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Sleep is a sedentary state of mind and body. It is characterized by altered
consciousness
Consciousness, at its simplest, is sentience and awareness of internal and external existence. However, the lack of definitions has led to millennia of analyses, explanations and debates by philosophers, theologians, linguisticians, and scien ...
, relatively inhibited
sensory
Sensory may refer to:
Biology
* Sensory ecology, how organisms obtain information about their environment
* Sensory neuron, nerve cell responsible for transmitting information about external stimuli
* Sensory perception, the process of acquiri ...
activity, reduced
muscle
Skeletal muscles (commonly referred to as muscles) are organs of the vertebrate muscular system and typically are attached by tendons to bones of a skeleton. The muscle cells of skeletal muscles are much longer than in the other types of muscl ...
activity and reduced interactions with surroundings.
It is distinguished from
wakefulness
Wakefulness is a daily recurring Human brain, brain state and state of consciousness in which an individual is conscious and engages in coherent cognition, cognitive and behavioral responses to the external world.
Being awake is the opposite of ...
by a decreased ability to react to
stimuli
A stimulus is something that causes a physiological response. It may refer to:
*Stimulation
**Stimulus (physiology), something external that influences an activity
**Stimulus (psychology), a concept in behaviorism and perception
*Stimulus (economi ...
, but more reactive than a
coma
A coma is a deep state of prolonged unconsciousness in which a person cannot be awakened, fails to respond normally to painful stimuli, light, or sound, lacks a normal wake-sleep cycle and does not initiate voluntary actions. Coma patients exhi ...
or
disorders of consciousness
Disorders of consciousness are medical conditions that inhibit consciousness. Some define disorders of consciousness as any change from complete self-awareness to inhibited or absent self-awareness and arousal. This category generally includes min ...
, with sleep displaying different, active brain patterns.
Sleep occurs in
repeating periods, in which the body alternates between two distinct modes: REM sleep and
non-REM
Non-rapid eye movement sleep (NREM), also known as quiescent sleep, is, collectively, sleep stages 1–3, previously known as stages 1–4. Rapid eye movement sleep (REM) is not included. There are distinct electroencephalographic and other char ...
sleep. Although REM stands for "rapid eye movement", this mode of sleep has many other aspects, including virtual
paralysis
Paralysis (also known as plegia) is a loss of motor function in one or more muscles. Paralysis can also be accompanied by a loss of feeling (sensory loss) in the affected area if there is sensory damage. In the United States, roughly 1 in 50 ...
of the body.
Dreams are a succession of images, ideas, emotions, and sensations that usually occur involuntarily in the
mind
The mind is the set of faculties responsible for all mental phenomena. Often the term is also identified with the phenomena themselves. These faculties include thought, imagination, memory, will, and sensation. They are responsible for various m ...
during certain stages of sleep. During sleep, most of the
body's systems are in an
anabolic
Anabolism () is the set of metabolic pathways that construct molecules from smaller units. These reactions require energy, known also as an endergonic process. Anabolism is the building-up aspect of metabolism, whereas catabolism is the breaking-do ...
state, helping to restore the
immune
In biology, immunity is the capability of multicellular organisms to resist harmful microorganisms. Immunity involves both specific and nonspecific components. The nonspecific components act as barriers or eliminators of a wide range of pathogens ...
,
nervous,
skeletal
A skeleton is the structural frame that supports the body of an animal. There are several types of skeletons, including the exoskeleton, which is the stable outer shell of an organism, the endoskeleton, which forms the support structure inside ...
, and
muscular systems;
these are vital processes that maintain mood, memory, and cognitive function, and play a large role in the function of the
endocrine
The endocrine system is a messenger system comprising feedback loops of the hormones released by internal glands of an organism directly into the circulatory system, regulating distant target organs. In vertebrates, the hypothalamus is the neu ...
and
immune system
The immune system is a network of biological processes that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to parasitic worms, as well as cancer cells and objects such as wood splinte ...
s.
The internal
circadian clock
A circadian clock, or circadian oscillator, is a biochemical oscillator that cycles with a stable phase (waves), phase and is synchronized with solar time.
Such a clock's ''in vivo'' period is necessarily almost exactly 24 hours (the earth's curre ...
promotes sleep daily at night. The diverse purposes and mechanisms of sleep are the subject of substantial ongoing research.
Sleep is a highly
conserved behavior across animal evolution.
Humans may suffer from various
sleep disorders, including
dyssomnias such as
insomnia
Insomnia, also known as sleeplessness, is a sleep disorder in which people have trouble sleeping. They may have difficulty falling asleep, or staying asleep as long as desired. Insomnia is typically followed by daytime sleepiness, low energy, ...
,
hypersomnia
Hypersomnia is a neurological disorder of excessive time spent sleeping or excessive sleepiness. It can have many possible causes (such as seasonal affective disorder) and can cause distress and problems with functioning. In the fifth edition ...
,
narcolepsy, and
sleep apnea;
parasomnias such as
sleepwalking and
rapid eye movement sleep behavior disorder;
bruxism
Bruxism is excessive teeth grinding or jaw clenching. It is an oral parafunctional activity; i.e., it is unrelated to normal function such as eating or talking. Bruxism is a common behavior; reports of prevalence range from 8% to 31% in the gene ...
; and
circadian rhythm sleep disorder
Circadian rhythm sleep disorders (CRSD), also known as circadian rhythm sleep-wake disorders (CRSWD), are a family of sleep disorders which affect the timing of sleep. CRSDs arise from a persistent pattern of sleep/wake disturbances that can be ...
s. The use of
artificial light has substantially altered humanity's sleep patterns. Common sources of artificial light include the screens of electronic devices such as
smartphone
A smartphone is a portable computer device that combines mobile telephone and computing functions into one unit. They are distinguished from feature phones by their stronger hardware capabilities and extensive mobile operating systems, whic ...
s and televisions, which emit large amounts of blue light, a form of light typically associated with daytime. This disrupts the release of the hormone
melatonin
Melatonin is a natural product found in plants and animals. It is primarily known in animals as a hormone released by the pineal gland in the brain at night, and has long been associated with control of the sleep–wake cycle.
In vertebrates ...
needed to regulate the sleep-cycle.
Physiology
The most pronounced physiological changes in sleep occur in the brain.
The brain uses significantly less energy during sleep than it does when awake, especially during non-REM sleep. In areas with reduced activity, the brain restores its supply of
adenosine triphosphate
Adenosine triphosphate (ATP) is an organic compound that provides energy to drive many processes in living cells, such as muscle contraction, nerve impulse propagation, condensate dissolution, and chemical synthesis. Found in all known forms of ...
(ATP), the molecule used for short-term storage and transport of energy. In quiet waking, the brain is responsible for 20% of the body's energy use, thus this reduction has a noticeable effect on overall energy consumption.
Sleep increases the
sensory threshold
In psychophysics, sensory threshold is the weakest stimulus that an organism can sense. Unless otherwise indicated, it is usually defined as the weakest stimulus that can be detected half the time, for example, as indicated by a point on a probabi ...
. In other words, sleeping persons perceive fewer stimuli, but can generally still respond to loud noises and other salient sensory events.
During
slow-wave sleep
Slow-wave sleep (SWS), often referred to as deep sleep, consists of stage three of non-rapid eye movement sleep. It usually lasts between 70 and 90 minutes and takes place during the first hours of the night. Initially, SWS consisted of both St ...
, humans secrete bursts of
growth hormone
Growth hormone (GH) or somatotropin, also known as human growth hormone (hGH or HGH) in its human form, is a peptide hormone that stimulates growth, cell reproduction, and cell regeneration in humans and other animals. It is thus important in h ...
. All sleep, even during the day, is associated with the secretion of
prolactin
Prolactin (PRL), also known as lactotropin, is a protein best known for its role in enabling mammals to produce milk. It is influential in over 300 separate processes in various vertebrates, including humans. Prolactin is secreted from the pit ...
.
Key physiological methods for monitoring and measuring changes during sleep include
electroencephalography
Electroencephalography (EEG) is a method to record an electrogram of the spontaneous electrical activity of the brain. The biosignals detected by EEG have been shown to represent the postsynaptic potentials of pyramidal neurons in the neocortex ...
(EEG) of
brain waves,
electrooculography (EOG) of eye movements, and
electromyography
Electromyography (EMG) is a technique for evaluating and recording the electrical activity produced by skeletal muscles. EMG is performed using an instrument called an electromyograph to produce a record called an electromyogram. An electromyog ...
(EMG) of
skeletal muscle
Skeletal muscles (commonly referred to as muscles) are organs of the vertebrate muscular system and typically are attached by tendons to bones of a skeleton. The muscle cells of skeletal muscles are much longer than in the other types of muscl ...
activity. Simultaneous collection of these measurements is called
polysomnography, and can be performed in a specialized
sleep laboratory.
Sleep researchers also use simplified
electrocardiography
Electrocardiography is the process of producing an electrocardiogram (ECG or EKG), a recording of the heart's electrical activity. It is an electrogram of the heart which is a graph of voltage versus time of the electrical activity of the hear ...
(EKG) for cardiac activity and
actigraphy
Actigraphy is a non-invasive method of monitoring human rest/activity cycles. A small actigraph unit, also called an actimetry sensor, is worn for a week or more to measure gross motor activity. The unit is usually in a wristwatch-like package wo ...
for motor movements.
Brain waves in sleep
The electrical activity seen on an EEG represents brain waves. The amplitude of EEG waves at a particular frequency corresponds to various points in the sleep-wake cycle, such as being asleep, being awake, or falling asleep. Alpha, beta, theta, gamma, and delta waves are all seen in the different stages of sleep. Each waveform maintains a different frequency and amplitude. Alpha waves are seen when a person is in a resting state, but is still fully conscious. Their eyes may be closed and all of their body is resting and relatively still, where the body is starting to slow down. Beta waves take over alpha waves when a person is at attention, as they might be completing a task or concentrating on something. Beta waves consist of the highest of frequencies and the lowest of amplitude, and occur when a person is fully alert. Alpha and beta waves are the only waves seen when a person is in an awake state. Gamma waves are seen when a person is highly focused on a task or using all their concentration. Theta waves occur during the period of a person being awake, and they continue to transition into Stage 1 of sleep and in stage 2. Delta waves are seen in stages 3 and 4 of sleep when a person is in their deepest of sleep.
Non-REM and REM sleep
Sleep is divided into two broad types:
non-rapid eye movement
Non-rapid eye movement sleep (NREM), also known as quiescent sleep, is, collectively, sleep stages 1–3, previously known as stages 1–4. Rapid eye movement sleep (REM) is not included. There are distinct electroencephalographic and other char ...
(non-REM or NREM) sleep and
rapid eye movement (REM) sleep. Non-REM and REM sleep are so different that physiologists identify them as distinct behavioral states. Non-REM sleep occurs first and after a transitional period is called
slow-wave sleep
Slow-wave sleep (SWS), often referred to as deep sleep, consists of stage three of non-rapid eye movement sleep. It usually lasts between 70 and 90 minutes and takes place during the first hours of the night. Initially, SWS consisted of both St ...
or deep sleep. During this phase, body temperature and heart rate fall, and the brain uses less energy.
REM sleep, also known as paradoxical sleep, represents a smaller portion of total sleep time. It is the main occasion for dreams (or
nightmare
A nightmare, also known as a bad dream, Retrieved 11 July 2016. is an unpleasant dream that can cause a strong emotional response from the mind, typically fear but also despair, anxiety or great sadness. The dream may contain situations of d ...
s), and is associated with desynchronized and fast brain waves, eye movements, loss of muscle tone,
[ and suspension of ]homeostasis
In biology, homeostasis (British English, British also homoeostasis) Help:IPA/English, (/hɒmɪə(ʊ)ˈsteɪsɪs/) is the state of steady internal, physics, physical, and chemistry, chemical conditions maintained by organism, living systems. Thi ...
.
The sleep cycle of alternate NREM and REM sleep takes an average of 90 minutes, occurring 4–6 times in a good night's sleep. The American Academy of Sleep Medicine
The American Academy of Sleep Medicine (AASM) is a United States professional society for the medical subspecialty of sleep medicine which includes disorders of circadian rhythms. It was established in 1975.
The organization's functions include t ...
(AASM) divides NREM into three stages: N1, N2, and N3, the last of which is also called delta sleep or slow-wave sleep
Slow-wave sleep (SWS), often referred to as deep sleep, consists of stage three of non-rapid eye movement sleep. It usually lasts between 70 and 90 minutes and takes place during the first hours of the night. Initially, SWS consisted of both St ...
. The whole period normally proceeds in the order: N1 → N2 → N3 → N2 → REM. REM sleep occurs as a person returns to stage 2 or 1 from a deep sleep.[ There is a greater amount of deep sleep (stage N3) earlier in the night, while the proportion of REM sleep increases in the two cycles just before natural awakening.]
Awakening
Awakening can mean the end of sleep, or simply a moment to survey the environment and readjust body position before falling back asleep. Sleepers typically awaken soon after the end of a REM phase or sometimes in the middle of REM. Internal circadian indicators, along with a successful reduction of homeostatic sleep need, typically bring about awakening and the end of the sleep cycle. Awakening involves heightened electrical activation in the brain, beginning with the thalamus
The thalamus (from Greek θάλαμος, "chamber") is a large mass of gray matter located in the dorsal part of the diencephalon (a division of the forebrain). Nerve fibers project out of the thalamus to the cerebral cortex in all directions, ...
and spreading throughout the cortex.
On a typical night of sleep, there is not much time that is spent in the waking state. In various sleep studies that have been conducted using the electroencephalography, it has been found that females are awake for 0-1% during their nightly sleep while males are awake for 0-2% during that time. In adults, wakefulness increases, especially in later cycles. One study found 3% awake time in the first ninety-minute sleep cycle, 8% in the second, 10% in the third, 12% in the fourth, and 13–14% in the fifth. Most of this awake time occurred shortly after REM sleep.
Today, many humans wake up with an alarm clock
An alarm clock (or sometimes just an alarm) is a clock that is designed to alert an individual or group of individuals at a specified time. The primary function of these clocks is to awaken people from their night's sleep or short naps; they ar ...
; however, people can also reliably wake themselves up at a specific time with no need for an alarm. Many sleep quite differently on workdays versus days off, a pattern which can lead to chronic circadian desynchronization. Many people regularly look at television and other screens before going to bed, a factor which may exacerbate disruption of the circadian cycle. Scientific studies on sleep have shown that sleep stage at awakening is an important factor in amplifying sleep inertia.
Timing
Sleep timing is controlled by the circadian clock
A circadian clock, or circadian oscillator, is a biochemical oscillator that cycles with a stable phase (waves), phase and is synchronized with solar time.
Such a clock's ''in vivo'' period is necessarily almost exactly 24 hours (the earth's curre ...
(Process C), sleep-wake homeostasis
In biology, homeostasis (British English, British also homoeostasis) Help:IPA/English, (/hɒmɪə(ʊ)ˈsteɪsɪs/) is the state of steady internal, physics, physical, and chemistry, chemical conditions maintained by organism, living systems. Thi ...
(Process S), and to some extent by the individual will.
Circadian clock
402px, The human " biological clock"
Sleep timing depends greatly on hormonal signals from the circadian clock, or Process C, a complex neurochemical system which uses signals from an organism's environment to recreate an internal day–night rhythm. Process C counteracts the homeostatic drive for sleep during the day (in diurnal animals) and augments it at night. The suprachiasmatic nucleus
The suprachiasmatic nucleus or nuclei (SCN) is a tiny region of the brain in the hypothalamus, situated directly above the optic chiasm. It is responsible for controlling circadian rhythms. The neuronal and hormonal activities it generates regula ...
(SCN), a brain area directly above the optic chiasm, is presently considered the most important nexus for this process; however, secondary clock systems have been found throughout the body.
An organism whose circadian clock exhibits a regular rhythm corresponding to outside signals is said to be '' entrained''; an entrained rhythm persists even if the outside signals suddenly disappear. If an entrained human is isolated in a bunker with constant light or darkness, he or she will continue to experience rhythmic increases and decreases of body temperature and melatonin, on a period that slightly exceeds 24 hours. Scientists refer to such conditions as free-running of the circadian rhythm. Under natural conditions, light signals regularly adjust this period downward, so that it corresponds better with the exact 24 hours of an Earth day.
The circadian clock exerts constant influence on the body, affecting sinusoidal
A sine wave, sinusoidal wave, or just sinusoid is a mathematical curve defined in terms of the '' sine'' trigonometric function, of which it is the graph. It is a type of continuous wave and also a smooth periodic function. It occurs often in m ...
oscillation of body temperature
Thermoregulation is the ability of an organism to keep its body temperature within certain boundaries, even when the surrounding temperature is very different. A thermoconforming organism, by contrast, simply adopts the surrounding temperature ...
between roughly 36.2 °C and 37.2 °C. The suprachiasmatic nucleus itself shows conspicuous oscillation activity, which intensifies during subjective day (i.e., the part of the rhythm corresponding with daytime, whether accurately or not) and drops to almost nothing during subjective night. The circadian pacemaker in the suprachiasmatic nucleus has a direct neural connection to the pineal gland
The pineal gland, conarium, or epiphysis cerebri, is a small endocrine gland in the brain of most vertebrates. The pineal gland produces melatonin, a serotonin-derived hormone which modulates sleep, sleep patterns in both circadian rhythm, circ ...
, which releases the hormone melatonin
Melatonin is a natural product found in plants and animals. It is primarily known in animals as a hormone released by the pineal gland in the brain at night, and has long been associated with control of the sleep–wake cycle.
In vertebrates ...
at night. Cortisol
Cortisol is a steroid hormone, in the glucocorticoid class of hormones. When used as a medication, it is known as hydrocortisone.
It is produced in many animals, mainly by the ''zona fasciculata'' of the adrenal cortex in the adrenal gland ...
levels typically rise throughout the night, peak in the awakening hours, and diminish during the day. Circadian prolactin
Prolactin (PRL), also known as lactotropin, is a protein best known for its role in enabling mammals to produce milk. It is influential in over 300 separate processes in various vertebrates, including humans. Prolactin is secreted from the pit ...
secretion begins in the late afternoon, especially in women, and is subsequently augmented by sleep-induced secretion, to peak in the middle of the night. Circadian rhythm exerts some influence on the nighttime secretion of growth hormone.
The circadian rhythm influences the ideal timing of a restorative sleep episode. Sleepiness increases during the night. REM sleep occurs more during body temperature minimum within the circadian cycle, whereas slow-wave sleep
Slow-wave sleep (SWS), often referred to as deep sleep, consists of stage three of non-rapid eye movement sleep. It usually lasts between 70 and 90 minutes and takes place during the first hours of the night. Initially, SWS consisted of both St ...
can occur more independently of circadian time.
The internal circadian clock is profoundly influenced by changes in light, since these are its main clues about what time it is. Exposure to even small amounts of light during the night can suppress melatonin secretion, and increase body temperature and wakefulness. Short pulses of light, at the right moment in the circadian cycle, can significantly 'reset' the internal clock. Blue light, in particular, exerts the strongest effect, leading to concerns that electronic media use before bed may interfere with sleep.
Modern humans often find themselves desynchronized from their internal circadian clock, due to the requirements of work (especially night shifts), long-distance travel, and the influence of universal indoor lighting. Even if they have sleep debt, or feel sleepy, people can have difficulty staying asleep at the peak of their circadian cycle. Conversely, they can have difficulty waking up in the trough of the cycle. A healthy young adult entrained to the sun will (during most of the year) fall asleep a few hours after sunset, experience body temperature minimum at 6 a.m., and wake up a few hours after sunrise.
Process S
Generally speaking, the longer an organism is awake, the more it feels a need to sleep ("sleep debt"). This driver of sleep is referred to as Process S. The balance between sleeping and waking is regulated by a process called homeostasis
In biology, homeostasis (British English, British also homoeostasis) Help:IPA/English, (/hɒmɪə(ʊ)ˈsteɪsɪs/) is the state of steady internal, physics, physical, and chemistry, chemical conditions maintained by organism, living systems. Thi ...
. Induced or perceived lack of sleep is called sleep deprivation
Sleep deprivation, also known as sleep insufficiency or sleeplessness, is the condition of not having adequate duration and/or quality of sleep to support decent alertness, performance, and health. It can be either chronic or acute and may vary ...
.
Process S is driven by the depletion of glycogen
Glycogen is a multibranched polysaccharide of glucose that serves as a form of energy storage in animals, fungi, and bacteria. The polysaccharide structure represents the main storage form of glucose in the body.
Glycogen functions as one o ...
and accumulation of adenosine
Adenosine ( symbol A) is an organic compound that occurs widely in nature in the form of diverse derivatives. The molecule consists of an adenine attached to a ribose via a β-N9-glycosidic bond. Adenosine is one of the four nucleoside building ...
in the forebrain that disinhibits the ventrolateral preoptic nucleus, allowing for inhibition of the ascending reticular activating system
The reticular formation is a set of interconnected nuclei that are located throughout the brainstem. It is not anatomically well defined, because it includes neurons located in different parts of the brain. The neurons of the reticular formation ...
.
Sleep deprivation tends to cause slower brain waves in the frontal cortex
The frontal lobe is the largest of the four major lobes of the brain in mammals, and is located at the front of each cerebral hemisphere (in front of the parietal lobe and the temporal lobe). It is parted from the parietal lobe by a groove betwe ...
, shortened attention span, higher anxiety, impaired memory, and a grouchy mood. Conversely, a well-rested organism tends to have improved memory and mood. Neurophysiological and functional imaging studies
Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to rev ...
have demonstrated that frontal regions of the brain are particularly responsive to homeostatic sleep pressure.
There is disagreement on how much sleep debt is possible to accumulate, and whether sleep debt is accumulated against an individual's average sleep or some other benchmark. It is also unclear whether the prevalence of sleep debt among adults has changed appreciably in the industrialized world
A developed country (or industrialized country, high-income country, more economically developed country (MEDC), advanced country) is a sovereign state that has a high quality of life, developed economy and advanced technological infrastruct ...
in recent decades. Sleep debt does show some evidence of being cumulative. Subjectively, however, humans seem to reach maximum sleepiness 30 hours after waking. It is likely that in Western societies
The Western world, also known as the West, primarily refers to the various nations and states in the regions of Europe, North America, and Oceania. , children are sleeping less than they previously have.
One neurochemical indicator of sleep debt is adenosine
Adenosine ( symbol A) is an organic compound that occurs widely in nature in the form of diverse derivatives. The molecule consists of an adenine attached to a ribose via a β-N9-glycosidic bond. Adenosine is one of the four nucleoside building ...
, a neurotransmitter that inhibits many of the bodily processes associated with wakefulness. Adenosine levels increase in the cortex and basal forebrain during prolonged wakefulness, and decrease during the sleep-recovery period, potentially acting as a homeostatic regulator of sleep. Coffee
Coffee is a drink prepared from roasted coffee beans. Darkly colored, bitter, and slightly acidic, coffee has a stimulant, stimulating effect on humans, primarily due to its caffeine content. It is the most popular hot drink in the world.
S ...
, tea, and other sources of caffeine
Caffeine is a central nervous system (CNS) stimulant of the methylxanthine class. It is mainly used recreationally as a cognitive enhancer, increasing alertness and attentional performance. Caffeine acts by blocking binding of adenosine t ...
temporarily block the effect of adenosine, prolong sleep latency, and reduce total sleep time and quality.
Social timing
Humans are also influenced by aspects of ''social time'', such as the hours when other people are awake, the hours when work is required, the time on clocks, etc. Time zone
A time zone is an area which observes a uniform standard time for legal, Commerce, commercial and social purposes. Time zones tend to follow the boundaries between Country, countries and their Administrative division, subdivisions instead of ...
s, standard times used to unify the timing for people in the same area, correspond only approximately to the natural rising and setting of the sun. An extreme example of the approximate nature of time zones is China, a country which used to span five time zones and now officially uses only one (UTC+8).
Distribution
In polyphasic sleep
Biphasic sleep (or ''diphasic'', ''bifurcated'', or bimodal sleep) is the practice of sleeping during two periods over the course of 24 hours, while polyphasic sleep refers to sleeping multiple times—usually more than two. Each of these is in ...
, an organism sleeps several times in a 24-hour cycle, whereas in monophasic sleep this occurs all at once. Under experimental conditions, humans tend to alternate more frequently between sleep and wakefulness (i.e., exhibit more polyphasic sleep) if they have nothing better to do. Given a 14-hour period of darkness in experimental conditions, humans tended towards bimodal sleep, with two sleep periods concentrated at the beginning and at the end of the dark time. Bimodal sleep in humans was more common before the industrial revolution
The Industrial Revolution was the transition to new manufacturing processes in Great Britain, continental Europe, and the United States, that occurred during the period from around 1760 to about 1820–1840. This transition included going f ...
.
Different characteristic sleep patterns, such as the familiarly so-called " early bird" and " night owl", are called '' chronotypes''. Genetics and sex have some influence on chronotype, but so do habits. Chronotype is also liable to change over the course of a person's lifetime. Seven-year-olds are better disposed to wake up early in the morning than are fifteen-year-olds. Chronotypes far outside the normal range are called circadian rhythm sleep disorders.
Naps
Naps are short periods of sleep that one might take during the daytime, often in order to get the necessary amount of rest. Napping is often associated with childhood, but around one-third of American adults partake in it daily. The optimal nap duration is around 10–20 minutes, as researchers have proven that it takes at least 30 minutes to enter slow-wave sleep, the deepest period of sleep.[Fry, A. (9 October 2020). ''Napping: Health Benefits & Tips for your best nap''. Sleep Foundation. Retrieved 14 November 2021, from https://www.sleepfoundation.org/sleep-hygiene/napping.] Napping too long and entering the slow wave cycles can make it difficult to awake from the nap and leave one feeling unrested. This period of drowsiness is called sleep inertia.
The siesta
A ''siesta'' (from Spanish, pronounced and meaning "nap") is a short nap taken in the early afternoon, often after the midday meal. Such a period of sleep is a common tradition in some countries, particularly those in warm-weather zones. The ...
habit has recently been associated with a 37% lower coronary mortality, possibly due to reduced cardiovascular stress mediated by daytime sleep. Short naps at mid-day and mild evening exercise were found to be effective for improved sleep, cognitive tasks, and mental health in elderly people.
Genetics
Monozygotic (identical) but not dizygotic (fraternal) twins tend to have similar sleep habits. Neurotransmitters, molecules whose production can be traced to specific genes, are one genetic influence on sleep that can be analyzed. The circadian clock has its own set of genes. Genes which may influence sleep include ABCC9
ATP-binding cassette, sub-family C member 9 (ABCC9) also known as sulfonylurea receptor 2 (SUR2) is an ATP-binding cassette transporter that in humans is encoded by the ''ABCC9'' gene.
Function
The protein encoded by this gene is a member of ...
, DEC2
"Basic helix-loop-helix family, member e41", or BHLHE41, is a gene that encodes a basic helix-loop-helix transcription factor repressor protein in various tissues of both humans and mice. It is also known as DEC2, hDEC2, and SHARP1, and was previ ...
, Dopamine receptor D2 and variants near PAX 8 and VRK2
Serine/threonine-protein kinase VRK2 is an enzyme that in humans is encoded by the ''VRK2'' gene.
This gene encodes a member of the vaccinia-related kinase (VRK) family of serine/threonine protein kinases. This gene is widely expressed in human ti ...
. While the latter have been found in a GWAS study that primarily detects correlations (but not necessarily causation), other genes have been shown to have a more direct effect. For instance, mice lacking dihydropyrimidine dehydrogenase (Dpyd) had 78.4 min less sleep during the lights-off period than wild-type mice. Dpyd encodes the rate-limiting enzyme
Enzymes () are proteins that act as biological catalysts by accelerating chemical reactions. The molecules upon which enzymes may act are called substrates, and the enzyme converts the substrates into different molecules known as products. A ...
in the metabolic pathway that catabolizes uracil
Uracil () (symbol U or Ura) is one of the four nucleobases in the nucleic acid RNA. The others are adenine (A), cytosine (C), and guanine (G). In RNA, uracil binds to adenine via two hydrogen bonds. In DNA, the uracil nucleobase is replaced by ...
and thymidine to β- alanine, an inhibitory neurotransmitter
A neurotransmitter is a signaling molecule secreted by a neuron to affect another cell across a synapse. The cell receiving the signal, any main body part or target cell, may be another neuron, but could also be a gland or muscle cell.
Neuro ...
. This also supports the role of β-alanine as a neurotransmitter that promotes sleep in mice.
Quality
The quality of sleep may be evaluated from an objective and a subjective point of view. Objective sleep quality refers to how difficult it is for a person to fall asleep and remain in a sleeping state, and how many times they wake up during a single night. Poor sleep quality disrupts the cycle of transition between the different stages of sleep. Subjective sleep quality in turn refers to a sense of being rested and regenerated after awaking from sleep. A study by A. Harvey et al. (2002) found that insomniacs were more demanding in their evaluations of sleep quality than individuals who had no sleep problems.
Homeostatic sleep propensity (the need for sleep as a function of the amount of time elapsed since the last adequate sleep episode) must be balanced against the circadian element for satisfactory sleep. Along with corresponding messages from the circadian clock, this tells the body it needs to sleep. The timing is correct when the following two circadian markers occur after the middle of the sleep episode and before awakening: maximum concentration of the hormone melatonin, and minimum core body temperature.
Ideal duration
Human sleep-needs vary by age and amongst individuals; sleep is considered to be adequate when there is no daytime sleepiness or dysfunction. Moreover, self-reported sleep duration is only moderately correlated with actual sleep time as measured by actigraphy
Actigraphy is a non-invasive method of monitoring human rest/activity cycles. A small actigraph unit, also called an actimetry sensor, is worn for a week or more to measure gross motor activity. The unit is usually in a wristwatch-like package wo ...
, and those affected with sleep state misperception may typically report having slept only four hours despite having slept a full eight hours.[Insomnia Causes]
. Healthcommunities.com. Original Publication: 1 December 2000, Updated: 1 December 2007.
Researchers have found that sleeping 6–7 hours each night correlates with longevity and cardiac health in humans, though many underlying factors may be involved in the causality behind this relationship.[
Sleep difficulties are furthermore associated with psychiatric disorders such as depression, ]alcoholism
Alcoholism is, broadly, any drinking of alcohol (drug), alcohol that results in significant Mental health, mental or physical health problems. Because there is disagreement on the definition of the word ''alcoholism'', it is not a recognize ...
, and bipolar disorder
Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of depression and periods of abnormally elevated mood that last from days to weeks each. If the elevated mood is severe or associated with ...
. Up to 90 percent of adults with depression are found to have sleep difficulties. Dysregulation detected by EEG includes disturbances in sleep continuity, decreased delta sleep and altered REM patterns with regard to latency, distribution across the night and density of eye movements.
Sleep duration can also vary according to season. Up to 90% of people report longer sleep duration in winter, which may lead to more pronounced seasonal affective disorder.
Children
By the time infants reach the age of two, their brain size has reached 90 percent of an adult-sized brain; a majority of this brain growth has occurred during the period of life with the highest rate of sleep. The hours that children spend asleep influence their ability to perform on cognitive tasks. Children who sleep through the night and have few night waking episodes have higher cognitive attainments and easier temperaments than other children.
Sleep also influences language development. To test this, researchers taught infants a faux language and observed their recollection of the rules for that language. Infants who slept within four hours of learning the language could remember the language rules better, while infants who stayed awake longer did not recall those rules as well. There is also a relationship between infants' vocabulary and sleeping: infants who sleep longer at night at 12 months have better vocabularies at 26 months.
Children can greatly benefit from a structured bedtime routine. This can look differently among families, but will generally consist of a set of rituals such as reading a bedtime story, a bath, brushing teeth, and can also include a show of affection from the parent to the child such a hug or kiss before bed. A bedtime routine will also include a consistent time that the child is expected to be in bed ready for sleep. Having a reliable bedtime routine can help improve a child's quality of sleep as well as prepare them to make and keep healthy sleep hygiene
Sleep hygiene is a behavioral and environmental practice developed in the late 1970s as a method to help people with mild to moderate insomnia. Clinicians assess the sleep hygiene of people with insomnia and other conditions, such as depression, ...
habits in the future.
Recommended duration
Children need many hours of sleep per day in order to develop and function properly: up to 18 hours for newborn babies, with a declining rate as a child ages. Early in 2015, after a two-year study, the National Sleep Foundation in the US announced newly revised recommendations as shown in the table below.
Functions
Restoration
The human organism physically restores itself during sleep, occurring mostly during slow-wave sleep
Slow-wave sleep (SWS), often referred to as deep sleep, consists of stage three of non-rapid eye movement sleep. It usually lasts between 70 and 90 minutes and takes place during the first hours of the night. Initially, SWS consisted of both St ...
during which body temperature, heart rate, and brain oxygen consumption decrease. In both the brain and body, the reduced rate of metabolism
Metabolism (, from el, μεταβολή ''metabolē'', "change") is the set of life-sustaining chemical reactions in organisms. The three main functions of metabolism are: the conversion of the energy in food to energy available to run cell ...
enables countervailing restorative processes.[Raymond Cespuglio, Damien Colas, & Sabine Gautier-Sauvigné, "Energy Processes Underlying the Sleep Wake Cycle"; Chapter 1 in Parmeggiani & Velluti (2005).] The brain requires sleep for restoration, whereas these processes can take place during quiescent waking in the rest of the body. The essential function of sleep may be its restorative effect on the brain: "Sleep is of the brain, by the brain and for the brain." This theory is strengthened by the fact that sleep is observed to be a necessary behavior across most of the animal kingdom, including some of the least evolved animals which have no need for other functions of sleep, such as memory consolidation or dreaming.[
While awake, brain metabolism generates end products, such as reactive oxygen species, which may be damaging to brain cells and inhibit their proper function. During sleep, metabolic rates decrease and reactive oxygen species generation is reduced, enabling restorative processes. The sleeping brain has been shown to remove metabolic end products at a faster rate than during an awake state.] The mechanism for this removal appears to be the glymphatic system. Sleep may facilitate the synthesis of molecules that help repair and protect the brain from metabolic end products generated during waking. Anabolic
Anabolism () is the set of metabolic pathways that construct molecules from smaller units. These reactions require energy, known also as an endergonic process. Anabolism is the building-up aspect of metabolism, whereas catabolism is the breaking-do ...
hormones, such as growth hormone
Growth hormone (GH) or somatotropin, also known as human growth hormone (hGH or HGH) in its human form, is a peptide hormone that stimulates growth, cell reproduction, and cell regeneration in humans and other animals. It is thus important in h ...
s, are secreted preferentially during sleep. The brain concentration of glycogen
Glycogen is a multibranched polysaccharide of glucose that serves as a form of energy storage in animals, fungi, and bacteria. The polysaccharide structure represents the main storage form of glucose in the body.
Glycogen functions as one o ...
increases during sleep, and is depleted through metabolism during wakefulness.
The effect of sleep duration on somatic
Somatic may refer to:
* Somatic (biology), referring to the cells of the body in contrast to the germ line cells
** Somatic cell, a non-gametic cell in a multicellular organism
* Somatic nervous system, the portion of the vertebrate nervous sys ...
growth is not completely known. One study recorded growth, height, and weight, as correlated to parent-reported time in bed in 305 children over a period of nine years (age 1–10). It was found that "the variation of sleep duration among children does not seem to have an effect on growth." Slow-wave sleep
Slow-wave sleep (SWS), often referred to as deep sleep, consists of stage three of non-rapid eye movement sleep. It usually lasts between 70 and 90 minutes and takes place during the first hours of the night. Initially, SWS consisted of both St ...
affects growth hormone
Growth hormone (GH) or somatotropin, also known as human growth hormone (hGH or HGH) in its human form, is a peptide hormone that stimulates growth, cell reproduction, and cell regeneration in humans and other animals. It is thus important in h ...
levels in adult men. During eight hours of sleep, men with a high percentage of slow-wave sleep (SWS) (average 24%) also had high growth hormone secretion, while subjects with a low percentage of SWS (average 9%) had low growth hormone secretion.
Memory processing
It has been widely accepted that sleep must support the formation of long-term memory, and generally increasing previous learning and experiences recalls. However, its benefit seems to depend on the phase of sleep and the type of memory. For example, declarative and procedural memory-recall tasks applied over early and late nocturnal sleep, as well as wakefulness controlled conditions, have been shown that declarative memory improves more during early sleep (dominated by SWS) while procedural memory during late sleep (dominated by REM sleep) does so.
With regard to declarative memory, the functional role of SWS has been associated with hippocampal replays of previously encoded neural patterns that seem to facilitate long-term memory consolidation. This assumption is based on the active system consolidation hypothesis, which states that repeated reactivations of newly encoded information in the hippocampus during slow oscillations in NREM sleep mediate the stabilization and gradual integration of declarative memory with pre-existing knowledge networks on the cortical level. It assumes the hippocampus might hold information only temporarily and in a fast-learning rate, whereas the neocortex is related to long-term storage and a slow-learning rate. This dialogue between the hippocampus and neocortex occurs in parallel with hippocampal sharp-wave ripples and thalamo-cortical spindles, synchrony that drives the formation of the spindle-ripple event which seems to be a prerequisite for the formation of long-term memories.
Reactivation of memory also occurs during wakefulness and its function is associated with serving to update the reactivated memory with newly encoded information, whereas reactivations during SWS are presented as crucial for memory stabilization. Based on targeted memory reactivation (TMR) experiments that use associated memory cues to triggering memory traces during sleep, several studies have been reassuring the importance of nocturnal reactivations for the formation of persistent memories in neocortical networks, as well as highlighting the possibility of increasing people's memory performance at declarative recalls.
Furthermore, nocturnal reactivation seems to share the same neural oscillatory patterns as reactivation during wakefulness, processes which might be coordinated by theta activity. During wakefulness, theta oscillations have been often related to successful performance in memory tasks, and cued memory reactivations during sleep have been showing that theta activity is significantly stronger in subsequent recognition of cued stimuli as compared to uncued ones, possibly indicating a strengthening of memory traces and lexical integration by cuing during sleep. However, the beneficial effect of TMR for memory consolidation seems to occur only if the cued memories can be related to prior knowledge.
Dreaming
During sleep, especially REM sleep, humans tend to experience dreams. These are elusive and mostly unpredictable first-person experiences which seem logical and realistic to the dreamer while they are in progress, despite their frequently bizarre, irrational, and/or surreal qualities that become apparent when assessed after waking. Dreams often seamlessly incorporate concepts, situations, people, and objects within a person's mind that would not normally go together. They can include apparent sensations of all types, especially vision and movement.[J. Alan Hobson, Edward F. Pace-Scott, & Robert Stickgold (2000), "Dreaming and the brain: Toward a cognitive neuroscience of conscious states", ''Behavioral and Brain Sciences'' 23.]
Dreams tend to rapidly fade from memory after waking. Some people choose to keep a dream journal
A dream diary (or dream journal) is a diary in which dream experiences are recorded. A dream diary might include a record of nightly dreams, personal reflections and waking dream experiences. It is often used in the study of dreams and psychology. ...
, which they believe helps them build dream recall and facilitate the ability to experience lucid dreams.
People have proposed many hypotheses
A hypothesis (plural hypotheses) is a proposed explanation for a phenomenon. For a hypothesis to be a scientific hypothesis, the scientific method requires that one can test it. Scientists generally base scientific hypotheses on previous obser ...
about the functions of dreaming. Sigmund Freud
Sigmund Freud ( , ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating psychopathology, pathologies explained as originatin ...
postulated that dreams are the symbolic expression of frustrated desires that have been relegated to the unconscious mind
The unconscious mind (or the unconscious) consists of the processes in the mind which occur automatically and are not available to introspection and include thought processes, memories, interests, and motivations.
Even though these processes exis ...
, and he used dream interpretation in the form of psychoanalysis
PsychoanalysisFrom Greek: + . is a set of theories and therapeutic techniques"What is psychoanalysis? Of course, one is supposed to answer that it is many things — a theory, a research method, a therapy, a body of knowledge. In what might b ...
in attempting to uncover these desires.
Counterintuitively, penile erections during sleep are not more frequent during sexual dreams than during other dreams. The parasympathetic nervous system
The parasympathetic nervous system (PSNS) is one of the three divisions of the autonomic nervous system, the others being the sympathetic nervous system and the enteric nervous system. The enteric nervous system is sometimes considered part of ...
experiences increased activity during REM sleep which may cause erection of the penis or clitoris. In males, 80% to 95% of REM sleep is normally accompanied by partial to full penile erection, while only about 12% of men's dreams contain sexual content.
John Allan Hobson and Robert McCarley
Robert W. McCarley, MD, (1937–2017) was Chair and Professor of Psychiatry at Harvard Medical School and the VA Boston Healthcare System. He is also Director of the Laboratory of Neuroscience located at the Brockton VA Medical Center and the M ...
propose that dreams are caused by the random firing of neurons in the cerebral cortex
The cerebral cortex, also known as the cerebral mantle, is the outer layer of neural tissue of the cerebrum of the brain in humans and other mammals. The cerebral cortex mostly consists of the six-layered neocortex, with just 10% consisting of ...
during the REM period. Neatly, this theory helps explain the irrationality of the mind during REM periods, as, according to this theory, the forebrain then creates a story in an attempt to reconcile and make sense of the nonsensical sensory information presented to it. This would explain the odd nature of many dreams.
Disorders
Insomnia
Insomnia is a general term for difficulty falling asleep and/or staying asleep. Insomnia is the most common sleep problem, with many adults reporting occasional insomnia, and 10–15% reporting a chronic condition. Insomnia can have many different causes, including psychological stress
In psychology, stress is a feeling of emotional strain and pressure. Stress is a type of psychological pain. Small amounts of stress may be beneficial, as it can improve athletic performance, motivation and reaction to the environment. Exces ...
, a poor sleep environment, an inconsistent sleep schedule, or excessive mental or physical stimulation in the hours before bedtime. Insomnia is often treated through behavioral changes like keeping a regular sleep schedule, avoiding stimulating or stressful activities before bedtime, and cutting down on stimulants such as caffeine. The sleep environment may be improved by installing heavy drapes to shut out all sunlight, and keeping computers, televisions, and work materials out of the sleeping area.
A 2010 review of published scientific research suggested that exercise generally improves sleep for most people, and helps sleep disorders such as insomnia. The optimum time to exercise ''may'' be 4 to 8 hours before bedtime, though exercise at any time of day is beneficial, with the exception of heavy exercise taken shortly before bedtime, which may disturb sleep. However, there is insufficient evidence to draw detailed conclusions about the relationship between exercise and sleep. Nonbenzodiazepine
Nonbenzodiazepines (), sometimes referred to colloquially as Z-drugs (as many of their names begin with the letter "z"), are a class of psychoactive drugs that are very benzodiazepine-like in nature. They are used in the treatment of sleep proble ...
sleeping medications such as Ambien, Imovane, and Lunesta
Eszopiclone, sold under the brand-name Lunesta among others such as Night Calm in Egypt, is a medication used in the treatment of insomnia. Evidence supports slight to moderate benefit up to six months. It is taken orally.
Common side effects i ...
(also known as "Z-drugs"), while initially believed to be better and safer than earlier generations of including benzodiazepine
Benzodiazepines (BZD, BDZ, BZs), sometimes called "benzos", are a class of depressant drugs whose core chemical structure is the fusion of a benzene ring and a diazepine ring. They are prescribed to treat conditions such as anxiety disorders, ...
are now known to be almost entirely the same as benzodiazepines in terms of their pharmacodynamics
Pharmacodynamics (PD) is the study of the biochemical and physiologic effects of drugs (especially pharmaceutical drugs). The effects can include those manifested within animals (including humans), microorganisms, or combinations of organisms (fo ...
, differing only at the molecular level in their chemical structure, and therefore exhibit similar benefits, side-effects, and risks. White noise
In signal processing, white noise is a random signal having equal intensity at different frequencies, giving it a constant power spectral density. The term is used, with this or similar meanings, in many scientific and technical disciplines, ...
appears to be a promising treatment for insomnia
Insomnia, also known as sleeplessness, is a sleep disorder in which people have trouble sleeping. They may have difficulty falling asleep, or staying asleep as long as desired. Insomnia is typically followed by daytime sleepiness, low energy, ...
.
Sleep health
Low quality sleep has been linked with health conditions like cardiovascular disease
Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, h ...
, obesity
Obesity is a medical condition, sometimes considered a disease, in which excess body fat has accumulated to such an extent that it may negatively affect health. People are classified as obese when their body mass index (BMI)—a person's we ...
, and mental illness
A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitti ...
. While poor sleep is common among those with cardiovascular disease, some research indicates that poor sleep can be a contributing cause. Short sleep duration of less than seven hours is correlated with coronary heart disease and increased risk of death from coronary heart disease. Sleep duration greater than nine hours is also correlated with coronary heart disease, as well as stroke
A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop functionin ...
and cardiovascular events.
In both children and adults, short sleep duration is associated with an increased risk of obesity, with various studies reporting an increased risk of 45–55%. Other aspects of sleep health have been associated with obesity, including daytime napping, sleep timing, the variability of sleep timing, and low sleep efficiency. However, sleep duration is the most-studied for its impact on obesity.
Sleep problems have been frequently viewed as a symptom of mental illness rather than a causative factor. However, a growing body of evidence suggests that they are both a cause and a symptom of mental illness. Insomnia is a significant predictor of major depressive disorder
Major depressive disorder (MDD), also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities. Introdu ...
; a meta-analysis
A meta-analysis is a statistical analysis that combines the results of multiple scientific studies. Meta-analyses can be performed when there are multiple scientific studies addressing the same question, with each individual study reporting me ...
of 170,000 people showed that insomnia at the beginning of a study period indicated a more than the twofold increased risk for major depressive disorder. Some studies have also indicated correlation between insomnia and anxiety
Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...
, post-traumatic stress disorder
Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on ...
, and suicide
Suicide is the act of intentionally causing one's own death. Mental disorders (including depression, bipolar disorder, schizophrenia, personality disorders, anxiety disorders), physical disorders (such as chronic fatigue syndrome), and s ...
. Sleep disorders can increase the risk of psychosis
Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior ...
and worsen the severity of psychotic episodes.
Sleep research also displays differences in race and class. Short sleep and poor sleep are observed more frequently in ethnic minorities than in whites. African-Americans report experiencing short durations of sleep five times more often than whites, possibly as a result of social and environmental factors. Black children and children in disadvantaged neighborhoods have much higher rates of sleep apnea than white children and respond more poorly to treatment.
Sleep health can be improved through implementing good sleep hygiene habits. Having good sleep hygiene can help to improve your physical and mental health by providing your body with the necessary rejuvenation only restful sleep can provide. Some ways to improve sleep health include going to sleep at consistent times every night, avoiding any electronic devices such as televisions in the bedroom, getting adequate exercise throughout your day, and avoiding caffeine in the hours before going to sleep. Another way to greatly improve sleep hygiene is by creating a peaceful and relaxing sleep environment. Sleeping in a dark and clean room with things like a white noise maker can help facilitate restful sleep.
Drugs and diet
Drugs which induce sleep, known as hypnotic
Hypnotic (from Greek ''Hypnos'', sleep), or soporific drugs, commonly known as sleeping pills, are a class of (and umbrella term for) psychoactive drugs whose primary function is to induce sleep (or surgical anesthesiaWhen used in anesthesia ...
s, include benzodiazepine
Benzodiazepines (BZD, BDZ, BZs), sometimes called "benzos", are a class of depressant drugs whose core chemical structure is the fusion of a benzene ring and a diazepine ring. They are prescribed to treat conditions such as anxiety disorders, ...
s, although these interfere with REM; Nonbenzodiazepine
Nonbenzodiazepines (), sometimes referred to colloquially as Z-drugs (as many of their names begin with the letter "z"), are a class of psychoactive drugs that are very benzodiazepine-like in nature. They are used in the treatment of sleep proble ...
hypnotics such as eszopiclone (Lunesta), zaleplon
Zaleplon, sold under the brand names Sonata among others, is a sedative-hypnotic, used to treat insomnia. It is a nonbenzodiazepine hypnotic from the pyrazolopyrimidine class.
It is manufactured by King Pharmaceuticals and Gedeon Richter Plc. ...
(Sonata), and zolpidem (Ambien); antihistamine
Antihistamines are drugs which treat allergic rhinitis, common cold, influenza, and other allergies. Typically, people take antihistamines as an inexpensive, generic (not patented) drug that can be bought without a prescription and provides re ...
s, such as diphenhydramine
Diphenhydramine (DPH) is an antihistamine and sedative mainly used to treat allergies, insomnia, and symptoms of the common cold. It is also less commonly used for tremor in parkinsonism, and nausea. It is taken by mouth, injected into a vein ...
(Benadryl) and doxylamine
Doxylamine, sold under the brand name Unisom among others, is an antihistamine medication which is used in the treatment of insomnia and allergies. In combination with pyridoxine ( vitamin B6), it is also used to treat morning sickness in pregna ...
; alcohol (ethanol), despite its rebound effect later in the night and interference with REM; barbiturate
Barbiturates are a class of depressant drugs that are chemically derived from barbituric acid. They are effective when used medically as anxiolytics, hypnotics, and anticonvulsants, but have physical and psychological addiction potential as we ...
s, which have the same problem; melatonin
Melatonin is a natural product found in plants and animals. It is primarily known in animals as a hormone released by the pineal gland in the brain at night, and has long been associated with control of the sleep–wake cycle.
In vertebrates ...
, a component of the circadian clock, and released naturally at night by the pineal gland
The pineal gland, conarium, or epiphysis cerebri, is a small endocrine gland in the brain of most vertebrates. The pineal gland produces melatonin, a serotonin-derived hormone which modulates sleep, sleep patterns in both circadian rhythm, circ ...
; and cannabis
''Cannabis'' () is a genus of flowering plants in the family Cannabaceae. The number of species within the genus is disputed. Three species may be recognized: ''Cannabis sativa'', '' C. indica'', and '' C. ruderalis''. Alternatively ...
, which may also interfere with REM. Some opioid
Opioids are substances that act on opioid receptors to produce morphine-like effects. Medically they are primarily used for pain relief, including anesthesia. Other medical uses include suppression of diarrhea, replacement therapy for opioid us ...
s (including morphine
Morphine is a strong opiate that is found naturally in opium, a dark brown resin in poppies (''Papaver somniferum''). It is mainly used as a analgesic, pain medication, and is also commonly used recreational drug, recreationally, or to make ...
, codeine
Codeine is an opiate and prodrug of morphine mainly used to treat pain, coughing, and diarrhea. It is also commonly used as a recreational drug. It is found naturally in the sap of the opium poppy, ''Papaver somniferum''. It is typically use ...
, heroin
Heroin, also known as diacetylmorphine and diamorphine among other names, is a potent opioid mainly used as a recreational drug for its euphoric effects. Medical grade diamorphine is used as a pure hydrochloride salt. Various white and brow ...
, and oxycodone) also induce sleep, and can disrupt sleep architecture and sleep stage distribution.
Stimulant
Stimulants (also often referred to as psychostimulants or colloquially as uppers) is an overarching term that covers many drugs including those that increase activity of the central nervous system and the body, drugs that are pleasurable and inv ...
s, which inhibit sleep, include caffeine
Caffeine is a central nervous system (CNS) stimulant of the methylxanthine class. It is mainly used recreationally as a cognitive enhancer, increasing alertness and attentional performance. Caffeine acts by blocking binding of adenosine t ...
, an adenosine
Adenosine ( symbol A) is an organic compound that occurs widely in nature in the form of diverse derivatives. The molecule consists of an adenine attached to a ribose via a β-N9-glycosidic bond. Adenosine is one of the four nucleoside building ...
antagonist; amphetamine
Amphetamine (contracted from alpha- methylphenethylamine) is a strong central nervous system (CNS) stimulant that is used in the treatment of attention deficit hyperactivity disorder (ADHD), narcolepsy, and obesity. It is also commonly used ...
, methamphetamine
Methamphetamine (contracted from ) is a potent central nervous system (CNS) stimulant that is mainly used as a recreational drug and less commonly as a second-line treatment for attention deficit hyperactivity disorder and obesity. Methamph ...
, MDMA
3,4-Methylenedioxymethamphetamine (MDMA), commonly seen in Tablet (pharmacy), tablet form (ecstasy) and crystal form (molly or mandy), is a potent empathogen–entactogen with stimulant properties primarily used for Recreational dru ...
, empathogen-entactogens, and related drugs; cocaine
Cocaine (from , from , ultimately from Quechuan languages, Quechua: ''kúka'') is a central nervous system (CNS) stimulant mainly recreational drug use, used recreationally for its euphoria, euphoric effects. It is primarily obtained from t ...
, which can alter the circadian rhythm, and methylphenidate
Methylphenidate, sold under the brand names Ritalin and Concerta among others, is the most widely prescribed central nervous system (CNS) stimulant medication used to treat attention deficit hyperactivity disorder (ADHD) and, to a lesser extent, ...
, which acts similarly; and other analeptic drugs like modafinil
Modafinil, sold under the brand name Provigil among others, is a central nervous system (CNS) stimulant medication used to treat sleepiness due to narcolepsy, shift work sleep disorder, and obstructive sleep apnea. While it has seen off-label ...
and armodafinil with poorly understood mechanisms. Consuming high amounts of the stimulant caffeine can result in interrupted sleep patterns and sometimes sleep deprivation. This vicious cycle can result in drowsiness which can then result in a higher consumption of caffeine in order to stay awake the next day. This cycle can lead to decreased cognitive function and an overall feeling of fatigue.
Some drugs may alter sleep architecture without inhibiting or inducing sleep. Drugs that amplify or inhibit endocrine and immune system secretions associated with certain sleep stages have been shown to alter sleep architecture. The growth hormone releasing hormone receptor agonist MK-677 has been shown to increase REM in older adults as well as stage IV sleep in younger adults by approximately 50%.
Dietary and nutritional choices may affect sleep duration and quality. One 2016 review indicated that a high-carbohydrate
In organic chemistry, a carbohydrate () is a biomolecule consisting of carbon (C), hydrogen (H) and oxygen (O) atoms, usually with a hydrogen–oxygen atom ratio of 2:1 (as in water) and thus with the empirical formula (where ''m'' may or ma ...
diet promoted a shorter onset to sleep and a longer duration of sleep than a high-fat diet. A 2012 investigation indicated that mixed micronutrient
Micronutrients are nutrient, essential dietary elements required by organisms in varying quantities throughout life to orchestrate a range of physiological functions to maintain health. Micronutrient requirements differ between organisms; for exam ...
s and macronutrient
A nutrient is a substance used by an organism to survive, grow, and reproduce. The requirement for dietary nutrient intake applies to animals, plants, fungi, and protists. Nutrients can be incorporated into cells for metabolic purposes or excret ...
s are needed to promote quality sleep. A varied diet containing fresh fruits and vegetables, low saturated fat
A saturated fat is a type of fat in which the fatty acid chains have all single bonds. A fat known as a glyceride is made of two kinds of smaller molecules: a short glycerol backbone and fatty acids that each contain a long linear or branched c ...
, and whole grain
A whole grain is a grain of any cereal and pseudocereal that contains the endosperm, germ, and bran, in contrast to refined grains, which retain only the endosperm.
As part of a general healthy diet, consumption of whole grains is associated w ...
s may be optimal for individuals seeking to improve sleep quality.[ High-quality ]clinical trial
Clinical trials are prospective biomedical or behavioral research studies on human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel vaccines, drugs, dietar ...
s on long-term dietary practices are needed to better define the influence of diet on sleep quality.[
]
In culture
Anthropology
Research suggests that sleep patterns vary significantly across cultures. The most striking differences are observed between societies that have plentiful sources of artificial light and ones that do not. The primary difference appears to be that pre-light cultures have more broken-up sleep patterns. For example, people without artificial light might go to sleep far sooner after the sun sets, but then wake up several times throughout the night, punctuating their sleep with periods of wakefulness, perhaps lasting several hours.[ During ]pre-industrial
Pre-industrial society refers to social attributes and forums of political and cultural organization that were prevalent before the advent of the Industrial Revolution, which occurred from 1750 to 1850. ''Pre-industrial'' refers to a time before ...
Europe
Europe is a large peninsula conventionally considered a continent in its own right because of its great physical size and the weight of its history and traditions. Europe is also considered a Continent#Subcontinents, subcontinent of Eurasia ...
, Biphasic and polyphasic sleep, biphasic (bimodal) sleeping was considered the norm. Sleep onset was determined not by a set bedtime, but by whether there were things to do.
The boundaries between sleeping and waking are blurred in these societies. Some observers believe that nighttime sleep in these societies is most often split into two main periods, the first characterized primarily by deep sleep and the second by REM sleep.[
Some societies display a fragmented sleep pattern in which people sleep at all times of the day and night for shorter periods. In many nomadic or hunter-gatherer societies, people sleep on and off throughout the day or night depending on what is happening. Plentiful artificial light has been available in the industrialized West since at least the mid-19th century, and sleep patterns have changed significantly everywhere that lighting has been introduced. In general, people sleep in a more concentrated burst through the night, going to sleep much later, although this is not always the case.][
Historian A. Roger Ekirch thinks that the traditional pattern of "segmented sleep," as it is called, began to disappear among the urban upper class in Europe in the late 17th century and the change spread over the next 200 years; by the 1920s "the idea of a first and second sleep had receded entirely from our social consciousness."] Ekirch attributes the change to increases in "street lighting, domestic lighting and a surge in coffee houses," which slowly made nighttime a legitimate time for activity, decreasing the time available for rest.[ Today in most societies people sleep during the night, but in very hot climates they may sleep during the day. During Ramadan, many Muslims sleep during the day rather than at night.
In some societies, people sleep with at least one other person (sometimes many) or with animals. In other cultures, people rarely sleep with anyone except for an intimate partner. In almost all societies, sleeping partners are strongly regulated by social standards. For example, a person might only sleep with the immediate family, the extended family, a spouse or romantic partner, children, children of a certain age, children of a specific gender, peers of a certain gender, friends, peers of equal social rank, or with no one at all. Sleep may be an actively social time, depending on the sleep groupings, with no constraints on noise or activity.][
People sleep in a variety of locations. Some sleep directly on the ground; others on a skin or blanket; others sleep on platforms or beds. Some sleep with blankets, some with pillows, some with simple headrests, some with no head support. These choices are shaped by a variety of factors, such as climate, protection from predators, housing type, technology, personal preference, and the incidence of pests.]
In mythology and literature
Sleep has been seen in culture as similar to death since antiquity; in Greek mythology, Hypnos (the god of sleep) and Thanatos (the god of death) were both said to be the children of Nyx (the goddess of night). John Donne, Samuel Taylor Coleridge, Percy Bysshe Shelley, John Keats and other poets have all written poems about the relationship between sleep and death. Shelley describes them as "both so passing, strange and wonderful!" Keats similarly poses the question: "Can death be sleep, when life is but a dream". Many people consider dying in one's sleep is the most peaceful way to die. Phrases such as "big sleep" and "rest in peace" are often used in reference to death, possibly in an effort to lessen its finality. Sleep and dreaming have sometimes been seen as providing the potential for visionary experiences. In medieval Irish tradition, in order to become a filí, the poet was required to undergo a ritual called the ''imbas forosnai'', in which they would enter a mantic, trancelike sleep.
Many cultural stories have been told about people falling asleep for extended periods of time. The earliest of these stories is the ancient Greek legend of Epimenides, Epimenides of Knossos. According to the biographer Diogenes Laërtius, Epimenides was a shepherd on the Greek island of Crete. One day, one of his sheep went missing and he went out to look for it, but became tired and fell asleep in a cave under Mount Ida (Crete), Mount Ida. When he awoke, he continued searching for the sheep, but could not find it, so he returned to his old farm, only to discover that it was now under new ownership. He went to his hometown, but discovered that nobody there knew him. Finally, he met his younger brother, who was now an old man, and learned that he had been asleep in the cave for fifty-seven years.
A far more famous instance of a "long sleep" today is the Christian Legendary material in Christian hagiography, legend of the Seven Sleepers, Seven Sleepers of Ephesus, in which seven Christians flee into a cave during pagan times in order to escape Persecution of Christians in the Roman Empire, persecution, but fall asleep and wake up 360 years later to discover, to their astonishment, that the Roman Empire is now predominantly Christian. The American author Washington Irving's short story "Rip Van Winkle", first published in 1819 in his collection of short stories ''The Sketch Book of Geoffrey Crayon, Gent.'', is about a man in Colonial history of the United States, colonial America named Rip Van Winkle who falls asleep on one of the Catskill Mountains and wakes up twenty years later after the American Revolution. The story is now considered one of the greatest classics of American literature.
In art
Of the thematic representations of sleep in art, physician and sleep researcher Meir Kryger wrote, "[Artists] have intense fascination with mythology, dreams, religious themes, the parallel between sleep and death, reward, abandonment of conscious control, healing, a depiction of innocence and serenity, and the erotic."
File:Carel Fabritius - De poort bewaker (1654).jpg, ''The Sentry (painting), The Sentry'' (1654) by Carel Fabritius
File:Museo del Prado - Goya - Caprichos - No. 43 - El sueño de la razon produce monstruos.jpg, ''The Sleep of Reason Produces Monsters'' (1799) by Francisco Goya
File:Honoré Daumier - The Second Class Carriage - Walters 371224.jpg, ''The Second Class Carriage'' (1864) by Honoré Daumier
File:Waterhouse-sleep and his half-brother death-1874.jpg, ''Sleep and his Half-brother Death'' (1874) by John William Waterhouse
File:William-Adolphe Bouguereau (1825-1905) - Lullaby (1875).jpg, ''Lullaby'' (1875) by William-Adolphe Bouguereau
File:Илья Е. Репин - Отдых. Портрет В.А.Репинa (1882).jpg, ''Taking a Rest'' (1882) by Ilya Repin
File:George Hare - Victory of Faith.jpg, ''The Victory of Faith (painting), The Victory of Faith'' (1891) by Saint George Hare
File:Auf dem Ofen 1895.jpg, ''Zwei schlafende Mädchen auf der Ofenbank'' (1895) by Albert Anker
File:Flaming June, by Frederic Lord Leighton (1830-1896).jpg, ''Flaming June'' ( 1895) by Frederic Leighton
File:Noon, rest from work - Van Gogh.jpeg, ''Noon – Rest from Work'' (1890) by Vincent van Gogh (after Jean-François Millet, Millet)
File:Albert Anker - Schlafendes Mädchen auf einer Holzbank.jpg, ''Sleeping Girl on a Wooden Bench'' by Albert Anker
File:Carlos Maria Herrera - Descansando.jpg, ''Descansando'' (1900) by Carlos María Herrera, Carlos Maria Herrera
See also
* Co-sleeping
* Hypnogram
* Microsleep
* Morvan's syndrome
* Oleamide
* Power nap
* Rheum
* Sleep epidemiology
* Sleep in space
* Sleep-learning
* Sleep medicine
* Sleep paralysis
* Sleeping positions
* Somnology
* Somnophilia
* Start school later movement
* Sudden infant death syndrome
* Sudden arrhythmic death syndrome
* Unconsciousness
* Yawn
* Yoga-nidra
References
Further reading
*
External links
Rethinking Sleep
David K. Randall, ''New York Times,'' September 2012
How to Sleep
James Hamblin, ''The Atlantic,'' January 2017
{{Authority control
Sleep,
Mental states
Unsolved problems in neuroscience