SLEEP: LEARN TO FACILITATE SLEEP ONSET

It is interesting to observe that some people fall asleep very easily, but some find it very difficult and need sleeping pills. Even the same person may fall asleep very easily at some times in his life but find it very difficult at other times. Why is this?

There are two sets of forces acting against each other which affect sleep onset. One group of forces includes good sleep hygiene, falling asleep at the right time of the biological clock, and, of course, being sleepy. The other group of forces includes poor sleep hygiene, trying to fall asleep at the wrong time of the biological clock, being unable to handle stress effectively, and, of course, having a genetic makeup that is of poor quality for sleeping. It is important to increase those forces that facilitate sleep onset and to decrease those that oppose it. Let us now analyse these factors in more detail.

Genetic make-up

Studies of identical twins show that much of our ability to sleep is coded in our genes. Identical twins, who have the same genes, have similar sleep patterns even if they live apart in different environments for years. Some people are born good sleepers and they can sleep at any time of the day and, in fact, anywhere. My wife is a good sleeper, and she could sleep easily at any time no matter what shift duty she was on when she was working as a nurse in the general hospital. My two daughters have different abilities to fall asleep. Melissa is more like me, whereas Melinda sleeps easily, very much like her mother. But for those of us who are not so lucky and have poor quality genes for sleep, we have to improve those factors that facilitate sleep onset so as to tip the balance in favour of the forces that bring about sleep.

Sleep hygiene

This is the most important force in facilitating sleep onset. As discussed, caffeine is the number one enemy; absolutely no coffee or tea. The bedroom is reserved for sleep and sex and no other activities. Leave the clock under the bed, but set the alarm to the same time every morning, even on Sundays and public holidays. A regular waking up time in the morning is an important Zeitgeber for entraining our circadian rhythm to the 24 hour clock. Daytime exercises are good, as they increase the amounts of NREM sleep.

Biological clock

If our circadian rhythm is entrained to the 24 hour clock, we should feel sleepy at about the same time every night. Also, our ultradian rhythm causes us to feel sleepy about every 90 minutes. Hence when we feel sleepy at night, we should go to bed and sleep, for this is the easiest time to fall asleep. It is a bad idea to finish a book or a television program before going to bed. Remember, for the insomniac, if you stay up a little later in the night and miss the 90 minute window, you may not feel sleepy again for a further 90 minutes or so. If your 90 minute window is at 10 p.m., it does not mean that you will be more sleepy at 10.30 p.m.

Stress management

Ordinary stress is everyday stress and, if you cannot cope with it and carry it over to your bedtime, it may become the biggest force in opposing your sleep. If you are unable to cope with ordinary stress, it may be a good idea to seek professional help.

How sleepy are you?

Sleep deprived people or people who have not been sleeping well for a few days fall asleep easily and deeply. It has been shown that, for the sleep deprived subject, the ultradian rhythm disappears. This means we can fall asleep at any time irrespective of where we are in the circadian or ultradian rhythm. This is the biggest facilitating force to sleep. If you are really sleepy and your body needs the sleep, you will sleep. We all possess a natural in-built mechanism in the brain that allows us to fall asleep regularly every night. Our body has a self-regulatory mechanism that allows us to fall asleep if we have not had sufficient sleep. If you are very sleepy, no matter how hard you want to stay awake you may find it impossible.

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