Stages of sleep and sleep hygiene

'I want to sleep... but I can't.'  So say many of the patients I see.  Further, some wonder:

'Can I take sleeping pills?'

'How long should I take them?'

'What is sleep hygiene?'

Sleep is a complex biological requirement that is poorly understood.  It is surmised that sleep helps in reorganization of memories and refreshment of cognitive abilities; a mental reboot of sorts.

What we do know, through sleep studies, is that sleep occurs in stages known as REM (rapid eye movement) and NREM (non-rapid eye movement).  NREM sleep is further divided into four stages that progressively take us deeper into sleep.  REM and NREM alternate with each other, and the duration of REM increases throughout an uninterrupted sleep session.  Both factors - the total duration of sleep and the quality of these successive stages - are required for a fulfilling and invigorating sleep experience.

While it is not known why we spend one-third of our lives sleeping, what we do know are the consequences of not sleeping: mental and physical disturbances that may even be fatal.  We also know that as a person ages, his/her sleep duration and quality diminish.

Watch this video for tips on sleeping naturally:

In English: https://youtu.be/8vfXkmMYR2A

In Hindi: https://youtu.be/1qlqrE6m0pI

In Kannada: https://youtu.be/cn33AFes_XE

Here are the dos and don'ts of sleep hygiene that you can put into practice if you are experiencing insomnia:

DO

• Keep your bedroom dark, noiseless, and of the right temperature that is comfortable for you.
• Sleep in the night time only since melatonin, the natural sleep hormone, is released according to the circadian rhythm of the body; that is to say, during the night when it is dark.
• Take up relaxing activities, especially in the evenings after 6 p.m., such as deep-breathing, meditation, listening to soothing music, reading a book, going for a leisurely stroll; whatever you find relaxing.
• Take plain milk (without sugar or other additions - milk is high on serotonin, the natural sleep neurotransmitter) or a warm shower, both of which are said to lull you into sleeping.
• Get your medical and mental health checkup done to make sure you don't have conditions that can keep you awake in the night.
• Get your regular medications reviewed to make sure they are not causing insomnia as a side-effect.

DON'T

• Sleep during the daytime or in the afternoons (that is, if this affects your night sleep; if, on the other hand, you happen to be one of the lucky ones who can sleep well both during day and night, enjoy your afternoon siesta).
• Take sleeping pills for too long, certainly not for more than two weeks.  They are only meant to bring your sleep back on track.  The longer you take these, the more dependent you become on them, and the more you would have to beg your doctor to prescribe higher doses of them.  So, be warned!
• Consume caffeinated food substances after 6 p.m., such as those mentioned in the video.
• Drink heavily: it is a common misconception that alcohol helps you fall asleep; in the long run it messes up your sleeping pattern.  
• Smoke cigarettes or beedis, or consume tobacco products.  They contain nicotine, another stimulant that makes falling asleep difficult, apart from every other disorder under the sun; so you are better off not smoking at all.  Needless to say, also do not take any other street drugs.
• Spend too much time gazing at screens of any kind when you are in bed.  The light emitted from gadgets is considered to be bad for sleep.
• Exercise heavily after 6 p.m. as this can stimulate you.  Regular exercise is a good habit, but do it during the mornings or early afternoons.
• Eat heavily: avoid 5/7-course buffets in the night since this can put your digestive system into overdrive, thus depriving brain of blood supply (brain is active during the REM stage of sleep). 

List of resources used in the video:

Music: 

• 'Sleeplessness' by The Brothers Records

Pictures:

• Sleep smiley: https://upload.wikimedia.org/wikipedia/commons/thumb/e/ea/Face-sleep.svg/1024px-Face-sleep.svg.png
• Sleeping woman: https://ecogreenlove.files.wordpress.com/2018/02/01312018_soothingplants.png?w=888
• Bedroom: https://s3.amazonaws.com/s3.frank.itlab.us/photo-essays/small/feb_04_0348_bedroom.jpg
• Clock: https://cdn.pixabay.com/photo/2012/04/10/16/11/clock-26106_960_720.png
• Tea: http://clamorworld.com/wp-content/uploads/2016/12/Chai-Tea-Cybilla.jpg
• Coffee: https://upload.wikimedia.org/wikipedia/commons/thumb/a/ab/Filter-Coffee.jpg/349px-Filter-Coffee.jpg
• Cola: https://upload.wikimedia.org/wikipedia/commons/thumb/f/f6/15-09-26-RalfR-WLC-0098.jpg/170px-15-09-26-RalfR-WLC-0098.jpg
• Chocolate: https://fairtradeindunedin.files.wordpress.com/2009/08/chocolate1.jpg?w=300&h=240
• Exercise: https://cdn.pixabay.com/photo/2013/07/13/10/16/woman-156892_640.png
• Buffet: https://upload.wikimedia.org/wikipedia/commons/thumb/c/c0/Chinese_buffet2.jpg/220px-Chinese_buffet2.jpg
• Milk: https://www.publicdomainpictures.net/pictures/20000/nahled/glass-of-milk.jpg
• Shower head: https://www.publicdomainpictures.net/pictures/10000/nahled/1-1242735684R0fs.jpg
• Meditation: http://wondergressive.com/wp-content/uploads/2014/08/medi11.jpg
• Lady with tanpura: https://upload.wikimedia.org/wikipedia/commons/thumb/1/13/A_Lady_Playing_the_Tanpura%2C_ca._1735.jpg/220px-A_Lady_Playing_the_Tanpura%2C_ca._1735.jpg
• Book reading: https://www.publicdomainpictures.net/pictures/20000/velka/reading-an-old-book.jpg
• Pills bottle: https://cdn.pixabay.com/photo/2014/03/25/16/59/medicine-297778_960_720.png