Sleep Information Page Do you ever feel sleepy or "zone
out" during the day? Do you find it hard to wake up on Monday
mornings? If so, you are familiar with the powerful need for sleep.
However, you may not realize that sleep is as essential for your well-being
as food and water.
Until the 1950s, most people thought of sleep as a passive, dormant
part of our daily lives. We now know that our brains are very active
during sleep. Moreover, sleep affects our daily functioning and
our physical and mental health in many ways that we are just beginning
to understand.
Nerve-signaling chemicals called neurotransmitters control whether
we are asleep or awake by acting on different groups of nerve cells,
or neurons, in the brain. Neurons in the brainstem, which connects
the brain with the spinal cord, produce neurotransmitters such as
serotonin and norepinephrine that keep some parts of the brain active
while we are awake. Other neurons at the base of the brain begin
signaling when we fall asleep. These neurons appear to "switch
off" the signals that keep us awake. Research also suggests
that a chemical called adenosine builds up in our blood while we
are awake and causes drowsiness. This chemical gradually breaks
down while we sleep.
During sleep, we usually pass through five phases of sleep: stages
1, 2, 3, 4, and REM (rapid eye movement) sleep. These stages progress
in a cycle from stage 1 to REM sleep, then the cycle starts over
again with stage 1 (see figure 1). We spend almost 50 percent of
our total sleep time in stage 2 sleep, about 20 percent in REM sleep,
and the remaining 30 percent in the other stages. Infants, by contrast,
spend about half of their sleep time in REM sleep.
During stage 1, which is light sleep, we drift in and out of sleep
and can be awakened easily. Our eyes move very slowly and muscle
activity slows. People awakened from stage 1 sleep often remember
fragmented visual images. Many also experience sudden muscle contractions
called hypnic myoclonia, often preceded by a sensation of starting
to fall. These sudden movements are similar to the "jump"
we make when startled. When we enter stage 2 sleep, our eye movements
stop and our brain waves (fluctuations of electrical activity that
can be measured by electrodes) become slower, with occasional bursts
of rapid waves called sleep spindles. In stage 3, extremely slow
brain waves called delta waves begin to appear, interspersed with
smaller, faster waves. By stage 4, the brain produces delta waves
almost exclusively. It is very difficult to wake someone during
stages 3 and 4, which together are called deep sleep. There is no
eye movement or muscle activity. People awakened during deep sleep
do not adjust immediately and often feel groggy and disoriented
for several minutes after they wake up. Some children experience
bedwetting, night terrors, or sleepwalking during deep sleep.
When we switch into REM sleep, our breathing becomes more rapid,
irregular, and shallow, our eyes jerk rapidly in various directions,
and our limb muscles become temporarily paralyzed. Our heart rate
increases, our blood pressure rises, and males develop penile erections.
When people awaken during REM sleep, they often describe bizarre
and illogical tales — dreams.
The first REM sleep period usually occurs about 70 to 90 minutes
after we fall asleep. A complete sleep cycle takes 90 to 110 minutes
on average. The first sleep cycles each night contain relatively
short REM periods and long periods of deep sleep. As the night progresses,
REM sleep periods increase in length while deep sleep decreases.
By morning, people spend nearly all their sleep time in stages 1,
2, and REM.
People awakened after sleeping more than a few minutes are usually
unable to recall the last few minutes before they fell asleep. This
sleep-related form of amnesia is the reason people often forget
telephone calls or conversations they’ve had in the middle
of the night. It also explains why we often do not remember our
alarms ringing in the morning if we go right back to sleep after
turning them off.
Since sleep and wakefulness are influenced by different neurotransmitter
signals in the brain, foods and medicines that change the balance
of these signals affect whether we feel alert or drowsy and how
well we sleep. Caffeinated drinks such as coffee and drugs such
as diet pills and decongestants stimulate some parts of the brain
and can cause insomnia, or an inability to sleep. Many antidepressants
suppress REM sleep. Heavy smokers often sleep very lightly and have
reduced amounts of REM sleep. They also tend to wake up after 3
or 4 hours of sleep due to nicotine withdrawal. Many people who
suffer from insomnia try to solve the problem with alcohol —
the so-called night cap. While alcohol does help people fall into
light sleep, it also robs them of REM and the deeper, more restorative
stages of sleep. Instead, it keeps them in the lighter stages of
sleep, from which they can be awakened easily.
People lose some of the ability to regulate their body temperature
during REM, so abnormally hot or cold temperatures in the environment
can disrupt this stage of sleep. If our REM sleep is disrupted one
night, our bodies don’t follow the normal sleep cycle progression
the next time we doze off. Instead, we often slip directly into
REM sleep and go through extended periods of REM until we "catch
up" on this stage of sleep.
People who are under anesthesia or in a coma are often said to be
asleep. However, people in these conditions cannot be awakened and
do not produce the complex, active brain wave patterns seen in normal
sleep. Instead, their brain waves are very slow and weak, sometimes
all but undetectable.
The amount of sleep each person needs depends on many
factors, including age. Infants generally require about 16 hours
a day, while teenagers need about 9 hours on average. For most adults,
7 to 8 hours a night appears to be the best amount of sleep, although
some people may need as few as 5 hours or as many as 10 hours of
sleep each day. Women in the first 3 months of pregnancy often need
several more hours of sleep than usual. The amount of sleep a person
needs also increases if he or she has been deprived of sleep in
previous days. Getting too little sleep creates a "sleep debt,"
which is much like being overdrawn at a bank. Eventually, your body
will demand that the debt be repaid. We don’t seem to adapt
to getting less sleep than we need; while we may get used to a sleep-depriving
schedule, our judgment, reaction time, and other functions are still
impaired.
People tend to sleep more lightly and for shorter time spans as
they get older, although they generally need about the same amount
of sleep as they needed in early adulthood. About half of all people
over 65 have frequent sleeping problems, such as insomnia, and deep
sleep stages in many elderly people often become very short or stop
completely. This change may be a normal part of aging, or it may
result from medical problems that are common in elderly people and
from the medications and other treatments for those problems.
Experts say that if you feel drowsy during the day, even during
boring activities, you haven’t had enough sleep. If you routinely
fall asleep within 5 minutes of lying down, you probably have severe
sleep deprivation, possibly even a sleep disorder. Microsleeps,
or very brief episodes of sleep in an otherwise awake person, are
another mark of sleep deprivation. In many cases, people are not
aware that they are experiencing microsleeps. The widespread practice
of "burning the candle at both ends" in western industrialized
societies has created so much sleep deprivation that what is really
abnormal sleepiness is now almost the norm.
Many studies make it clear that sleep deprivation is dangerous.
Sleep-deprived people who are tested by using a driving simulator
or by performing a hand-eye coordination task perform as badly as
or worse than those who are intoxicated. Sleep deprivation also
magnifies alcohol’s effects on the body, so a fatigued person
who drinks will become much more impaired than someone who is well-rested.
Driver fatigue is responsible for an estimated 100,000 motor vehicle
accidents and 1500 deaths each year, according to the National Highway
Traffic Safety Administration. Since drowsiness is the brain’s
last step before falling asleep, driving while drowsy can –
and often does – lead to disaster. Caffeine and other stimulants
cannot overcome the effects of severe sleep deprivation. The National
Sleep Foundation says that if you have trouble keeping your eyes
focused, if you can’t stop yawning, or if you can’t
remember driving the last few miles, you are probably too drowsy
to drive safely.
Although scientists are still trying to learn exactly why people
need sleep, animal studies show that sleep is necessary for survival.
For example, while rats normally live for two to three years, those
deprived of REM sleep survive only about 5 weeks on average, and
rats deprived of all sleep stages live only about 3 weeks. Sleep-deprived
rats also develop abnormally low body temperatures and sores on
their tail and paws. The sores may develop because the rats’
immune systems become impaired. Some studies suggest that sleep
deprivation affects the immune system in detrimental ways.
Sleep appears necessary for our nervous systems to work properly.
Too little sleep leaves us drowsy and unable to concentrate the
next day. It also leads to impaired memory and physical performance
and reduced ability to carry out math calculations. If sleep deprivation
continues, hallucinations and mood swings may develop. Some experts
believe sleep gives neurons used while we are awake a chance to
shut down and repair themselves. Without sleep, neurons may become
so depleted in energy or so polluted with byproducts of normal cellular
activities that they begin to malfunction. Sleep also may give the
brain a chance to exercise important neuronal connections that might
otherwise deteriorate from lack of activity.
Deep sleep coincides with the release of growth hormone in children
and young adults. Many of the body’s cells also show increased
production and reduced breakdown of proteins during deep sleep.
Since proteins are the building blocks needed for cell growth and
for repair of damage from factors like stress and ultraviolet rays,
deep sleep may truly be "beauty sleep." Activity in parts
of the brain that control emotions, decision-making processes, and
social interactions is drastically reduced during deep sleep, suggesting
that this type of sleep may help people maintain optimal emotional
and social functioning while they are awake. A study in rats also
showed that certain nerve-signaling patterns which the rats generated
during the day were repeated during deep sleep. This pattern repetition
may help encode memories and improve learning.
We typically spend more than 2 hours each night dreaming. Scientists
do not know much about how or why we dream. Sigmund Freud, who greatly
influenced the field of psychology, believed dreaming was a "safety
valve" for unconscious desires. Only after 1953, when researchers
first described REM in sleeping infants, did scientists begin to
carefully study sleep and dreaming. They soon realized that the
strange, illogical experiences we call dreams almost always occur
during REM sleep. While most mammals and birds show signs of REM
sleep, reptiles and other cold-blooded animals do not.
REM sleep begins with signals from an area at the base of the brain
called the pons (see figure 2). These signals travel to a brain
region called the thalamus, which relays them to the cerebral cortex
— the outer layer of the brain that is responsible for learning,
thinking, and organizing information. The pons also sends signals
that shut off neurons in the spinal cord, causing temporary paralysis
of the limb muscles. If something interferes with this paralysis,
people will begin to physically "act out" their dreams
— a rare, dangerous problem called REM sleep behavior disorder.
A person dreaming about a ball game, for example, may run headlong
into furniture or blindly strike someone sleeping nearby while trying
to catch a ball in the dream.
REM sleep stimulates the brain regions used in learning. This may
be important for normal brain development during infancy, which
would explain why infants spend much more time in REM sleep than
adults (see Sleep: A Dynamic Activity). Like deep sleep, REM sleep
is associated with increased production of proteins. One study found
that REM sleep affects learning of certain mental skills. People
taught a skill and then deprived of non-REM sleep could recall what
they had learned after sleeping, while people deprived of REM sleep
could not.
Some scientists believe dreams are the cortex’s attempt to
find meaning in the random signals that it receives during REM sleep.
The cortex is the part of the brain that interprets and organizes
information from the environment during consciousness. It may be
that, given random signals from the pons during REM sleep, the cortex
tries to interpret these signals as well, creating a "story"
out of fragmented brain activity.
Circadian rhythms are regular changes in mental and physical characteristics
that occur in the course of a day (circadian is Latin for "around
a day"). Most circadian rhythms are controlled by the body’s
biological "clock." This clock, called the suprachiasmatic
nucleus or SCN (see figure 2), is actually a pair of pinhead-sized
brain structures that together contain about 20,000 neurons. The
SCN rests in a part of the brain called the hypothalamus, just above
the point where the optic nerves cross. Light that reaches photoreceptors
in the retina (a tissue at the back of the eye) creates signals
that travel along the optic nerve to the SCN.
Signals from the SCN travel to several brain regions, including
the pineal gland, which responds to light-induced signals by switching
off production of the hormone melatonin. The body’s level
of melatonin normally increases after darkness falls, making people
feel drowsy. The SCN also governs functions that are synchronized
with the sleep/wake cycle, including body temperature, hormone secretion,
urine production, and changes in blood pressure.
By depriving people of light and other external time cues, scientists
have learned that most people’s biological clocks work on
a 25-hour cycle rather than a 24-hour one. But because sunlight
or other bright lights can reset the SCN, our biological cycles
normally follow the 24-hour cycle of the sun, rather than our innate
cycle. Circadian rhythms can be affected to some degree by almost
any kind of external time cue, such as the beeping of your alarm
clock, the clatter of a garbage truck, or the timing of your meals.
Scientists call external time cues zeitgebers (German for "time
givers").
When travelers pass from one time zone to another, they suffer from
disrupted circadian rhythms, an uncomfortable feeling known as jet
lag. For instance, if you travel from California to New York, you
"lose" 3 hours according to your body’s clock. You
will feel tired when the alarm rings at 8 a.m. the next morning
because, according to your body’s clock, it is still 5 a.m.
It usually takes several days for your body's cycles to adjust to
the new time.
To reduce the effects of jet lag, some doctors try to manipulate
the biological clock with a technique called light therapy. They
expose people to special lights, many times brighter than ordinary
household light, for several hours near the time the subjects want
to wake up. This helps them reset their biological clocks and adjust
to a new time zone.
Symptoms much like jet lag are common in people who work nights
or who perform shift work. Because these people’s work schedules
are at odds with powerful sleep-regulating cues like sunlight, they
often become uncontrollably drowsy during work, and they may suffer
insomnia or other problems when they try to sleep. Shift workers
have an increased risk of heart problems, digestive disturbances,
and emotional and mental problems, all of which may be related to
their sleeping problems. The number and severity of workplace accidents
also tend to increase during the night shift. Major industrial accidents
attributed partly to errors made by fatigued night-shift workers
include the Exxon Valdez oil spill and the Three Mile Island and
Chernobyl nuclear power plant accidents. One study also found that
medical interns working on the night shift are twice as likely as
others to misinterpret hospital test records, which could endanger
their patients. It may be possible to reduce shift-related fatigue
by using bright lights in the workplace, minimizing shift changes,
and taking scheduled naps.
Many people with total blindness experience life-long sleeping problems
because their retinas are unable to detect light. These people have
a kind of permanent jet lag and periodic insomnia because their
circadian rhythms follow their innate cycle rather than a 24-hour
one. Daily supplements of melatonin may improve night-time sleep
for such patients. However, since the high doses of melatonin found
in most supplements can build up in the body, long-term use of this
substance may create new problems. Because the potential side effects
of melatonin supplements are still largely unknown, most experts
discourage melatonin use by the general public.
Sleep and sleep-related problems play a role in a large number of
human disorders and affect almost every field of medicine. For example,
problems like stroke and asthma attacks tend to occur more frequently
during the night and early morning, perhaps due to changes in hormones,
heart rate, and other characteristics associated with sleep. Sleep
also affects some kinds of epilepsy in complex ways. REM sleep seems
to help prevent seizures that begin in one part of the brain from
spreading to other brain regions, while deep sleep may promote the
spread of these seizures. Sleep deprivation also triggers seizures
in people with some types of epilepsy.
Neurons that control sleep interact closely with the immune system.
As anyone who has had the flu knows, infectious diseases tend to
make us feel sleepy. This probably happens because cytokines, chemicals
our immune systems produce while fighting an infection, are powerful
sleep-inducing chemicals. Sleep may help the body conserve energy
and other resources that the immune system needs to mount an attack.
Sleeping problems occur in almost all people with mental disorders,
including those with depression and schizophrenia. People with depression,
for example, often awaken in the early hours of the morning and
find themselves unable to get back to sleep. The amount of sleep
a person gets also strongly influences the symptoms of mental disorders.
Sleep deprivation is an effective therapy for people with certain
types of depression, while it can actually cause depression in other
people. Extreme sleep deprivation can lead to a seemingly psychotic
state of paranoia and hallucinations in otherwise healthy people,
and disrupted sleep can trigger episodes of mania (agitation and
hyperactivity) in people with manic depression.
Sleeping problems are common in many other disorders as well, including
Alzheimer’s disease, stroke, cancer, and head injury. These
sleeping problems may arise from changes in the brain regions and
neurotransmitters that control sleep, or from the drugs used to
control symptoms of other disorders. In patients who are hospitalized
or who receive round-the-clock care, treatment schedules or hospital
routines also may disrupt sleep. The old joke about a patient being
awakened by a nurse so he could take a sleeping pill contains a
grain of truth. Once sleeping problems develop, they can add to
a person’s impairment and cause confusion, frustration, or
depression. Patients who are unable to sleep also notice pain more
and may increase their requests for pain medication. Better management
of sleeping problems in people who have other disorders could improve
these patients’ health and quality of life.
Researchers believe that both depression and suicidal behavior can
be linked to decreased serotonin in the brain. Low levels of a serotonin
metabolite, 5-HIAA, have been detected in cerebral spinal fluid
in persons who have attempted suicide, as well as by postmortem
studies examining certain brain regions of suicide victims. One
of the goals of understanding the biology of suicidal behavior is
to improve treatments. Scientists have learned that serotonin receptors
in the brain increase their activity in persons with major depression
and suicidality, which explains why medications that desensitize
or down-regulate these receptors (such as the serotonin reuptake
inhibitors, or SSRIs) have been found effective in treating depression.
Currently, studies are underway to examine to what extent medications
like SSRIs can reduce suicidal behavior.
At least 40 million Americans each year suffer
from chronic, long-term sleep disorders each year, and an additional
20 million experience occasional sleeping problems. These disorders
and the resulting sleep deprivation interfere with work, driving,
and social activities. They also account for an estimated $16 billion
in medical costs each year, while the indirect costs due to lost
productivity and other factors are probably much greater. Doctors
have described more than 70 sleep disorders, most of which can be
managed effectively once they are correctly diagnosed. The most
common sleep disorders include insomnia, sleep apnea, restless legs
syndrome, and narcolepsy.
Insomnia
Almost everyone occasionally suffers from short-term insomnia. This
problem can result from stress, jet lag, diet, or many other factors.
Insomnia almost always affects job performance and well-being the
next day. About 60 million Americans a year have insomnia frequently
or for extended periods of time, which leads to even more serious
sleep deficits. Insomnia tends to increase with age and affects
about 40 percent of women and 30 percent of men. It is often the
major disabling symptom of an underlying medical disorder.
For short-term insomnia, doctors may prescribe sleeping pills. Most
sleeping pills stop working after several weeks of nightly use,
however, and long-term use can actually interfere with good sleep.
Mild insomnia often can be prevented or cured by practicing good
sleep habits (see "Tips for a Good Night’s Sleep").
For more serious cases of insomnia, researchers are experimenting
with light therapy and other ways to alter circadian cycles.
Sleep Apnea
Sleep apnea is a disorder of interrupted breathing during sleep.
It usually occurs in association with fat buildup or loss of muscle
tone with aging. These changes allow the windpipe to collapse during
breathing when muscles relax during sleep (see figure 3). This problem,
called obstructive sleep apnea, is usually associated with loud
snoring (though not everyone who snores has this disorder). Sleep
apnea also can occur if the neurons that control breathing malfunction
during sleep.
During an episode of obstructive apnea, the person’s effort
to inhale air creates suction that collapses the windpipe. This
blocks the air flow for 10 seconds to a minute while the sleeping
person struggles to breathe. When the person’s blood oxygen
level falls, the brain responds by awakening the person enough to
tighten the upper airway muscles and open the windpipe. The person
may snort or gasp, then resume snoring. This cycle may be repeated
hundreds of times a night. The frequent awakenings that sleep apnea
patients experience leave them continually sleepy and may lead to
personality changes such as irritability or depression. Sleep apnea
also deprives the person of oxygen, which can lead to morning headaches,
a loss of interest in sex, or a decline in mental functioning. It
also is linked to high blood pressure, irregular heartbeats, and
an increased risk of heart attacks and stroke. Patients with severe,
untreated sleep apnea are two to three times more likely to have
automobile accidents than the general population. In some high-risk
individuals, sleep apnea may even lead to sudden death from respiratory
arrest during sleep.
An estimated 18 million Americans have sleep apnea. However, few
of them have had the problem diagnosed. Patients with the typical
features of sleep apnea, such as loud snoring, obesity, and excessive
daytime sleepiness, should be referred to a specialized sleep center
that can perform a test called polysomnography. This test records
the patient’s brain waves, heartbeat, and breathing during
an entire night. If sleep apnea is diagnosed, several treatments
are available. Mild sleep apnea frequently can be overcome through
weight loss or by preventing the person from sleeping on his or
her back. Other people may need special devices or surgery to correct
the obstruction. People with sleep apnea should never take sedatives
or sleeping pills, which can prevent them from awakening enough
to breathe.
Restless Legs Syndrome
Restless legs syndrome (RLS), a familial disorder causing unpleasant
crawling, prickling, or tingling sensations in the legs and feet
and an urge to move them for relief, is emerging as one of the most
common sleep disorders, especially among older people. This disorder,
which affects as many as 12 million Americans, leads to constant
leg movement during the day and insomnia at night. Severe RLS is
most common in elderly people, though symptoms may develop at any
age. In some cases, it may be linked to other conditions such as
anemia, pregnancy, or diabetes.
Many RLS patients also have a disorder known as periodic limb movement
disorder or PLMD, which causes repetitive jerking movements of the
limbs, especially the legs. These movements occur every 20 to 40
seconds and cause repeated awakening and severely fragmented sleep.
In one study, RLS and PLMD accounted for a third of the insomnia
seen in patients older than age 60.
RLS and PLMD often can be relieved by drugs that affect the neurotransmitter
dopamine, suggesting that dopamine abnormalities underlie these
disorders’ symptoms. Learning how these disorders occur may
lead to better therapies in the future.
Narcolepsy
Narcolepsy affects an estimated 250,000 Americans. People with narcolepsy
have frequent "sleep attacks" at various times of the
day, even if they have had a normal amount of night-time sleep.
These attacks last from several seconds to more than 30 minutes.
People with narcolepsy also may experience cataplexy (loss of muscle
control during emotional situations), hallucinations, temporary
paralysis when they awaken, and disrupted night-time sleep. These
symptoms seem to be features of REM sleep that appear during waking,
which suggests that narcolepsy is a disorder of sleep regulation.
The symptoms of narcolepsy typically appear during adolescence,
though it often takes years to obtain a correct diagnosis. The disorder
(or at least a predisposition to it) is usually hereditary, but
it occasionally is linked to brain damage from a head injury or
neurological disease.
Once narcolepsy is diagnosed, stimulants, antidepressants, or other
drugs can help control the symptoms and prevent the embarrassing
and dangerous effects of falling asleep at improper times. Naps
at certain times of the day also may reduce the excessive daytime
sleepiness.
In 1999, a research team working with canine models identified a
gene that causes narcolepsy—a breakthrough that brings a cure
for this disabling condition within reach. The gene, hypocretin
receptor 2, codes for a protein that allows brain cells to receive
instructions from other cells. The defective versions of the gene
encode proteins that cannot recognize these messages, perhaps cutting
the cells off from messages that promote wakefulness. The researchers
know that the same gene exists in humans, and they are currently
searching for defective versions in people with narcolepsy.
Sleep research is expanding and attracting more and more attention
from scientists. Researchers now know that sleep is an active and
dynamic state that greatly influences our waking hours, and they
realize that we must understand sleep to fully understand the brain.
Innovative techniques, such as brain imaging, can now help researchers
understand how different brain regions function during sleep and
how different activities and disorders affect sleep. Understanding
the factors that affect sleep in health and disease also may lead
to revolutionary new therapies for sleep disorders and to ways of
overcoming jet lag and the problems associated with shift work.
We can expect these and many other benefits from research that will
allow us to truly understand sleep’s impact on our lives.
Adapted from "When You Can't Sleep: The ABCs of ZZZs,"
by the National Sleep Foundation.
Set a schedule:
Go to bed at a set time each night and get up at the same time each
morning. Disrupting this schedule may lead to insomnia. "Sleeping
in" on weekends also makes it harder to wake up early on Monday
morning because it re-sets your sleep cycles for a later awakening.
Exercise:
Try to exercise 20 to 30 minutes a day. Daily exercise often helps
people sleep, although a workout soon before bedtime may interfere
with sleep. For maximum benefit, try to get your exercise about
5 to 6 hours before going to bed.
Avoid caffeine, nicotine, and alcohol:
Avoid drinks that contain caffeine, which acts as a stimulant and
keeps people awake. Sources of caffeine include coffee, chocolate,
soft drinks, non-herbal teas, diet drugs, and some pain relievers.
Smokers tend to sleep very lightly and often wake up in the early
morning due to nicotine withdrawal. Alcohol robs people of deep
sleep and REM sleep and keeps them in the lighter stages of sleep.
Relax before bed:
A warm bath, reading, or another relaxing routine can make it easier
to fall sleep. You can train yourself to associate certain restful
activities with sleep and make them part of your bedtime ritual.
Sleep until sunlight:
If possible, wake up with the sun, or use very bright lights in
the morning. Sunlight helps the body’s internal biological
clock reset itself each day. Sleep experts recommend exposure to
an hour of morning sunlight for people having problems falling asleep.
Don’t lie in bed awake:
If you can’t get to sleep, don’t just lie in bed. Do
something else, like reading, watching television, or listening
to music, until you feel tired. The anxiety of being unable to fall
asleep can actually contribute to insomnia.
Control your room temperature:
Maintain a comfortable temperature in the bedroom. Extreme temperatures
may disrupt sleep or prevent you from falling asleep.
See a doctor if your sleeping problem continues:
If you have trouble falling asleep night after night, or if you
always feel tired the next day, then you may have a sleep disorder
and should see a physician. Your primary care physician may be able
to help you; if not, you can probably find a sleep specialist at
a major hospital near you. Most sleep disorders can be treated effectively,
so you can finally get that good night’s sleep you need.
For information on other neurological disorders or research programs
funded by the National Institute of Neurological Disorders and Stroke,
contact the Institute's Brain Resources and Information Network
(BRAIN) at:
BRAIN
P.O. Box 5801
Bethesda, MD 20824
(800) 352-9424 www.ninds.nih.gov
Prepared by:
Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892
NINDS health-related material is provided for information purposes
only and does not necessarily represent endorsement by or an official
position of the National Institute of Neurological Disorders and
Stroke or any other Federal agency. Advice on the treatment or care
of an individual patient should be obtained through consultation
with a physician who has examined that patient or is familiar with
that patient's medical history.
All NINDS-prepared information is in the public domain and may be
freely copied. Credit to the NINDS or the NIH is appreciated.
Reviewed July 3, 2003
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