Sleep

Shakespearean Quotations:

Enjoy the honey-heavy dew of slumber:
Thou hast no figures nor no fantasies
Which busy care draws in the brains of men;
Therefore thou sleep’st so sound.

-Julius Cæsar (2.1.248-251)-

Huh? No matter how many times I read it, still don't get it...lol...
(Sorry Shakespeare~)

What is Sleep?

Sleep is the period when the alphabet ‘Z’ appears around our head continuously without us realizing it.


Generally, there are 2 types of sleep:

1. Rapid Eye Movement (REM) Sleep -
   This sleep makes up approximately one fifth of our sleeping time - comes and goes throughout the night. During REM sleep, our brain is very active, our body muscles are very relaxed, our eyes move quickly from side to side and we dream.
   
   
2. Non-REM Sleep -
   In contrary, during Non-REM Sleep, our brain is inactive, but our body may move around. Hormones are secreted by our body into the bloodstream for our body to ‘repair’ itself.
   
   There are 4 stages of Non-REM Sleep:
   i. Pre-Sleep - the muscles relax, the heart beats slower and body temperature falls.
   ii. Light Sleep –can be woken easily without feeling confused.
   iii. “Slow wave” Sleep – blood pressure falls, may sleep talk or sleep walk.
   iv. Deep “slow wave” Sleep – hard to wake, and feels confused when awakened.

We move between REM and non-REM sleep about five times throughout the night, dreaming more as we get toward the morning.

During a normal night, we will also have short periods of waking that last about 1 to 2 minutes, and happen every 2 hours or so without us realizing. However, we tend to remember them if we feel anxious or there is something else going on - noises outside, partner snoring, etc…


How Long to Sleep?

1. Infants – About 16 hours per day
2. Babies & Toddlers (6 months to 3 years old) – 10 to 14 hours per day
3. Children : Ages 3 to 6 – between 10 to 12 hours per day
   Ages 6 to 9 – about 10 hours per day
   Ages 9 to 12 – about 9 hours per day
4. Teenagers – 9 hours per day
5. Adults – 7-8 hours per day
6. Pregnant Women –may need few more hours of sleep per day

Effects of Sleeping Deprivation

If you cannot sleep last night or on occasional nights, you might feel tired the next day, but it would not harm your physical or mental health.

However, several sleepless nights, you will tend to:

• be tired all the time.drop off during the day;
• lose concentration;
• find it hard to make decisions;
• begin to feel depressed;
• be more vulnerable to hypertension (high blood pressure), obesity and diabetes.

Causes of Sleeping Deprivation
Minor:

• Your bedroom may be too noisy, too hot or too cold
• Your bed may be uncomfortable or too small
• Your partner may have a different sleeping pattern from yourself
  
• Eating too much
  
• Going to bed hungry can make you wake too early
  
• Cigarettes, alcohol and drinks containing caffeine, such as tea and coffee
• Suffering from illnesses or pain.

Serious:

• Problems at work
  
• Emotion instability – anxiety, worry, depression.
  

Forms of Medication
For many years, people have used Nitrazepam, Diazepam, Temazepam (older versions), and Zolpidem, Zalpelon, and Zopiclone (newer versions) as their sleeping deprivation remedy. However, now we know that these sleeping pills:

• leave you tired and irritable the next day.
• lose effectiveness quite quickly, thus the need to increase dosage.
• causes people to be addicted to them or physically or psychologically dependent on them.

It is advised that you should not consume sleeping tablets for more than 2 weeks. Only use it when you are so distressed that deprives you from sleeping. If you are already on sleeping pills for a long time, it is best to decrease your intake gradually after discussing with your doctor. Another alternative to sleeping pills is antidepressant.

Besides that, you can purchase other remedies at your chemist without the need of prescription. These products often contain anti-histamine (similar content used in medicines for hay-fever, coughs and flues. Be cautioned that you might still be drowsy the next morning, and it is best not to take anti-histamines for a long period.

Herbal alternatives are usually based on a herb called Valerian. However, its effects are not immediate, as it probably works best over 2-3 weeks of nightly consumption. Like anti-histamines, drowsiness may persist the following morning. If you are taking any medication for your blood pressure (or sleeping pills or tranquillizers), it is advised that you discuss with your doctor first.

Cognitive behavioural therapy, a form of psychological treatment can be helpful too. It involves looking at unhelpful ways of thinking that can make you more anxious, and so interfere with your sleep.


Other Sleeping Disorders

1. Narcolepsy (Daytime Sleepiness)
   This is an uncommon condition that doctors often do not recognise.
   Symptoms:
   
   • feel sleepy during the day, unexpected sleepiness attacks even in the company of people.
   • suddenly loses control over muscles, and collapse when you are angry, excited or laughing (known as cataplexy).
   • cannot speak or move when falling asleep or waking up (Sleep Paralysis)
     (this explains the body paralysis while sleeping whom people thought was ghost sitting/controlling them).
   • begin to hallucinate (hearing odd sounds, see dream-like images, etc…)
   • “run on auto-pilot” where you did something, but could not remember doing them, as if you had been asleep.
   • wake up with hot flushes during the night.
   
   Cause: Lack of substance called orexin or hypocretin.
   
   Treatment:
   
   
   • Regular exercise
   • Having regular night time routine
   • Medications (depending on symptoms) – antidepressant or drugs which increase wakefulness, such as Modafinil.
   
   
   
2. Sleep Apnoea (Interrupted Sleep)
   More common in older people, the overweight, smokers, and alcoholics.
   
   Symptoms:
   
   • Reoccurrence of loud snoring and stop breathing for short periods during the night. (Caused by the closure of the upper part of airway).
   • Every time you stop breathing, you wake suddenly, jerking your body, arms and legs but will fall asleep again.
   • Feel tired the next day with an irresistible urge to sleep.
   • May have dry mouth and headache when you wake up in the morning.
   Treatment:
   
   • correcting the parts of your lifestyle that worsens the problem – smoke and drink less, lose weight, and sleep in different position.
   • if in critical condition, wear a Continuous Positive Airway Pressure (CPAP) mask to supply high pressure air to keep your airway open.

Useful Tips
Do's:

• Ensure a comfortable bed and bedroom - not too hot, not too cold, not too noisy.
• Ensure that your mattress supports you properly. It should not be so firm that your hips and shoulders are under pressure or so soft that your body sags. Generally, you should replace your mattress every 10 years to get the best support and comfort.
• Exercise. Do not overdo it, but try some regular swimming or walking. The best time to exercise is in the daytime - particularly late afternoon or early evening. Exercising later in the evening may disrupt your sleep.
• Take some time to relax properly before going to bed. Aromatherapy may be helpful.
• If something is troubling you, and there is nothing you can do about it right away, try writing it down before going to bed and then tell yourself to deal with it tomorrow.
• If you cannot sleep, get up and do something you find relaxing. Read, watch television or listen to soothing music. After a while you should feel tired enough to go to bed again.

Don'ts:

• Do not go without sleep for a long time - go to bed when you are tired and stick to a routine of getting up at the same time every day, despite feeling tired or not.
• Caffeine remains in your body for several hours after your last drink of tea or coffee. Stop drinking tea or coffee by mid-afternoon. If you want a hot drink in the evening, try something milky or herbal (ensure there is no caffeine in it).
• Do not drink a lot of alcohol. It may help you fall asleep, but you will almost certainly wake up during the night.
• Do not eat or drink a lot late at night. Try having supper early in the evening rather than late.
• If you have had a bad night, do not sleep in the next day - it will make it harder to go to sleep the following night.
• Slimming tablets make it hard to sleep, as do street drugs like Ecstasy, cocaine and amphetamines.