Do We Need Sleep?

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Is sleep important?

Yes, sleep is essential to health and survival. No animal can remain healthy and live without sleep. Sleep is also important in keeping ourself looking good, hence the phrase "beauty sleep." The rest and benefit our body gets from sleep depends on many factors, including our emotional state. The value of sleep should never be ignored.

What are the kinds of sleep?

There are two types of sleep. One is nonrapid-eye-movement (NREM, which is 75% to 80% of total sleep time) which normally initiates sleep, and ranges in depth from 1 to 4 (4, being the deepest level) with commensurate difficulties in arousal. The other is the rapid-eye-movement (REM, which makes up the 20% to 25%).

What is the difference between the two?

In NREM, the EEG (electroencephalogram: brain waves) are slow. The muscle tone, respiratory rate, heart rate, blood pressure are lowered. In REM, other the respiratory rate and depth are increased but the muscle tone is even less than in NREM. The blood pressure varies and could be elevated, especially at dawn, near the waking stage. In normal sleep, the REM follow NREM in each of 5 to 6 cycles.

Why is sleep important?

Sleep provides our body our much-needed physical and mental rest. This is the time when we revitalize our system, re-charge and re-energize our "power-pack," in preparation for the following day's activities. Rest maximizes the regenerative and repair processes for our cells in the body. Adequate sleep keeps the wrinkles at bay. People who lack sleep grow older and look older prematurely. Those of us who claim sleep is not improtant were probably asleep when Mother Nature gave us the instructions about our physiology and biological clock.

How much sleep does one need?

Infants need about 20 hours of sleep a day. They wake up only to feed evry 3-4 hours, and go right back to sleep, because their basal metabolism is faster. They churn energy at a higher speed for growth and development. As we grow older, the need for sleep becomes less. Somebody 60 years or older might wake up after 4 hours of sleep and level 4 sleep disappears. However, we recommend at least 8 hours of sleep for any adult. And if practical, a siesta or a catnap in the early afternoon is beneficial. One feels energized even after a very short nap.

Why do some people have insomnia?

Insomnia or difficulty in sleeping may be primary (long standing with no obvious physical or emotional cause) or secondary (due to aches and pains from any source, depression, anxiety, withdrawal from cigarette, alcohol or drug, etc).

Should insomnia be treated?

Any condition that affects our health, sense of well-being and comfort should be treated. There are now sleeping aids that are safe and can be taken regularly, provided it is done under medical supervision. And insomnia, after properly diagnosed and the etiology determined by the physician, could be a simple matter of socio-pyschological adjustment or using hypnotics (sleeping pills) or mild tranquilizers that will spell the difference between feeling great or feeling tired and lousy everyday. The key here is medical consultation and evaluation to rule out any hidden serious illness causing the insomnia.

What is Sleep Walking?

Somnambolism, or sleep walking or sitting, or other complex behavior during sleep, is most common among late childhood and adolescence. The eyes are open but without evidence of recognition. The person may mumble repeatedly, and walk almost normally except that they may hit chairs, tables and other obstacles without realizing it. There is no accompanying dream and their EEG (electroencephalogram) shows a state of wakefulness than sleep. When they wake up, they do not remember the episode.

What is hypersomnia?

This is a condition where a person regularly sleeps about 25% or more than usual, to the extent that it interferes with his/her socioeconomic functions. This could be caused by excessive use of sleeping pills or by a tumor in the brain affecting the hypothalamus or brain stem. When this abnormal increase in absolute sleep persists, it must be investigated.

How is this different from narcolepsy?

Narcolepsy is a rare syndrome of recurrent attacks of sleep, sudden loss of muscle tone sleep paralysis, with initial REM sleep pattern, instead of the normal NREM. Sleeps occurs anytime, suddenly, uncontrollably, to a person, wherever he/she is, whether talking to another or attending a conference, etc. The attacks may happen from a few to many times a day, from a few minutes to hours duration.

What is Sleep Paralysis?

Sleep paralysis is an occasional occurrence (just when falling asleep or right after waking up) the person wants to move and for a moment could not move at all. This is temporary and can be due to a feeling of terror, and happens in normal children and adults. No treatment is needed for this episodes except eliminating the cause of the "terror," in the few cases where this is the cause.

What is Sleep Apnea?

Sleep apnea is a condition where the person holds his breath for an abnormally long period (say, 40 seconds or longer), and as a result reduces his/her level of oxygen in the blood. If this persists, some people develop a heart attack or even cardiac arrest. This could be from blockage of the upper airway breathing passages, especially in fat people. Men are more affected than women, and snoring is greatly associated with sleep apnea. When this keeps on happening, night after night, the individual feels fatigued and sleepy even as early as mid afternoon. This is due to lack of sleep and low oxygen level in the blood, because of the breathing problem. A medical consultation with a Throat Specialist may be in order if this condition persists.

Why do people snore?

Snoring is caused by the vibration of the uvula (small appendage that hangs down at the back end of the roof of the mouth, the upper palate), the softer part of the roof (soft palate), the back part (base) of the tongue and the vocal cords. Snoring happens when the soft palate and the structures in the area adjacent to it (which normally are taut and firm) become limp and sagging, especially as we grow older. The structures could be so sagging as to block the upper airway, causing, not only snoring, but sleep apnea. Allergies, causing nasal congestion and leading to mouthing breathing can also cause temporary snoring. Sleeping prone or on the side, with the head of the bed raised, could help reduce snoring. Taking sleep medications, tranquilizers, alcoholic beverages can also aggravate snoring (and apnea) among those who snore. We recommend snorers not to take any of these.

Are all sedatives and hypnotics safe?

No, not all sedatives and sleeping pills are safe. Some are too potent, some are too crude and ill-refined, and some have worse side effects than others. If too strong for you, the sleeping pills can hurt you seriously. Many of them can cause addiction also. It is not safe to buy over the counter medications without physician advice and supervision. Your medical caretaker can recommend to you the sedative or hypnotic best suited for you and your condition.

©2003Raoul R. Diez, M.A.O.D.