbearable, try considering some of the most recommended treatments, which include vitamin D supplements, light therapy, counseling, and antidepressants. 

Since the decreased exposure to sunlight has been recognized as one of the main factors for SAD, light therapy became pretty popular and used in the purpose of reducing the symptoms of winter depression. The treatment implies regular exposure to artificial light during the morning hours, to mimic the effects of natural, outdoor light. Usually, the person needs to sit in front of a lightbox or to wear a light visor each day from 30 to 60 minutes during the fall and winter season. The exact duration of the therapy varies from one person to another, but if you notice the improvements in terms of energy and other symptoms, you should continue with it until the springtime arrives, and then gradually stop using it, if you stop your therapy too early, the symptoms can return.

Side effects of light therapy are not often discussed since its benefits are much more significant, but we would like to mention some of them here briefly. Patients claimed to have fatigue, headaches, eyestrain, or irritability; hence this form of treatment may not be suitable for patients who are diagnosed with bipolar disorder, or for those who have very sensitive skin and eyes. 

If you do not notice any improvement after a few days of practicing light therapy, then you should try with some medications or CBT behavioral therapy, individual or even in combination with light therapy. People with SAD often experience insomnia and its symptoms so CBT therapy can be pretty useful for them too. The therapist will work with patients in order to help them to be able to recognize some things and patterns which are preventing them from falling asleep so that they can change them and develop more healthier habits which will induce sleep instead of postponing it. 

Besides this, there are some behavioral changes that everyone can do with the power of will, try spending more time outside, walking, jogging, or even exercising which will raise the energy level, and clear up your mind. When indoors, you can also increase the amount of daylight in your home by opening the shades and removing curtains as much as possible, so that your home is bright and sunbathed. One study was researching how the exposure to sunlight effects on sleep of people who work in offices, the results showed that people who were working near the windows had a better sleep due to the higher exposure to daylight.

On the other hand, people who are dealing with summer SAD will probably need to do the reverse thing, buy some blackout curtains and limit their exposure to sunlight. For them, it is highly recommended to wear sunglasses when outside, and to turn off or stop using all electronic gadgets at least one hour before the desired bedtime. 

If you are into traveling, SAD can be the perfect excuse to go on an extended holiday and spend more time in the conditions you prefer, which can be particularly tempting during the cold winter days.

Besides these, it is essential to do some basic self-care precautions measures such as:

• Take notes of your mood and energy level on a daily basis
• Try taking the most of available daily sunlight, and exposing yourself to it
• Make in advance a plan of joyful activities for the upcoming season
• Try approaching the winter season with a positive attitude
• Start practicing some physical activities
• Once you start feeling the symptoms, seek help immediately, do not wait for them to aggravate

SAD and Sleep

SAD can be the cause why some people developed other sleep problems, or why their existing ones became even worse, and since sleep issues are one of the first signs of depression, it is not a surprise that they go along with SAD. 

People dealing with SAD are usually one of the people who divide into two major groups known as night owls and early birds, meaning that they either sleep for more than 9 hours, or less than 6, and none of those options are not considered to be healthy.

Most people with seasonal affective disorder develops hypersomnia or insomnia, but hypersomnia is more dominant as it strikes around 80% of people with this disorder. Another reason why people with SAD are struggling with the amount of sleep they get is that they tend to spend the majority of their time in bed, but they are not sleeping effectively for the most of time. They think that they are getting enough sleep and rest, but that is only an illusion, which later leads to misleading estimations and diagnosis. 

Since Nordic countries are particularly affected by this disorder, one study focused on people in Finland and the sleep problems that were common among people with SAD, in the chart below are their conclusions.

SAD Risk Factors

Interestingly, in a lot of disorders, there is no difference among sexes, and usually, the older we get, the more we are prone to various symptoms and diseases. But, seasonal affective disorder strikes women more often than men, and the younger population is more liable to it than seniors, which is more an exception than a rule. 

Although we do not know what causes it, there are some, generally speaking, common risk factors, which may indicate if a person has predispositions for SAD or not.

• Family medical history. Although it has not been proved that SAD can be transferred genetically, we are familiar with the cases in which a person suffering from SAD has relatives who struggle with other types of depression.
• Distance from the equator. We cannot choose where to be born; hence, people who were “unlucky” enough to be born or to live too north or south from the equator have higher chances for developing SAD. The number of people living remotely from the equator, and dealing with SAD should not be neglected since it shows how geographic location impacts people’s overall health. In such areas, during the summer months, the days are incredibly long, and during the winter the amount of sunlight on a daily level is not enough and can cause health-related problems.
• Already having depression or bipolar disorder. People who are diagnosed with some similar mood disorders can experience an aggravation of their symptoms during the problematic seasons.

Possible Complications

Symptoms of SAD should not be neglected, and even when they go away with the change of seasons, they will come back next year at the same time. Hence, if it is not treated, SAD can progress over time and even trigger some other conditions and problems.

• Problems at work or in school. Moodiness can cause problems if you are out of focus, alert, or you are not interested in participating in your daily obligations at work. Since younger adults are the major risk group, their scores at university could be jeopardized.
• Social withdrawal. People with depression tend to act like introverts; they refuse social contact, and always have an excuse for not showing up. However, social isolation is not the solution, the best is to inform your close people and coworkers about what is going on, and they will show more understanding of your condition.
• Substance abuse. A lot of people try to lift their mood with different substances, which inevitably leads to addiction. The thrill they can provide comes with a time limit, and as soon as it expires, the depression will hit back even harder. That is how many people get addicted to these substances, and start using them even after the season changes.
• Eating disorder or anxiety. Anxiety and depression often go hand in hand, but an eating disorder is not lacking behind a lot. Depressive people often search for comfort in food and overeating, since it is one of the rare things that can provide them comfort and satisfaction. 
• Suicidal behavior and thoughts. Unfortunately, this is also possible, and it happens sometimes. Depression is a dangerous condition, but since the term is so overused these days, we tend to forget how serious its consequences can be.

Frequently, one ailment can lead to another, culminating in a combined effect that plagues us. This is seen in the relationship between diabetes and sleep disturbances. Insufficient sleep may raise the risk of developing diabetes, whereas individuals with diabetes frequently struggle to get adequate sleep.

Diabetes occurs when the body is not able to respond and produce insulin, which leads to a higher level of sugar in the blood and urine. It is estimated that currently, around 30 million Americans have some type of it, which is approximately 28% to 32% of the population, but what is concerning even more is the fact that around 83 million have a prediabetes condition, which if it is not treated correctly can cause Type 2 in the next five years.

Today we will be discussing the relationship between diabetes and different sleep disorders, how can they be treated, how they interfere with one another, and what are the possible treatments.

Types of Diabetes

This title stands for a group of conditions or disorders, which hinders the body’s ability to process glucose, which is blood sugar. This condition requires constant maintenance, control, and careful observation, without it, the sugar will start piling up in the blood, and increasing the risk of various dangerous complications such as heart diseases and stroke.

Some types of this illness can appear in childhood, and they do not depend on the weight or inactive lifestyle, so each case should be treated individually. There are three main types of it, and we will now explain them briefly, but besides them, some more rare types are cystic fibrosis-related and monogenic diabetes.

• Type 1 is also called juvenile and occurs as a consequence when the body stops producing insulin. People who suffer from it depend on insulin, and they need to take its artificial forms daily; otherwise, they would not survive.
• Type 2 is also known as insulin resistance, and it impacts how our body uses insulin. The main difference in comparison to the Type 1 is that in this case, the body is producing insulin, but the body cells are not responding to it in a way they should be, or as they did before. This type is usually connected to obesity, and according to the data provided by the National Institute of Diabetes and Digestive and Kidney Diseases, this is its most common type.
• Gestational diabetes is a specific type which can strike women during their pregnancy when the body is less sensitive to insulin. However, this is not something which will happen to all pregnant women, and it usually goes away after they gave birth.

Prediabetes is a term which many doctors use to define the condition of a person who has borderline diabetes, which is usually when the blood sugar level is between 100 and 125 mg/dl. So the glucose level is not too high, but not low enough to be in the safe zone. Anything between 70 and 99 mg/dl is considered normal, while everything above 126 is considered as diabetes. People who have this borderline diabetes have a higher risk for Type 2, but they will not experience all the symptoms of it. Most common risk-factors for this condition are:

• Obesity 
• HDL cholesterol level below 40 or 50 mg/dL
• History of PCOS or high blood pressure 
• Medical family history 
• Sedentary lifestyle
• Being older than 45

The exact cause of Type 1 is unknown, while for the Type 2 things are much more introduced, so the resistance to insulin occurs as a consequence of some of the following things:

• Due to the genetics or environment, a person cannot produce enough insulin to cover the amount of glucose they intake.
• The pancreas cannot stand the increasing demands, and excess glucose starts circulating through the blood.
• The body is trying to produce more insulin to cover the extra glucose.
• Over time, insulin can become less effective; hence, the level of blood sugar will rise.

Can Lack of Sleep Cause Diabetes?

Researchers were able to find a link between poor sleep and Type 2, several studies have confirmed that not enough sleep, or sleeping less than 5 hours per night, increases the risk of this disease. People who sleep little, usually also have a below average tolerance on glucose even though they were not diagnosed or had any symptoms of illness. 

Some studies found the connection between lack of sleep and insulin resistance, or Type 2. One case study presented at the American Diabetes Society showed that healthy youngsters who sleep less than 6.5 hours regularly have higher chances to become insulin resistant. On the other hand, sleepers who spend at least 7.5 hours snoozing have significantly lower risk to get it. 

The enchanted circle involves diabetes, poor sleep, and obesity. Lack of sleep can cause obesity, which is one of the primary causes of this illness. Missing sleep regularly affects our appetite and glucose level and causes our body to struggle when controlling hunger or having to recognize satiation. Also, sleep-deprived people are usually exhausted at the same time, which hinders their intentions and readiness to exercise and fight with their weight loss. Sleeping more than 7 hours per night is essential for the prevention of obesity and other illnesses, including diabetes. 

Diabetes Sleep Problems

Most of the people with it usually struggle with some other disorders at the same time, and it is confirmed that insomnia runs among them more often since the symptoms of their condition cause them problems with falling asleep quickly and the lack of sleep only aggravates their symptoms.

A higher level of blood sugar during the daytime will hinder the body’s ability to rest at night, and being tired all the time will have a negative impact on the body’s ability to control the glucose level.

Some of the common sleep disorders which diabetic experience are:

• Sleep apnea, a breathing disorder, which results in occasional breathing stops during the sleep, is particularly common among obese diabetics, so it usually goes hand in hand with sleep apnea.
• Restless leg syndrome is also common among diabetics, and it contributes to their poor sleep.
• Insomnia, or difficulty with falling or staying asleep
• A higher level of glucose can lead to many painful and uncomfortable sensations such as tingling or burning in the toes, fingers, feet, and hands.

Restless Leg Syndrome

One of the sleep disorders which is often experienced among diabetics is the RLS if your legs get twitchy during the night, and you feel the urge to move them, most likely it is RLS. The uncontrollable urge to move the legs, and the uncomfortable feeling in them at the same time are the main symptoms of RLS. It usually feels like something is crawling over your leg, or tickling it from inside, and it can be very intense. However, if a pain in your feet wakes you up, it should not be RLS, neuropathy, or nerve damage, which also strikes diabetics and causes them many sleep problems, but the condition can be controlled with prescribed medications.

In the case of RLS, the tingling sensation will disappear when you start moving your legs, but it tends to get back quickly once you stop. The itchy symptoms usually begin around the evening hours and bedtime, and become more present during the night, hindering the patients sleep or preventing him from falling asleep. It has been stated that RLS runs more often among diabetics than among the healthy people, it could be that it is a feature of diabetic neuropathy, but it is also common among the patients with Parkinson’s, multiple sclerosis or kidney diseases.

The way in which RLS should be treated depends on how often the symptoms occur, how severe are they, and how much they hinder your sleep. Some patients claim that taking a warm bath, or stretching and doing some light exercises helps with keeping the symptoms under control, but medications or iron supplements should do the work. 

Sleep Apnea

Once the patients get their diabetes diagnosed, the danger of getting some other illnesses or disorders on the way only rises, so diabetics also have a strong predisposition for developing sleep apnea. Having sleep apnea means that you will occasionally stop breathing while you are sleeping and being unaware of it. Although the sleepers with this disorder are having no clue about what is going on with them, these breathing pauses are preventing them from entering into a stage of deep sleep. The good news is that there are successful treatments for sleep apnea, and they include the CPAP machine, weight loss, change of sleep position, or allergy treatment; it depends on the severity of the disorder and other individual properties.

It is very hard for an individual who is single to know if he/she has sleep apnea, but if you are waking up often throughout the night, or you feel tired during the daytime, and most importantly, your bed partner claims that you have been snoring, it is sleep apnea. Also, some of the symptoms are morning headaches and gasping for breath, but not everyone will have the same signs or combination of them. Usually, most people find out that they have a nocturnal sleep problem only when someone else suggests them that they have been snoring, that is when they start researching and usually undertaking sleep studies, which is the only way to be diagnosed with sleep apnea. Sleep studies for sleep apnea can be done in two ways, you can do it in your home, with a device which will record your breathing, and you can do it in a lab in a sleep clinic.

The most effective type of treatment for sleep apnea is the CPAP machine. CPAP stands for continuous positive airway pressure,  and it is a machine which blows the air through a hose to the mask on the patient’s face. Patients need to wear this mask every time they go to sleep because it will keep their throat opened, and their breathing will be back to normal. This treatment is working, but for some patients, it could be an issue to get used to sleeping with a mask on. Masks come in various types; some go to the nostrils, some will cover only the nose, or the nose and the mouth, etc. There is also another treatment called oral appliance, and this is done by a dentist who needs to take a mold of your teeth, and in its most common type, the dentist would use patients upper teeth as a brace, to pull closer the lower jaw.

A part of therapy for those with mild types of sleep apnea is weight loss and visiting a psychologist. Another option is positional therapy, which means that the patient has to avoid sleeping on the back and find a new preferred position instead. In many cases, patients tie something to their pajamas so that if they accidentally fall asleep on their back or they turn around during the night, this object will make them feel uncomfortable, forcing them to change the position. Some people even used tennis balls and sewed them to their pajamas, and you can try this too, or use something smaller and lighter. Apnea can also be treated surgically.

Sleep apnea should not be neglected. Even though patients are not aware of it most of the time, it affects their daytime, and by treating it they will have more energy, less fatigue, and be able to deal with their illness better. Especially patients coping with Type 2 should treat their sleep apnea, because it will decrease their resistance to insulin, and lower the risk of stroke and heart attacks.

Insomnia

Studies have confirmed the connection between Type 2 diabetes and insomnia, which was not a surprise, and the longer the person has symptoms of insomnia, the higher the risk of diabetes. The population of younger people with insomnia is particularly liable to developing some type of this illness; everyone who has less than 40 years, and has insomnia should consider changing their lifestyle.

A large study gathered the data from 28,000 people of both sexes, who were diagnosed with insomnia from the beginning of 2001 till the end of 2004, and none of them had diabetes when they were diagnosed with insomnia. Researchers were following their data and sleep disorder progress for six years on average, or until they were diagnosed with the illness. In the end, they concluded that the risk of getting diabetes is 16% higher in people who were diagnosed with insomnia since the data of participants were compared to the data of millions of healthy people from the National Health Insurance base. 

When it comes to age, among insomniacs, people younger than 40 had a higher risk of getting Type 2, than those who were older, regardless of their sex. The younger group had a 31% higher chances of Type 2, than the people of their age who were free of insomnia. Diagnosed insomniacs between 41 and 65 years old have 26% more chances for diabetes than healthy people of the same age, and those older than 66 are only 6% more likely to get another diagnose. 

The duration of insomnia played a key role according to the researchers; patients who were living with it for eight years had a 50% higher risk of diabetes. The risk was around 14% higher at those who had insomnia for less than four years.

The clear answer to the question of how insomnia increases the risk of diabetes does not exist, but scientists have a few ideas. Since lack of sleep is connected to glucose metabolism, and balance of hormones ghrelin and leptin, that can affect appetite and take over control of it, and lead to overeating. 

Irregular sleep pattern also triggers unhealthy eating habits, such as the intake of too many calories and fats, but sleep deprivation also decreases our sensitivity to insulin, affecting the way our body uses insulin in the reduction of glucose level.

In diabetics with insomnia, insomnia is treated as a primary cause, and many scientists believe that most of its symptoms come from bad habits, unhealthy lifestyle, etc. That is why they all first start recommending a change in lifestyle and sleep hygiene. Make sure that a night of good sleep becomes your priority, and that you have comfort, darkness, optimal temperature, quiet surroundings, etc. 

Keeping Diabetes and Sleep Disorders Under Control

Since these conditions cannot be cured with a single treatment or medication, they require maintenance and proper care, to prevent their aggravation. 

One of the essential things that anyone can do is pretty simple, and it is based on healthy and regular meals. Eating healthy food and maintaining the glucose level during the day will ease the body’s duty to keep them under control during the night and provide better sleep quality. Keeping the sugar level under control will reduce the intensity of RLS symptoms and neuropathy. A night of quality sleep will, in return, lower the blood sugar level and ease diabetes symptoms.

As we get older, we become more susceptible to various diseases and conditions that are commonly associated with later stages in life. Among these is dementia, which serves as an umbrella term for several specific types of this condition. While dementia may be seen as a natural aspect of aging, it doesn’t affect everyone equally or manifest with the same symptoms. In fact, there are individuals in their 80s or 90s who show no symptoms whatsoever. The reasons why dementia affects some and spares others remain puzzling. Symptoms such as loss of memory, impaired thinking, and diminished mental abilities are among the primary signs of this disorder or condition, which frequently occurs alongside other illnesses.

Since we were born, sleeping was a substantial part of our lives, and it is still essential even for seniors, but the problem is when some other condition disrupts our sleep, and by doing that it also tackles our health and everyday functioning. Sleep disorders have become our reality, and the more they interfere with other conditions, the harder it is to find the real cause and treat things separately.

So we are going to start from the primary cause, which in this case is dementia. We mentioned that there are a few types of it, but they all represent a pathophysiological condition. The most common type of it, and the one about everyone has at least heard of, is Alzheimer’s disease, some other not so common examples include Lewy body dementia; Parkinson’s disease, vascular dementia, Huntington’s disease, Shy-Drager syndrome, alcohol-related dementia, Creutzfeldt-Jakob disease, and AIDS-related dementia. 

In today’s post, apart from the usual, we will also go through some of the most common questions people have on this topic, hoping this will help you understand this complicated condition a bit better.

What Is Dementia?

We know that it runs among the elderly population, and some of the latest data provided by the Institute for Dementia Research and Prevention show that every sixth woman, and every tenth man older than 55 years, will have some of the symptoms which are related to this mental illness. Although it covers a lot of different diagnoses, in its core, it represents the loss of cognitive functions such as remembering, thinking, reasoning, talking, and also some behavioral features which can aggravate the normal daily functioning. There are a lot of stages of this disease, but while in some more mild phases the patient can keep up with regular operations, in the more severe cases, patients have to depend on someone else, even for the most basic daily things because they are no longer capable of taking care of themselves.

So how this happens? Once our brain nerve cells stop working, they lose the connection with other brain cells, and eventually they die, we all lose some number of brain cells as we get older, but people with this illness lose a significantly higher number of these cells; hence, they develop these symptoms. 

We mentioned that dementia is used as a term which covers several diseases; they differ by their cause or the type of brain change. The most known and common type of it, the Alzheimer, effects from 60% to 70% of all patients who suffer from it, and it is connected to the loss of cognitive functions. To get the idea how widespread Alzheimer’s disease is in the US, we would like to share the data that currently around 5.5 millions of Americans are living with it, and experts predict that by 2020. that number will increase up to 14 million. Vascular dementia is also a common type of it, and it affects the blood flow going to the brain, and in the worst case scenario, it causes a stroke. Lewy body dementia is also quite often, around 1.4 million Americans are diagnosed with it, but because of the high resemblance with Alzheimer and Parkinson’s disease, many patients are often misdiagnosed, so it is estimated that the number of people is even higher.

When it comes to predispositions, age is the primary factor, and the senior population is the category of people who are mostly suffering from this disease. Besides age, people who have cognitive impairment or neurodegenerative diseases are also at a higher risk of this disease.

About Dementia and Sleep Disorders

These two have a very complicated relationship, in most cases, they go together, and often cause each other’s symptom, which means that patients who suffer from one of these two have a higher chance for developing the other one.

Patients suffering from this disease usually have a poor sleep, and those who are already diagnosed with some sleep disorder will likely get some symptoms of dementia. Researchers are generally struggling to give the right answer because they also are not sure how it works, so the situation between these two reminds a little bit on the tale as old as time, what is older, the chicken or the egg?

Seniors usually have a poor sleep, and they tend to sleep less, wake up often, or go to sleep with a lot of worries on their mind, even 40% of them have some sleep-related problems. Insomnia is, of course, the predominant disorder among seniors, followed by sleep apnea, RLS, RBD, PLM, etc. which all start to develop as we age. For people who have a mental illness, two sleep disorders are symptomatic. 

For example, RBD denotes Lewy body syndrome, but it can also be observed as an early indicator of Parkinson’s disease. It is the same with Alzheimer and obstructive sleep apnea because OSA can contribute to Alzheimer’s pathopsychology. 

Patients with this illness who have done the polysomnogram tests have increased sleep fragmentation, longer sleep latency, decrease in sleep time, and sleep efficiency. Their main symptoms are excessive daytime sleepiness, confusion, nighttime wanderings, and sundowning, for which the causes are still unknown. They progressively have an increased time of nighttime awakenings, and less and less REM sleep during the night. People living with Alzheimer’s have the neuronal degeneration which damages the forebrain and reticular region of the brain system, which are the two areas in charge of regulating sleep, that is why their sleep patterns go through substantial changes.

Excessive daytime sleepiness hits from 30% to 50% of all Alzheimer patients, and as the disease progresses, this symptom becomes more prominent and aggravates, the same is with Parkinson’s patients and insomnia, for example, in one of the studies which focus on the relationship between Alzheimer and sleep, the connection between elderly population and insomniacs has been found in a higher rate of beta-amyloid plaques in their brains, in comparison to those of healthy people.

Sleep Apnea and Dementia

Snoring as the typical sign of sleep apnea can also be something that patients with mental illness will experience. Sleep apnea cannot be the direct cause of it, although many claim that it can. A study which caused many controversies states that sleep apnea drains the oxygen away from the brain during the night. This study included 83 participants who all had problems with memory or the first potential sign of Alzheimer’s. Since this was a small study, with a lot of limitations, it is hard to take their conclusions for granted, for example, although all participants reported having issues with their memory, their memory and sleep were measured only one time, and the most important thing is that no one of them was officially diagnosed with sleep apnea. This study was performed in Australia, and publishing of its results lead to many premature conclusions and misunderstandings because when we consider all the information, we cannot rely on those results. The results were accurate, but they failed to prove that sleep apnea caused patients symptoms.

Insomnia and Dementia

The idea that people who have insomnia have a higher risk of dementia has been a subject of many studies, a more recent one, suggests that that connection could be possible. The link lies in the number of amyloid-beta proteins, which rises when we are awake, and goes down during sleep. This protein also creates some of the brain plaques, which were found in patients with Alzheimer’s.  

Irregular sleep can be one of the early signs of this disorder; patients who noticed changes in their sleep reported having restless nights, excessive daytime sleepiness, and extended naps. Healthy people take daytime naps that last around 20 minutes, but people with Alzheimer’s can have naps, which can last even 3 hours, and that is the main predictor of this disease.

A team of Canadian researchers was trying to determine when and how early will the symptoms of Alzheimer’s start showing off. Their study processed data from more than 14,000 healthy people who were included in the extensive international health survey in which people older than 50 years old from 12 countries were included. They concluded that the participants who have had restless nights, tiredness during the day and the need to use sleep pills, are more liable to be diagnosed with Alzheimer’s at some point in the next two years.

A neurologist from Missouri, dr Holtzman agrees that sleep disturbances are the first sign of the brain changes which cause the disease. Together with colleagues researchers, Holtzman performed a study on mice, the mouse with Alzheimer had an irregular sleep-wake cycle and increased number of amyloid-beta plaques, when the plaques were eliminated, the course went back to normal, which leads to the conclusion that plaques cause sleep irregularities. However, to prove if this is the case with humans as well, would require plenty of long-term studies.

How to Diagnose a Sleep Disorder in Patients With Dementia

It is never an easy task to set a diagnosis of some sleep disorder, a lot of them have similar features, but they can also be easily confused with other conditions. But, with patients who suffer from mental illnesses, the situation is even more tricky since there are a lot of underlying causes, too common symptoms and mitigating factors. When we speak about patients with this disease, sleep regulations splits into four categories:

• Excessive daytime sleepiness, also known as hypersomnia
• Issues with falling and staying asleep
• Unusual behavior and nocturnal hallucinations
• Troubles with breathing during sleep, such as sleep apnea, and restless leg syndrome

Of course, patients can have one, or more of these symptoms combined, to be diagnosed with this mental illness. A complex of different symptoms complicates the road to diagnosis.

Next, we will like to present the diagnostic criteria which are used to evaluate sleep disorders among seniors and patients who have been diagnosed with dementia.

Insomnia

The intensity and symptoms of insomnia tend to vary from one person to another, but this disorder can usually split into two groups, one is called sleep onset insomnia, and it refers to people who have problems with falling asleep, while the other one is sleep maintenance insomnia, and it stands for inability to stay asleep during the night. Insomnia is usually considered for an initial condition, since it develops independently, as an initial condition, but it can also coexist with many other disorders.

Many people are struggling with their sleep, but to be diagnosed with insomnia, a patient must be experiencing insomnia symptoms or problems with staying and falling asleep for at least a month. There is also an option to be diagnosed with chronic insomnia, which happens rarely, and usually among older adults. Since many of seniors use a lot of different medications, that has to be taken into consideration as well, so the diagnosis requires a detailed inspection of the patient’s medical history with all of its prescriptions and previous conditions.

Hypersomnia

Hypersomnia is another broad term which can cover a lot of different conditions which cause excessive daytime sleepiness but are not connected with sleep deprivation and insomnia. Some of them are idiopathic hypersomnia and narcolepsy, which can show off on their own, but they can also be triggered by some other substances or medications with side effects. People who suffer from hypersomnia cannot stay awake and alert during the usual morning waking hours. There is not a lot of studies of hypersomnia among seniors, and the doctors have to use the same diagnostic criteria which they use for the younger population, they usually inspect the patient’s medical history and some of the symptoms which often follow narcolepsy. Some of them are cataplexy and weak muscles, but mostly the patients will be asked to create a sleep journal in which they will note all of their sleepy episodes during the day, and the amount of sleep they get during the night.

Sleep Apnea

Sleep apnea is one of the more severe types of sleep disorders cause it involves occasional breathing stops during sleep, and we differ two main types of it. Obstructive sleep apnea, which refers to the obstruction of the upper airway, and the central sleep apnea, which occurs because of some cardiovascular problems or due to the issues in the central nervous system.

Common signs and symptoms of sleep apnea include severe snoring, choking, and nocturia, and they are pretty often among the elderly and obese population.

Restless Leg Syndrome

RLS is a sleep disruptive disorder; people who suffer from it experience painful and tickling sensations in their legs, and those sensations are so intense and persistent that they can wake up the sleeper. RLS can be developed independently from other conditions, but in the vast majority of cases, it is a secondary condition which most likely occurs due to the iron deficiency. 

Diagnosing RLS can be challenging since there are no proven lab tests which can diagnose it; instead, the doctors have to rely on patients reports and based on that to determine whether or not is RLS a proper diagnosis for them. RLS patients feel very intense pain during the night, and an urge to move their legs while their body is resting, so physicians focus on those symptoms when trying to identify and seclude RLS from other similar disorders that cause leg pain.

Circadian Rhythm Sleep Disorders

This group of disorders manifests in regular sleep patterns which happen at unusual times, mostly because the patient’s internal circadian clock is in disbalance. Some of the common types of CRSD are irregular sleep-wake disorder and advanced sleep phase disorder. ASPD patients are mostly known as early birds since they tend to go to sleep earlier and wake up before others. ISWD patients have fragmented sleep because they can hardly pull off full 7 or 8 hours of sleep at night, and their rest is split into several portions during the 24-hours. 

CRSD especially hit the senior population, because of the natural aging changes which occur in their circadian rhythm, lower level of physical activity, and also less exposure to sunlight. Researchers rely on body temperature and the level of melatonin to determine if the patients have a disorder of their circadian clock. Since a lot of sleep disorders share similar symptoms, and these symptoms can sometimes be misleading, doctors have to do a full screening to exclude the possibility of other sleep disorders, and some psychological ones such as anxiety, depression, etc.

Parasomnia

Parasomnia is a category of sleep disorders or a parachute-term which covers disorders with abnormal behavior, movements, emotional or physical reactions, and perceptions which can occur during sleep. The most common type of it which strikes seniors and patients who have a mental illness is a REM sleep disorder or REM behavior disorder. RBD is characterized by physical movements which are usually violent and can harm the sleeper or its partner. Other types of parasomnias are sleepwalking, night terrors, and enuresis, but these disorders typically strike children and teens, and they are rare among adults.

RBD is diagnosed after a detailed inspection of patients medical history, tests which show the level of muscle activity during sleep, but it often goes hand in hand with dementia, Shy-Drager syndrome and Parkinson’s disease. 

Essential Questions

Due to the vast number of similar conditions, symptoms, diagnosis, and also the complicated relationship between a lot of these disorders, most of the doctors agree that the patient’s answers and experience are crucial for setting a proper diagnosis. A specific study even published a list of questions that can be of vital help to the doctors to determine a sleep disorder and eliminate other similar ones. Here we share the list of notes and questions, so you can think about them, prepare the answers, and have enough time to remember all the details.

• At what time do you usually go to bed at night and when do you wake up in the morning?
• Estimate, how many times do you wake up during the night?
• Have you ever had some struggles with falling asleep at night?  
• When you wake up at night, how long does it take before you fall asleep again?
• Does your partner claim that you are moving or kicking in your sleep?
• Does your partner claim that you have issues with snoring, breathing stops, or gasping for air? 
• Are you aware that you tend to move, walk, talk, kick, or punch while you are sleeping?
• Do you feel tired or sleepy most of the time?
• Do you ever involuntarily doze-off during the daytime?
• How many naps do you usually have during the daytime?
• How much sleep do you need to feel functional and alert during the day?
• Are you taking any medication or other things that are helping you with your sleep at the moment?

How to Treat Sleep Disorders in Patients With Dementia

Even though modern medicine is very advanced, and researchers are working hard on discoveries each day, there are still no effective cures for both, only the treatments that can alleviate these conditions to some point. Some medications are capable of improving cognitive abilities of patients with this condition, but the remedies for reducing symptoms of sleep disorders in people with mental illness are still not pinpointed.

Many effective treatments for sleep disorders include significant lifestyle changes; however, it has not been researched how that works on people who also have a mental illness, and if it would mild their other symptoms. 

Sleep-disordered breathing or sleep apnea is pretty often among patients, but it can be treated with CPAP machines, which patients with dementia can only stand for around five hours each night. The CPAP treatment has proven to be useful since it lowers the number of SDB episodes from 24 to 10 during each hour of sleep. Other benefits of this therapy are less snoring, better mood, and improved quality of life, but there are also some indications that it can slow down the process of cognitive impairment. 

Bright light therapy is getting more and more popular, and it is being used for various reasons. A study gathered 8 patients with Alzheimer’s, 4 with vascular dementia, and 5 with LBD, to explore how light therapy can improve their sleep patterns. The participants had only one task, to sit in front of a light box for one hour, every morning for two weeks. A slight improvement was noticed in 4 participants with a more mild type of Alzheimer who were diagnosed in the near past. In conclusion, further and larger studies will be needed, to determine in which stages of illness light therapy can be beneficial. Melatonin and melatonin supplements are also effective for improving the symptoms of sleep disorders, especially insomnia, but also for some signs of Alzheimer’s disease.

Today the precaution measures have become essential, especially for patients with RBD, because the risk of injuries during the night is always present. It is necessary to create a safe sleep environment, to remove any dangerous objects, weapons, lock the doors and windows, and visit a doctor for regular check-ups so that the progress of brain diseases can be monitored and recorded. Sedatives are widely used in many nursing homes because they can ensure the night of full sleep, but they should not become a habit because they can further damage the cognitive functions.

Tips For Relieving Symptoms of Dementia

Besides already mentioned treatments and medications, there are some beneficial things that every patient can do to mitigate the symptoms of sleep disorders.

• Create a sleep schedule. For regular circadian patterns, the most important thing is to maintain a healthy sleep routine. Patients should try to go to bed and wake up at the same time. It will be difficult in the beginning, but soon they will get used to it, and start noticing the benefits. 
• Natural light therapy. We mentioned indoor light therapy, but the outdoor therapy with natural light is just as efficient. Studies have shown that exposure to sunlight is highly beneficial for older people with Alzheimer and their sleep.
• Physical activity. Even though seniors are not able to be active as when they were younger, they can still do some lighter exercises, or walk, because that could exhaust them and make them sleepy.
• Personalized diet. Eating balanced and healthy meals is always a good thing, but there are some diets composed of sleep inducing foods. Calcium-rich products such as milk, cheese, and other dairy products can induce sleepiness, and oatmeal raises the blood sugar level, which causes drowsiness.