Do you ever feel sleepy or
"zone out" during the day?
Do you find it hard to wake
up on Monday mornings? If
so, you are familiar with
the powerful need for sleep.
However, you may not realize
that sleep is as essential
for your well-being as food
and water.
Until the 1950s, most people
thought of sleep as a
passive, dormant part of our
daily lives. We now know
that our brains are very
active during sleep.
Moreover, sleep affects our
daily functioning and our
physical and mental health
in many ways that we are
just beginning to
understand.
Nerve-signaling chemicals
called neurotransmitters
control whether we are
asleep or awake by acting on
different groups of nerve
cells, or neurons, in the
brain. Neurons in the
brainstem, which connects
the brain with the spinal
cord, produce
neurotransmitters such as
serotonin and norepinephrine
that keep some parts of the
brain active while we are
awake. Other neurons at the
base of the brain begin
signaling when we fall
asleep. These neurons appear
to "switch off" the signals
that keep us awake. Research
also suggests that a
chemical called adenosine
builds up in our blood while
we are awake and causes
drowsiness. This chemical
gradually breaks down while
we sleep.
During sleep, we usually
pass through five phases of
sleep: stages 1, 2, 3, 4,
and REM (rapid eye
movement) sleep. These
stages progress in a cycle
from stage 1 to REM sleep,
then the cycle starts over
again with stage 1 (see
figure 1 ). We
spend almost 50 percent of
our total sleep time in
stage 2 sleep, about 20
percent in REM sleep, and
the remaining 30 percent in
the other stages. Infants,
by contrast, spend about
half of their sleep time in
REM sleep.
During stage 1, which is
light sleep, we drift in and
out of sleep and can be
awakened easily. Our eyes
move very slowly and muscle
activity slows. People
awakened from stage 1 sleep
often remember fragmented
visual images. Many also
experience sudden muscle
contractions called
hypnic myoclonia, often
preceded by a sensation of
starting to fall. These
sudden movements are similar
to the "jump" we make when
startled. When we enter
stage 2 sleep, our eye
movements stop and our brain
waves (fluctuations of
electrical activity that can
be measured by electrodes)
become slower, with
occasional bursts of rapid
waves called sleep
spindles. In stage 3,
extremely slow brain waves
called delta waves
begin to appear,
interspersed with smaller,
faster waves. By stage 4,
the brain produces delta
waves almost exclusively. It
is very difficult to wake
someone during stages 3 and
4, which together are called
deep sleep. There
is no eye movement or muscle
activity. People awakened
during deep sleep do not
adjust immediately and often
feel groggy and disoriented
for several minutes after
they wake up. Some children
experience bedwetting, night
terrors, or sleepwalking
during deep sleep.
When we switch into REM
sleep, our breathing becomes
more rapid, irregular, and
shallow, our eyes jerk
rapidly in various
directions, and our limb
muscles become temporarily
paralyzed. Our heart rate
increases, our blood
pressure rises, and males
develop penile erections.
When people awaken during
REM sleep, they often
describe bizarre and
illogical tales – dreams.
The first REM sleep period
usually occurs about 70 to
90 minutes after we fall
asleep. A complete sleep
cycle takes 90 to 110
minutes on average. The
first sleep cycles each
night contain relatively
short REM periods and long
periods of deep sleep. As
the night progresses, REM
sleep periods increase in
length while deep sleep
decreases. By morning,
people spend nearly all
their sleep time in stages
1, 2, and REM.
People awakened after
sleeping more than a few
minutes are usually unable
to recall the last few
minutes before they fell
asleep. This sleep-related
form of amnesia is the
reason people often forget
telephone calls or
conversations they've had in
the middle of the night. It
also explains why we often
do not remember our alarms
ringing in the morning if we
go right back to sleep after
turning them off.
Since sleep and wakefulness
are influenced by different
neurotransmitter signals in
the brain, foods and
medicines that change the
balance of these signals
affect whether we feel alert
or drowsy and how well we
sleep. Caffeinated drinks
such as coffee and drugs
such as diet pills and
decongestants stimulate some
parts of the brain and can
cause insomnia, or
an inability to sleep. Many
antidepressants suppress REM
sleep. Heavy smokers often
sleep very lightly and have
reduced amounts of REM
sleep. They also tend to
wake up after 3 or 4 hours
of sleep due to nicotine
withdrawal. Many people who
suffer from insomnia try to
solve the problem with
alcohol – the so-called
night cap. While alcohol
does help people fall into
light sleep, it also robs
them of REM and the deeper,
more restorative stages of
sleep. Instead, it keeps
them in the lighter stages
of sleep, from which they
can be awakened easily.
People lose some of the
ability to regulate their
body temperature during REM,
so abnormally hot or cold
temperatures in the
environment can disrupt this
stage of sleep. If our REM
sleep is disrupted one
night, our bodies don't
follow the normal sleep
cycle progression the next
time we doze off. Instead,
we often slip directly into
REM sleep and go through
extended periods of REM
until we "catch up" on this
stage of sleep.
People who are under
anesthesia or in a coma are
often said to be asleep.
However, people in these
conditions cannot be
awakened and do not produce
the complex, active brain
wave patterns seen in normal
sleep. Instead, their brain
waves are very slow and
weak, sometimes all but
undetectable.
The amount of sleep each
person needs depends on many
factors, including age.
Infants generally require
about 16 hours a day, while
teenagers need about 9 hours
on average. For most adults,
7 to 8 hours a night appears
to be the best amount of
sleep, although some people
may need as few as 5 hours
or as many as 10 hours of
sleep each day. Women in the
first 3 months of pregnancy
often need several more
hours of sleep than usual.
The amount of sleep a person
needs also increases if he
or she has been deprived of
sleep in previous days.
Getting too little sleep
creates a "sleep debt,"
which is much like being
overdrawn at a bank.
Eventually, your body will
demand that the debt be
repaid. We don't seem to
adapt to getting less sleep
than we need; while we may
get used to a
sleep-depriving schedule,
our judgment, reaction time,
and other functions are
still impaired.
People tend to sleep more
lightly and for shorter time
spans as they get older,
although they generally need
about the same amount of
sleep as they needed in
early adulthood. About half
of all people over 65 have
frequent sleeping problems,
such as insomnia, and deep
sleep stages in many elderly
people often become very
short or stop completely.
This change may be a normal
part of aging, or it may
result from medical problems
that are common in elderly
people and from the
medications and other
treatments for those
problems.
Experts say that if you feel
drowsy during the day, even
during boring activities,
you haven't had enough
sleep. If you routinely fall
asleep within 5 minutes of
lying down, you probably
have severe sleep
deprivation, possibly even a
sleep disorder.
Microsleeps, or very
brief episodes of sleep in
an otherwise awake person,
are another mark of sleep
deprivation. In many cases,
people are not aware that
they are experiencing
microsleeps. The widespread
practice of "burning the
candle at both ends" in
western industrialized
societies has created so
much sleep deprivation that
what is really abnormal
sleepiness is now almost the
norm.
Many studies make it clear
that sleep deprivation is
dangerous. Sleep-deprived
people who are tested by
using a driving simulator or
by performing a hand-eye
coordination task perform as
badly as or worse than those
who are intoxicated. Sleep
deprivation also magnifies
alcohol's effects on the
body, so a fatigued person
who drinks will become much
more impaired than someone
who is well-rested. Driver
fatigue is responsible for
an estimated 100,000 motor
vehicle accidents and 1500
deaths each year, according
to the National Highway
Traffic Safety
Administration. Since
drowsiness is the brain's
last step before falling
asleep, driving while drowsy
can – and often does – lead
to disaster. Caffeine and
other stimulants cannot
overcome the effects of
severe sleep deprivation.
The National Sleep
Foundation says that if you
have trouble keeping your
eyes focused, if you can't
stop yawning, or if you
can't remember driving the
last few miles, you are
probably too drowsy to drive
safely.
Although scientists are
still trying to learn
exactly why people need
sleep, animal studies show
that sleep is necessary for
survival. For example, while
rats normally live for two
to three years, those
deprived of REM sleep
survive only about 5 weeks
on average, and rats
deprived of all sleep stages
live only about 3 weeks.
Sleep-deprived rats also
develop abnormally low body
temperatures and sores on
their tail and paws. The
sores may develop because
the rats' immune systems
become impaired. Some
studies suggest that sleep
deprivation affects the
immune system in detrimental
ways.
Sleep appears necessary for
our nervous systems to work
properly. Too little sleep
leaves us drowsy and unable
to concentrate the next day.
It also leads to impaired
memory and physical
performance and reduced
ability to carry out math
calculations. If sleep
deprivation continues,
hallucinations and mood
swings may develop. Some
experts believe sleep gives
neurons used while we are
awake a chance to shut down
and repair themselves.
Without sleep, neurons may
become so depleted in energy
or so polluted with
byproducts of normal
cellular activities that
they begin to malfunction.
Sleep also may give the
brain a chance to exercise
important neuronal
connections that might
otherwise deteriorate from
lack of activity.
Deep sleep coincides with
the release of growth
hormone in children and
young adults. Many of the
body's cells also show
increased production and
reduced breakdown of
proteins during deep sleep.
Since proteins are the
building blocks needed for
cell growth and for repair
of damage from factors like
stress and ultraviolet rays,
deep sleep may truly be
"beauty sleep." Activity in
parts of the brain that
control emotions,
decision-making processes,
and social interactions is
drastically reduced during
deep sleep, suggesting that
this type of sleep may help
people maintain optimal
emotional and social
functioning while they are
awake. A study in rats also
showed that certain
nerve-signaling patterns
which the rats generated
during the day were repeated
during deep sleep. This
pattern repetition may help
encode memories and improve
learning.
We typically spend more than
2 hours each night dreaming.
Scientists do not know much
about how or why we dream.
Sigmund Freud, who greatly
influenced the field of
psychology, believed
dreaming was a "safety
valve" for unconscious
desires. Only after 1953,
when researchers first
described REM in sleeping
infants, did scientists
begin to carefully study
sleep and dreaming. They
soon realized that the
strange, illogical
experiences we call dreams
almost always occur during
REM sleep. While most
mammals and birds show signs
of REM sleep, reptiles and
other cold-blooded animals
do not.
REM sleep begins with
signals from an area at the
base of the brain called the
pons (see
figure 2 ).
These signals travel to a
brain region called the
thalamus, which relays
them to the cerebral
cortex – the outer
layer of the brain that is
responsible for learning,
thinking, and organizing
information. The pons also
sends signals that shut off
neurons in the spinal cord,
causing temporary paralysis
of the limb muscles. If
something interferes with
this paralysis, people will
begin to physically "act
out" their dreams – a rare,
dangerous problem called
REM sleep behavior disorder.
A person dreaming about a
ball game, for example, may
run headlong into furniture
or blindly strike someone
sleeping nearby while trying
to catch a ball in the
dream.
REM sleep stimulates the
brain regions used in
learning. This may be
important for normal brain
development during infancy,
which would explain why
infants spend much more time
in REM sleep than adults (see
Sleep: A Dynamic Activity
). Like deep sleep, REM
sleep is associated with
increased production of
proteins. One study found
that REM sleep affects
learning of certain mental
skills. People taught a
skill and then deprived of
non-REM sleep could recall
what they had learned after
sleeping, while people
deprived of REM sleep could
not.
Some scientists believe
dreams are the cortex's
attempt to find meaning in
the random signals that it
receives during REM sleep.
The cortex is the part of
the brain that interprets
and organizes information
from the environment during
consciousness. It may be
that, given random signals
from the pons during REM
sleep, the cortex tries to
interpret these signals as
well, creating a "story" out
of fragmented brain
activity.
Circadian rhythms
are regular changes in
mental and physical
characteristics that occur
in the course of a day (circadian
is Latin for "around a
day"). Most circadian
rhythms are controlled by
the body's biological
"clock." This clock, called
the suprachiasmatic
nucleus or SCN
(see
figure 2 ), is
actually a pair of
pinhead-sized brain
structures that together
contain about 20,000
neurons. The SCN rests in a
part of the brain called the
hypothalamus, just
above the point where the
optic nerves cross. Light
that reaches photoreceptors
in the retina (a
tissue at the back of the
eye) creates signals that
travel along the optic nerve
to the SCN.
Signals from the SCN travel
to several brain regions,
including the pineal
gland, which responds
to light-induced signals by
switching off production of
the hormone melatonin. The
body's level of melatonin
normally increases after
darkness falls, making
people feel drowsy. The SCN
also governs functions that
are synchronized with the
sleep/wake cycle, including
body temperature, hormone
secretion, urine production,
and changes in blood
pressure.
By depriving people of light
and other external time
cues, scientists have
learned that most people's
biological clocks work on a
25-hour cycle rather than a
24-hour one. But because
sunlight or other bright
lights can reset the SCN,
our biological cycles
normally follow the 24-hour
cycle of the sun, rather
than our innate cycle.
Circadian rhythms can be
affected to some degree by
almost any kind of external
time cue, such as the
beeping of your alarm clock,
the clatter of a garbage
truck, or the timing of your
meals. Scientists call
external time cues
zeitgebers (German for
"time givers").
When travelers pass from one
time zone to another, they
suffer from disrupted
circadian rhythms, an
uncomfortable feeling known
as jet lag. For
instance, if you travel from
California to New York, you
"lose" 3 hours according to
your body's clock. You will
feel tired when the alarm
rings at 8 a.m. the next
morning because, according
to your body's clock, it is
still 5 a.m. It usually
takes several days for your
body's cycles to adjust to
the new time.
To reduce the effects of jet
lag, some doctors try to
manipulate the biological
clock with a technique
called light therapy. They
expose people to special
lights, many times brighter
than ordinary household
light, for several hours
near the time the subjects
want to wake up. This helps
them reset their biological
clocks and adjust to a new
time zone.
Symptoms much like jet lag
are common in people who
work nights or who perform
shift work. Because these
people's work schedules are
at odds with powerful
sleep-regulating cues like
sunlight, they often become
uncontrollably drowsy during
work, and they may suffer
insomnia or other problems
when they try to sleep.
Shift workers have an
increased risk of heart
problems, digestive
disturbances, and emotional
and mental problems, all of
which may be related to
their sleeping problems. The
number and severity of
workplace accidents also
tend to increase during the
night shift. Major
industrial accidents
attributed partly to errors
made by fatigued night-shift
workers include the Exxon
Valdez oil spill and the
Three Mile Island and
Chernobyl nuclear power
plant accidents. One study
also found that medical
interns working on the night
shift are twice as likely as
others to misinterpret
hospital test records, which
could endanger their
patients. It may be possible
to reduce shift-related
fatigue by using bright
lights in the workplace,
minimizing shift changes,
and taking scheduled naps.
Many people with total
blindness experience
life-long sleeping problems
because their retinas are
unable to detect light.
These people have a kind of
permanent jet lag and
periodic insomnia because
their circadian rhythms
follow their innate cycle
rather than a 24-hour one.
Daily supplements of
melatonin may improve
night-time sleep for such
patients. However, since the
high doses of melatonin
found in most supplements
can build up in the body,
long-term use of this
substance may create new
problems. Because the
potential side effects of
melatonin supplements are
still largely unknown, most
experts discourage melatonin
use by the general public.
Sleep and sleep-related
problems play a role in a
large number of human
disorders and affect almost
every field of medicine. For
example, problems like
stroke and asthma attacks
tend to occur more
frequently during the night
and early morning, perhaps
due to changes in hormones,
heart rate, and other
characteristics associated
with sleep. Sleep also
affects some kinds of
epilepsy in complex ways.
REM sleep seems to help
prevent seizures that begin
in one part of the brain
from spreading to other
brain regions, while deep
sleep may promote the spread
of these seizures. Sleep
deprivation also triggers
seizures in people with some
types of epilepsy.
Neurons that control sleep
interact closely with the
immune system. As anyone who
has had the flu knows,
infectious diseases tend to
make us feel sleepy. This
probably happens because
cytokines, chemicals
our immune systems produce
while fighting an infection,
are powerful sleep-inducing
chemicals. Sleep may help
the body conserve energy and
other resources that the
immune system needs to mount
an attack.
Sleeping problems occur in
almost all people with
mental disorders, including
those with depression and
schizophrenia. People with
depression, for example,
often awaken in the early
hours of the morning and
find themselves unable to
get back to sleep. The
amount of sleep a person
gets also strongly
influences the symptoms of
mental disorders. Sleep
deprivation is an effective
therapy for people with
certain types of depression,
while it can actually cause
depression in other people.
Extreme sleep deprivation
can lead to a seemingly
psychotic state of paranoia
and hallucinations in
otherwise healthy people,
and disrupted sleep can
trigger episodes of mania
(agitation and
hyperactivity) in people
with manic depression.
Sleeping problems are common
in many other disorders as
well, including Alzheimer's
disease, stroke, cancer, and
head injury. These sleeping
problems may arise from
changes in the brain regions
and neurotransmitters that
control sleep, or from the
drugs used to control
symptoms of other disorders.
In patients who are
hospitalized or who receive
round-the-clock care,
treatment schedules or
hospital routines also may
disrupt sleep. The old joke
about a patient being
awakened by a nurse so he
could take a sleeping pill
contains a grain of truth.
Once sleeping problems
develop, they can add to a
person's impairment and
cause confusion,
frustration, or depression.
Patients who are unable to
sleep also notice pain more
and may increase their
requests for pain
medication. Better
management of sleeping
problems in people who have
other disorders could
improve these patients'
health and quality of life.
At least 40 million
Americans each year suffer
from chronic, long-term
sleep disorders each year,
and an additional 20 million
experience occasional
sleeping problems. These
disorders and the resulting
sleep deprivation interfere
with work, driving, and
social activities. They also
account for an estimated $16
billion in medical costs
each year, while the
indirect costs due to lost
productivity and other
factors are probably much
greater. Doctors have
described more than 70 sleep
disorders, most of which can
be managed effectively once
they are correctly
diagnosed. The most common
sleep disorders include
insomnia, sleep apnea,
restless legs syndrome, and
narcolepsy.
Almost everyone occasionally
suffers from short-term
insomnia. This problem can
result from stress, jet lag,
diet, or many other factors.
Insomnia almost always
affects job performance and
well-being the next day.
About 60 million Americans a
year have insomnia
frequently or for extended
periods of time, which leads
to even more serious sleep
deficits. Insomnia tends to
increase with age and
affects about 40 percent of
women and 30 percent of men.
It is often the major
disabling symptom of an
underlying medical disorder.
For short-term insomnia,
doctors may prescribe
sleeping pills. Most
sleeping pills stop working
after several weeks of
nightly use, however, and
long-term use can actually
interfere with good sleep.
Mild insomnia often can be
prevented or cured by
practicing good sleep habits
(see "Tips
for a Good Night's Sleep").
For more serious cases of
insomnia, researchers are
experimenting with light
therapy and other ways to
alter circadian cycles.
<back>
Sleep apnea is a disorder of
interrupted breathing during
sleep. It usually occurs in
association with fat buildup
or loss of muscle tone with
aging. These changes allow
the windpipe to collapse
during breathing when
muscles relax during sleep (see
figure 3 ).
This problem, called
obstructive sleep apnea,
is usually associated with
loud snoring (though not
everyone who snores has this
disorder). Sleep apnea also
can occur if the neurons
that control breathing
malfunction during sleep.
During an episode of
obstructive apnea, the
person's effort to inhale
air creates suction that
collapses the windpipe. This
blocks the air flow for 10
seconds to a minute while
the sleeping person
struggles to breathe. When
the person's blood oxygen
level falls, the brain
responds by awakening the
person enough to tighten the
upper airway muscles and
open the windpipe. The
person may snort or gasp,
then resume snoring. This
cycle may be repeated
hundreds of times a night.
The frequent awakenings that
sleep apnea patients
experience leave them
continually sleepy and may
lead to personality changes
such as irritability or
depression. Sleep apnea also
deprives the person of
oxygen, which can lead to
morning headaches, a loss of
interest in sex, or a
decline in mental
functioning. It also is
linked to high blood
pressure, irregular
heartbeats, and an increased
risk of heart attacks and
stroke. Patients with
severe, untreated sleep
apnea are two to three times
more likely to have
automobile accidents than
the general population. In
some high-risk individuals,
sleep apnea may even lead to
sudden death from
respiratory arrest during
sleep.
An estimated 18 million
Americans have sleep apnea.
However, few of them have
had the problem diagnosed.
Patients with the typical
features of sleep apnea,
such as loud snoring,
obesity, and excessive
daytime sleepiness, should
be referred to a specialized
sleep center that can
perform a test called
polysomnography. This
test records the patient's
brain waves, heartbeat, and
breathing during an entire
night. If sleep apnea is
diagnosed, several
treatments are available.
Mild sleep apnea frequently
can be overcome through
weight loss or by preventing
the person from sleeping on
his or her back. Other
people may need special
devices or surgery to
correct the obstruction.
People with sleep apnea
should never take sedatives
or sleeping pills, which can
prevent them from awakening
enough to breathe.
<back>
Restless legs syndrome (RLS),
a familial disorder causing
unpleasant crawling,
prickling, or tingling
sensations in the legs and
feet and an urge to move
them for relief, is emerging
as one of the most common
sleep disorders, especially
among older people. This
disorder, which affects as
many as 12 million
Americans, leads to constant
leg movement during the day
and insomnia at night.
Severe RLS is most common in
elderly people, though
symptoms may develop at any
age. In some cases, it may
be linked to other
conditions such as anemia,
pregnancy, or diabetes.
Many RLS patients also have
a disorder known as
periodic limb movement
disorder or PLMD,
which causes repetitive
jerking movements of the
limbs, especially the legs.
These movements occur every
20 to 40 seconds and cause
repeated awakening and
severely fragmented sleep.
In one study, RLS and PLMD
accounted for a third of the
insomnia seen in patients
older than age 60.
RLS and PLMD often can be
relieved by drugs that
affect the neurotransmitter
dopamine, suggesting that
dopamine abnormalities
underlie these disorders'
symptoms. Learning how these
disorders occur may lead to
better therapies in the
future.
<back>
Narcolepsy affects an
estimated 250,000 Americans.
People with narcolepsy have
frequent "sleep attacks" at
various times of the day,
even if they have had a
normal amount of night-time
sleep. These attacks last
from several seconds to more
than 30 minutes. People with
narcolepsy also may
experience cataplexy (loss
of muscle control during
emotional situations),
hallucinations, temporary
paralysis when they awaken,
and disrupted night-time
sleep. These symptoms seem
to be features of REM sleep
that appear during waking,
which suggests that
narcolepsy is a disorder of
sleep regulation. The
symptoms of narcolepsy
typically appear during
adolescence, though it often
takes years to obtain a
correct diagnosis. The
disorder (or at least a
predisposition to it) is
usually hereditary, but it
occasionally is linked to
brain damage from a head
injury or neurological
disease.
Once narcolepsy is
diagnosed, stimulants,
antidepressants, or other
drugs can help control the
symptoms and prevent the
embarrassing and dangerous
effects of falling asleep at
improper times. Naps at
certain times of the day
also may reduce the
excessive daytime
sleepiness.
In 1999, a research team
working with canine models
identified a gene that
causes narcolepsy–a
breakthrough that brings a
cure for this disabling
condition within reach. The
gene, hypocretin receptor 2,
codes for a protein that
allows brain cells to
receive instructions from
other cells. The defective
versions of the gene encode
proteins that cannot
recognize these messages,
perhaps cutting the cells
off from messages that
promote wakefulness. The
researchers know that the
same gene exists in humans,
and they are currently
searching for defective
versions in people with
narcolepsy.
Sleep research is expanding
and attracting more and more
attention from scientists.
Researchers now know that
sleep is an active and
dynamic state that greatly
influences our waking hours,
and they realize that we
must understand sleep to
fully understand the brain.
Innovative techniques, such
as brain imaging, can now
help researchers understand
how different brain regions
function during sleep and
how different activities and
disorders affect sleep.
Understanding the factors
that affect sleep in health
and disease also may lead to
revolutionary new therapies
for sleep disorders and to
ways of overcoming jet lag
and the problems associated
with shift work. We can
expect these and many other
benefits from research that
will allow us to truly
understand sleep's impact on
our lives.
Adapted from "When You
Can't Sleep: The ABCs of
ZZZs," by the National Sleep
Foundation.
Go to bed at a set
time each night and get
up at the same time each
morning. Disrupting this
schedule may lead to
insomnia. "Sleeping in"
on weekends also makes
it harder to wake up
early on Monday morning
because it re-sets your
sleep cycles for a later
awakening.
Try to exercise 20 to
30 minutes a day. Daily
exercise often helps
people sleep, although a
workout soon before
bedtime may interfere
with sleep. For maximum
benefit, try to get your
exercise about 5 to 6
hours before going to
bed.
- Avoid caffeine,
nicotine, and alcohol:
Avoid drinks that
contain caffeine, which
acts as a stimulant and
keeps people awake.
Sources of caffeine
include coffee,
chocolate, soft drinks,
non-herbal teas, diet
drugs, and some pain
relievers. Smokers tend
to sleep very lightly
and often wake up in the
early morning due to
nicotine withdrawal.
Alcohol robs people of
deep sleep and REM sleep
and keeps them in the
lighter stages of sleep.
A warm bath, reading,
or another relaxing
routine can make it
easier to fall sleep.
You can train yourself
to associate certain
restful activities with
sleep and make them part
of your bedtime ritual.
If possible, wake up
with the sun, or use
very bright lights in
the morning. Sunlight
helps the body's
internal biological
clock reset itself each
day. Sleep experts
recommend exposure to an
hour of morning sunlight
for people having
problems falling asleep.
If you can't get to
sleep, don't just lie in
bed. Do something else,
like reading, watching
television, or listening
to music, until you feel
tired. The anxiety of
being unable to fall
asleep can actually
contribute to insomnia.
- Control your room
temperature:
Maintain a
comfortable temperature
in the bedroom. Extreme
temperatures may disrupt
sleep or prevent you
from falling asleep.
- See a doctor if your
sleeping problem
continues:
If you have trouble
falling asleep night
after night, or if you
always feel tired the
next day, then you may
have a sleep disorder
and should see a
physician. Your primary
care physician may be
able to help you; if
not, you can probably
find a sleep specialist
at a major hospital near
you. Most sleep
disorders can be treated
effectively, so you can
finally get that good
night's sleep you need.
For information on other
neurological disorders or
research programs funded by
the National Institute of
Neurological Disorders and
Stroke, contact the
Institute's Brain Resources
and Information Network
(BRAIN) at:
BRAIN
P.O. Box 5801
Bethesda, MD 20824
(800) 352-9424
www.ninds.nih.gov
Prepared by:
Office of Communications and
Public Liaison
National Institute of
Neurological Disorders and
Stroke
National Institutes of
Health
Bethesda, MD 20892
NINDS health-related
material is provided for
information purposes only
and does not necessarily
represent endorsement by or
an official position of the
National Institute of
Neurological Disorders and
Stroke or any other Federal
agency. Advice on the
treatment or care of an
individual patient should be
obtained through
consultation with a
physician who has examined
that patient or is familiar
with that patient's medical
history.
