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

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

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

Short Sleeper Syndrome

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

Symptoms

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

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

Causes

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

Diagnosis

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

Polysomnography (sleep study)

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

Actigraphy

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

Treatment

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

Light therapy

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

Chronotherapy

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

Sleep hygiene

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

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

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

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

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

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

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

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

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

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

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

Is it Possible to Repay Your Sleep Debt? 

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

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

How to Get Enough Sleep? 

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

Establish a Sleep Routine 

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

Be Careful with Daily Naps 

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

Create a Sleep Sanctuary 

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

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

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

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

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

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

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

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

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

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

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

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

Note  

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

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

Nonrestorative Sleep and Insomnia

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

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

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

Nonrestorative Sleep and Fibromyalgia

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

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

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

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

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

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

Nonrestorative Sleep Treatment In Fibromyalgia

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

• Elavil
• Cymbalta
• Lyrica
• Savella
• Xyrem

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

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

Nonrestorative Sleep and Chronic Fatigue Syndrome

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

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

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

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

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

The differences in sleep at people who have CFS/ME

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

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

Nonrestorative Sleep Treatment In Chronic Fatigue Syndrome

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

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

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

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

How To Get More REM and Deep Sleep?  

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

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

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

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

Watch this video before reaching for another melatonin pill!

What is Melatonin?

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

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

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

How does Melatonin work for Sleep?

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

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

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

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

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

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

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

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

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

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

Homeostasis

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

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

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

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

Now back to homeostasis.

How Melatonin Affects other Hormones?

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

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

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

Alternatives to Melatonin

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

Magnesium

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

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

L-theanine

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

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

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

Glycine

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

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

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

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

Why Do We Need to Sleep?

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

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

What Causes Parasomnia?

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

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

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

How Sleep Impacts Memory?

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

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

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

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

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

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

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

Genetics and Sleep

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

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

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

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

Can Sleep Disorders Cause Vision Loss?

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

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

The Mysteries of Dreams

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

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

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

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

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

Circadian rhythm sleep disorders

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

Symptoms

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

Causes

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

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

Risk Factors

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

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

Diagnosis

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

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

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

Treatment

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

Practicing Good Sleep Hygiene

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

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

Use The Bed Only For Sleep And Sex

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

Avoid Stimulants

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

Have a Comfortable Sleep Environment

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

Light Therapy

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

Melatonin Supplements

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

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

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

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

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

Things to Record in Your Sleep Diary 

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

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

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

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

Reasons to Keep a Sleep Diary 

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

You Will Have a Better Idea about Your Sleep Patterns 

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

You Will Help Your Doctor to Give You a Proper Diagnosis 

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

You Will Notice the Improvement Easily 

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

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

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

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

What is Multiple Sclerosis?

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

Symptoms

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

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

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

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

Risk Factors

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

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

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

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

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

Diagnosis

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

Treatment

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

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

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

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

Sleep Disturbances in Patients With Multiple Sclerosis

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

Most common sleep disorders in people with MS are:

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

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

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

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

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

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

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

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

MS and Fatigue

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

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

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

MS and Sleep Apnea

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

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

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

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

MS and Restless Legs Syndrome (RLS)

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

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

Sleeping Tips for People With Multiple Sclerosis

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

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

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

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

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

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

How Tech Devices Impact Sleep?

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

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

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

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

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

Passive and Interactive Activity

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

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

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

Does Technology Affect Children’s Sleep more than Adults?

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

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

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

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

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

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

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

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

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

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

How to Power Down for a Better Night’s Rest

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

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

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

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

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

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

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

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

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

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

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

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

What is Sleep Restriction Therapy? 

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

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

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

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

How Does Sleep Restriction Therapy Work?
 

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

1. Usual sleep duration 

1. Wake up time during the workday 

1. Sleep efficiency  

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

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

1. Usual Sleep Duration 

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

1. Schedule wake up time that works for you 

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

1. Sleep Efficiency 

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

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

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

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

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

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

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

Tips for Stimulus Control 

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

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

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