Counting Sheep by Paul Martin

Counting Sheep by Paul Martin

Contents

Introduction. 2

Chapter 1: A Third of Life. 2

Chapter 2: Sleepy People. 3

Chapter 3 Dead Tired. 3

Chapter 4 The Golden Chain. 4

Chapter 5 The Shape of sleep. 4

The sleep cycle. 5

REM sleep. 5

The Sleep cycle continued. 5

Waking up. 6

Quality of sleep. 6

Chapter 6: Morpheus Undressed. 6

Larks and Owls. 7

Chapter 7 Strange tales of Erections and yawning. 7

Chapter 8 Friends and enemies of sleep. 7

Things that affect sleep. 7

Caffeine: 7

Alcohol 7

Tobacco. 8

Food. 8

Exercise. 8

Noise. 8

Shift Work. 8

Hypnotics. 8

Chapter 9: Dreams. 8

Chapter 10 A Second Life. 9

Chapter 11 from Egg to Grave. 10

Chapter 12 The Reason for sleep. 10

What is sleep for. 10

What is REM sleep for?. 10

Chapter 13 Bad Sleepers. 11

Why can’t you sleep. 11

What to do to help sleep. 12

Treatment. 12

What to do to stay awake. 12

Chapter 14 Dark Night. 12

Moving Sleep. 13

Sleep and guts. 13

Troubled minds. 13

Sudden nocturnal death. 13

Narcolepsy. 13

Chapter 15 Pickwickian Problems. 13

Chapter 16: And so to bed. 14

Chapter 17 An Excellent thing. 14

Introduction

What follows are my scant notes on what is an awesome and inspiring book, my advice is read it!!

Chapter 1: A Third of Life

There is a current prejudice, if you are asleep you are doing nothing. If you are doing nothing then you are not producing value. If you are not producing value in a consumerist society then you are worthless.

Our bodies are designed to have sleep according to circadian rhythms that hooks into the light of the day. Our sleep lives are regulated however by work schedules, electric light, alarms and caffeine.

Whilst attention to the body, to extend biological life, to enhance of desirability and esteem is something that is socially of concern to us, even if we don’t heed the advice. Sleep however is not, it doesn’t fit with our currents societies’ zeitgeist.

We can last longer without food that we can sleep, if we do not sleep are some time, not very long, our body forces us to go to sleep.

All species of animals sleep, and in terms of who sleeps the most and the least, we are on the low to middle ground at around 8 hours, 20 being the highest from the sloth.

Biological necessary behaviours can provide pleasure, e.g. sex, eating and drinking which help them be done, but sleeping is seemingly a source of neglected pleasure.

Sleep currently has the joyless status of 1950s canteen cooking, it is something done for refuelling, and the more quickly and more cheaply, the better.

Chapter 2: Sleepy People

The effects of sleep deprivation are daytime sleepiness, tiredness, loss of motivation, impaired cognitive faculty, decreases mood, decrease performance, loss of concentration, irritation, decrease of range of tasks people want to get involved in.

There is no right amount of sleep for people but 8 hours a night for an adult seems to suit most.  People sleep less than they used to and this seems related to a move to a long day, with work which now can extend around 24 hours as can entertainment plus caffeine in everything.  The work and success ethic keeps us from our bed, we use the work ethic to work harder being successful at work, and in social life, and sleep takes us away from that.

People used to sleep when it was dark, and work when it was light, the industrial revolution changed that with the electric light bulb which enabled us to work or socialise or to perform leisure activities through all house.  Where we used to sleep when we were tired, now we sleep according to clock time, we go to bed when it is time to go to bed, not when we are tired.

Through giving people long periods of dark, as would have been the experience in winter in pre-industrial northern Europe, then people slept in two 4 hour blocks punctuated by 2 quiet hours, during the night. So two quiet hours, then sleep, then wake then 2 quiet hours then sleep for four hours. Sleep length then used to vary with the seasons. Our current sleep pattern is one of permanent mid-summer.

Sleep deprivation causes car accidents, plane accidents, poor decisions and accidents in hospital. Sleep deprivation not only detracts from quality of life, it is also dangerous.

Chapter 3 Dead Tired

Whilst a poor night’s sleep can affect you strongly the next day a good night’s sleep can cure it. However chronic sleep deprivation can have a more insidious effect on you, your mood and your performance. Chronic sleep deprivation affects our creative problem solving, our judgement, mood physical health and social skills.

If you have not slept for 2 or three days you would need stimulation to keep you awake.  To tell how tired someone is you can measure it with sleep latency, the time it takes someone to get to sleep. The standard sleep day time latency is 15-25 minutes. Under 10 minutes would indicate a problem under 5 minutes would show excessive tiredness that was a cause for concern.  However some people can fall asleep very quickly and are not sleep deprived, so there are exceptions to this rule.

Sleepiness is affected by the last time you slept plus the time of the day. Stimulation can mask tiredness, busy people just don’t realise how tired they are.

Lack of sleep affects us emotionally, cognitively and behaviourally.  Emotionally we are less resilient and become more angry and irritable or sad. We have less energy and therefore less motivation. Our social skills are weakened, our brains don’t work as well, we have reduced focus, creativity and staying power.   Tiredness affects reaction times, and ability to put in sustained concentration or effort in something. Tired people are grumpy and reckless. Tired people become more inflexible and stick with standard responses, as they require less energy. They also take bigger risks, I guess as they might find the solution with one easy stroke, so need less effort to achieve their goals.

Growth hormones are produced during sleep, therefore the less sleep you get the less replenishment of your body you get and you see in middle age men the results of a loss of growth hormone with their double chins and pot bellies.

Sleep experiments, where deprivation of sleep happens for 90 hours results in hallucination, slurred speech, you basically feel like you are losing your mind after 2 or 3 days without sleep, indeed it is used as a torture by the military

Chapter 4 The Golden Chain

14:58 start

There is a link between sleep deprivation and poor physical health.  They have done experiments on dogs where they have forcibly kept them awake and they died within 20 days.  Sleep diminishes your perception, so vision is blurred but it has no effect on your physical strength.

Sleep deprivation can impair the efficiency of the immune system. It is argued that this is why sleep deprivation has proved fatal as the immune system stops working.  During infection the immune system issues chemicals that promote sleep\drowsiness\weariness and deep sleep within the sleep cycle.

One night without sleep can reverse the effect of immunisation, one night without sleep can increase cortisol levels by 45% which in turn reduces the immune systems efficiency.

Tired people are also more sensitive to pain, pain disrupts sleep, so you have a vicious cycle.

Chapter 5 The Shape of sleep

Human life has three states:

1.       Waking state

2.       Nrem Sleep

3.       Rem Sleep

Sleep is measured via an EEG machine, which measures electrical impulses from the brain.

A PSG machine measures brain activity, muscle tone and eye movement.

Falling asleep is not an abrupt process, rather it a continuous process moving from drowsiness to the first or second stage of sleep.  The movement between consciousness and sleep can be accompanied by hypnagogic dreams, which are generally less bizarre than standard dreams in sleep, in NRem and REM sleep. Indeed these sleep onset dreams can be seen as a watered down version from ordinary sleep.

Sleep latency=the length of time it takes you from wanting to fall asleep when you are laying down to when you actually do.

People with really long sleep latencies are generally either bored or ill. People with really short ones are generally sleep deprived.

The body’s core temperature drops an hour before the onset of sleep.  If you take a bath 2 hours before bed time this will have the same effect.  As the core temperature drops so the temperature in the feet and hand rises.

The sleep cycle

There are two section REM and Non Rem (NREM)

There are 4 parts of NREM, which relate to brain wave patterns.

Stage 1 NREM= muscles relax, brain wave patterns slow, lasts a couple of minutes, you can be easily awoken from this stage.

Stage 2 Brain waves patterns of K complexes and sleep spindles. K complexes are a brief burst of sleep wave that lasts under a second. Sleep spindles look on an EEG like a spindle moving across a loom. After 2 minutes you see delta brain waves, low frequency high amplitude, large waves slowly rolling across the screen.  Delta waves are the heralds of Stage 3 or deep sleep

Stage 3: Deep sleep, your eyes and muscles are still and relaxed

Stage 4: The deepest of deep sleep. Here you have slow rolling delta waves about 4 cycles a second. This is accompanied by profound muscle relaxation. This is the hardest state to be woken from and the one that you are most impervious to any sleep interruptions.  The first episode of stage 4 sleep lasts about 30 to 40 minutes

Stages 3 & 4 occupy 25% of our sleep time and are characterised by delta wave brain activity.

In Nrem sleep then the areas of brain where activity is most reduced is within the emotional and social behaviour areas, which is no surprise given that sleep deprivation affects these areas most.

After about an hour you have gone through Stages 1-4 of Nrem sleep, then you go into REM sleep

REM sleep

Has the same brain activity pattern as when awake, however the brain issues signals to prevent and signals being able to be sent to move the muscles, in effect the brain turns us into quadriplegics.  Rem sleep is also known as paradoxical sleep as it looks like from a brain scan you are awake.  Your brain is bombarding itself with stimuli but you are paralysed with the exception of your eyeballs.  Brain activity is intense in areas that process memories with an emotional content.

Your body is REM sleep is erratic, with breathing irregular, erogenous zones engorged and you have fluctuations in heart rate and temperature.  If you are awoken when you are in REM sleep there is an 80-90% chance you will be dreaming.

The body is paralysed as the brain sends out signals that block sensory inputs or muscular action. In NRem there is no paralysis and therefore this is the place where you get sleep walking, talking, teeth grinding etc.

The Sleep cycle continued

Each night’s sleep has 4-5 sleep cycles.  Each cycle starts with a descent into light slept NREM Stages 1 and 2 then slow wave sleep Stages 3 & 4, then a brief semi awaking then into REM sleep. One complete cycle lasts 90 mins in adults.  During progressive cycles the REM section becomes longer the short wave cycle, i.e. light sleep becomes shorter.  The final sleep episode before waking is an REM episode.  In a healthy adult they have 25% deep sleep, 25% REM sleep, and 50% light sleep. 

Periodically through the night you will awake briefly, i.e. be at very shallow sleep or on the edge of waking, but generally too quickly for you to be aware or for you to remember.  These are the body’s way of rising to the surface, seeing if there is anything dangerous around and if there’s not then sinking back down to sleep. During these partial awakenings you change your body posture. You change your body posture 30-40 times during the night.

All your sensory systems vision, sound, taste etc. have remained active, however the way that you process the input differs overnight. Sensory input influences your sleep although the full extent of this is not known. If you hear your own name or one that is significant to you then it will change your EEG pattern, again you are more likely to be woken by a noise that you would find irritating during the day rather than the level of noise.

Waking up

The body prepares you before you wake up. Your temperature rises and your hormone levels will change to help you get in gear. There is a hormone called ACTH that is produced about an hour before waking.

The grogginess we can experience in the morning is known as sleep inertia. Sleep deprivation increases the length of sleep inertia. Sleep inertia can last up to 3 hours, and is unaffected by morning routine!

Quality of sleep

You can measure the quality of sleep by Sleep efficiency:

Healthy sleeper has an efficiency of 90-95%

Insomniac 70-80%

Above 95% might indicate sleep deprivation.

Subjective reports of quality of sleep correlated with sleep efficiency. Another factor is amount of time in deep sleep, i.e. NREM stage3 or 4.Other facts are length of sleep and levels of immobility. So to summarise

Quality of sleep factors

1.       Sleep efficiently

2.       Amount of deep sleep

3.       Levels of immobility

4.       Length of sleep

Chapter 6: Morpheus Undressed

Sleep is an actively induced state. In REM sleep it is as active as when you are awake.

Rhythms of life

Virtually all bodily functions from cell biochemistry to social function exhibit a 24 hour cycle governed by an internal clock.  This clock is known as the circadian rhythm.  If you have sleep deprivation then it blunts this rhythm.  Circadian rhythms are universal characteristics of the living world. Circadian rhythms in humans apply to temperature, height, hormone production, digestion, urine production.

Some say the circadian rhythm evolved as the world revolves, it keeps us in sync and prepared for the changes in the day. Our circadian rhythm alters to external cues.

The electric light from a single lightbulb can reset the circadian clock. Light can be shone onto the knees to achieve the same effect.  The pineal gland produces melatonin when it is dark that affects how sleepy we feel.  Whilst the circadian clock does get reset, it has limits, so for instance submariners on an 18 hour day still exhibited the melatonin levels of a 24 hour day.

Growth hormones are secreted during sleep, in the first few episode of deep sleep. Between 30 and 40s the amount of growth hormone and the amount of deep sleep decreases. Testosterone levels reach their peak during the night and are depleted during the day.

The biological clock and circadian rhythm decreases as people age. So the daily differences in temperature and function are not as defined in older people.

Larks and Owls

Larks sleep pre 11pm and rise pre 8am. Most people are neither extreme larks nor owls, but 5-10% are markedly one or the other to a significant degree.

Larks have a circadian rhythm that is close to 24 hours, whereas owls have one that is over 24 hours and therefore they need to use environmental clues to manage their circadian rhythms, in fact you could argue their circadian rhythms don’t work.  Larks have consistently more cortisol in their systems.

Chapter 7 Strange tales of Erections and yawning

During REM sleep, which is standardly 4 half hourly sessions a night your genitals are engorged. Irrespective or age or sobriety this is the case. REM sleep does decline with age however, so there is less time spent engorged for the older person however.

Yawning is understood as a prompt to a change of behaviour, which is generally collective. The yawning when tired theory is challenged as yawning doesn’t change physiology not is always seen as a precursor to sleep, indeed soldiers yawn before battle

There is a connection between yawning and erections, the more someone yawns the more erections they have. This is because both behaviours are controlled by the same part of the brain. Dopamine is the main chemical transmitter for both yawns and hard-ons.

Chapter 8 Friends and enemies of sleep

Things that affect sleep

Caffeine:

This has a 7 hour half-life and is a stimulant that will keep you awake, it’s contained in coffee, tea, cocoa.  Caffeine works by inhibiting drowsiness, in large quantities it can produce adrenaline. People vary in their receptivity to caffeine

Alcohol

Alcohol helps us get to sleep, but reduces the amount of REM sleep in the second half of the night. Large doses do more harm than is good as far as sleep is concerned. Even middling amounts of alcohol drunk 6 hours before bedtime can affect sleep efficiency, REM sleep and total time asleep.

Insomnia is a notorious outcome of alcoholism.  There is  a vicious circle here where alcohol makes sleep easier, but disrupts sleep, produces insomnia with its adverse outcomes, which alcohol can be used to aid the low mood, or the insomnia, which in turn promotes it.

Tobacco

This is a central nervous stimulant and will increase the frequency of awakenings during the night.  Like caffeine nicotine provides a chemical boost when fatigue looms.

Food

Eating a large meal can make you feel sleepy, it could be this is because the body temperature drops when you are digesting, and a drop in body temperature is the herald to sleep. Spicy food can disrupt your sleep as it raises the body temperature, cheese can affect dreams as it takes longer to digest therefore can disrupt your sleep, which means you therefore can remember more of your dreams.

Exercise

Exercise does promote sleep although not directly, as fit people who take more exercise don’t sleep more. The probable relation is that it reduces anxiety which can affect sleep. It could be that if you have been very sedentary then you may find sleep difficult as your body is bored and exercise can help with that.

Noise

Repeated exposure to the same noise you habituate to it and it doesn’t wake you. Noise tends to act as a trigger to switch from deep sleep to shallow sleep.  40 Decibels affects sleep. 60 Decibels will wake people.  The quality of the noise and how it affects sleep matters, if the noise evokes an unpleasant emotion then it will be more evocative that if not.

Shift Work

Shift work is not good for you.  Shift work disrupts sleep and makes people tired.  There is a correlation between those who have worked shifts for over 10 years and heart disease.

Hypnotics

Drugs that induce drowsiness are called hypnotics. Natural hypnotics can be found in the amino acids of milky drinks. Melatonin can aid sleep as can certain smells: lavender oil.

Antihistamines can be hypnotics. The sleeping pills of the 70s have fallen out of favour as they created addictions and disrupted the quality of sleep. The modern drugs, e.g. zoplicone have little side effects and small chance of being addictive.

Chapter 9: Dreams

Dream themes:

Most dreams contain the dreamer and happen in the present.  Most characters in a dream are known to the dreamer. People with high verbal creativity have shorter dreams whilst those with high blood pressure have more dreams about hostility.  Dreams have a large emotional content.

During REM sleep the brain that processes rational content is less active and the area that processes emotional content more active.  Dreams are predominantly visual. Whilst dreams are wildly fantastical they are drawn out of elements of our lives.

We dream in NREM sleep but they are less vivid. If woken in NREM 6% of the time people say they are dreaming and 40% would say they are thinking.

Other animals dream and it seems the closer to humans in terms of consciousness the closer the likelihood that dreams are similar. 

It seems that recent\significant waking life provides most of the content for dreams and what happens in dreams influences how we lead our waking life.

The brain activity in a dream in similar to the content when someone is delirious.  There is an automatic amnesia for dreams that helps to keep a strong divide between dreaming and rationality.

People do standardly remember dream fragments and confuse them with a real memory.

Some psychiatric patients have difficulty in distinguishing their remembered dreams from a remembered reality.

Dreams could be understood as

1.       Wish fulfilment: Freud

a.       However how come we dream at regular intervals, and we dream as foetuses, and our levels of dreams decline as we grow old. If they are wish fulfilment\sexual why would any of this happen?

2.       Noise

a.       However we tend to dream about current concerns

3.       Consolidation of memory

4.       Working through conscious difficulties, so having the ability to work through all the various permutations of a current concern without committing yourself to any.

Chapter 10 A Second Life

Dreams seem to be play, a form of safe simulation. We disconnect our motoric capacity, mix up different ways of doing standard things, and then we can safely play. So we can try out different ways of behaving with no consequences.

Dreams can provide creative inspiration but it seems only if you have been working on that theme before you dream

Lucid dreams are dreams where you know you’re dreaming and can get certain things to happen.  They are relatively infrequent even for those who are well versed in them.

Chapter 11 from Egg to Grave

How the adult responds to the baby’s needs when they don’t sleep will affect how they sleep. How they sleep in turn affects how we respond to them.  A woman’s sleep alters according to their menstrual cycle.  There are generally sleep problems during pregnancy and a reduction of deep slow wave sleep.  REM sleep during pregnancy increases and the   amount of dreams does too. Babies have a circadian rhythm pre-birth, and can start sleeping 14-16 hours a day in blocks, which gradually reduces and turns into a single block. Children as adults can react to a lack of sleep and tiredness by being manic and keeping busy.

In teenage years our body clocks shift to a more owl like one.  We sleep less well in our old age and get less sleep, this doesn’t mean that we don’t need it.  AS we grow older we shift more to darkness.

Chapter 12 The Reason for sleep

Evolution of sleep

Primitive reptiles only have NREM Sleep. Primitive mammals do have REM sleep, therefore you can deduce that REM sleep evolved at a later stage than NREM sleep. Given that primitive as well as higher order animals have REM sleep, then it seems reasonable that REM sleep evolved to perform a basic function. Dreaming may well have been grafted onto REM sleep later in evolution, so there is the function REM sleep provides, that which NREM sleep provides, and then what the function of dreaming is.

What is sleep for

1.       Physical recuperation

2.       Saving energy

3.       Staying safe

There is some support, albeit limited, that sleep is for physical recuperation: the production of the building blocks of DNA increases during the night.  However some parts of the brain are more active than when awake, and sleep doesn’t vary according to physical exercise. So there is a part of sleep that is physically restorative but it is not the whole story.

Again there is some support for the saving energy argument as sleep varies when there is less food around, in humans and in animals. However we could get the same by just resting and purpose swim whilst sleeping.

The staying safe argument makes some sense in animals who can’t see at night, can’t get food, and will be hunted by those who can see at night, although this can’t account for baby humans who sleep most of the time. Still it’s more than possible that there are different purposes for sleep in different animals.

You may conclude that NREM has the purpose of giving the animal inactivity when it is the best strategy. Most large animals have NREM standing up, but need to lie down for REM sleep.

What is REM sleep for?

REM is a universal feature of large brained animals. Due to the specific brain activity that is REM sleep then it seems reasonable to assume that REM sleep is something to do with the brain. Young animals spend much more time in REM sleep that adults.

Dreams under represent and over represent, they in short distort through a number of ways but too much and too little are one aspect. I would note here that the author is conflating REM with dreams, but dreams happen within REM. REM has brain activity, paralysis and a certain muscle tone.

1.       Provide oxygen to the cornea (the aqueous fluid in the eye transports oxygen)

2.       Self-assembly of the brain: so the brain is cut off from sensory inputs so REM generates them. A cat deprived of one eye doesn’t grow as many visual processing brain cells

3.       Reverse learning: Watson and crick argue that information in the brain is stored over many synapses, and that too many things being remembered weakens the whole system, therefore the weaker memories get pruned and that is what happens in REM. They argue

that spurious memories are also pruned. However dreams are meaningful. Also we try to remember our dreams which would be the complete opposite of what their theory would argue but this is common in human culture and revered in many places

4.       Brain processes new information and consolidates memories:

a.       People have more REM sleep after doing a new task, if they don’t have REM sleep they forge the new task. Without REM sleep long term memory of what has been learnt is impaired.

b.      NREM sleep correlates with declarative sleep

c.       REM sleep correlates with procedural

5.       Resolving problems, emotional or otherwise

Chapter 13 Bad Sleepers

Insomnia is a symptom not a cause. Its homeland is USA, where one in three Americans have persistent sleep problems. Insomnia btw is persistent bad sleep. Insomnia increases in the over 60s.

The problems of sleep are:

1.       You are tired

a.       You can’t focus

b.      You can’t work on certain type of tasks

c.       Your social skills diminish

d.      You are more of a risk taker

e.      You lack motivation

2.       You don’t consolidate memories

3.       You don’t consolidate new skills

4.       The outcome of feeling tired is reduced activity which lowers mood

Why can’t you sleep

It is very hard to be objective about the quality of your sleep. No person has gone for sleep for more than a few days, you die if this is the case.

Reason for Insomnia

1.       Night shifts

2.       Respiratory problems

3.       Anxiety\depression\stress

4.       Caffeine

5.       Alcohol

6.       Migraines

7.       Pain

What to do to help sleep

1.       Only use bed for sex or sleep

2.       Go to bed at regular time and get up at one

3.       Have no disturbances in bedroom

4.       Avoid caffeine

5.       Pre bed relaxation routine

Treatment

1.       Zoplicone can be effective when taken once or twice a week

2.       CBT effective in achieving a 29% increase of the total sleep time

What to do to stay awake

1.       Caffeine works in the short term

2.       Sleep well the night before

3.       Napping

4.       Modafinil

5.       Physical exercise

Chapter 14 Dark Night

Some of the distress of sleep:

1.       Bed wetting

2.       Sudden death

3.       Sleep walking

4.       Night terrors

5.       Sleep paralysis

6.       Grinding teeth

7.       Nightmares

Sleep walking and talking at the product of NREM sleep. Benign in children but can be a sign of psychological difficulty if it persists into adult hood.

Night terrors: People awake with a sense of dread that there is an alien presence in the room

Sleep paralysis, you want to move but cant.

Night terrors and sleep paralysis are from waking from slow wave sleep. Like sleep walking and talking they arise in the first period of the night.

Nightmares happen during REM sleep. People who have regular nightmares are more likely to require hospital treatment for mental health difficulties during their lives.  People who have nightmares are easier to hypnotise.

To get rid of nightmares, tell yourself whilst awake you won’t have one and then do some CBT image work

Moving Sleep

You move in your sleep every 15-20 minutes, usually at the end of REM or slow wave sleep. This is necessary as you can get nerve damage if you lie on the same part too long. Your limbs may jerk during NREM sleep. We tend to notice these as we are dropping off to sleep as they can wake us up again. There is no correlation between limb movement and reported quality of sleep. If you really thrash about you might be suffering from REM sleep disorder where the signals to prevent muscle movement aren’t working correctly.

Occasional bedwetting can continue into adult hood in 1:200, more common in males than females

Teeth grinding: 8% do this once a week: causes of this heavy snoring, caffeine, alcohol, stress, anxiety and smoking.

Sleep and guts

There’s a subtle relationship reciprocal between sleep and guts. If you have a bad night’s sleep your digestive system may be upset. This can be because there is a gut rebuilding enzyme that is released at night.  IBS symptoms correlate with a good night’s sleep.

Troubled minds

Again there is a reciprocal relationship between psychological states and sleep.  Chronic insomnia, produces chronic fatigue that can leave you with depressive symptoms.  Sleep problems precede depression. SSRIS can cause detrimental problems on sleep, which can cause a vicious cycle.  One study showed that the best predictor of depression in old people was insomnia.

Depression affects REM sleep, it increases its amount and decreases the time it takes to get into it and a higher frequency of REM. The higher frequency of eye movements predicts suicide in schizophrenics and relapse in alcoholics.

Depriving depressed people of sleep can alleviate their depression, but it returns the next time they have sleep. This happens in 50% of the cases, and the other half nothing happens. Why this works is it correct an unusual pattern of brain activity. This could be rumination, self-criticism etc.

Sudden nocturnal death

Most likely explanation is cardiac arrest. Mostly happens to young Asian men, possibly as a result of nightmares. This would mean the increase of emotion causes a heart attack in someone with a pre-existing condition.

Narcolepsy

Can be triggered by emotional arousal. A Narcoleptic sleep has a very rapid onset on REM

Chapter 15 Pickwickian Problems

Snoring can have a decibel range of 70-90. When in REM sleep, our muscles relax, our upper airways become more constricted and greater effort is required to pull air through. Pulling air through quickly causes the elastic walls to vibrate as does any other loose tissue, back of tongues etc. The tongue and the fatty tissue of the soft palette are prime areas that cause the sound of snoring.

What causes snoring?

1.       Obesity

2.       Alcohol

3.       Nasal congestion

4.       A receding chin

5.       Gravity, allowing the tongue and other tissue to fall back into the air ways.

6.       Tiredness: the more deep sleep you have the more relaxed the more snoring is likely

Snoring sounds much worse than it is, people’s subjective rating to the noise of it bears little relation to the actual sound, it seems the irritation factor, through the type of sound and its intermittency is a major factor

1 in 3 men snore regularly. Habitual heavy snoring can dent your mental performance.

Chapter 16: And so to bed

Beds used to be a status symbol until two hundred years ago when the industrial revolution and light bulbs happened. There were day beds and night beds.

Two thirds of people sleep with a partner. Sleep deprivation can affect your partner. Until the eighteenth century many people shared a bed.

Couples movement is often synchronised and men move more than women. There is nothing to show that a baby that sleep with his parents, becomes less independent.

Sudden infant death syndrome is only a problem if you smoke or drink heavily and share a bed with your baby,

Chapter 17 An Excellent thing

The sense that sleep is a passive, purposeless waste of time is founded on fallacy.

Napping:

This works, indeed many people who were hailed as people who could work all the time and didn’t need sleep, Napoleon, Churchill were great nappers. A nap is intentional day time sleep between a few minutes and a few hours. Do not however use them if you are insomniac.

3 Types of Nap

1.       Prophylactic Nap

2.       Relief Nap

3.       Pleasure nap