Prof. Idzikowski - Sleep - The secret to sleeping well and waking refreshed

Cover Page

Title Page Collins need to know? Sleep The secret to sleeping well and waking refreshed Doctor Chris Idzikowski

Introduction

1 Knowing the basics

2 Why can’t we sleep?

3 Life’s journey

4 How to sleep better

5 Taking control

6 Sleep disorders

7 Sleep medicine

Glossary

Useful addresses

Index

Copyright

About the Publisher

Sleep and wakefulness are two sides of the same coin and just about everyone has had a problem with them at one time or another. For many people the difficulties associated with sleep – sleeplessness, sleepiness, tiredness, fatigue – are short-lived and manageable while for others they become chronic and very hard to cope with.

People who need more than the average amount of sleep, say 9-10 hours a day tend to get little sympathy from those who get by on less. The latter, the ‘short’ sleepers, cannot understand why more is necessary to feel, function and look well. They are likely to know what it is like only when they cannot get enough sleep or their sleep is disrupted, such as from long commutes which do not leave much time for work and sleep, illness, jet lag, shift work, caring for others, etc. They have managed so they will wonder why it is not possible for others to cope – of course, they might lack insight because they are themselves chronically sleep-deprived; rather like someone who has drunk a little alcohol and thinks they are performing as well as before. Hence ‘long’ sleepers have a problem, as do ‘average’ sleepers if their sleep is disrupted and they are not getting enough. Those people with sleep disorders such as insomnia, narcolepsy, sleep apnoea (stopping breathing during sleep) or restless legs will be similarly aware that people who don’t have these disorders seem not to care.

Well, this book does care and its aim is not only to help both the sufferers from sleep disorders but also those who want to feel better rested. After all, it has been shown that daytime napping improves mental performance later in the day. The book takes a systematic approach by first exploring what sleep is, its patterns and different stages. This enables readers to understand what their sleep problem is as well as enabling them to work out solutions for themselves. Chapter 2 runs through all those factors that impact on sleep. Sleep varies over our lifetimes and Chapter 3 examines these changes; it helps to understand whether there is a natural process at work or an underlying problem.

Chapter 4 starts to look at solutions that may not necessarily require medical aid or intervention. Chapter 5 delves even deeper and provides some self-assessment procedures that may give an idea of what is causing the sleep problems.

The field of sleep medicine has grown over the last decade or so. In the US it has become a medical speciality. In the UK, on the other hand, expertise runs across a number of specialities, ranging from general practice to respiratory medicine, ENT surgery, psychiatry, neurology and occupational medicine. Sleep medicine has developed in a way that is shared across countries and Chapters 6 and 7 deal with what are now considered sleep disorders and their specific solutions.

Disturbed or shortened sleep not only has an impact on mental performance, both in terms of concentration and increased risk of car accidents, for instance, but it is also associated with diabetes, obesity, heart disease and strokes. Problems with sleep should be tackled and this book shows how to go about this.

With our 21st-century lifestyles and the everincreasing need to juggle work and family commitments, getting a good night’s sleep has never seemed more important, yet although we spend a third of our lives asleep, research in this area is still relatively new. What really happens when we are asleep? And why is sleep so important? Although much of this fascinating and complex subject remains a mystery, scientists now have some of the answers to these all-important questions.

Sleep is essential for our survival and wellbeing. We all know it makes us feel good, alert and able to cope with our waking lives. But why is it so important? What are the benefits of sleep and what happens when we don’t get enough?

Animal sleep

• Sleep is so essential to animals that Nature has made special arrangements to enable it to happen. Horses’ tendons are specially adapted to allow them to sleep standing up; similar adaptations allow South American sloths to sleep upside down, and migratory birds to sleep on the wing. Dolphin brains are so constructed to enable them to swim continuously while breathing (half their forebrain goes to sleep while the other half remains awake).

• The amount of sleep animals need varies according to their size. Elephants sleep for four hours, for instance; rats for 14.

Sleep is not an optional extra. Like the food we eat and the air we breathe, it is a fundamental need. Sleep is essential for all living beings. Studies on animals have shown that sleep provides a period of enforced quietness in which they can hide from predators, and that sleep exists in all varieties of mammal, irrespective of their size, temperament and habitat.

The generally held view is that sleep energizes and revives, providing us with an enforced time of rest that allows us to recharge our batteries to cope with the everyday business of living. But many scientists argue that to think of sleep entirely in terms of rest is misleading, because it is also an active period when the restoration and repair of body tissue takes place. It is during sleep, for example, that growth hormones are released in developing babies and children.

There is also evidence to suggest that sleep plays a significant role in brain development, and that learning may improve after sleep. In experiments carried out in the UK and USA, subjects who were allowed to sleep after learning new information were found to have a better recall of the data they had learned than those who had not slept.

To most of us, the benefits of sleep are evident from the way we feel after a good night’s rest. But perhaps a better way to understand the role of sleep is to look at what happens when we don’t sleep.

Rest and sleep

Scientists are baffled about the role of rest in sleep, as the amount of energy saved during sleep is only 100 kcal – the same number of calories as in a large piece of toast.

Classic sleep deprivation experiments consist of depriving subjects of one night’s sleep, then asking them to listen to about 1800 bleeps for an hour or so. About 40 of the bleeps are a second shorter than the others, and these are the ones the subjects have to react to. (Most errors of detection generally occur in the last 15 minutes of the task.) Experiments such as this have proved useful to scientists’ understanding of the consequences of lack of sleep. Findings have shown the main short-term effects to be as follows:

• General lack of wellbeing.Lack of sleep can cause fatigue and grogginess.

• Concentration and vigilance.Experiments have invariably shown damaging effects in these areas. People who have been sleep-deprived are more likely to have difficulty taking in information and to make mistakes at work. In real-life situations requiring constant vigilance, such as driving, the dangers are obvious. Statistics show that 20 per cent of all road accidents are caused by fatigue and that many of these accidents will lead to fatalities.