Why do we persist in thinking that it’s efficient, effective, and macho to function on as few hours of sleep as possible?

For one, we simply don’t understand the importance of sleep and the serious deleterious consequences of sleep deprivation on health and performance. These include a significantly higher risk of high blood pressure [heart attacks and strokes], type-2 diabetes, depression, influenza, skin and allergy conditions, cancer, Alzheimer’s disease, and obesity. Furthermore, sleep deprivation disrupts cognitive processing, including acquisition, retention and recall of information, as well as diminishing our creativity, and critical thinking skills.

Along with not understanding sleep’s importance, many of us suffer occasionally from one or more of the 89 known sleep disorders and are unaware of the proper treatments. In a culture that devalues sleep, we think we can accomplish more if we sleep less. Nothing could be further from the truth. After 16 hours of being awake, we are incapable of performing efficiently and effectively; mistakes are made and accidents and illness often follow. The bottom line is that most of us have no clue as to what constitutes good sleep hygiene and how to obtain a great night’s sleep for a better tomorrow.

Here are five golden rules of sleep:

1. Determine your personal sleep requirement

How many hours of sleep do you get per night? The majority of us are moderately to severely sleep deprived. In fact, 71 per cent do not meet the recommended 7.5 – 9.25 hours per night.

Determine and meet your sleep requirement every night. It’s hard-wired, not adaptable! There are individual differences that are genetically determined. For example, if both of your parents are short sleepers, you may be one of the lucky five per cent of the population who can perform satisfactorily on less than six hours of sleep per night.

An adequate night’s sleep should leave you feeling wide-awake and energetic all day long, with little to no need for an afternoon nap. If you experience daytime sleepiness, start by adding 15 minutes to your normal routine each night until you feel fully rested all day long. This is your set point for a great night’s sleep.

The majority of us are moderately to severely sleep deprived

To test your finding, you should subtract 15 minutes of sleep for a night to see if it affects your energy levels the next day. If you are a bit sleepy, you’ll know that you are not quite meeting your required amount of sleep. Most people will find they should add at least one more hour to their current sleeping time. If that’s you, you’ll quickly realise that you never really knew what it’s like to be fully alert and at your best physically, emotionally and cognitively. We need to value sleep. To be healthy and a peak performer, sleep is not a luxury; it’s a necessity.

2. Establish a normal sleep/wake schedule

While you may be tempted to make up for lost sleep during the week by sleeping longer on the weekends, this can be very disruptive to your circadian rhythm. Instead, try to go to bed and get up at, or near, the same time every day. We only have one biological clock that determines our wakefulness and sleepiness, not one for the weekday and one for the weekend.

We must synchronise the sleepy phase of our biological clock with the hours we spend in bed and the waking phase for the hours we are out of bed. If we vary our sleep/wake schedule, it has the same effect of eastbound jet lag. We will have daytime sleep inertia, feel drowsy and lack mental clarity throughout the day.

Take a hot bath, do some easy stretching, yoga, or meditation before sleeping to help you relax

3. Use these proven strategies for great sleep

Get plenty of exercise everyday, even if it’s just taking the dog for a 20-minute walk after dinner. Avoid heavy cardio workouts within an hour of bedtime. Eliminate caffeine after 2pm. Even decaffeinated coffee contains small amounts of caffeine, so avoid that too if possible. Refrain from drinking alcohol within three hours of bedtime. Alcohol in large amounts is a stimulant, not a sedative. Therefore, while you may feel that alcohol helps you fall asleep, it actually disturbs your sleep every 90 minutes thereafter.

Be sure to avoid the use of electronics within one hour of bedtime. Television, computer screens, and iPads contain blue daylight spectrum light that blocks the secretion of melatonin, thus making it more difficult to fall asleep when you turn off the lights. If you must watch these screens, be sure to use blue daylight spectrum blocking glasses. Make sure that your bedroom is quiet, dark, and cool. You can also take a hot bath, do some easy stretching, yoga, or meditation before sleeping to help you relax.

4. Get one block of continuous sleep

To give you adequate nocturnal sleep in one block of time, avoid naps and falling asleep in the reclining chair after dinner. Those with insomnia must avoid any napping. Continuous sleep does not mean totally uninterrupted sleep. It’s completely normal to wake up several times during the night. Don’t worry if you can fall back to sleep within 20 minutes. If you do find yourself awake for longer, you might remain awake for as long as 90 minutes. Get out of bed, keep the lights low and read a book or do some light housework rather than toss and turn in bed.

Sleep loss doesn’t disappear by itself—you have to pay it back

5. Make up for lost sleep

For every hour you are awake, you increase your sleep debt. It takes one hour of sleep to make up for every two hours of being awake. If you are up for 16 hours, you need to sleep eight hours that night to fully restore your energy.

Sleep loss doesn’t disappear by itself—you have to pay it back. Compare your sleep to a bank account; if you make a withdrawal, the balance is reduced until you put money back into your account. Similarly, if you have a sleep debt, your loss accumulates. Therefore, make up for lost sleep as soon as possible. You can’t do it all at once, but after a week of adequate sleep you should be back on track.

Lauren Sietz is pursuing a Master’s degree in Physician Assistant Studies.
Emily Coolen is a certified personal trainer and sleep educator.

The post The five golden rules of sleep: Ignore them at your own risk appeared first on Complete Wellbeing.

What is narcolepsy?

Narcolepsy is a term for a disorder of the part of our brain that controls sleep and wakefulness. As a result, sleep or parts of sleep intrude into periods when a person is awake, often at inappropriate times. Typically, individuals with narcolepsy get sleep attacks anytime during the day. They also feel sleepy all the time and suffer from tiredness [like they haven’t slept enough] no matter how much they sleep. If severe, the condition seriously affects a person’s quality of life. Although there is no cure for it, the good news is that it can be effectively managed with proper treatment.

What causes narcolepsy?

Although the exact cause is not known, it is certain that narcolepsy is not caused by psychiatric or psychological problems. Recent studies have found low levels of a brain chemical called hypocretin in people with narcolepsy. Some researchers have suggested that a problem with the gene responsible for making hypocretin, combined with other factors in a person’s life may cause the disorder.

Probable causes include:

• Autoimmune mechanisms
• Deficiency of hypocretin/Orexin
• HLA subtypes HLA-DQBI*0602 linked
• Other factors like infections/toxin stress/ hormonal/ dietary.

Symptoms of narcolepsy

The four cardinal features of narcolepsy are:

1. Excessive daytime sleepiness
2. Cataplexy
3. Sleep paralysis
4. Hypnagogic hallucinations.

These symptoms are now thought to include disrupted or non-refreshing sleep.

In most cases, excessive daytime sleepiness is the most bothersome symptom.

Excessive daytime sleepiness

This is usually the first symptom of narcolepsy that shows up. Narcoleptics report feeling continually sleepy and tired all the time, seemingly without any reason. The drowsiness or grogginess is felt at times when we are usually fully awake and alert or in situation where alertness is required, for instance while driving.

Sleep specialists access excessive daytime sleepiness using various scales such as the Epworth Sleepiness Scale. On the scale, 0= no chance of dozing, 1= slight chance of dozing, 2= moderate chance of dozing and 3= high chance of dozing.

Patients are asked to rate the everyday situations in their lives such as: sitting and reading, watching TV, sitting inactive in a public place [a theater or a meeting], as a passenger in a car for an hour without a break, lying down to rest in the afternoon when circumstances permit, sitting and talking to someone, sitting quietly after lunch without alcohol, in a car, while stuck in traffic. A score of more than 10 on this scale is worrisome.

Cataplexy

It is a condition in which strong emotions, laughter, anger, fear or surprise cause a person to suddenly feel weak. The mild form is characterised by a brief feeling of weakness, while the severe form is characterised by a complete physical collapse, resulting in fall and, sometimes, even injury.

Sleep paralysis

Sleep paralysis too is a brief loss of muscle strength. However, it occurs when a person is either falling asleep or waking up. The person may be somewhat aware of his or her surroundings, but is unable to move or speak—feels powerless and paralysed.

Hypnagogic hallucinations

These are vivid dreams—complete with disturbing images and sounds—that occur when a person is drowsy. These hallucinations may be frightening because the person is partly awake but has no control over the events.

How is narcolepsy diagnosed?

The first step in diagnosing this disorder would be an evaluation by your physician to eliminate other medical illness as the cause. The next step is usually a visit to a physician specialising in sleep disorders.

At a sleep disorders centre, the specialist will thoroughly review your medical history and give you a complete physical examination. If the specialist suspects narcolepsy, s/he will ask you to undergo the following steps:

1. Maintaining a sleep log over a period of two weeks.
2. Review of the antidepressants such as SSRI, TCAs and other medicines you have been taking
3. Polysomnogram [sleep study].
4. Multiple sleep latency test [MSLT] to confirm the diagnosis of narcolepsy.

Cerebrospinal fluid levels of ‘hyprocretin’ are also used to diagnose narcolepsy.

How is narcolepsy treated?

Narcolepsy cannot be cured but its symptoms can usually be controlled or improved. If you are diagnosed with narcolepsy your treatment plan would likely to have a multidisciplinary approach.

1. Medication
2. Behaviour modification
3. Environment management

Medications

Prescription medications effectively help control excessive daytime sleepiness, cataplexy,hallucinations, and sleep disruptions. These include:

1. Stimulants like methylphenidate and amphetamines
2. Wakefulness-promoting agents like modafinil
3. Medications to suppress the cataplexy sleep paralysis and hypagogic hallucinations— tricyclic anti-depressants.

Lifestyle modifications

• Following a regular sleep/wake schedule.
• Taking regular short naps.
• Following your healthcare professional’s instructions regarding medications.

Managing your environment

• Keep family, friends, co-workers, employers and other individuals with whom you have frequent contact informed about your condiion
• Make sure you plan ahead and stay prepared for the potential impact of your condition on family and work
• Seek help from the community and support groups like narcolepsy support groups

With the help of some modifications, medicines and positive attitude, narcoleptics can learn to effectively manage their situation.

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