By Virginia Thornley, M.D., Neurologist, Epileptologist
February 15, 2018
Many neurological diseases are affected by lack of sleep most significantly migraine and epilepsy. A person performs suboptimally with lack of sleep with inattention and lack of coordination. In someone with a neurological condition, the symptoms become even more manifest. Weakness becomes more prominent, double vision may be more pronounced and difficulty speaking will become more prominent. Sleep plays a vital role in the restorative function of the body.
Stages of sleep, why adequate and continuous sleep is refreshing
Sleep is divided into 2 categories, Non-REM (rapid eye movement) sleep and REM sleep. During non-REM sleep, there are 4 stages. Stage 1 and 2 constitute drowsiness which transitions into light sleep. The electroencephalogram is a study that reflects brain activity. Stages 1 and 2 demonstrates sleep complexes including vertex waves then K complexes. Sleep spindles occur during stage 2 sleep. During stages 3 and 4 also known as slow-wave sleep, delta waves which are the slowest waves between 1-3 Hertz start to occur. Stage 4 shows delta waves of greater than 50% of the recording. People enter these stages of sleep and then subsequent REM sleep. REM sleep is where dreaming occurs.
One can go through a few cycles of these so that you wake up refreshed. Sleep disruption occurs when continuous sleep is not achieved. Causes include chronic pain which wakes people up at night, recurrent symptoms such as seizures, sleep apnea or exposure to constant loud noises achieves the same effect.
The body is designed to fall asleep naturally at night without artificial aids. It is a nocturnal event where the body is designed to secrete hormones and substances which occur only at night. This does not happen during the daytime. Hence, night shift workers do not get the same quality of sleep as a normal person with daytime work. In short, achieving not just 6-8 hours of sleep is not only recommended but it needs to have the restorative continuous sleep quality primarily at night.
Good sleep hygiene
1. Sleep hygiene includes avoidance of all caffeine including coffee, tea, soda, chocolate. Even decaffeinated beverages will still have a small amount. Caffeine withdrawal symptoms may result if stopped abruptly in large consumers which can be avoided by tapering first.
2. Avoidance of stress helps with sleep. Relaxation can be achieved with yoga, Tai Chi, meditation or anything enjoyable. Thinking too much is not beneficial especially at night unless it’s a constructive thought process finding a solution. Worrying can disrupt sleep. One hour in the day may be set aside for stressing during the daytime.
3. Avoidance of laying in bed once insomnia sets in can help. Getting out of bed to do light activity allows the body to tire naturally.
4. Naps disrupt sleep and the body’s natural desire to sleep at night
5. TV’s and computers in the bedroom can stimulate the mind. A bedroom is a place of peace and relaxation. Electronics signifies activity to your brain and does not ease your state of mind into the state of peace it needs to start falling asleep.
6. Increased physical activity during the daytime allows the body to tire naturally but may be overstimulating if done less than 2 hours before bedtime.
7. It is a good idea to sleep at the same time every night. In addition, sleeping past 12 midnight interrupts the natural cycle of sleep. The body is designed to sleep at night for the fullest restorative effects.
Chronic medical conditions that may affect the quality of sleep may be addressed with your physician.