Tag Archives: sleep

Sleepy Nation

Microbursts of sleep refers to periods of sudden somnolence that last from a few to several seconds. People who experience these episodes may doze off without realizing it.
It can occur anywhere, such as at work, at school, or while watching TV. Episodes of microsleep can also happen while driving or operating machinery, which makes this a dangerous condition. People may fall asleep at a stoplight, in a restaurant, at the theater, or at a work meeting. In addition to the potential for serious physical harm to self or others, these bursts of sleep can cause embarrassment and secondary problems (hitting your head, work problems, falling on another person, dropping or breaking items).
Microbursts of sleep happen when parts of your brain are asleep and other parts remain awake.
Warning signs of an episode of microsleep include:
  • inability to keep eyes open
  • excessive yawning
  • body jerks and head bobs
  • constantly blinking or widening eyes to stay awake
  • sudden onset of severe fatigue
  • short REM latencies (entering REM sleep very quickly)
  • feeling foggy; not being able to concentrate on a task or conversation
  • making careless mistakes (inattention to detail)
  • slow processing speed and task completion
  • impaired fine motor skills
Why does our brain go into a shut down and reboot? The biggest culprit is sleep deprivation.
Causes can include:
  • medical concerns (sleep apnea, restless leg and movement disorders, perimenopause, chronic pain, frequent urination)
  • shift work: overnight schedules and changing hours make it difficult for our brains to adjust
  • circadian rhythms that are irregular. Even DST can affect sleep for days to weeks
  • medications: stimulants like Concerta and Adderall may result in fatigue and sleepiness when they ‘wear off’.  Others cause excessive sleepiness if not timed properly, including antihistamines and even melatonin
  • alcohol and substance abuse
  • anxiety/worry/depression
  • boredom: repetitive tasks; solitary work; long drives; excessive sitting
  • ‘revenge insomnia’ is the tendency to purposefully stay up late binge watching, scrolling, chatting, gaming, after working all day. It’s reclaiming ‘me time’ with a cost and can be beguiling for those who work long hours
What to do:
  • Address underlying medical issues. Sleep studies may also be required. A single study or examination may only reveal a partial picture.
  • Get enough sleep. Prioritize rest and listen to your body. The average adult becomes sleepy after being awake for about 7-8 hours. Even with formulas for how much you ‘should be sleeping,’ how you sleep is highly individualized. More more info read: Got Sleep.
  • Exercise and get daily sunlight during the day.
  • When you feel tired, don’t push yourself into continuing to work. You’re not getting much work done anyway. Reboot by resting and starting again later.
  • Reframe attitudes about resting. The old adages about ‘toughing it out’ are not helpful for our mental, cognitive, or physical health.
  • Sleep well before road trips or long tasks. If possible, drive with a passenger. Avoid driving at times when you naturally feel tired, such as times you’re normally asleep, near dusk, or during your post-lunch or afternoon lull. Stop often and get out of the car.
  • Talk to other people. Neuropsychological research shows that conversation and social interaction reduce sleepiness. One study also found that hearing your own name was more effective than other auditory input for attention during a vigilance test.
  • Don’t rely on loud music. Loud volume won’t do much to keep you awake while driving. Some research suggests that the brain may not be registering auditory inputs during periods of microsleep.
  • Caffeine helps a little. It takes a while to kick in and only provides a moderate effect for a couple of hours. You can also have a high tolerance if you frequently use caffeine.
  • Take movement breaks. Fidgeting, stretching, and moving keeps the mind more engaged. Take regular breaks and stretch if you are sitting for long periods of time.
  • Rest when you are tired.
  • Most importantly, work with your own circadian rhythms, schedule, and responsibilities as much as possible. These vary. Micro sleep is our brain trying to function and rest at the same time. Work with it, not against it.

What is Winter Fatigue?

I enjoy receiving psychology/mental health questions on my website and social media. A couple of times a month, I write a post or article to respond to questions I feel are particularly timely and helpful to many people, including me!

ST writes: Do you have any tips for dealing with endless cloudy, cold, and rainy days? I saw the extended forecast, and it’s not letting up anytime soon. I get very down and cranky, and sometimes even anxious when there is no sun for days and days…

What is Winter Fatigue?

The sky is grey, and the chill wind blows outside. Right now, the best thing in the world feels like curling up in a fluffy blanket with a cup of something hot to drink, a bowl of decadent noodles, and a good book, binge-worthy series, or movie. Sure, there is meal prep to do, work deadlines, appointments to keep, and an elliptical machine to hop on, but you just don’t have the motivation.

There are five types of fatigue—medical (such as chronic illness), physical, mental, emotional, and environmental. Welcome to winter fatigue. According to the American Academy of Family Physicians, at least 20% of people experience a form of winter fatigue, from mild to significant.

Common symptoms may include:

  • Fatigue
  • Weight gain
  • Cravings for carbohydrates (“comfort foods”)
  • Irritability/easily frustrated
  • Anxiety
  • Difficulty with concentration
  • Avoidance of social situations (hibernating)
  • Hunkering down (stock piling snacks, home supplies, and groceries)
  • Difficulty getting out of bed
  • Increased sensitivity to social rejection (feelings easily hurt; loneliness)

Our nervous systems are designed to handle short-term stress and distress- we get hits of adrenaline and cortisol as part of the body’s fight, flight, or freeze response. When acute stress becomes chronic stress, when we become normalized to being in this state, it takes a huge toll on our bodies.

Recently, people have also been experiencing what I call catch-up fatigue. After 2 1/2 years of having to modify lifestyles and juggle uncertainty, people are attempting to celebrate, meet others, travel, be sociable. It takes a lot out of us. There’s been a recent study in the Washington, DC area that there has been an uptick in rage incidents while driving. Frankly, we’re not used to being around other humans. We are slightly socially stunted.

Circadian rhythms and Cortisol Fluctuations
It would be great if your sleep-wake cycle could align with the season/winter’s light-dark cycle. But I don’t think many of us could sustain families or jobs resting from 5 pm to 8 am each day. Being completely aligned with the season’s natural rhythms is not possible with our multiple responsibilities. However, we can certainly take steps to better align with the winter season. At my company, we come up with an individualized daily schedule, that works with commitments, deadlines, and personal biorhythms as much as possible.

Below are some of the best things you can do to remedy winter fatigue:

    • Schedule 8-9 hours of rest/sleep each night.
    • Most of us have morning commitments; therefore, waking up later is not an option. Instead, make your bedtime earlier. This means that if you need to get up at 6 am, ensure your lights are out no later than 10 pm.
    • Make your bedroom a sanctuary.
    • Adjust the temperature of your house: Your body prefers to be slightly cool before bed. Decreasing the temperature of your house a few degrees overnight will likely improve your sleep quality. Do you know how you feel chilly if you’re woken during REM sleep? Our body temperature drops while sleeping. Having cooler air temperature or taking a hot bath and your body cooling after mimics sleep.
    • Avoid bright lights in the evening: Try using accent lighting in your home in place of overhead lights, or use dimming switches. If you’re using electronic devices, install apps like f.lux. to block the blue light from being emitted.
    • Practice relaxation techniques before bed.
    • Reading, audiobooks, podcasts, hot baths, meditation, pranayama, or a cup of tea are a few great ways to unwind in the evening. Turn off screens as much as possible.
    • Stress makes you tired.
    • Much like melatonin, the cortisol hormone follows what is called a diurnal rhythm. In a perfect scenario, cortisol levels peak optimally after waking. After waking, there is a gradual decline in cortisol levels. Cortisol reaches its lowest point of the day shortly before bed. As you sleep, cortisol levels increase and the cycle starts again. However, excessively high levels of cortisol also cause fatigue. Stress causes a surge of cortisol or adrenalin at different times of the day which can be exhausting to the body. Stress cannot be completely avoided, but learning to recognize the buildup and stave it off is so important.
    • Light therapy: During the winter months, exposure to morning sunlight may not be an option. Sometimes it’s dark when leaving the house and it’s dark coming home. Using a light therapy device for 10 minutes immediately after waking can ensure you have the energy needed to get out of bed (a light therapy box mimics outdoor light, which causes a chemical change in the brain that lifts your mood; Amazon offers a wide variety of such products that are well priced). This therapy is an alternative to pushing snooze dozens of times.
    • Get outside: Exposure to sunlight keeps melatonin production under control. Even five minutes of outdoor sun exposure can improve your energy levels. Open your curtains and blinds early in the day to let in as much sunlight as possible. This is a mood booster, but we cannot obtain the necessary Vitamin D that we need through windows. Direct exposure to sunlight, even on a cloudy day, helps us get our required
    • Vitamin D.
    • Mood disturbances and symptoms: Many people struggle with sadness, depression and anxiety during the winter. Add physical distancing, post-holiday blues, and sleep problems to the mix, and it’s no wonder exhaustion sets in. If you have an uptick in symptoms of anxiety or depression, it’s time to talk to your primary care doctor or a mental health specialist.
    • Exercise matters (in addition to outdoor time): Try to fit in 30 minutes of exercise four to six times a week. Whether it’s walking on the treadmill, taking a couple of laps around the block, taking the stairs at the mall, or walking around your office building, exercise keeps endorphins pumping in your body, helping keep you energized to combat the winter blahs.
    • Balance your food: Comfort foods like mashed potatoes, bowls of rice, macaroni and cheese, etc. sound great when the weather is chilly and the days are short. Our bodies crave more sweets and carbohydrates to help us build that insular layer of fat that kept us alive back in our caveman days. However, balanced eating gives you more energy to fight the cold, and a well-rounded diet keeps the cravings at bay. Find comfort foods that boost energy, such as a delicious lentil curry, a veggie frittata, or homemade soup.
    • Relax: Find hobbies and activities that help relieve stress. Meditation can be a great time to let the mind relax and unwind, journaling, crochet/knitting, coloring in an adult coloring book, chatting with a good friend, and yoga can all reduce out of control cortisol levels.
    • Massage Therapy: Therapeutic massage can ease body tension and pain, and wakes up your nervous system, turning on your power so you can fight the winter blues. A great massage can also release oxytocin, the hormone of relaxation and contentment.

Timing and Dosage

    • Time your exercise: Exercise can help combat winter fatigue, particularly if you take your fitness time into the sunlight. Exercising first thing in the morning can help wake up your body and regulate your circadian rhythm. Exercise in the afternoon can get you through that tired slump. Exercise too close to bedtime, and you may have trouble sleeping.
    • Take a power nap: If you can sneak in a 25-30 minute nap between noon and 4 p.m., you’re more likely to power through your day. Snoozing too late in the day could make it more difficult to fall asleep at night.
    • Use caffeine. Judiciously: Well-timed caffeine can help you feel more alert, awake and ready to take on the day. Need to perk up before a presentation? Get some caffeine about an hour before it begins. You can also have a cup of coffee before you take a nap. By the time you wake up, the coffee has kicked in.
    • Monitor sleep patterns: People demonstrate patterns of sleep that are individual. Biphasic or polyphasic sleep was more common before standard office hours. Sleeping two or even three times a day was not uncommon to combat fatigue and complete life tasks. Learn more: Got Sleep?
    • Keep an eye on medical concerns: Are you tired during certain times of the day, all the time, or in specific situations? There can be chronic medical fatigue from a host of significant conditions including sleep apnea, diabetes, fibromyalgia, hypertension, and autoimmune disorders. These conditions and their subsequent fatigue do not necessarily respond to everyday strategies. For example, recently I have started completing evaluations for individuals suffering from Long Covid. The fatigue, cognitive fog, and impaired attention I have assessed has been striking. Getting a medical differential for your fatigue is imperative.

Also see: Pandemic Fatigue.

The Mental Health Bedroom: Making Your Room a Sanctuary

How to make your room a sanctuary.

Sleep-only zone
Studies have shown that if you engage in a number of activities in your bedroom, you will come to think of your room as a place of activity and even stress rather than one of relaxation and peacefulness. So, out go the exercise equipment, office set-up, computer, textbooks, television, snacks and that mound of clothes you’ve been meaning to launder. Of course, there are exceptions to the sleeping-only rule. These are reading, dressing, relaxing to music, and of course, intimacy.

Declutter
Your brain is actually calmed by the sight of an empty or well-organized table top or dresser top. Decluttering at night, before bed, will keep your room feeling less like a busy traffic lane, and more like a private oasis.

Out of mind
Closed storage can be anything from a dresser or armoire with doors, to simple baskets or boxes. The idea is to put out of sight all those items that used to live on the top of your nightstand or dresser. It’s a good idea to have a small tray or drawer to corral the keys and pens and change that you might empty out of your pockets when you get home, but everything else should be put away, out of sight. You’ll feel instantly more relaxed when you put “Out of sight, out of mind” to work in your bedroom. If you have something that needs to be done, like a bill or email, do it in another part of the house. Your bedroom should be for relaxing and resting only, not working.

Have a seat
If you have room, it’s a great idea to have an extra chair or bench in your bedroom. It just feels more homey when you can carve out a little bit of sitting area, such as a reading corner by a window or lamp.

Cool down your bedroom
Try to crank up the air conditioning a little more at night before bed. Cooling down your body actually mimics sleep and promotes sleepiness.

White noise machines
Noise can also affect your sleep in a negative way. When you hear sounds, your brain tries to actively process them, which can cause problems when you’re trying to fall asleep. While noise affects everyone differently—some are more sensitive to it than others—it’s still important to create a quiet environment as possible for a good night’s sleep.

Write a single sentence
Simply write one sentence in a journal that you keep by your bedside, every night. It helps you reflect on the day, consider your word choice, and summarize your thoughts. It’s a powerful way to close the day.

Add some greenery
Add greenery to your room but if you don’t want to add the stress of keeping it alive, choose one of the low-maintenance, hard-to-kill indoor plants, such as English Ivy or a Snake Plant.

Soft music
Music does wonders to set the mood. In the case of your bedroom, your objective is to create a peaceful, relaxing mood, so choose your music accordingly. Whether you prefer soft jazz, classical, world, or trip hop, keep the beat and the sound soft and calm. Keep the volume low. Set the music to shut off automatically after a certain amount of time, because even though the soft sounds may lull you to sleep, they are likely to wake you during the night.

Aromatherapy
Your sense of smell is a very powerful thing. It is our only sense that goes directly into our brains. Smells enter our nostrils and up the olfactory nerve onto the surface of our brain. Integrating essential oils like lavender and chamomile into your bedtime routine can work wonders at keeping your mind calm and centered. These scents can also get the brain to release the hormone melatonin. When that hormone is released, it washes over the brain and uses it as a signal to shut down all those distracting thoughts and just go to sleep.

Podcasts
Listening to podcasts is a great way to lull yourself to sleep without the intrusive glare of television, telephone, laptop, or tablet screens. Find some podcasts that are soothing to you.

Relaxation apps
The Calm App (Android and Apple) has sleep meditations, breathing exercises, bedtime stories, and white noise to promote sleep and relaxation.

Yoga Nidra
This is an ancient breath work tradition used to battle insomnia and facilitate deep rest. https://www.yoganidranetwork.org/downloads

For more tips check out, Making Sleep Your Best Friend. 

The Small Things That Are Huge

  • Telling people that you can’t take on any more tasks.
  • Allowing yourself to sleep when you are tired. (See also Making Sleep Your Best Friend)
  • Spending your time with people who get you.
  • Respecting your limitations and boundaries.
  • Being honest. With you and others.
  • Walking your talk.
  • Asking for help.
  • Enjoying your leisure time.
  • Throwing away guilt.
  • Speaking about your expectations in relationships.
  • Recognizing red flags. This is intuition, an ancient trait.
  • Not arguing with people about your values.
  • Stepping away when angry, instead of engaging in that moment.
  • Allowing yourself to be loved and supported by others.
  • Forgiving yourself.

Making Sleep Your Best Friend

Sleep loss is linked to a slew of medical and mental health issues, including: Cancer, Diabetes, Dementia, and Heart Disease.

Dr. Matthew Walker, a professor of neuropsychology at the University of California, Berkeley, has focused his research on the impact that sleep has on human health and disease. In his 2017 book; Why We Sleep, Walker discusses how sleep is our best friend.

Sleep Tips:
Stick to a sleep schedule
This means weekends too! Sleeping in late on the weekends only interrupts the pattern you have spent the week nailing down. Schedule your sleep schedule and stick to it.

Don’t exercise too late in the day

Avoid alcoholic drinks before bed
If alcohol is present in your system before going to bed, it will interrupt your REM sleep, keeping you in the lighter stages of sleep.

Don’t nap after 3 pm
Although naps can be a great pick-me-up, taking them too late in the day, or napping too long can make it hard to fall asleep at night.

Unwind
Scheduling in time to relax before bed is a great way to prep your body to unwind before falling to sleep.

Take a hot bath
If you like aromatherapy, include lavender and chamomile, which are natural sleep inducers.

Turn off screens
Cell phones, televisions, and computers can be a major distraction if used before bed. The light they emit, especially the blue light, suppresses the secretion of melatonin, the hormone that regulates sleep/wake cycle which increases in the evening.

Get outdoor time
Sun exposure during the day helps to regulate sleeping patterns. It’s recommended to soak in the sun at least 30 minutes a day.

Don’t stay in bed if you can’t sleep
If you find yourself tossing and turning in bed for more than 20 minutes, get up and do something else until you feel sleepy, like reading a book.
(Painting, Gerrit Dou)

Got sleep?

How did you sleep seems to be a question that people frequently ask each other. Did you rest? Some sleep patterns mean a person will sleep once per day while others mean they sleep at intervals. However, the pattern that is most common or traditional in a population may or may not be the healthiest option for people. A person’s internal circadian rhythm is responsible for their sleep-wake cycle.

A monophasic sleep pattern is when an individual sleeps once per day, typically for 8 or so hours a night.

A biphasic sleep pattern is when someone sleeps twice per day, sometimes referred to as a siesta sleeping pattern. In many cultures, particularly along the equator, people sleep in the afternoon especially during the hottest part of the day, and the workday is extended into the evening.

A polyphasic sleep pattern is when a person sleeps for periods of time throughout the day.

People have an internal circadian rhythm, a routine of biological and behavioral processes that roughly occur every day over a 24-hour cycle. Despite this, what is the correct time for a person to sleep per night?

Monophasic sleep
Monophasic sleep is what today’s society would refer to as a “normal” sleeping pattern. There is, however, discussion that this has not always been the case.
This sleep pattern became “the norm” during the industrial revolution’s longer-than-normal hours of working time. Some argue that since the advent of electricity and increased exposure to bright artificial indoor light instead of sunshine, melatonin and Vitamin D levels are decreasing. This can interrupt a person’s sleep-wake cycle and have a negative impact on their sleep durations.

Biphasic sleep
Those who practice biphasic sleep typically sleep for a long duration at night, for 5-6 hours, and have a shorter period of sleep or siesta during the day. The shorter period of rest typically lasts 30 minutes and gives an energy boost to finish the day. I asked my patients to set their alarm so that they wake up after 30 minutes, thereby not disrupting their sleep later on in the day. Some neuropsychology research shows that biphasic sleep is a healthier sleep pattern than a monophasic pattern, and some countries have adopted a biphasic sleep pattern as the norm.

Another form of biphasic sleep is segmented sleep, which some may refer to as the most natural of all sleeping patterns. Segmented sleep includes two sleep periods, both of which occur at night. A person experiencing segmented sleep will sleep for 6-8 hours but in two shifts during the night. This becomes more common as we age.

Naps may be beneficial and be a more natural way of sleeping. The suggested benefits of brief naps include improved memory and learning ability, increased alertness, and an improved mood. In fact, certain innovative companies have implemented napping periods or even rooms where employees can rest during the workday. If naps improve health, then is insomnia an actual disorder or a natural form of the sleep-wake cycle?

One theory by social psychologists is that before industrialization in the modern world, it was normal for people to have what was called first and second sleep. This meant that a person would sleep in two segments of time throughout the night with a waking period of about one to three hours in between.

Polyphasic sleep
Polyphasic sleepers can rest 4 to 6 times during a day. These sleep combinations are broken down into categories including:
– A long sleep time of around 3 hours with approximately three 20-30minute naps throughout the day.
– Only 3 hours of sleep per day in the form of six 30 minute naps throughout the day.
No individual person’s sleep requirements are exactly the same. Some require 8 solid hours of sleep for optimal function. Someone else, however, may lead a productive and healthy life on 5 hours of sleep per night with a short nap or naps during the day.

At my practice, we individualize and fine-tune sleeping patterns, and figure out what works best for each person, from sleep hygiene patterns, to duration.

Embolden Psychology
Embolden

Embolden offers the ADOS-2, the gold standard assessment for kids on the spectrum.

Combined with psychoeducational testing, it helps provide comprehensive information and recommendations to help children and teens six and up.

Thank you for contacting us.