Evie Summers
Sleep is a body process that allows the body to rest, repair, and restore itself. The human body cycles through two phases of sleep: rapid-eye movement (REM) sleep and non-rapid eye movement (NREM) sleep. NREM sleep is further divided into three stages, with each stage leading to progressively deeper sleep. During NREM sleep, the brain uses significantly less energy, and the body enters a more subdued state where body temperature drops, muscles relax, and heart rate and breathing slow. If NREM sleep is disrupted, it can interfere with the restorative process and lead to chronic health problems. When NREM sleep intrudes into wakefulness, it can cause parasomnias such as sleep starts, night terrors, sleepwalking, and confusional arousals.
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What You'll Learn
Sleep inertia
The sleep cycle consists of four stages, including one REM stage and three NREM stages. A typical night of sleep consists of four to six sleep cycles, with each cycle lasting about 90 minutes. The first sleep cycle is often the shortest, ranging from 70 to 100 minutes, while later cycles tend to be longer, ranging from 90 to 120 minutes.
The first stage of sleep is N1, which usually lasts from one to seven minutes. During this stage, the body hasn't fully relaxed, but body and brain activities start to slow, with periods of brief movements. It is easy to wake someone up during this stage, but if undisturbed, they will quickly move into N2 sleep.
N2 sleep is a more subdued state, where body temperature drops, muscles relax, and heart rate and breathing slow. Eye movement stops, and brain activity slows, with short bursts of activity known as sleep spindles, which are essential for memory and learning. Sleep spindles also help to shut out external stimuli, making it harder to wake up.
The third stage of sleep is N3, which is the deepest stage of sleep. During this stage, the body experiences further decreases in muscle tone, pulse, and breathing rate, and brain activity is dominated by delta waves, which have a slow frequency of 1 to 4 Hertz. N3 sleep is critical for restorative sleep, allowing for bodily recovery, growth, and immune system functioning.
REM sleep is the second phase of sleep, characterised by rapid eye movements, and it is when most dreams occur. It usually begins about 90 minutes after falling asleep, and it makes up about 25% of total sleep time. During REM sleep, the body becomes temporarily paralysed, and brain activity is similar to that of wakefulness.
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Sleep deprivation
Sleep is a vital process that allows the body to rest, repair, and restore itself. It accounts for about one-third of our lives, and a good night's sleep is essential for proper functioning during the remaining two-thirds.
The human sleep cycle consists of two main types of sleep: non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep. NREM sleep is further divided into four stages, from N1 to N3 or N4, with each stage representing a deeper level of sleep. NREM sleep accounts for approximately 75% of total sleep, with most time spent in the N2 stage. During NREM sleep, the body experiences reduced muscle tone, decreased breathing rate, and slower brain activity, characterised by delta waves in the deeper stages.
REM sleep, on the other hand, is associated with vivid dreaming, increased eye movement, and brain activity similar to that of wakefulness. REM sleep makes up about 25% of total sleep time and typically occurs after approximately 90 minutes of sleep.
To address sleep deprivation, individuals should monitor their sleep patterns and seek guidance from healthcare professionals. Sleep hygiene tips, such as maintaining a consistent sleep schedule, creating a relaxing sleep environment, and limiting screen time before bed, can be helpful. In some cases, underlying sleep disorders may need to be addressed to improve sleep quality and duration.
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Sleep disorders
Sleep is a vital process that allows the body to rest, repair, and restore itself. The human body cycles through two phases of sleep: rapid-eye movement (REM) sleep and non-rapid eye movement (NREM) sleep. NREM sleep is further divided into three or four stages, with each stage leading to progressively deeper sleep.
NREM stage 1 sleep acts as a transitional phase, usually lasting one to seven minutes in the initial cycle. During this stage, the body hasn't fully relaxed, and it is easy to wake someone up. NREM stage 2 sleep is when the body enters a more subdued state, with a drop in body temperature, relaxed muscles, and slower heart rate and breathing. Brain activity also slows down, with occasional bursts of activity. NREM stage 3 sleep is deep sleep, and it is challenging to wake someone up during this phase. The brain produces slow delta waves, and the body experiences decreased muscle tone, pulse, and breathing rate. This stage is crucial for restorative sleep and immune system support.
Diagnosing sleep disorders involves various tests, such as the Multiple Sleep Latency Test (MSLT) and Maintenance of Wakefulness Test (MWT). Treatments for sleep disorders vary, ranging from no treatment to lifelong care or interventions like CPAP support for sleep apnea. Sleep hygiene tips and consulting a healthcare provider can help address underlying sleep issues.
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Circadian rhythm disorders
The types of circadian rhythm disorders include advanced or delayed sleep-wake phase disorder, irregular or non-24-hour sleep-wake rhythm disorder, shift work disorder, and jet lag disorder. Advanced sleep-wake phase disorder (ASWPD) is characterized by early sleepiness, early sleep onset, and waking up earlier than desired, which can interfere with daily activities. Delayed sleep-wake phase disorder (DSWPD) leads to falling asleep later than intended and difficulty waking up on time.
Shift work disorder affects those who work at night or on rotating schedules, resulting in insomnia, extreme tiredness, and sleepiness during work hours. Jet lag disorder occurs when travelling across multiple time zones, causing the sleep-wake cycle to fall out of sync with the local time, leading to sleepiness or alertness at inappropriate times.
Symptoms of circadian rhythm disorders include extreme daytime sleepiness, decreased alertness, problems with memory and decision-making, and periods of insomnia. Diagnosis involves discussing sleep habits with a doctor and possibly undergoing sleep studies and other diagnostic tests. Treatment plans vary depending on the specific type and cause of the disorder. Bright light therapy, chronotherapy, and other behavioural techniques can be used to adjust the patient's sleep pattern and reset their circadian rhythm.
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Sleep-disordered breathing
SDB can affect both children and adults. Approximately 10% of children snore regularly, and about 2-4% experience OSA. In children, SDB can lead to increased urine production at night, resulting in bedwetting. It can also cause irritability, sleepiness during the day, and difficulty concentrating. These children may become moody and disruptive, or display hyperactive behaviour. SDB has also been linked to attention deficit disorders and slow growth in children due to insufficient production of growth hormone.
Symptoms of SDB in adults include snoring, gasping, and snorting associated with waking up from sleep. Obstructive sleep apnea can cause people to feel tired and drained even after sleeping for a long time. Sleep apnea can be diagnosed through a sleep test called polysomnography (PSG), which monitors brain waves, muscle tension, eye movement, breathing, and blood oxygen levels. Treatment for sleep apnea may include CPAP support.
SDB can have significant impacts on daily life and work performance. ENT specialists treat sleep-disordered breathing, nasal and airway obstruction, snoring, and sleep apnea. If you or your child experience symptoms of SDB, it is recommended to consult an ENT specialist or otolaryngologist for diagnosis and treatment.
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Frequently asked questions
NREM sleep is non-rapid eye movement sleep, which is further divided into 3 or 4 stages—N1 to N3 or N4. Each phase and stage of sleep includes variations in muscle tone, brain wave patterns, and eye movements.
When NREM sleep intrudes into wakefulness, it can cause a person to feel tired and drained. This can lead to "sleep inertia", a state of confusion or "mental fog" that can last about 30 minutes.
If you are having trouble sleeping and don't know why, it is recommended that you ask your doctor. They can recommend sleep hygiene tips or identify an underlying sleep disorder that could be interfering with your NREM sleep.
Common sleep disorders include insomnia, sleep apnea, restless leg syndrome, sleepwalking, sleep eating disorder, and sleep myoclonus.
