Miya Pearson
Sleep and wakefulness are controlled by a single area of the brain, according to a 2018 study by neuroscientists at the University of Bern. The thalamus, a central hub of the brain, was found to have a dual control over sleep and wakefulness, with its neurons generating slow waves to induce sleep and also waking up from sleep, depending on their electrical activity. This discovery is of great importance for finding new sleep therapies, as sleep deprivation has been deemed a public health epidemic by the CDC.
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Sleep disorders
One of the most common sleep disorders is insomnia, which is characterised by the inability to fall asleep and stay asleep. Sleep apnea is another prevalent disorder, affecting at least 30 million Americans, where people experience disrupted breathing while sleeping, often accompanied by heavy snoring, and they may wake up choking or gasping for air. Obstructive sleep apnea occurs when tissues in the mouth and throat relax, blocking the upper airway, while central sleep apnea is caused by a lack of signals from the brain to the muscles that control breathing. Narcolepsy, which affects about 1 in 2,000 people in the United States, is a disorder that causes extreme daytime sleepiness despite adequate nighttime sleep. It can lead to sudden and irrepressible sleep attacks and an increased risk of accidents or injuries.
Restless leg syndrome (RLS) is a disorder characterised by a tingling or prickly sensation in the legs, along with a powerful urge to move them. It is associated with abnormalities in the neurotransmitter dopamine. Circadian rhythm disorders are problems with the sleep-wake cycle, leading to difficulties in falling asleep and waking up at the right times. Parasomnia involves unusual behaviours during sleep or transitional states, such as sleepwalking, talking, or eating.
The treatment for sleep disorders varies depending on the specific disorder. It may include lifestyle changes such as adopting good sleep habits, a healthy diet, and exercise. Cognitive behavioural therapy and relaxation techniques can help reduce anxiety related to sleep. In the case of sleep apnea, CPAP (continuous positive airway pressure) machines, oral appliances, or surgery may be recommended. Medications, including sleeping pills and melatonin, can be used but usually for a short period and under the guidance of a healthcare provider.
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Sleep stages
Sleep is divided into cycles and stages. A typical night of sleep consists of four to six sleep cycles. Each cycle is made up of four stages: three non-rapid eye movement (NREM) stages and one rapid eye movement (REM) stage. The first sleep cycle is usually the shortest, ranging from 70 to 100 minutes, while later cycles tend to be between 90 and 120 minutes long. The duration of each cycle and the composition of each cycle (how much time is spent in each sleep stage) vary from person to person and from night to night, depending on factors such as age, recent sleep patterns, and alcohol consumption.
The first stage of the sleep cycle, N1, is when a person first falls asleep. This stage usually lasts just one to seven minutes, and the body and brain activities start to slow, with periods of brief movements. It is easy to wake someone up during this stage, but if they are not disturbed, they will quickly move into the second stage. As the night goes on, an uninterrupted sleeper will not spend much time in the first stage as they move through the sleep cycles.
The second stage, N2, is still light sleep but deeper than the first stage. During this stage, brain waves slow down and have noticeable pauses between short, powerful bursts of electrical activity. Experts believe that these bursts are the brain organizing memories and information from the time spent awake. Stage 2 NREM sleep accounts for about 45% of total sleep time and is the stage that people spend the most time in. As the night progresses, each successive period of N2 sleep becomes longer than the last.
The third stage, N3, is deep sleep. Brain waves during this stage are slow but strong, and the body takes advantage of this very deep sleep to repair injuries and strengthen the immune system. The same bursts of brain activity that occur in stage 2 can also happen in stage 3, and brain waves specific to this stage help regulate those bursts. Stage 3 NREM sleep makes up about 25% of total sleep time in adults, but babies and children need more of it. As people age, they need less of this type of sleep.
The fourth stage is REM sleep, during which most dreams occur. During this stage, the eyes move rapidly behind closed eyelids, and brain activity is similar to that of a waking brain. Each successive REM cycle is longer than the last, with the first cycle being the shortest, at around 10 minutes.
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Sleep-wake homeostasis
The interaction between sleep-wake homeostasis and the circadian rhythm means that we don't constantly yo-yo between sleep and alertness throughout the day. Instead, our alertness levels fluctuate, with most adults feeling sleepiest between midnight and 4 a.m., and also between 1 p.m. and 3 p.m. Getting plenty of regular sleep each night can help to balance out these sleepy lows.
The two processes of sleep-wake homeostasis and the circadian rhythm can influence each other. For example, a strong central clock will induce periods of deep sleep, which in turn will strengthen the clock function. Shift work and jet lag are situations where the circadian rhythm is compromised, and the introduction of nap schedules can help to reduce sleep pressure and increase the body's susceptibility to light.
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Circadian rhythm
The hypothalamus contains a group of nerve cells that form a structure called the suprachiasmatic nucleus (SCN). The SCN is sensitive to signals of dark and light. When the optic nerve in the eyes senses morning light, the SCN triggers the release of cortisol and other hormones to help you wake up. In response to darkness, the SCN sends messages to the pineal gland, which releases the sleep-inducing chemical melatonin.
The circadian rhythm is influenced by regular variations in the environment, such as the alternation of night and day. However, it can also be disrupted by changes in daily schedules, such as shift work, travel across time zones, and light from electronic devices at night. These disruptions can lead to drowsiness, poor coordination, and difficulty with learning and focus.
To regulate your circadian rhythm, it is important to maintain a consistent sleep schedule, even on weekends and vacations. This helps your body's ability to wake up naturally and improves sleep quality.
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Sleep quality
There are also four elements of sleep quality that were decided by an NSF-led expert group after an extensive review of 277 research studies. The most recognized way to measure these four elements is through a polysomnogram (PSG), an in-lab sleep test. However, recent innovations in technology have made it possible to measure nearly all of the same sleep features through at-home tests and wearable devices.
To improve sleep quality, it is recommended to set and keep to a sleep schedule, making sure to get the recommended amount of sleep for your age. Having a bedtime routine can help "train" your brain that sleep is coming. It is also important to avoid bright lights and electronics before bed, as the light from these devices can disrupt your body's natural sleep-wake functions. Caffeine can also promote wakefulness, so it is best to avoid it close to bedtime.
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Frequently asked questions
The sleep/wake cycle is the period during which the body alternates between two distinct modes: rapid eye movement sleep (REM) and non-rapid eye movement sleep (NREM).
REM sleep is the stage of sleep where most dreams occur. Your eyes move rapidly behind your eyelids, and your brain activity is similar to when you are awake.
NREM sleep is composed of three different stages. The higher the stage of NREM sleep, the harder it is to wake someone up.
The circadian rhythm is a 24-hour repeating rhythm that affects every cell, tissue, and organ in your body. It is influenced by your internal circadian clock, which is controlled by an area of the brain called the suprachiasmatic nucleus (SCN).
To improve your sleep/wake cycle, it is important to set and maintain a consistent sleep schedule, avoid bright lights and electronics before bed, and make time for sleep by picking a bedtime that allows you to get the recommended amount of sleep for your age.
