Your Beauty Sleep and Its Significance

Why Is Sleep Important?

We spend one-third of our lifetime in sleep and yet its importance is not fully understood. Sleep is not just putting your body to rest and switching off your brain activity. It will be quite surprising to know that during sleep our brain will never switch off and continue to be active without disturbing our body.

Just imagine a librarian who organizes and arranges the scattered books in the book rack, by giving them a unique code number and clearing the waste after the library hours. Similarly, our brain organizes scattered thoughts, imaginations, and memories by arranging them with unique code in our brain’s hard disc and putting unwanted files in the recycle bin after we sleep.

How to Repay Your Sleep Debt?

Sleep debt is the difference between your body’s sleep requirements and your actual sleep duration. For example, if your body requires 6 cycles of sleep every night but you slept for only 5 cycles, there is a debt of 1 cycle.

How to repay this debt?? Simple. By sleeping compensatory extra 1 cycle the next day.

Be aware! Our brain is a strict accountant – the debt will keep on accumulating if this sleep deficit continues; it will not leave you till you repay it completely. To understand your sleep debt, you need to know your sleep cycle.

What Is a Sleep Cycle?

We have 2 types of sleep:

1. REM (rapid eye movement sleep) constitutes 20 to 25% of sleep.

2. NREM (non-rapid eye movement sleep) constitutes 75 to 80% of sleep.

This NREM sleep has 4 stages.

Before going into actual sleep, we enter a waiting period called sleep latency which may prolong up to 20 minutes.

We need 4 to 6 cycles of sleep every day, each cycle lasting for an average duration of 90 minutes. The REM sleep duration increases as the time progresses.

What Are Your Sleep Requirements?

What Is a Nightmare?

It is one of the sleep disorders called parasomnia. Dreaming happens more often in REM Sleep. 80% of vivid dream recall happens after waking up from this REM sleep, which we call NIGHTMARE. Other parasomnias like acting out of dreams, and sleep paralysis also happen in REM sleep.

Though we get dreams in NREM sleep, it is difficult to recollect. All other parasomnias such as:

• Sleepwalking (somnambulism)
• Sleep talking (somniloquy)
• Bed-wetting (nocturnal enuresis)
• Night terror
• Sleep-related sexual behavior (sexsomnia) happens during NREM sleep.

Types of Insomnia

Insomnia, the commonest sleep disorder, is of 3 types:

*Onset Insomnia – Difficulty with the onset of sleep, even after 30 minutes.

*Middle Insomnia – Difficulty in the maintenance of sleep with frequent awakening in between and difficulty going back to sleep.

*Late Insomnia – Early morning awakening, at least 30 minutes before desired time, and sleeping for less than 6.5 hours.

If any of the above sleep difficulties is present at least 3 times a week, for a period of minimum 3 months, even with ample opportunity and comfort to sleep, then it is a sleep disorder requiring medical intervention.

All these types of insomnia can be either primary (if it occurs in the absence of concurrent physical/mental illness/substance abuse), now called insomnia disorder, or secondary (if due to underlying physical or mental illness).

In many neurotic disorders like depression/anxiety, insomnia is the major complaint. Also, insomnia is the risk factor or prodromal sign of psychosis.

Treatment for Insomnia:

There are 2 types of approaches for the treatment of insomnia:

1. Psychological approach and 2. Pharmacological approach

When it comes to the psychological approach, CBT–I, a type of cognitive behavior therapy for insomnia, plays an important role.

Cognitive Behavior Therapy for Insomnia

It is a multi-component method, which helps patients with chronic or long-term insomnia.

The key components of CBT-I:

• Cognitive Restructuring
• Sleep Hygiene
• Relaxation Techniques
• Sleep Restriction
• Stimulus Control

Cognitive Restructuring:

Because of their past bad experience with insomnia, patients will start worrying before going to bed, get more anxious and force themselves to sleep. Cognitive restructuring helps to break these unhelpful and challenging thoughts that lead to sleep anxiety. This helps to set realistic expectations about the quantity and quality of sleep.

Sleep Hygiene:

• Avoid caffeine (at least 4 to 6 hours) before bedtime.
• Avoid excess fluid intake (at least 1 to 2 hours) before bedtime.
• Regular exercise either morning or evening.
• Noise-free surroundings.

Relaxation Techniques:

• Breathing exercises – slow and deep breathing before bedtime.
• Progressive muscle relaxation – it may be combined with breathing exercises.
• Meditation – helps to focus attention and reduces stress.

Sleep Restriction:

People who suffer from insomnia often spend a lot of time in bed without sleeping. In selected patients, a sleep restriction method that limits the time spent in bed will improve sleep by increasing the drive to sleep. A sleep diary has to be maintained. Time spent in bed is restricted to the time actually spent on sleep plus 30 minutes.

Stimulus Control:

• Dark/dim light in the room before going to bed.
• Avoid brain-stimulating activities like using mobile and electronic gadgets and watching TV lying in bed.
• Going to bed at the same time and setting an alarm to wake up at the same time.
• Avoid daytime naps or simply lying in bed unless you are physically sick.

Pharmacological Treatment

After a detailed evaluation, medicines are carefully chosen based on the type of insomnia, duration of the problem, underlying psychiatric illness, and co-morbid medical conditions. Melatonin, melatonin agonists, sedatives, hypnotics, anti-anxiety pills, antidepressants, and low dose antipsychotics are the medicines generally prescribed. Once the underlying problem is addressed and resolved properly, most of the medicines given for sleep will be gradually tapered and stopped.

Getting treated early is wise. Seek professional help, don’t ignore or postpone due to fear of getting addicted to sleeping pills.