Sleep Eludes Me: Awake Every Other Night

Sleep is an essential human function, and the average adult needs seven to eight hours of sleep per night. However, some people claim to follow a sleep pattern known as segmented sleep or polyphasic sleep, where they sleep every other day or break up their sleep into two or more shifts. While this may work for some, it is not recommended by experts due to potential negative impacts on health and the difficulty of maintaining such a schedule with family and work commitments.

Segmented sleep, or sleeping in two shifts, is a natural way to sleep

According to historian Roger Ekirch, in pre-industrial times, it was normal for people to wake up for a couple of hours in the middle of the night. They would spend this time praying, smoking, having sex, or visiting their neighbours before returning to sleep until morning.

Historical records, such as Homer's Odyssey, published in the late 8th or early 7th century B.C., also contain references to "first" and "second" sleeps, indicating that segmented sleep was once considered a natural and unremarkable part of life.

In modern times, segmented sleep typically involves sleeping for four to five hours at night and then taking a two to three-hour nap during the day. This type of sleep pattern is often seen in shift workers, new parents, and students during exam periods.

Some people who practice segmented sleep find that it suits their lifestyle and provides them with extra energy and a sense of calm throughout the day. However, others argue that segmented sleep is not practical or sustainable in today's society.

There are mixed views on the health impacts of segmented sleep. Some experts warn that it can lead to sleep deprivation and disrupt the body's circadian rhythms, while others claim that there is no evidence that segmented sleep causes health problems as long as the individual feels healthy and well-rested.

Overall, while segmented sleep may not be feasible for everyone due to work and family commitments, it is a natural way of sleeping that has been practised throughout history and continues to be a part of certain cultures, such as the siesta in Spain and Italy.

Short sleep syndrome is a rare gene mutation that allows people to function normally on fewer than six hours of sleep per night

Short sleep syndrome, or familial natural short sleep, is a rare genetic mutation that allows people to function normally on fewer than six hours of sleep per night. This condition is characterised by individuals sleeping for fewer hours than average without experiencing daytime sleepiness or other consequences of sleep deprivation. Natural short sleepers wake up feeling relatively well-rested and are known for their ability to recall memories, outgoing personalities, high productiveness, lower body mass index, higher resilience, and heightened pain tolerance.

The cause of short sleep syndrome is largely genetic, with a specific mutation of the ADRB1 gene identified as a key factor. This mutation is associated with shortened sleep cycles and higher levels of β1-adrenergic receptors, which play a crucial role in regulating body functions during the circadian rhythm or sleep-wake cycle. The circadian rhythm in individuals with the ADRB1 mutation is "reprogrammed", allowing the body to undergo the necessary biological and hormonal changes during a shorter sleep period.

The discovery of the genetic basis for short sleep syndrome is relatively recent. For a long time, short sleepers were concerned that their sleep habits were a disorder or a curse. However, research led by Ying-Hui Fu and her team at the University of California, San Francisco, identified the first short-sleep gene in 2009. This gene, known as DEC2, was found to be associated with shorter sleep durations of around 6.25 hours per night in those who inherited the mutation.

The identification of the DEC2 mutation was a breakthrough, but it couldn't explain all cases of natural short sleepers. Fu and her team continued their search and, after a decade, discovered a second short-sleep gene: a mutation in the ADRB1 gene. This discovery provided further evidence of the genetic basis of short sleep syndrome and opened new avenues for understanding the connection between sleep and overall health.

While short sleep syndrome allows people to function well on fewer than six hours of sleep, it is important to note that this condition is distinct from sleep deprivation. Sleep deprivation occurs when an individual does not get enough quality sleep, leading to symptoms such as drowsiness, forgetfulness, and moodiness. Short sleepers, on the other hand, do not experience these negative consequences and can maintain normal functioning with their reduced sleep needs.

Insomnia is a common sleep disorder that can cause people to sleep terribly one night and then compensate the next

Insomnia is a common sleep disorder that affects around a third of adults worldwide, with about 10% of these cases being severe enough to be classified as insomnia disorder. It involves problems with falling or staying asleep, and can cause significant distress and impairment in daily functioning.

The effects of insomnia can vary from person to person. For some, it may be a minor inconvenience, while for others, it can be a major disruption to their lives. Insomnia can lead to symptoms such as fatigue, decreased energy, irritability, and problems with focus and concentration. It can also affect one's mood, causing anxiety, depression, and irritability.

There are two main types of insomnia: acute (short-term) and chronic (long-term). Chronic insomnia, also known as insomnia disorder, is characterised by insomnia that occurs at least three times a week for a duration of at least three months. It is often caused by a combination of factors, including genetics, brain activity differences, medical conditions, mental health issues, stressful life events, and poor sleep habits.

While insomnia is usually not dangerous, severe or long-lasting cases can lead to sleep deprivation, which can interfere with one's ability to function normally. Sleep deprivation can cause symptoms such as carbohydrate cravings, decreased interest in sex, and trouble concentrating. It can also increase the risk of developing chronic health conditions such as high blood pressure, obstructive sleep apnea, and psychosis.

Treating insomnia typically involves a combination of lifestyle changes, sleep medications, and behavioural techniques such as cognitive behavioural therapy. Simple changes in sleep habits, such as sticking to a consistent sleep schedule, avoiding naps, and creating a comfortable sleeping environment, can often help improve sleep quality. In more severe cases, medications and mental health treatments may be recommended.

Non-24-hour sleep-wake disorder (N24SWD) is a rare disorder where a person's sleep-wake cycle does not synchronize with the 24-hour daylight cycle

N24SWD is primarily observed in blind individuals, affecting up to 70% of the totally blind population. However, it can also occur in sighted people, although the exact cause is not well understood. In sighted individuals, N24SWD may be linked to various factors such as male gender, age (teens and twenties), unusual work schedules, low-light environments, prior mental health disorders, and even traumatic brain injuries.

The impact of N24SWD on daily life can be significant. Individuals with this disorder often struggle to maintain work, school, and social commitments. They may experience difficulties in adjusting to changes in "regular" sleep-wake cycles, such as vacations, stress, evening activities, time zone differences, and seasonal variations in daylight hours. The disorder can severely impair their ability to function in conventional jobs and maintain ordinary social lives.

Treatment options for N24SWD include melatonin supplements, bright light therapy, and the FDA-approved drug tasimelteon. These interventions aim to help individuals establish a more consistent sleep-wake cycle and alleviate symptoms of sleep deprivation.

Sleep deprivation can be caused by various factors, including stress, caffeine consumption, and poor sleep environments

Stress

Stress is a common cause of sleep deprivation, particularly in individuals with demanding jobs or those experiencing challenging life circumstances. Work-related stress, such as time pressure, high expectations, and low tolerance for errors, can significantly impact sleep quality and duration. For example, healthcare professionals often experience sleep deprivation due to long work hours and stressful working conditions.

Caffeine Consumption

Caffeine, often consumed in the form of coffee, tea, or energy drinks, is a well-known stimulant that can disrupt sleep. It acts as an adenosine receptor antagonist, occupying receptors related to sleep, arousal, and cognition. The effects of caffeine on sleep can last for several hours due to its short half-life, and regular consumption can lead to caffeine tolerance and withdrawal symptoms. Even moderate caffeine intake can impact sleep quality and duration, and individuals may find themselves in a cycle of caffeine consumption and disrupted sleep.

Poor Sleep Environments

Uncomfortable sleep environments can also contribute to sleep deprivation. Environmental factors such as extreme temperatures, noise, light, and shift work can disrupt sleep patterns and reduce sleep quality. Maintaining a comfortable bedroom environment, including optimal temperature, darkness, and quiet, can promote better sleep. Additionally, the use of electronic devices before bed and irregular sleep schedules can further exacerbate sleep deprivation.

Other Factors

In addition to stress, caffeine consumption, and poor sleep environments, there are other factors that can cause sleep deprivation. These include sleep disorders such as insomnia, narcolepsy, and sleep apnea, as well as lifestyle choices, medical conditions, and genetic factors. Addressing these factors and creating a conducive sleep environment can help improve sleep quality and duration.

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