Notes from the Land of Nod

 

Imagine a condition that causes an estimated 100,000 car accidents a year.   Imagine that it can cause alcoholism, depression and anxiety,  or be caused by alcoholism, depression and anxiety. Imagine that it is associated with higher blood pressure and coronary heart disease, reduces our ability to heal from wounds, and that it can contribute to overeating and weight gain.  That this condition lowers your ability to process blood glucose, sometimes even leading to a pre-diabetic state, and can cause your ability to function to be equal  to that of a person with a blood alcohol level of .7.  In addition,  50-75 million people report suffering from this condition.  You can stop imagining, because it is real.  Have you guessed this condition?  Sleep deprivation.  And these are just the effects that have been studied.  There may be much more.*

 

If sleep doesn’t serve an absolutely vital function,” the renowned sleep researcher Allan Rechtschaffen once said, “it is the greatest mistake evolution ever made.”  Sleep researchers will admit that we really don’t know WHY we sleep, or what functions it provides.  What we do know is that we need to sleep regularly and deeply, and that we suffer if the cycle is interrupted.  Indeed, scientists are recognizing that sleep provides more benefits than they previously thought.  It may be absolutely crucial to promoting health.**  In a study conducted in the 1980’s, and then recreated in 2002 with more sophisticated instruments***, rats were kept awake.  After two weeks, every rat was either dead or close to death.  In spite of increased eating, all had lost weight, and were experiencing lower internal temperatures, as well as lesions on their paws and tail. Necropsies could not find a cause of death.  They apparently died of exhaustion.

 

With these profound effects, you would think that all doctors know a lot about sleep.  Surprisingly, in their many years of schooling and training, most medical students spend on average only 4 hours  learning about this condition.  We have all probably even heard about the crazy work schedules interns are required to keep. This risk was noted in a landmark study on the effects of sleep deprivation and error rate in an intensive care unit.****  During this study, interns made 35.9% more serious medical errors when working a “traditional” shift of 24 hours or more.  There have been many changes since this study, but the Institute of Medicine still feels it necessary to  recommend “strategic napping” between the hours of 10pm and 8am for shifts lasting up to 30 hours’.   Yikes.  

 

One recent historical study brought to light a little known major change that our culture has made in the way we sleep.*****   Roger Ekirch, using historical documents, discovered that prior to the industrial revolution, we naturally divided our sleep into at least two segments.  First sleep began soon after dark and continued until just after midnight.  For the next hour or two, people prayed, played, had family time and many other activities, and then fell into Second (or Beauty) sleep until morning.  It is estimated by Charles Czeisler of Harvard that they got as much as 1 ½ hours more sleep on average at that time than we do today.  With the invention of the light bulb, people began to stay up later. Those who continued waking up in the middle of the night were perhaps awake for partying or illegal activities, and documents of the day were published that encouraged one long sleep for ethical and healthful reasons. As our culture changed, even the memory of how we used to sleep disappeared. In 1992 a study was conducted that confined volunteers to a location without windows or clocks or any other way to tell time.  After a period of catching up on their sleep deficit, the men fell into a segmented sleep schedule, like the one described above.  Is this our natural sleep pattern?  It has been found that the brain exhibits high levels of the pituitary hormone prolactin during the period of nighttime wakefulness.  Perhaps those of us who become upset in the middle of the night because we are awake (AGAIN!!!), can relax, knowing that it is a normal sleep pattern and allow the calming chemicals to do their work.  

 

So what happens while we sleep?  First of all, by measuring muscle tone, eye movement,  and brain waves, researchers have divided our sleep into distinct stages, which pattern repeatedly throughout the night.  In stage one and two, we are very lightly asleep.  Often a person who is awoken during these stages will not even believe they were asleep, but there are many healthful benefits to this light (alpha) sleep .  In stage three, your brain waves begin to move into the slower delta pattern, but you still have bursts of faster brain waves in between, until they settle into the consistent slow delta pattern.  This stage is a deep sleep with no eye movement or muscle activity.  Someone woken from this state will be groggy. We then cycle back up.   Sometimes we will open our eyes and look around at the end of the cycle..  If we are satisfied that we are safe and all is well, we will close our eyes and start the sleep cycle again without memory of the event. This full cycle lasts about 90 minutes.  During the first half of the night, this is how we sleep.  A change occurs during the second part of the night with REM (rapid eye movement) sleep replacing stage one, and the amount of delta sleep diminishing.  There are variations on this cycle, and age plays a role in how well and how long we sleep, at what times we are sleepy, and what stages we spend the most time in. ( An example is the shifting of circadian rhythms as children move into their teen years, staying up late, and having a difficult time waking early in the morning.)

 

Often, when someone complains of insomnia, it is found that they actually are getting a lot more sleep than they would guess.  Stage 1 and 2 may not be identified as sleep, since it is very light and people can remember their thought processes during these stages. It may be helpful to note that there is restful benefit to these light stages of sleep when you are lying in bed getting frustrated.  Relax!  Enjoy the light state.  And if you are able to relax into it, perhaps that can help you slide into the deeper states more easily.  

 

And this is where hypnotherapy can be of help. When working with a client, I first want to retrain their brain to change the thought processes.  When going to sleep, it may not be helpful to rethink their day, or to worry about tomorrow, but instead to concentrate on positive future oriented messages.  Our goal is to eliminate that unpleasant circular thinking process and allow their subconscious to focus on positive issues throughout the night.  Secondly, we work with their subconscious mind to remember how to fall into a deep a healthful sleep.   Our subconscious is in charge of all of our automatic functions, which include falling asleep.  We were all born knowing how to sleep, and under hypnosis we remind the subconscious of the process. Finally, we will look for the core cause – the’ reason why’ – of each individual’s sleep issues in order to remove any blockages, allowing them to regularly drift into the deep and healthful sleep we all need and crave.

 

As an ironic side note, I have been fascinated with sleep information for many years.  However, I found that when I was doing the research for this article, I became extremely sleepy after a short time and took many unscheduled naps.  Indeed it has taken me months to complete this short article, as I kept being ‘sidetracked’ with a need for extra sleep.  Even thinking about working on this article could elicit a yawn or two.  Right now, I am SO ready to snooze and I’m not sure an extra cup of coffee will do the trick.  I have jokingly recommended researching sleep to people who have complained about insomnia, but who knows? If my article has caused your eyes to become droopy, it just might work for you, too.

 

*http://sleepfoundation.org/sleep-topics/sleep-studies/

**http://sleepfoundation.org/sites/default/files/SleepWakeCycle.pdft.              ***http://www.journalsleep.org/Articles/250104.pdf  

****  http://www.nejm.org/doi/full/10.1056/NEJMoa041406

***** http://www.bbc.com/news/magazine-16964783  

 

 

 

 

Leave a Comment