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Your Guide to Healthy Sleep National Heart Lung and
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Y o u r G u i d e t o,Healthy Sleep,NIH Publication No 11 5271. Originally printed November 2005,Revised August 2011. Introduction 1,What Is Sleep 4,What Makes You Sleep 7. What Does Sleep Do for You 12,Your Learning Memory and Mood 12. Your Heart 13,Your Hormones 14,How Much Sleep Is Enough 19.
What Disrupts Sleep 25,Is Snoring a Problem 30,Common Sleep Disorders 33. Insomnia 35,Sleep Apnea 38,Restless Legs Syndrome 47. Narcolepsy 48,Parasomnias Abnormal Arousals 51,Do You Think You Have a Sleep Disorder 53. How To Find a Sleep Center and Sleep Specialist 56. Research 57,For More Sleep Information 60,Introduction. Think of your daily activities Which activity is so important you. should devote one third of your time to doing it Probably the first. things that come to mind are working spending time with your. family or doing leisure activities But there s something else you. should be doing about one third of your time sleeping. Many people view sleep as merely a down time when their brains. shut off and their bodies rest People may cut back on sleep think. ing it won t be a problem because other responsibilities seem much. more important But research shows that a number of vital tasks. carried out during sleep help people stay healthy and function at. their best, While you sleep your brain is hard at work forming the pathways.
necessary for learning and creating memories and new insights. Without enough sleep you can t focus and pay attention or respond. quickly A lack of sleep may even cause,mood problems Also growing. evidence shows that a chronic,lack of sleep increases your risk. of obesity diabetes cardiovas,cular disease and infections. Introduction, Despite growing support for the idea that adequate sleep like. adequate nutrition and physical activity is vital to our well being. people are sleeping less The nonstop 24 7 nature of the world. today encourages longer or nighttime work hours and offers. continual access to entertainment and other activities To keep up. people cut back on sleep, A common myth is that people can learn to get by on little sleep.
such as less than 6 hours a night with no adverse effects Research. suggests however that adults need at least 7 8 hours of sleep each. night to be well rested Indeed in 1910 most people slept 9 hours a. night But recent surveys show the average adult now sleeps fewer. than 7 hours a night More than one third of adults report daytime. sleepiness so severe that it interferes with work driving and social. functioning at least a few days each month, Evidence also shows that children s and adolescents sleep is shorter. than recommended These trends have been linked to increased. exposure to electronic media Lack of sleep may have a direct effect. on children s health behavior and development,Chronic sleep loss or sleep disorders may. affect as many as 70 million Americans,This may result in an annual cost of. 16 billion in health care,expenses and 50 billion in. lost productivity,Your Guide to Healthy Sleep, What happens when you don t get enough sleep Can you make up.
for lost sleep during the week by sleeping more on the weekends. How does sleep change as you become older Is snoring a problem. How can you tell if you have a sleep disorder Read on to find the. answers to these questions and to better understand what sleep is. and why it is so necessary Learn about common sleep myths and. practical tips for getting enough sleep coping with jet lag and. nighttime shift work and avoiding dangerous drowsy driving. Many common sleep disorders go unrecognized and thus are not. treated This booklet also gives the latest information on sleep. disorders such as insomnia trouble falling or,staying asleep sleep apnea pauses in. breathing during sleep restless legs,syndrome narcolepsy extreme daytime. sleepiness and parasomnias abnormal,sleep behaviors. It s important to tell your,doctor what you are,experiencing so you can. help your doctor diagnose,your condition,Introduction.
What Is Sleep, Sleep was long considered just a block of time when your brain and. body shut down Thanks to sleep research studies done over the. past several decades it is now known that sleep has distinct stages. that cycle throughout the night in predictable patterns How well. rested you are and how well you function depend,not just on your total sleep time but on how much. sleep you get each night and the timing of your,sleep stages. Your brain and body functions stay active through,out sleep and each stage of sleep is linked to a. specific type of brain waves distinctive,patterns of electrical activity in the brain.
Sleep is divided into two basic types,rapid eye movement REM sleep and. non REM sleep with three different,stages For more information see. Types of Sleep on page 5 Typically,sleep begins with non REM sleep In. stage 1 non REM sleep you sleep lightly,and can be awakened easily by noises or. other disturbances During this first stage,of sleep your eyes move slowly your.
muscles relax and your heart and breath,ing rates begin to slow You then enter. stage 2 non REM sleep which is defined,by slower brain waves with occasional. bursts of rapid waves You spend about,Your Guide to Healthy Sleep. half the night in this stage,When you progress into stage 3 non. REM sleep your brain waves become,even slower and the brain produces.
extremely slow waves almost exclusively,called Delta waves. Stage 3 is a very deep stage of sleep during which it is very difficult. to be awakened Children who wet the bed or sleep walk tend to do. so during stage 3 of non REM sleep Deep sleep is considered the. restorative stage of sleep that is necessary for feeling well rested. and energetic during the day,Non REM Sleep REM Sleep. Stage 1 Light sleep easily l Usually first occurs,awakened muscles about 90 minutes. relax with occasional after you fall asleep,twitches eye and longer deeper. movements are slow periods occur during,the second half of the.
Stage 2 Eye movements stop night cycles along with. slower brain waves the non REM stages,with occasional bursts throughout the night. of rapid brain waves,l Eyes move rapidly, Stage 3 Occurs soon after you behind closed eyelids. fall asleep and mostly l Breathing heart rate,in the first half of the and blood pressure are. night Deep sleep irregular,difficult to awaken,l Dreaming occurs. large slow brain,waves heart and l Arm and leg muscles.
respiratory rates are are temporarily,slow and muscles are paralyzed. Types of Sleep, During REM sleep your eyes move rapidly in different directions even. though your eyelids stay closed Your breathing also becomes more. What Is Sleep, rapid irregular and shallow and your heart rate and blood pressure. increase Dreaming typically occurs during REM sleep During this. type of sleep your arm and leg muscles are temporarily paralyzed so. that you cannot act out any dreams that you may be having. You typically first enter REM sleep about an hour to an hour and a. half after falling asleep After that the sleep stages repeat them. selves continuously while you sleep As you sleep REM sleep time. becomes longer while time spent in stage 3 non REM sleep becomes. shorter By the time you wake up nearly all your sleep time has. been spent in stages 1 and 2 of non REM sleep and in REM sleep. If REM sleep is severely disrupted during one night REM sleep time. is typically longer than normal in subsequent nights until you catch. up Overall almost one half of your total sleep time is spent in. stage 2 non REM sleep and about one fifth each in deep sleep stage 3. of non REM sleep and REM sleep In contrast infants spend half. or more of their total sleep time in REM sleep Gradually as they. grow the percentage of total sleep time they spend in REM contin. ues to decrease until it reaches the one fifth level typical of later. childhood and adulthood, Why people dream and why REM sleep is so important are not well. understood It is known that REM sleep stimulates the brain. regions you use to learn and make memories Animal studies. suggest that dreams may reflect the brain s sorting and selectively. storing new information acquired during wake time While this. information is processed the brain might revisit scenes from the day. and mix them randomly Dreams are generally recalled when we. wake briefly or are awakened by an alarm clock or some other noise. in the environment Studies show however that other stages of. sleep besides REM also are needed to form the pathways in the. brain that enable us to learn and remember,Your Guide to Healthy Sleep.
What Makes You Sleep, Although you may put off going to sleep in order to squeeze more. activities into your day eventually your need for sleep becomes. overwhelming This need appears to be due in part to two sub. stances your body produces One substance called adenosine. builds up in your blood while you re awake Then while you sleep. your body breaks down the adenosine Levels of this substance in. your body may help trigger sleep when needed, A buildup of adenosine and many other complex factors might. explain why after several nights of less than optimal amounts of. sleep you build up a sleep debt This may cause you to sleep longer. than normal or at unplanned times during the day Because of your. body s internal processes you can t adapt to getting less sleep than. your body needs Eventually a lack of sleep catches up with you. The other substance that helps make you sleep is a hormone called. melatonin This hormone makes you naturally feel sleepy at night. It is part of your internal biological clock which controls when. you feel sleepy and your sleep patterns Your biological clock is a. small bundle of cells in your brain that works throughout the day. and night Internal and external environmental cues such as light. signals received through your eyes control these cells Your biologi. cal clock triggers your body to produce melatonin which helps. prepare your brain and body for sleep As melatonin is released. you ll feel increasingly drowsy Because of your biological clock. you naturally feel the most tired between midnight and 7 a m You. also may feel mildly sleepy in the afternoon between 1 p m and. 4 p m when another increase in melatonin occurs in your body. Your biological clock makes you the most alert during daylight. What Makes You Sleep, hours and the least alert during the early morning hours Conse. quently most people do their best work during the day Our 24 7. society however demands that some people work at night Nearly. one quarter of all workers work shifts that are not during the. daytime and more than two thirds of these workers have problem. sleepiness and or difficulty sleeping Because their work schedules. are at odds with powerful sleep regulating cues like sunlight night. shift workers often find themselves drowsy at work and they have. difficulty falling or staying asleep during the daylight hours when. their work schedules require them to sleep, The fatigue experienced by night shift workers can be dangerous. Major industrial accidents such as the Three Mile Island and. Chernobyl nuclear power plant accidents and the Exxon Valdez oil. spill have been caused in part by mistakes made by overly tired. workers on the night shift or an extended shift, Night shift workers also are at greater risk of being in car crashes.
when they drive home from work during the early morning hours. because the biological clock is not sending out an alerting signal. One study found that one fifth of night shift workers had a car crash. or a near miss in the preceding year because of sleepiness on the. drive home from work Night shift workers are also more likely to. have physical problems such as heart disease digestive troubles and. infertility as well as emotional problems All of these problems may. be related at least in part to the workers chronic sleepiness possi. bly because their biological clocks are not in tune with their work. schedules See Working the Night Shift on page 9 for some. helpful tips if you work a night shift, Other factors also can influence your need for sleep including your. immune system s production of hormones called cytokines Cyto. kines are made to help the immune system fight certain infections or. chronic inflammation and may prompt you to sleep more than. usual The extra sleep may help you conserve the resources needed. to fight the infection Recent,studies confirm that being well. rested improves the body s,responses to infection,People are creatures of. habit and one of the,Your Guide to Healthy Sleep,hardest habits to break is. the natural wake and,sleep cycle Together a,number of physiological.
factors help you sleep,and wake up at the,same times each day. Consequently you may have a hard time adjusting when you travel. across time zones The light cues outside and the clocks in your new. location may tell you it is 8 a m and you should be active but your. body is telling you it is more like 4 a m and you should sleep The. end result is jet lag sleepiness during the day difficulty falling or. staying asleep at night poor concentration confusion nausea and. generally feeling unwell and irritable See Dealing With Jet Lag on. Working the,Night Shift, Try to limit night shift work if that is possible If you must work. the night shift the following tips may help you, l Increase your total amount of sleep by adding naps and. lengthening the amount of time you allot for sleep. l Use bright lights in your workplace, l Minimize the number of shift changes so that your body s. biological clock has a longer time to adjust to a nighttime. work schedule, l Get rid of sound and light distractions in your bedroom.
during your daytime sleep, l Use caffeine only during the first part of your shift to. promote alertness at night, If you are unable to fall asleep during the day and all else fails. talk with your doctor to see whether it would be wise for you. to use prescribed short acting sleeping pills to help you sleep.

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