Insomnia is the experience of not getting enough sleep. Despite considerable research, there is still much to be discovered around the sleep mechanism and why some people struggle to enjoy a proper sleep. This article looks at what happens when we sleep, what happens when we don't sleep and the causes that can trigger sleep problems. Dealing with the causes is then the main way to restore good sleep.
Chemical messengers, called neurotransmitters, in the brain control whether we are asleep or awake. Activity in certain neurones in the brain can either keep us active and awake. Then other neurones in the base of the brain will become active to switch off the signals keeping us awake. There are two general ways of sleep being regulated. One is the circadian (time of day) influence and the other is the homeostatic (sleep drive) influence.
Research is still looking at possible genetic triggers with sleep, but it is still very complex. Dr Mark Wu. a leading scientist in sleep research, states on his website that 'ultimately all of our behaviours - our thoughts, our feelings, our actions involve the computational power derived from the co-ordinated actions of many neurons.' Emerging research is also revealing a possible bidirectonal link between poor sleep and Alzheimer's disease.
When we are asleep we go through 5 stages, which vary in length. They are;
Stage 1: This is a light sleep where muscle activity slows and we have slow eye movements. In this stage we can easily awake and sometimes experience muscle jerks.
Stage 2 : Brain waves slow except for occasional spikes and eye movements stop.
Stage 3 : Extremely slow brain waves form (delta waves) interspersed with small and fast waves.
Stage 4 : Almost only delta waves - this and stage 3 are very deep sleep & difficult to come round from if disturbed in this phase. However you can sleep walk or bed wet in deep sleep, especially children.
REM : This is Rapid Eye Movement stage of sleep when the eyes jerk back and forth rapidly. Also our breathing rate increases with shallow breaths, heart rate increases and blood pressure increases, but muscles become temporarily paralysed.
Going through all 5 stages takes about 90 to 110 minutes on average, with the REM stage becoming longer as the sleep night progresses. Most sleep will have been spent in stages 1,2 and REM.
Read more about sleep stages here
Although the full requirements for sleep are still being explored, there some already established adverse effects of not experiencing proper sleep. They are as follows;
1. Forgetfulness. Dr Robert Stickgold discusses it here.
2. Inability to think and concentrate.
3. The immune system can be impaired.
5. Increased risk of weight gain.
6. Diminished sexual function, loss of libido, for men and women.
7. Anxiety risk increased.
You can read more about the adverse effects of insomnia here.
Even studies on rats from 1989 have shown increased physical problems including premature death.
The impact of poor sleep can therefore be huge and is still being wholly underestimated by employers and individuals alike.
So what can we do about insomnia? Firstly, identify and remedy the underlying causes. The common underlying causes are;
LIFESTYLE - eg: shift working, jet lag, drugs, staying up late for internet/TV, smoking, caffeine, heavy late meals.
STRESS - chronic stress affects every system in the body including sleep. In turn sleep loss increases stress, so a rapid spiral of decline between the two can emerge.
POOR SLEEP ENVIRONMENT - too hot, too cold, too light, too noisy
SLEEP DISORDERED BREATHING - e.g. sleep apnoea
ANXIETY,DEPRESSION & other MENTAL HEALTH DISORDERS - e.g. Alzheimers, Autism
PAIN - back and neck problems, joint conditions, nerve problems.
URINARY SYMPTOMS- prostate problems, drinking too much late at night, infections.
ALCOHOL - although this initially seems to help it then disturbs deep sleep
MEDICAL CONDITIONS such as restless legs, heartburn, epilepsy, arthritis, homone problems such as hyperactive thyroid, bowel disorders.
INFECTION - any chronic infection can disturb sleep patterns.
MEDICATION side effects
If no cause is obvious and you have been checked to exclude medical conditions then you can try 'sleep hygiene, which involves altering your environment and habits to suit better sleep.' There is good guidance on improving sleep from the Mental Health Foundation
Sleeping tablets are rarely prescribed now because they are ineffectual in the longterm. The body rapidly becomes tolerant to sleeping tablets, which then means increasing doses are required to give effect and leads to addiction, whilst still not resolving sleep issues in the long run. Some antidepressants can help, but of note Cognitive Behavioural Therapy research has been shown to help with sleep.
If you want to read more on the extent of the issues caused by sleep loss please read this article published in the National Centre for Biotechnology Information (NCBI).
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