Vijai P. Sharma, Ph.D
Sound and satisfying sleep, to a great extent, depends on our behavior. Behavioral changes are more effective in treating insomnia than medication alone. Yet, when we experience any problems with sleeping, we tend to seek that magical pill.
About 40 percent of people buy over-the counter medications intended for allergy, cold and sinus problems for their sleep problem. Those with sleep difficulties, who depend on medications without changing behavior, might be headed for trouble.
Sleep is not well understood in our society. Sleep is generally regarded as a passive state in which the mind and the body go to sleep.
Not true! The brain is as active during sleep as it is during the waking hours.
What is commonly referred to as "sleep" consists of the following three distinctive parts:
1 Dream sleep, also referred to as the Rapid Eye Movement (REM) sleep.
2 Deep sleep, also referred to as Non-Rapid Eye Movement (NREM) sleep.
3 Transitional state, which we may refer to as a twilight state.
These three states have their own physiology, mental activity and brain wave patterns.
Sleep quality is related to the number and length of REM and NREM episodes experienced throughout the night.
So, how well are you sleeping these days? Don't answer the question by merely counting the number of hours of sleep you get. Determine it by the quality of freshness and energy you experience when you wake up, and by the quality of alertness and efficiency during the rest of the day.
In REM sleep, the eyes shift rapidly from side to side accompanied with dreaming and semi-paralysis of muscles (so that we don't act out our dreams). During the REM sleep, blood flow is concentrated into the brain activating and engaging the mind, but during the NREM sleep, the blood flow is concentrated in the muscles repairing and nourishing the tissues.
On average, we dream about 4 to 5 times a night with dreams spaced about 90 minutes apart. We dream in real time. Our first dream lasts about 10 minutes and the last dream about 30 to 50 minutes. Brain is active during REM sleep in much the same way as it is during the waking state.
Brain activity during REM promotes immune system functioning. The brain is engaged in rehearsing and consolidating learning acquired during the waking hours and committing it to the long-term memory. REM nurtures and strengthens memory, learning, attention and concentration.
Cognitive development is facilitated by sleep. It is interesting to note that the more severe the level of mental retardation, the greater the disruption in the REM sleep pattern.
Sleep has a restorative function. Sleep replenishes the physical and mental resources. Lack of restful sleep causes fatigue and magnifies one's perception of pain. Thus, pain contributes to insomnia, which in turn contributes to pain.
Insomnia is associated with excessive worrying and anxiety, depression, chronic pain, sleep apnea, lung diseases, stomach ailments, heart problems, smoking, alcohol and drug abuse, evening-time caffeine, watching television in bed, lack of physical activity and hundreds of prescribed medications, to name a few.
As regards medication, non-benzodiazepines such as Ambien and Sonata and most of the antidepressants, along with behavioral changes, are regarded as the treatment of choice for chronic insomnia.
Go to the bedroom only when you feel sleepy. Don't watch TV, read, eat, worry, use the phone, argue or fight in the bedroom. Sex is the only activity permissible in the bedroom besides sleeping. All other activities are tabooed.
Do not engage in the act of worrying in the bedroom. If you must engage in the act of worrying, walk out of the bedroom to another area of the house, pick up a pencil and pad and write your action plan about the things about which you worry. Return to bed only when you are sleepy.
Psychological conditions such as anxiety, tension, stress, depression and chronic pain need to be addressed to get a relief from chronic insomnia. Moderate activity and exercise during the day is vital for good sleep.
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Copyright 2002, Mind Publications
Posted November 2002