About sleep

How did you sleep? The answer to that question says more about us than we think. "Excellent", "pretty good", "just about", "lousy".

For a long time, sleep has been defined as "absence of consciousness". One of the keys to interpretation of sleep issues is the interchangeable use of the terms sleep and 'sleep' and 'rest'. Although we attribute the same meaning to them, the two phenomena are completely different. and understanding these distinctions can help us to achieve better sleep. sleep.

Sleep is the physical and mental state in which we experience a detachment sensory detachment from our surroundings. It influences our mood and performance performance, is essential for the health of our immune system and helps us to regulate our appetite. Sleep is a state characterised in terms of behavioural:

• loss of consciousness

• adopting a characteristic posture and reducing movementr

• reduced sensitivity to stimuli

In the 1950s, data suggest that most people slept about eight hours a night. Today, we sleep an hour and a half to two hours less each night, so we're in a six-and-a-half-hour-a-night league.

The so-called biological clock is responsible for regulating sleep cycles, controls fatigue and tells us when we need rest or when we feel refreshed and energetic. It works in 24-hour cycles, known as the circadian rhythm. The need for sleep is related to sleep homeostasis and may be linked to the level of of an organic compound produced by the brain, adenosine. The circadian rhythm (the biological rhythm that repeats every 24 hours) is a complex rhythm that governs our level of alertness during the day and night. The complexity is complexity is due to the many mechanisms that are set in motion, which can be as follows, molecular, biochemical, physiological and behavioural mechanisms. We spend about a third of our lives sleeping. And yet - out of all that time, how much can we say is quality sleep? In a world based on hyper-arousal our nerve centres, it's no wonder that 67% of adults experience sleep disturbances at least once a night (Philips Global Sleep Survey, 2019) and that 8 in 10 adults are trying to improve their sleep globally, of which only 40% have tried to seek medical help to regulate their sleep (Philips Global Sleep Survey, 2019). On the other hand, the human species is the only that deliberately deprives itself of sleep. Although we spend, on average, a third of our of our lives sleeping, the feeling of rest does not always come with sleep.

We privilege and devalue sleep, depending on our position in life, age and circumstances, explains Eric L. Hsu, an Australian researcher specialising in the sociology of sleep.

How much sleep we should get depending on our age

Restful sleep means:

-16-18 hours in newborns, but sleep is not continuous, but rather consists of several episodes, the longest being 2.5-4 hours. At 6 months, there is already sleep of about 6 hours. At 12 months, sleep duration is reduced to 14-15 hours per day, concentrated in the evening and in one or two naps (sleep during daytime sleep)
• 10 - 11 hours for children. Some researchers believe the decrease is also due to social reasons, with children interrupting their sleep to socialise and assimilate (daytime sleep).
• 8.5 - 9.5 hours for teenagers. Recent studies show a decrease of up to 6 hours through socially induced sleep deprivation, but also of impact that technology is having. Duration of stage 3 non-REM and but increases the duration of Non-REM stage 2, due to the mechanisms of mechanisms that accompany puberty.
• 7-9 hours for adults. Adults 65-75 years wake up 90 minutes earlier and go to sleep 70 minutes earlier minutes compared to people aged 20-30. Adults over 65 will have more awakenings throughout the night and thus a shorter sleep duration, although the need for sleep remains the same.

Compared to a 5-year-old child, a person over 65 will sleep 36% more less. However, many people do not get enough sleep. Almost 30% of adults sleep less than six hours each night and only about 30% of teenagers sleep at least eight hours on a school night. From birth to old age, there are significant changes in the way sleep is maintained, the percentages of time spent in each of the sleep stages and the overall sleep efficiency (i.e. how easily sleep is initiated and maintained). After relative stability with large amounts of slow-wave sleep in childhood and early adolescence, sleep continuity and depth degrade over time. with advancing age. There are individual differences, in that people who need less than 6 hours of sleep and people who feel only feel rested if they sleep more than 10 hours. The same person may also need less or more sleep depending on various factors.

Globally there is a movement of specialists and scientists who are encouraging doctors to 'prescribe sleep'. In terms of medical recommendations, sleep is essential (for our proper functioning), pain-free and without effects adverse effects. And when we talk about prescribing sleep, we're not talking about sleeping pills, we're talking about including a sleep schedule of at least 7 hours during the night, with daily, 7 days a week.

Stages of sleep

Sleep is divided into several stages during the course of a night, which follow one another in a cyclically: stages 1,2,3, which constitute non-REM sleep, occur first, followed by REM sleep.

• Non-REM sleep - has three phases and precedes REM sleep.

– The first stage of NREM sleep is the actual transition to sleep, when the body begins to relax and muscles may twitch involuntarily. It is absent at newborns and people suffering from narcolepsy, but also in other conditions. At this stage, we wake up very easily.

– In the 2nd stage of Non-REM sleep, the brain starts producing rhythmic, fast waves, known as sleep spindles. This is when the brain gathers, processes and recent memories of the previous day.

– In the 3rd stage of Non-ReM sleep, noises and outside activity may pass unnoticed, this is the stage that helps us feel energetic during the day. following sleep. In this stage, sleep is deep, the body is regenerates, the immune system strengthens. This stage is about 13-18% of all sleep.

• REM (Rapid Eye Movement) sleep - this is when dreams usually occur, blood pressure and respiration rate increase, and information from the day the previous day is processed and stored in long-term memory. REM sleep helps us emotionally adjust for the day ahead and contributes to the proper functioning of the memory and memory fixation. REM sleep can create general knowledge abstract knowledge and prioritise concepts drawn from sets of information. If not sleep, we risk becoming more irritable, more anxious, and the chances of getting a good night's depressive episode or other types of psycho-emotional disorders increases. drastically.

Sleep disorders

Sleep disorders are the consequence of direct or indirect damage to the structures and mechanisms responsible for initiating and maintaining sleep, the mechanisms responsible for responsible for the sleep-wake transition and the mechanisms involved in regulation of circadian rhythm.

These are:

• Primary: caused by dysfunction of the systems that control sleep/wake rhythm. Disorders related to sleep initiation and maintenance or excessive sleepiness and are characterised by a disturbance in the quantity, quality or regulation of sleep. Primary sleep disorders: insomnia, insomnia, parasomnia. - Secondary, comorbid or acquired: due to medical conditions, use of drugs or other substances or caused by environmental factors. Usually corrected if the cause is removed.

Insomnia

Insomnia is a disorder that involves difficulty initiating and maintaining sleep and waking up earlier than the desired time, ultimately meaning deterioration in sleep quality. Sometimes total sleep time may be normal, but the insomnia accusation may be related to the lack of normal alternation in cycles sleep cycles. Insomnia is the most common sleep disorder (6-12% of the population), it is the second most common reason for presenting to the doctor (after pain). Insomnia is more common in women (report on 1.4:1), one of the explanations being the hormonal changes that women go through in during menstruation/menopause or pregnancy. Some studies show that genetics plays an important role in the onset of insomnia, with several members of the same family may experience insomnia.

Signs of insomnia

• difficulty falling asleep, taking more than 40-50 minutes to sleep onset

• waking up earlier than the desired time and difficulties in getting back to sleep

• persistence of waking tiredness

• presence of migraines and decreased immunity

• drowsiness and exhaustion during the day, disorganised behaviour on the during the day

• frequent status changes

• decreased ability to concentrate

• poor performance at school or work

Events must occur at least three nights a week for a minimum of at least three months. Most cases of insomnia have a very early onset. during psychological, social or medical stress. Primary insomnia often persists long after the original causative factors have resolved, due to increased brain arousal and negative conditioning. Related problems with the rapidity of falling asleep are more common among young adults in while difficulties in staying asleep through the night are more common in among middle-aged and older adults.

Parasomnias

They are a class of sleep disorders that cause abnormal movements and behaviors in during sleep, which can lead to intermittent waking from sleep. Parasomnias are disorders of the transition to wakefulness or between stages of sleep.

Parasomnias include:

• Nightmares - actively experiencing dreams, which become recurrent and occur in the R stage causing awakenings in intense fear or negative emotions
• teeth grinding or clenching of the jaws
• sleepwalking - complex behaviours leading to large movements in bed or walking sleep or unresponsiveness when spoken to or their responses may not make sense
• restless legs syndrome
• enuresis
• Sleep paralysis - may occur when falling asleep or waking up and consists of inability to move voluntarily, often accompanied by visual hallucinations

Hypersomnia

Hypersomnia is described by excessive sleepiness for at least a month and that is manifested either by prolonged sleep episodes or by sleep episodes during the night. day, occurring almost daily. In people with hypersomnia, sleep duration may between 9 and 12 hours and is then followed by difficult awakening in the morning. This prolonged impairment of alertness at the sleep-wake transition is often referred to as "sleep drunkenness". The quality of nocturnal sleep is normal. Sleep tends to be continuous. Excessive sleepiness during involuntary hours of wakefulness takes the form of intentional dozing or involuntary sleep episodes.

Narcolepsy

Narcolepsy is a sudden need for sleep, preceded by loss of tone muscle tone. It can occur in periods of inactivity, but people suffering from narcolepsy can also fall asleep in full activity. Sleep is shallow, interrupted by awakenings, unpleasant dreams, vegetative reactions, sweating. Narcolepsy results almost always from the loss of hypocretin (orexin) producing cells hypothalamic. This hypocretin deficiency can be tested from the fluid cerebrospinal fluid by performing a lumbar puncture. The person suffering from narcolepsy may experience an inability to move or speak for a short time, even if awake and conscious. These episodes can last from a few seconds to a few minutes.

Episodes of drowsiness in narcolepsy are often described as irresistible and lead unintentional sleep in inappropriate situations, for example when driving or attending meetings or holding a conversation. Understimulation, situations of activity situations usually accelerate sleepiness. Sleep time lasts between 10-20 minutes, but can extend up to an hour if there are no interruptions. People with narcolepsy usually have between 2 and 6 sleep episodes/day ( intentional or unintentional) when they are not treated. Among the causes of narcolepsy can be a low level of hypocretin or genetic causes or lesions in the the brain.

Breathing disorders in sleep

Primary central sleep apnoea is a disorder of unknown aetiology, characterized by recurrent episodes of cessation of breathing without a ventilatory effort. Airway blockages are caused by relaxation of the muscles that normally keep the airway open. Wheezing is a symptom of sleep apnoea or sudden awakenings due to breathlessness or the sensation of dry mouth, sore throat, headache in the morning when waking up are some of the symptoms of sleep breathing tubes. It is more common in adults in older adults, in people with heart or stroke disorders and in people who use opioids to combat pain.

Circadian sleep rhythm disorders

The essential element of circadian sleep disruption is a pattern of or recurrent pattern of sleep disruption resulting from a lack of sleep. persistent or recurrent synchronisation of the individual sleep pattern with the sleep pattern of the or required by social norms. Sleep occurs either too early in the day or too late in the night. normal sleep hours, or much too late, or completely disrupted from day to day. These circadian rhythm disturbances can be temporary, caused by external factors - like sleep habits (going to bed and waking up late), working late at night, or night shifts, travel (jet lag).

Apparently, when people live without any artificial light, they sleep twice every night. They go to bed around 8:00 p.m. until midnight and then sleep again from about 2:00 a.m. until dawn. sunrise.

Causes of sleep disorders

Multiple causes of sleep disorders can be determined by:

• psychological factors (such as major events or changes, stress, depression, anxiety disorders);
• physical factors (gastritis/ulcer);
• medical factors (asthma, for example);
• neurological conditions (stroke, dementia, etc.);
• somatic diseases (cardiovascular, renal, etc.);
• pharmacological treatments;
• shift or night work;
• environmental factors (caffeine, nicotine or alcohol);
• genetic factors (e.g. narcolepsy);
• ageing (about half of people over 65 are experience various sleep problems);
• travelling and passing through different time zones.

What are the signs of sleep deprivation?

Lack of sleep has both short-term and long-term effects. Effects of sleep deprivation or restful sleep:

• obesity - over 21% of people (in Romania)
• diabetes - more than 25% of people (in Romania)
• heart disease - more than 35% of people (in Romania)
• cardiovascular diseases / stroke - over 22% of people (in Romania)
• increased blood pressure
• reduced reaction speed and impaired attention and concentration
• a high level of stress
• depression
• impulsive behaviour
• paranoia
• frustration
• great difficulty in discerning
• suicidal thoughts

There is little information about how Romanians sleep. A study on time use published at the end of 2013 by the National Institute of Statistics (INS) says that a Romanian sleeps 8 hours and 37 minutes a day working day and 56 minutes more on a rest day. By age group, children aged between 10 and 14 sleep about an hour and a half more than those aged 24 to 44, and those aged 65 and over had half as many hours of sleep as those aged 24 to 44. hour more sleep on a working day than the 24-44 age group.

Sleep deprivation leaves your brain exhausted, so it won't be able to perform as well well. Mental illness and sleep are not just associated, they are directly physically linked in the brain. The neural networks that predispose to normal sleep give a normal sleep, and those that support mental health overlap. The genes that have proven to be very important in normal sleep production, when they were altered, automatically predisposed individuals to mental illness.

Some of the benefits of sleep

• Helps the body regenerate
• Supports executive brain functions
• Helps maintain balance and physical abilities
• Contributes to body weight control
• Improves memory consolidation processes
• Supports the immune system and reduces inflammation and infection
• Reduces stress levels
• Maintains heart health

How do certain sleep disorders manifest themselves in children?

• Experiencing daytime sleepiness or, conversely, a state of restlessness;
• They show irritability
• Changes to the provision;
• They have tantrums and repeatedly display aggression;
• Low frustration tolerance;
• Difficulty in committing to a task/activity;
• They have memory problems and attention deficit.

Recommendations for quality sleep

Rest, on the other hand, has a broader definition than sleep. According to Sleep.org, in medicine, rest is defined as behavior aimed at increasing physical and mental well-being and usually consists of a cessation of activity. In while sleep is certainly a restful activity, forms of rest do not usually involve the same level of detachment as sleep.

The key to restful sleep is precisely this separation between sleep and rest: Active rest should be part of our sleep preparation ritual. In this way, our body begins to relax and get rid of the stimuli that have kept it alert all day, which will lead to a more restful sleep.

✅ Establish a regular sleep schedule, with (more or less) the same hours to go to sleep and wake up.

✅ Avoid conflict or demanding tasks before we put ourselves in bed.

✅ Let's take melatonin or valerian to fall asleep easier and magnesium for relax the nervous system.

✅ Let's organize the room we sleep in properly: comfortable pillows, mattress quality mattress, curtains that prevent light from coming in through the window over the and possibly earplugs handy, in case there are noise from outside, such as traffic noise.

✅ Don't eat too late in the evening, don't drink alcohol and don't drink coffee with the at least 4-5 hours before sleep. According to Healthline, caffeine levels remain in our bodies for 6-8 hours after drinking coffee, so large cups of coffee do not are not indicated after 3pm-4pm, especially for people who have problems with falling asleep.

✅ Use active rest techniques, such as reading, meditation, exercises, and breathing exercises, yoga or listening to a relaxing playlist.

✅ Exercise during the day, but not too close to bedtime. As a rule, instead of making us tired, they give us more energy.

✅ Take a hot bath or shower.

✅ Expose ourselves to enough natural daylight during the day and avoid sitting in bright artificial light in the evening. It's also good not to use phones mobile phones or laptops at least an hour before going to sleep. Light blue light negatively influences sleep quality. If you can't give up these devices, then turn on a blue light filter to 'warm up' the screen colours.

✅ Let's avoid going to bed with a negative mindset, such as "If I don't sleep enough tonight, how will I get through tomorrow?"

✅ Making sure we don't have other medical problems that prevent us from getting sleep quality sleep, such as apnoea.