Sleeping in your arm: top sleep problems

Sleep is the subject of many scientific publications. Researchers still do not stop arguing with each other and setting up new experiments and experiments. In the modern world, sleep problems are becoming more and more acute. The average city dweller is increasingly complaining about lack of sleep and its consequences. 

– There are international guidelines for the duration of sleep to maintain health. For adults, this is seven hours. It is believed that this is necessary for sufficient recovery of the body. What happens if a person sleeps less than seven hours for a long time? It has now been proven that short sleep contributes to the development of various diseases. First of all, arterial hypertension, diabetes mellitus, impaired functioning of the immune system. There are other consequences, but what I have listed is already enough. Today there are many professions related to sleep restriction. For example, people who work in shifts do not sleep at night, and then the next day they cannot “ get enough sleep.»The amount of time they lost. By the way, nurses or flight attendants have a chronic lack of sleep. They have an increased risk of breast cancer. This is associated with improper sleep and wakefulness, and with the limitation of sleep time because of this.

In addition, reducing sleep time also entails a decrease in labor productivity. Despite the fact that a person seems to devote more time to work, taking him away from sleep, work turns out to be less effective. Labor efficiency in this case is halved.

The risk of various socially dangerous situations also increases. First of all, traffic accidents. In Australia, a study was conducted at one time, which showed that a person who did not sleep all night behaves like a drunk by the end of the next day. He makes as many mistakes as a person who has taken a noticeable dose of alcohol. In this case, the lack of sleep affects not so much health as it has dangerous social consequences. 

– If we talk about the relationship between labor productivity and time spent on sleep, then I immediately recall the practice, which we have all heard about many times, when the Japanese have the opportunity to get some sleep in the middle of the working day. We do not have such a trend among the adult population, and it is unlikely to be. But we still make our children sleep during the day. Do you think this is generally needed? Does it have any effect? Or is it some kind of kindergarten remnants of the Soviet Union?

– Sleeping during the day definitely increases productivity in adults. If we talk about children, then after lunchtime they become calmer and more balanced. Therefore, we recommend that children sleep during the day exactly as long as they can be put to bed. Another thing is that they begin to give up daytime sleep due to their temperament. Then the experts insist on a quiet hour. Even if the child is awake, let him spend an hour lying in bed with his eyes closed.

– There is a theory that how much a person gets enough sleep is directly related to the number of even or odd hours he spent sleeping. Does this have any justification?

– This theory has no scientific confirmation. But there is a similar point of view, which says that it is better to sleep in multiples, for one and a half hours. This is how much the sleep cycle in a healthy adult is. During this time, all stages of sleep change. If we fall asleep in the superficial stage of sleep, then after an hour and a half it will happen again and it will be easier for us to get out of it.

– I heard about such a phenomenon as sleep deprivation when experiments were carried out to deprive subjects of sleep. This even gave rise to some hallucinations and changes in the body. Surely you can tell a lot about this. The main question is, what are these experiments for?  

– Sleep deprivation is a well-known scientific method that is used to assess and understand what sleep is for. Such experiments were carried out back in the 19th century. And for the first time they were held in Russia. There was such a wonderful woman scientist Maria Mikhailovna Manaseina , who was the first in the world to study the effects of sleep deprivation in animals. Then, of course, there were no perfect possibilities for carrying out these experiments, so now their results are disputed. She concluded that sleep is more important to the animal than food. She found more changes in the brains of dogs that died of insomnia than in those animals that died of starvation. This point of view is currently being rejected. More well-designed animal experiments have shown no changes in the brains of animals that died from sleep deprivation. Sleep deprivation is unlikely to have a direct brain damage. However, sleep deprivation has been shown to adversely affect cognitive function. The ability to think, remember, attention decreases, this also affects the emotional state. In the first experiments, which were conducted on healthy volunteers, scientists noted that the subjects fell into a psychosis-like state when hallucinations occurred . But in subsequent experiments this was not confirmed. That is, now the point of view that lack of sleep leads to the development of mental disorders has not received confirmation.  

The record for the time without sleep for today is 11 days. It was installed by a Stanford student in a laboratory under the supervision of scientists. It is listed in the Guinness Book of Records. Attempts were made to set new records, but the book of records stopped registering them, because its representatives considered it unhealthy. Although there are references to 16 days without sleep on the Internet, this has not been documented. A student who did not sleep for 11 days, after the experiment, slept for 16 hours and was declared completely healthy.

– In order to cheer up, we often use various kinds of stimulants. I am not talking about chemicals and drugs, but let’s talk about natural stimulants. For example, drinking coffee to be in good shape is actually as harmful as we are often told from the TV screen?

– Coffee is indeed the most popular stimulant. It is used all over the world, for example, by the military or dispatchers at nuclear power plants. They have a supply of caffeine pills to keep them awake. In principle, there is nothing terrible in this, except that coffee stimulates the sympathetic part of the nervous system quite strongly. In addition, it loosens the cardiovascular system. We are talking primarily about arterial hypertension and arrhythmias.

Other psychostimulants are significantly weaker than coffee. Of the real medicines, in order to maintain a sufficient level of vigor, the drug ” modafinil ” is used. In Russia, it is not registered, but abroad it is used to treat such a rare disease as narcolepsy, which is accompanied by daytime sleepiness. It is also used by the military to maintain attention.

– In the current turmoil, most people blur the boundaries of day and night quite strongly. I would like to ask if there are any reasonable recommendations on the time of day, when is it better to go to bed?

– The universal recommendation is to go to bed when it’s dark outside. You can go to bed at 10 pm, or at 11, or at 12 o’clock. Then the body itself will determine how much to sleep. With the onset of darkness, the body begins to produce the hormone melatonin, which rebuilds our body to the “night” mode. It slows down metabolic processes, including in the brain. At this point, it is easier to enter sleep. Then the body gets its 7-8 hours of sleep and wakes up safely.

– I realized that the normal time for sleep is about 8 hours. But there are people who need 10-12 hours to get enough sleep. This is normal?

– Most often, such a need for excess sleep is associated with the presence of a disease. These are mental disorders, various forms of depression or some sleep disturbance. There is a condition associated with snoring called sleep apnea syndrome , when breath holding occurs against the background of snoring. At the same time, it turns out that, no matter how much a person sleeps, he never gets enough sleep. Then, of course, he will try to spend more time in a dream, if possible. But this is not the norm. That is, people can say that they have such a need, but in fact this is not their norm, but rather a disease. 

– If we are already talking about snoring, which is a problem for many, tell us how dangerous it is at all. Is it worth fighting with him, and most importantly how?

– Snoring is a common sleep-related condition. On average, 10% of women and 20% of men snore. But it should be clarified what we mean by the word snoring. After all, anyone can snore sometimes. This may be due to the fact that he is very tired or has a cold. Nothing wrong with that. But when a person snores every night, then we begin to treat him with special attention. This snoring is called habitual snoring. It arises from the fact that, during inhalation, the air flow passing at high speed through the airways vibrates the tongue, which ends with the soft palate. The higher the speed of passing air, the greater the likelihood of fluctuations in sleep. Accordingly, the most common cause of snoring is narrowing of the airways. For example, it can be during a cold, when there is swelling of the nasal mucosa. It turns out that in order for a sufficient amount of air to enter the lungs during inhalation, he has to enter there at a higher speed. Accordingly, the strength of this vibration increases significantly.

Narrowing of the upper airways is most obvious in children who suffer from “adenoids” – the proliferation of lymphoid tissue of the pharyngeal tonsil. In adults, the most common cause of snoring is obesity. After all, fat is deposited not only in the stomach, but also in the neck. This leads to a narrowing of the airways.

Snoring itself is not dangerous. It’s just a sound phenomenon that disturbs others. But at some point, it can develop into a disease called obstructive sleep apnea syndrome. Then, against the background of snoring, breath holding occurs, as an extreme manifestation of the narrowness of the airways. At the same time, air enters through the respiratory tract so quickly that at this time a very low negative pressure is formed there. This leads to the fact that the walls of the pharynx tend to ” collapse “. Periodically, this succeeds and the breath is held. In this case, there is an increased movement of the stomach and diaphragm, and the air does not flow, because the upper respiratory tract is blocked. A few seconds later, a signal reaches the brain that something is wrong, additional impulses are given to the muscles of the upper respiratory tract, which open the lumen for breathing. On average, respiratory arrest lasts 20 to 40 seconds. During this time, the oxygen content in the blood has time to decrease. First of all, it affects the cardiovascular system, the heart rate increases, blood pressure rises. This is where the first dangers of such a condition lie, since breath holding occurs not five or ten times a night, but about 300 times. It turns out that quite quickly, in comparison with the natural course of things, a person can ” snore ” a serious illness, for example, hypertension, cardiac arrhythmia, pulmonary hypertension and much more.

– Can you somehow fight this? Perhaps there are some preventive measures?

– You need to understand at what stage the disease is. Is it just snoring, or maybe already holding your breath. To do this, it is imperative to do a sleep study called polysomnography . Then the method of treatment is chosen. Surgical treatment consists in the fact that simply mechanically cut out the obstacles to the air in the airways, most often the uvula or palatine tonsils are trimmed, or the nasal passages are aligned. Such surgeries are effective when a person snores at the beginning, when it is accompanied by a small number of sleep apnea. If there are a lot of breath holdings, then surgical treatment is ineffective. The next method of treatment is CPAP therapy, that is, the use of special medical compressors. Before going to bed, a person puts on a mask on his face, through which the device delivers air into the respiratory tract under slight pressure. Due to the fact that the airway lumen is constantly expanding, it turns out to eliminate snoring and breath holding. But this device does not cure the disease and you have to live with it all the time.

In addition, there are attempts by orthodontists to combat snoring. They try to do this with the help of a special mouth guard, which holds the lower jaw during sleep . It turns out that during sleep a person’s mouth is closed, and the lower jaw is in a slightly extended position. Due to this, the airways open and the respiratory lumen increases. In Russia, such devices are not very common, because they are expensive to manufacture. And abroad these methods are quite popular.  

There are also completely homemade methods. For example, sew a tennis ball into a special pocket on the back of your pajamas. This is done so that the person sleeps less on their back. It is in this position that people snore most often. Cessation of smoking is also recommended, because tobacco smoke irritates the respiratory tract and their inflammation is constantly maintained. I must say right away that no gymnastics for strengthening the muscles of the jaw or pharynx is effective in this case.

– Many experts argue that at once a number of diseases in a dream proceed much more severely and have more serious consequences than if they developed and manifested themselves during wakefulness. Do you agree with this and what is the reason for this phenomenon?

– Yes, there is a concept according to which, if a disease began in a dream, then it flows heavier and leads to more sad consequences. For example, myocardial infarctions that develop during sleep are more likely to be fatal. Cerebral strokes are also more severe. Experts dealing with this issue believe that by improving sleep, it is possible to prevent the development of nocturnal exacerbations. But now this concept is developing rather slowly, because the data is inconsistent.

– Is this due to the fact that the brain is less active during sleep and cannot promptly mobilize defense mechanisms?

– This is a difficult question. For some diseases, sleep is believed to be a time of risk. For example, why do vascular disorders occur more often at night? Because at this time, cortisol, a stress hormone, begins to be produced. This increases blood clotting. Therefore, the likelihood of blood clots increases significantly. In addition, during sleep, there are periods, the so-called vegetative storms, when cardiac output, blood pressure, and pulse change sharply. This instability can also contribute to the development of heart disorders.

– In the media space there are many ” scarecrows ” about sudden and inexplicable death in a dream. Does it have scientific and medical grounds at all? What should be feared?

– Most likely, you mean sudden infant death syndrome. It is still not clear from what these states develop. Previously, it was assumed that the delay in breathing was to blame, then there were suggestions that the child may have a cardiac arrhythmia, they also thought that the reflux of gastric contents could cause spasm during breathing. But they did not come to a consensus. Moreover, when the slogan “sleep on the back” was put forward in America, so that the child could sleep without a pillow, the mortality rate of children in the first year of life was approximately halved. So everything could be much simpler, and the most common reason could simply be self-strangulation . Well, if we talk about adults, then for a healthy person the problem of death in a dream is unlikely. Sleep death occurs when you have severe heart disease. But it happens with the same success in the daytime.

– I would also like to ask separately about cases of walking and talking in a dream, about enuresis , that is, about such arbitrary and unusual manifestations. Is this generally worth fearing, how to deal with such problems?

– These conditions are now considered not even as diseases, but as features. They have no consequences for humans. The concept of local sleep is now actively developing, which suggests that the brain may not sleep entirely. Some of its zones can be awake and react to external stimuli. Sleepwalking is now considered as a variant of local sleep, when some part of the brain does not fully wake up and “leads somewhere” a person. The rest of the brain continues to sleep without knowing anything about what is going on. This often happens in children and is associated with insufficient maturity of certain connections in the nervous system. It is believed that there is a hereditary predisposition to these conditions. That is, there are genes that prevent some parts of the brain from maturing quickly and fully control sleep processes. Although they will ripen anyway, because sleepwalking is extremely rare in adults.

Also nocturnal enuresis , the causes of which are still not understood. The main concept of the occurrence of this disease is that in the presence of special genes, the maturation of the central parts of the nervous system, which control the automatic operation of the bladder, slows down. That is, if the bladder is devoid of influence from the brain, then when it feels that there is enough urine in it, it turns on reflex emptying. But bedwetting usually goes away on its own with time. 

– The last question may be trivial, but when it comes to the problem of sleep, they inevitably remember about owls, pigeons and larks. This is the division into those who are active at night or, conversely, in the morning, how adequate is it at all? Is it really worth considering what type you are, adjusting your activity to this, or are these just some myths?

– Chronotypes do exist. These are preferences for the evening or morning time, when a person is most active. The presence of a chronotype is associated with the individual characteristics of the daily sleep-wake cycle. Special “bunker” studies were carried out where volunteers were locked up in an old military bunker. They completely lost contact with the outside world and began to live according to their own rhythm. It turned out that for most people the sleep and wake cycle is not 24 hours, but 25 hours, or, conversely, about 23 hours.

Who are the “owls”? To put it simply, these are people who have not yet completed their own internal day in the past 24 hours. They are still not averse to being awake, their evening will be extended. Larks, on the other hand, end their inner days earlier. They go to bed earlier, wake up earlier, their morning is more active. It is interesting that these features are laid not at the level of the central nervous system, but at the level of individual cells of the body. Experiments were carried out, which showed that even if a skin cell is removed and placed in a nutrient medium, in order to see the bioluminescence period, at which the cell’s glow in a certain spectrum will change depending on the time of day. And this intensity in the skin cells of “owls” and “larks” is different.

They also believed that the genetic component determines only 54% of an owl or a lark. And 46% of the component is determined by age and social environment. That is, you can tell your boss that you are an owl, that is why you are late, but you will only be 54% right. Your boss will be 46% right, who will offer to cut salaries in this case. This is where social factors come into play, and you quickly turn from an owl to a morning person.

It is difficult to model the ideal regime for an owl or a lark. And this, in fact, is not so important. In medicine, there is such a thing as clinical significance. From the point of view of “pure” physiology, it would be ideal for an owl to work in the evenings, and a lark in the morning. But if the owl is offered a large salary for arriving early to work? I am sure that she will come and will be happy, because the social mechanisms of motivation will already work. Therefore , from my point of view, these chronotypes have no significant meaning in real life .

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