The Body's Need For Sleep: Understanding Daily Slumber

Sleep is an essential part of our daily routine, with the average person spending about a third of their life asleep. While the biological purpose of sleep remains a mystery, it is clear that it is vital for our health and survival. Sleep affects almost every type of tissue and system in the body, from the brain and heart to metabolism, immune function, mood, and disease resistance. When we sleep, our body cycles through four stages of sleep, which occur multiple times throughout the night for different lengths of time. These stages include three stages of non-REM sleep, characterised by an absence of eye movements, and one stage of REM sleep, when dreaming occurs and which is marked by rapid eye movements.

Sleep disorders, such as sleep apnea, restless legs syndrome, and narcolepsy

Sleep disorders can significantly impact an individual's sleep patterns and energy levels during the day. Here is an overview of three common sleep disorders:

Sleep Apnea

People with sleep apnea experience frequent pauses in their breathing during sleep, which can occur as often as every minute. This interruption causes the brain to send a 'wake-up' call, leading the person to briefly rouse and gasp for air before falling back asleep. As a result, their sleep is fragmented, and they may feel tired during the day.

Restless Legs Syndrome

Restless legs syndrome is characterised by sensations of cramps or irritation in the legs, particularly the calves. This compulsion to move the legs can disrupt sleep, causing individuals to get out of bed and walk around to find relief. The disorder can lead to non-restorative sleep and daytime drowsiness.

Narcolepsy

Narcolepsy is a rare sleep disorder that causes excessive daytime sleepiness, often leading to involuntary napping. It is characterised by muscle paralysis during sleep (sleep paralysis), vivid hallucinations before falling asleep, and muscle weakness during strong emotions (cataplexy). These symptoms can significantly impact an individual's ability to stay awake and alert during the day.

Idiopathic Hypersomnia

While not as well-known as the other disorders mentioned, idiopathic hypersomnia shares similarities with narcolepsy, causing excessive night-time sleeping and daytime napping. However, it does not include cataplexy or sleep paralysis, which are commonly associated with narcolepsy.

It is important to note that these sleep disorders can have varying effects on individuals, and proper diagnosis and treatment are crucial. Sleep disorders can impact daily functioning and increase the risk of accidents, especially when left untreated.

Lifestyle choices, including diet, exercise, and substance use

Diet:

The foods you consume can either help or hinder your sleep. A healthy, balanced diet that includes a variety of fruits, vegetables, whole grains, and lean proteins is essential for promoting healthy sleep patterns. A diet rich in nutrients like calcium, magnesium, and vitamins A, C, D, and E is particularly beneficial for sleep. Consuming simple carbohydrates four hours before bedtime can help you fall asleep faster. However, high-sugar and high-carbohydrate diets are associated with disrupted sleep. Caffeine and alcohol are known to reduce sleep quality, especially when consumed close to bedtime.

On the other hand, foods rich in the amino acid tryptophan, such as specific types of cherries, oily fish, and grain mixes, can improve sleep quality. A well-balanced diet with adequate amounts of carbohydrates, protein, and healthy fats is generally recommended for optimal sleep. Additionally, maintaining a consistent meal schedule and avoiding late-night meals can positively impact your sleep by regulating your body's circadian rhythms.

Exercise:

Physical activity and exercise play a crucial role in improving sleep quality. Both aerobic exercise, such as cardio and running, and resistance training or weightlifting, can enhance your sleep. Engaging in regular physical activity, especially during the daytime, can help regulate your sleep-wake cycle and improve your overall sleep quality. Morning or afternoon workouts are ideal, as exercising too close to bedtime may disrupt your ability to fall asleep.

Exercising outdoors and exposing yourself to natural light during the day can also help keep your body's internal clock in sync, promoting better sleep at night. However, it is important to avoid excessive exercise or intense workouts too close to bedtime, as this may make it challenging to wind down and fall asleep.

Substance Use:

The use of certain substances, such as drugs, alcohol, and cigarettes, can negatively impact your sleep. These substances can disrupt your sleep patterns and contribute to sleep disorders. Additionally, the use of certain medications can also affect sleep, and it is important to consult your healthcare provider if you suspect that your medication is interfering with your sleep.

In summary, making conscious lifestyle choices, including maintaining a healthy diet, engaging in regular physical activity, and being mindful of substance use, can significantly improve your sleep quality and overall well-being.

Underlying health conditions, like thyroid issues or cancer

Sleep is an essential part of what makes our bodies function. While the amount of sleep needed varies from person to person, most adults require seven to nine hours of sleep per night. If you're sleeping all day, there could be underlying health conditions that are causing this, such as thyroid issues or cancer.

Thyroid conditions can cause imbalances in your body chemistry, affecting your internal body clock and sleep-wake cycle. Hyperthyroidism, or an overactive thyroid, can lead to frequent waking, nervousness, irritability, night sweats, and a frequent need to urinate during the night. On the other hand, hypothyroidism, or an underactive thyroid, can make it difficult to fall asleep or stay asleep, impacting your sleep quality. It can also cause daytime sleepiness, joint pain, and muscle pain.

Cancer and its treatment can also disrupt sleep. Some common sleep issues related to cancer include insomnia, sleep apnea, and restless legs syndrome. Cancer and its treatment may cause pain, discomfort, anxiety, depression, and medication side effects, all of which can impact sleep. Additionally, cancer treatments like chemotherapy and radiation therapy can lead to fatigue and sleep disturbances.

If you're experiencing excessive daytime sleepiness or the constant need to sleep, it's important to consult a healthcare professional. They can help identify any underlying health conditions and provide appropriate treatment or referrals to specialists.

Mental health, specifically depression and anxiety

Sleep and mental health are closely linked. Poor sleep can be both a cause and a symptom of depression and anxiety.

Depression

Depression is a mental health condition that can be all-encompassing and extremely challenging and exhausting. It is often associated with sleep difficulties, such as shortening the amount of restorative slow-wave sleep a person gets each night. Sleep problems can increase the risk of developing depression, and persistent sleep issues can also increase the risk of relapse in people who have been treated for depression.

People with depression may find it difficult to fall asleep and stay asleep at night or experience periods of excessive daytime sleepiness. They may also experience insomnia, hypersomnia, and obstructive sleep apnea. Research suggests that many people with depression experience both insomnia and hypersomnia, with some patients experiencing both during a single period of depression.

Depression can cause a range of symptoms, many of which have a direct impact on energy levels. These include:

• Feelings of sadness, worthlessness, or hopelessness
• Loss of interest in hobbies or normal activities
• Tiredness and poor sleep or sleep problems
• Headaches or other body aches
• Anxiety or restlessness
• Trouble concentrating or remembering things
• Thoughts of death or suicide

The fatigue experienced by people with depression can be caused by a variety of factors, including lack of sleep, poor sleep habits, hypersomnia, poor diet, chemical imbalances, medication side effects, and stress.

Anxiety

Anxiety can also contribute to sleep disturbances. Anxious thoughts can keep people awake at night or disrupt their sleep, leading to a cycle of more anxious thoughts and further sleep disruption.

Treatment

Treating sleep problems can help alleviate symptoms of depression and anxiety. Cognitive behavioral therapy for insomnia (CBT-I) has been found to improve sleep in people with depression and may increase the chances of remission. Other treatments for depression, such as selective serotonin reuptake inhibitors and other medications, may improve mood and outlook but may not be enough to improve sleep.

Establishing good sleep hygiene practices can also help improve sleep quality. This includes setting a regular sleep and wake schedule, avoiding screens, alcohol, caffeine, and large meals before bed, and using the bed only for sleep.

Additionally, spending time outdoors and exposing oneself to sunlight can aid sleep by aligning the body's internal clock and circadian rhythms. Regular exercise can also improve sleep quality and decrease symptoms of depression.

Medication side effects, including antihistamines and antiemetics

Antihistamines

Antihistamines are commonly used to treat allergies and colds, and while drowsiness is often a welcome side effect for those suffering from these conditions, they are not recommended as a sleep aid. Many over-the-counter sleep aids are simply repackaged antihistamines. However, long-term use of antihistamines may lead to harmful side effects, and they are not recommended by sleep experts due to their lack of effectiveness in treating insomnia.

Antihistamines work by blocking the production of histamine in the immune system, which also decreases histamine levels in the brain, inducing sleep. Some antihistamines, such as diphenhydramine and doxylamine succinate, are known to cause drowsiness and are found in many over-the-counter medications and sleep aids.

Side effects of antihistamines include:

• Altered mental state
• Urinary retention
• Dry mouth
• Sleepwalking and other parasomnias
• Hyperactivity, especially in children
• Short-term memory loss
• Increased heart rate
• Difficulty urinating

Antiemetics

Antiemetic drugs are used to ease nausea and vomiting caused by various factors such as viral or bacterial infections, surgery, or other medications like chemotherapy. They work by blocking chemical messengers called neurotransmitters that send signals of nausea to the brain. Antiemetics can be over-the-counter or prescription medications and are particularly useful for treating morning sickness during pregnancy, motion sickness, and nausea after surgery or chemotherapy.

Antiemetics that are known to cause sleepiness include antihistamines such as diphenhydramine (Benadryl), promethazine (Phenergan), and dimenhydrinate (Dramamine, Gravol). It is important to note that antiemetics have various side effects depending on their specific type and formulation, and it is recommended to consult a doctor or pharmacist before taking them.

Other common side effects of antiemetics include:

• Dry mouth and dry nasal passages
• Indigestion, increased appetite or thirst, and acne (corticosteroids)
• Fatigue, constipation, ringing in the ears, dry mouth, restlessness, and muscle spasms (dopamine receptor blockers)
• Dry mouth, reduced urine volume, and heartburn (NK1 receptor blockers)
• Fatigue, dry mouth, and constipation (serotonin receptor blockers)

Frequently asked questions