sleep

Drugs and sleep

Sleep disturbances have been associated with drug use and the withdrawal from drug abuse.  Sleep disturbances also have been linked to the use of alcohol and to chronic alcoholism.

Many prescription and non-prescription medicines can cause sleep problems.  The severity of sleep problems caused by a medicine will vary from person to person. 

Prescription drugs that might cause sleep problems include:

• High blood pressure medicines
• Hormones such as oral contraceptives
• Steroids including prednisone
• Respiratory medicines
• Diet pills
• Attention deficit/hyperactivity disorder medicines
• Some antidepressants

The following non-prescription medicines can cause sleep problems:

• Pseudoephedrine, including the brand Sudafed
• Medicines with caffeine (These include the brands Anacin, Excedrin, and No-Doz as well as cough and cold medicines
• Marijuana, heroin, cocaine amphetamines and methamphetamines
• Nicotine, which can disrupt sleep and reduce total sleep time.

Alcohol and sleep

Alcohol is a sedative, which can help induce sleep, but the quality of sleep is often fragmented.  Alcohol prevents you from getting the deep sleep and rapid eye movement (REM) sleep you need because alcohol keeps you in the lighter stages of sleep.

REM and NREM Sleep

The importance of sleep cannot be overestimated, and lack of sleep can wreak havoc in our lives.  Having enough sleep is essential, because during this time the body repairs and rejuvenates itself.  While it seems that the body is at rest the brain is busy managing and supervising other body activities.

The basic stages of sleep are classified as rapid eye movement sleep and non-rapid eye movement sleep, which are then broken down into other segments.

Non-rapid eye movement (NREM) is the first stage of sleep followed by rapid eye movement (REM).  The length of each cycle between NREM and REM sleep varies but usually last about 75 minutes, and then increase in length throughout the night.  A person spends about 75% of their time asleep in NREM.  NREM sleep can be further broken down into 4 more stages and each stage has its own characteristics. 

Stage 1 is the lightest form of sleep and people can easily be woken up in this stage.  A person spends approximately 7 minutes in this dreamy like state.  It is during this stage that people have the feeling of falling or slipping away and can awake abruptly.

Stage 2 of NREM sleep last about 25 minutes and during this time a person is harder to wake, and there is a decrease in temperature and heart rate.  This is also the time when information that has been learned throughout the day becomes memory.  A person who does not get enough of this Stage 2 sleep may have difficulty retaining memory that needs to be recalled at a later event.

Stage 3 NREM sleep is where a person moves from light to deep sleep.  It is during this stage that slow wave sleep, which is restorative for the body.  This stage last only a few minute before moving into Stage 4.

Stage 4 NREM sleep is the deepest form of sleep and may last up to 40 minutes.  It is during this stage that certain types of sleep disorder being to manifest as behaviors.

REM sleep.

Unlike NREM sleep, REM sleep consists of much less total sleep time.  REM, rapid eye movement occurs when a person is dreaming.  This stage is made up of low voltage brain wave activity and muscle paralysis.  The first phase of REM sleep is usually very short, but gets longer as the night progresses.  During REM sleep, the heart rate increases, blood pressure increases, as does, blood flow to the brain.  Breathing becomes faster and body temperature may now start to rise.  During REM sleep the body does not regulate and the person is unable to sweat or shiver. 

Sleep Hormones

One of the major functions of sleep is the production of sleep hormones.  These hormones regulate the amount of sleep a person gets.  They help a person fall asleep and wake up and they also play a role in metabolism and stress.

Melatonin

The body has a 24 hour clock known as the circadian rhythm.  The body produces hormones in response to certain times of day when it knows it should be sleeping or awake.  One of these hormones is melatonin.  The control of this hormone happens in the brain in the area known as the supra-chiasmatic nucleus (SCN).  The SCN responds to environment when then days get shorter, and it then stimulates the brain to secrete hormones such as melatonin.  Very little melatonin is secreted from the pineal gland in the brain during the day, but larger amounts are secreted at night which helps individuals sleep.   The release of melatonin usually starts to occur around 9 pm and lasts for about 12 hours.  Melatonin is only released in an environment that doesn’t have bright light.  The amount of melatonin that a body releases varies from person to person.  In some situation melatonin supplements may be necessary and it can be purchased without a prescription. 

Sleep recommendations

A good night’s sleep is essential to maintain a healthy balanced life.   Getting enough sleep helps reduce illnesses and injuries.  Different ages need a different amount of sleep with children needing the most.  On average a 1 month old child sleeps 16 hours a day.  At 3 months a baby may sleep 6 to 10 hours at night and about 6-8 hours during the day.  At around 4 months a baby can sleep for much longer periods of time at night, which gives parents some much needed rest.    Between 9 & 12 months a baby sleeps for about 11 hours with a couple of naps during the day.  Children can develop sleep deprivation at an early age.  Sleep difficulties cause fatigue, lethargy and difficulty with concentration and memory, which makes performance at school difficult.  As children continue to grow, they continue to sleep about 11 to 12 hours.  This number drops to 10 hours for children between the age of 10 and 12 years.  By 16 years of age teenager will need 9.5 hours of uninterrupted sleep. 

The optimal amount of time needed for adults is between 7.5 and 9 hours per night.  When an adult is getting less 6 hours of sleep a night; performance starts to suffer and so does their energy level.

A Guide to Sleep Hygiene

Proper sleeping habits are necessary for a healthy life.  Here are a few suggestions.

1. Avoid napping during the day.
2. Avoid coffee at least 6 hours before going to bed.
3. Avoid alcohol, nicotine and street drugs.
4. Don’t eat a heavy meal before going to bed.
5. Don’t watch TV that will over stimulate your mind.
6. Keep your room dark and have minimal noise in your room.
7. Go to bed at the same time each night.
8. Use some form of relaxation method to help calm you.
9. Take a warm bath.
10. If you have trouble falling asleep or if you wake up in the night. Don’t lie in bed thinking about other things or worrying that you can’t sleep as this will only make you more agitated.  Get up and do something soothing until you feel tired enough to go back to sleep.
11. Don’t over exercise just before going to bed as your body needs time to wind down and relax.
12. If you sleep problems persist consult a medical professional for help.

Johnina Noar, CADC-II
CD Councelor
AToN Center  888-535-1516