Wednesday 16 March 2011

SLEEP: a necessity of life

Sleeping is a naturally recurring state characterized by reduced or absent consciousness, relatively suspended sensory activity, and inactivity of nearly all voluntary muscles. It is distinguished from quiet wakefulness by a decreased ability to react to stimuli, but it is more easily reversible than hibernating or being in a coma. One thing is for sure. It is absolutely necessary. The purpose and mechanism of sleep are only partially clear and are the subject of intense research. Sleep is often thought to help conserve energy, but it actually only decreases metabolism about 5–10%. It is observed in all mammals, all birds, and many reptiles, amphibians, and fish.

As humans, we will spend almost one third of our lives sleeping? This means that if you live to be sixty-six years of age, during twenty-two years of your life, you will be unconscious. So in actual fact, your conscious life will only be forty-four years in which you can do whatever it is you wish to do and accomplish what you want to accomplish in your lifetime. So if you die at the age of sixty-six, your friends could hardly say that you had a full and active life since during twenty-two years of it, you were doing nothing except breathing and dreaming.

During our waking moments our nerve cells are constantly active and become more or less fatigued. Sleep gives our body cells an opportunity of ridding themselves of waste and of repairing themselves. To insure a recovery period from such fatigue, we undergo the periodic loss of consciousness known as sleep. Sleep is such an important bodily function, and even though we might put off going to sleep, eventually sleep will take over.

There was one man however who was denied sleep for a year. He was a general who was captured sometime before Christ was born. Keeping him awake was a form of torture. He died a year after he was captured after being subjected to such torture. The same thing was done to the Panamanian dictator, Manuel Antonio Noriega after the invasion of Panama by the American forces. He was discovered to be in the Apostolic Nunciature, the Holy See's embassy in Panama. He refused to leave the embassy. Everyone else left the embassy and the Americans brought very large speakers onto the scene and subjected Noriega to extremely loud heavy music hour after hour for several days. When he could take no more, he surrendered on January 3, 1990. He has been in custody ever since; first by the Americans and now by the French.

How much sleep should a person get each night? The answer depends on the individual. Some people need a great deal of sleep, while others require only a minimum of sleep. The individual needs to get the amount of sleep necessary to feel alert, healthy, and totally fit. Nervous and tense people usually require more sleep than those of a placid disposition. The average individual maintains his health with about eight hours of sleep.

Toddlers need 11 hours of sleep every night, plus a two-hour nap during the day. Preschoolers need 11 to 12 hours of sleep a night. School-age children need 10 hours of sleep each night. Teens need 9.25 hours of sleep every night. Most get less than 8.5. Adults need at least 8 hours of sleep every night but most rarely get that much. If as an adult, you get one hour less sleep than you need each night for eight nights in a row, your brain will need sleep as desperately as if you had stayed up all night.

I generally go to bed around 11:00 at night and wake up at six or seven in the morning. Being retired gives me the opportunity to take one or two-hour naps in the afternoon if I feel tired but I only do that once or twice a week. I don’t know if that is because I am pushing 78 or because I am restless at night.

A great many people suffer from parasomnia which can be any number of sleep disorders that will keep some people from getting a normal sleep. A few of the most common parasomnias are sleep walking, sleep terrors, and gritting of the teeth.

Sleep walking occurs when one gets up during sleep and walks around. This can be very dangerous if a person leaves the house. Their have been cases in which people walked out into busy streets and were killed by oncoming traffic. A man in Canada while asleep, got up and drove his car to his mother-in-law’s home and killed her.
Sleep terrors or screaming occurs during sleep and can disrupt the whole house. As a person sits up in bed, screaming and trashing about. A person having a sleep terror is hard to arouse from sleep and is confused if woken up.

Teeth gritting is also a parssomina called bruxism. Bruxism is damage or wear to the teeth caused by gritting of the teeth during sleep. Symptoms can include jaw discomfort, fatigue, pain, and headaches.

Insomnia is a plague that haunts a great many people world-wide. Insomnia is hitting epidemic proportions. It started when early man began moving away from his origins near the equator, where the day is predictably divided into equal amounts of day and light. The introduction of artificial lighting made it worse. Humans have been marching zombie-like, arms outstretched, eyes half shut toward a 24-7 world of shift work, job-and family-related stress and all-night shopping and movie channels.

There is the common belief by man that counting sheep will ease you to sleep. Don’t believe it. It’s a myth same as drinking warm milk.

I have to undergo a rather strange procedure when I am sleeping. Because I broke the upper bone of my right arm in half many years ago, I suffer from permanent nerve damage in that arm. When I am sleeping, sometime during the night, I roll over on my right side and that wakes me up because of the pain that occurs at that moment in that arm. I then get up and go to our living room and sit in a comfortable sofa chair and after placing a blanket over me, I am asleep in about two minutes. I wake up approximately two hours later and go back to my bed and then I am asleep again in a few minutes until I get up in the morning. It’s a ritual that I have generally undergone every night for years. It’s not really disturbing to my wife because she can sleep through anything. She goes to bed at ten in the evening and gets up at five because she has to be at work at seven since her employer is in downtown Toronto and we live in the outskirts of that large city which is some considerable distance away.


I really feel sorry for those unfortunate people who suffer from insomnia. Most adults have experienced insomnia or sleeplessness at one time or another in their lives. I certainly do while flying on a long flight at night. One flight my wife and I took in 2005 lasted 14 hours in which all of it was in darkness due to the fact that we were crossing time zones as we flew from Toronto to Hong Kong. Try sleeping on a plane that long when your seat is just several seats from the all-night movie screen.

An estimated 30%-50% of the general population are affected by insomnia, and 10% have chronic insomnia.

Insomnia is a symptom, not a stand-alone diagnosis or a disease. By definition, insomnia is ‘difficulty initiating or maintaining sleep, or both’ or the perception of poor quality sleep. Insomnia may therefore be due to inadequate quality or quantity of sleep. Insomnia is not defined by a specific number of hours of sleep that one gets, since individuals vary widely in their sleep needs and practices. Most of us know what insomnia is and how we feel and perform after one or more sleepless nights. Few seek medical advice because they remain unaware of the behavioral and medical options available to treat insomnia.

Symptoms lasting less than one week are classified as transient insomnia, symptoms between one to three weeks are classified as short-term insomnia, and those longer than three weeks are classified as chronic insomnia.

Insomnia affects all age groups. Among adults, insomnia affects women more often than men. The incidence tends to increase with age. It is typically more common in people in lower socioeconomic (income) groups, chronic alcoholics, and mental health patients. Stress most commonly triggers short-term or acute insomnia. If you do not address your insomnia, however, it may develop into chronic insomnia.

Many of the causes of transient and short-term insomnia are similar and they include: jet lag, changes in shift work, excessive or unpleasant noise, uncomfortable room temperature (too hot or too cold) stressful situations in life (exam preparation, loss of a loved one, unemployment, divorce, or separation, waiting for a trial) presence of an acute medical or surgical illness or hospitalization, withdrawal from drug, alcohol, sedative, or stimulant medications, insomnia related to high altitude (mountains).

Uncontrolled physical symptoms (pain, fever, breathing problems caused by nasal congestion, or too much carbon dioxide in the bedroom because the window and door are both closed, cough, diarrhea, etc.) can also cause someone to have insomnia. Controlling these symptoms and their underlying causes may lead to a resolution of insomnia.

The majority of causes of chronic or long-term insomnia are usually linked to an underlying psychiatric or physiologic (medical) condition.

The most common psychological problems that may lead to insomnia include: anxiety, depression, stress (mental, emotional, situational, etc), schizophrenia, and/or mania (bipolar disorder)

Insomnia may be an indicator of depression. Many people will have insomnia during the acute phases of a mental illness. As mentioned earlier, depression and anxiety are strongly associated with insomnia. Out of the all the other secondary medical and psychological causes of insomnia, anxiety and depression are the most common. It follows that someone suffering from these disorders should seek treatment for these ailments. Treatment may then solve the insomnia problem also.

Physiological causes span from circadian rhythm disorders (disturbance of the biological clock), sleep-wake imbalance, to a variety of medical conditions. The following are the most common medical conditions that trigger insomnia: chronic pain syndromes, chronic fatigue syndrome, congestive heart failure, (very scary-seek immediate help) night time angina (chest pain) from heart disease, acid reflux disease, chronic obstructive pulmonary disease, nocturnal asthma (asthma with night time breathing symptoms), obstructive sleep apnea, degenerative diseases, such as Parkinson's disease and Alzheimer's disease (Often insomnia is the deciding factor for nursing home placement), brain tumors, strokes, or trauma to the brain.

In addition to people with the above medical conditions, certain groups may be at higher risk for developing insomnia such as: travelers, shift workers with frequent changing of shifts, seniors, adolescents or young adult students, pregnant women, women in menopause, people who use abuse drugs, alcoholics.

Certain medications have also been associated with insomnia. Among them are:
• Certain over-the-counter cold and asthma preparations.
• The prescription varieties of these medications may also contain stimulants and thus produce similar effects on sleep.
• Some medications used to treat high blood pressure have also been associated with poor sleep.
• Some medications used to treat depression, anxiety, and schizophrenia.

Other causes of insomnia are: common stimulants associated with poor sleep include caffeine and nicotine. You should consider not only restricting caffeine and nicotine use in the hours immediately before bedtime but also limiting your total daily intake. People often use alcohol as a nightcap to help induce sleep. However, it is a poor choice. Alcohol is associated with sleep disruption and creates a sense of non-refreshed sleep in the morning. And of course, another reason why people can’t sleep is that world-wide complaint; a disruptive bed partner who snores loudly or has periodic leg movements which will also impair your ability to get a good night's sleep.

Daytime problems caused by insomnia include the following: poor concentration and focus, difficulty with memory, impaired motor coordination (being uncoordinated), irritability and impaired social interaction, motor vehicle accidents because of fatigued, sleep-deprived drivers.

People may worsen these daytime symptoms by their own attempts to treat the symptoms such as using alcohol and antihistamines which may compound the problems with sleep deprivation. Others have tried nonprescription sleep aids which may or not work.
Many people with insomnia do not complain of daytime sleepiness, and in fact, they may have difficulty falling asleep during intentional daytime naps.

In addition to the causes and conditions listed above, there are also a number of conditions that are associated with insomnia in the absence of another underlying condition. These are called ‘primary sleep disorders’, in which the sleep disorder is the main cause of insomnia. These conditions generally cause chronic or long-term insomnia. They are:

Idiopathic insomnia (unknown cause) or childhood insomnia, which start early on in life and results in lifelong sleep problems. This may run in families.Central sleep apnea. This is a complex disorder. It can be the primary cause of the insomnia itself or it may be caused by other conditions, such as brain injury, heart failure, high altitude, and low oxygen levels. Restless legs syndrome (a condition associated with creeping sensations in the leg during sleep that are relieved by leg movement), periodic limb movement disorder (a condition associated with involuntary repeated leg movement during sleep). Circadian rhythm disorders (disturbance of the biological clock) which are conditions with unusual timing of sleep (for example, going to sleep later and waking up late, or going to sleep very early and getting up very early). Sleep state misconception, in which the patient has a perception or feeling of not sleeping adequately, but there are no objective (polysomnographic or actigraphic) findings of any sleep disturbance. Insufficient sleep syndrome, in which the person's sleep is insufficient because of environmental situations and lifestyle choices, such as sleeping in a bright or noisy room and inadequate sleep hygiene, in which the individual has poor sleep or sleep preparation habits.

It must be obvious by now that anyone suffering from insomnia should see their doctor and get treatment for the underlying causes of insomnia. Treatment may then resolve this terrible problem that so many people suffer from.

The following is a random compendium of sleep-related stats. Read them and then go to sleep:The estimated segment of the Canadian population that are aged 15 and older — that’s 3.3 million people or 13.4% meet the criteria for insomnia (difficulty going to sleep or staying asleep).

Amount of sleep people with mild insomnia squeeze in each night, is 6,5 hours compared to 7.5 hours for those without insomnia. Eighteen per cent of the former averaged less than five hours a night. (There was no conclusive word on whether a glass of warm milk and counting sheep are enough to induce drowsiness.)The percentage of insomniacs who took sleep medication as least once in the previous 12 months is 29%.

The extra sleep women get compared with men each night is 11 minutes on average. Men sleep more soundly, however, as women suffer more disturbed sleep because they wake more easily. Women are also more likely to report insomnia among all age groups, except in 35- to 44-year-olds, where rates were similar.

The extra sleep single people get compared with married people and those in common-law unions is 24 minutes.

The amount of minutes of extra sleep someone who makes $20,000 a year compared with someone who makes $60,000 or more a year is 40 minutes. That’s probably because the person who makes a great deal of money probably has a great deal on his or her mind and can’t shake it while trying to sleep.

Rise in the prevalence of insomnia from ages 15 to 24 (10 per cent) to 75 and older (20 per cent).

Sleeping pill prescriptions filled in 2005 in the United States, up nearly 60 per cent from 2000, according to IMS Health. Most of the sleep medications taken by insomniacs were prescribed: 23 per cent had used prescription medication in the past year, while 6.5 per cent used over-the-counter drugs. That amounts to 42 million sleeping pills.

Long pauses in breathing last between 10 and 30 seconds for sufferers of sleep apnea, in which the brain then automatically kicks in to alleviate the problem.

Some of my readers have suggested that reading my blogs is enough to make anyone go to sleep. One nasty individual actually had the temerity to suggest that anesthetists in hospital operating rooms should read to their patients excerpts from my blog. He said as a warning that will not only put the patient to sleep, the patient may actually go into an irreversible coma if he is read too much from my blog at any one time.

Speaking of sleeping, it is now time for my afternoon nappy. Good Lord. I just read my blog. I hope I don’t go into an irreversible coma.

No comments: