Sleepbook Progress

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Circadian Rhythm

Cycle of Rest and Renewal

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Circadian Rhythm

Cycle of Rest and Renewal

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Copyright Š 2015 Published by The Guilford Press, 72 Spring Street, New York, N.Y. 10012

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All rights reserved.

No part of this book may be reproduced, stored in a retrieval system, or transmitted, in any form or by any

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means, electronic, mechanical, photocopying, recording, or otherwise, without permission from the publisher.

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This book is dedicated to my loved ones and countless hours of lost slumber.

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Rest Is Renewal Pg. 2

Sleep Patterns Pg. 12

Sleep Interrupted Pg. 26

Set Your Rhythm Pg. 38

Introduction » Sleep is vital for both your health

» Circadian rhythms rule our lives, and wellbeing, yet millions of people today regulate our sleep and tell us when to get simply don't get enough sleep. In up in the morning. Understanding the twenty first century, there are several your body's internal clock is the first step things that seem more important to a better sleep. This complex time than getting the right amount of sleep. But keeper is controlled by an area of the brain just as nutrition and exercise are that responds to light, which is why essential for your optimal happiness and humans are most alert while the sun is up health, so is sleep! The quality of and are ready to sleep when it’s dark. sleep affects your waking life. With all the » This book is an artistic look into the distractions of today, it is hard to Biological and Psychological affects that find the balance and maintain the proper sleep and sleeplessness have on the dose of sleep you need each night. human body. Explore the cycles of rest to As we continue to learn more about sleep learn the art of sleep and urgency we realize that rest and restoration of balancing your own circadian rhythm, are fundamental to our lives as a whole. for a better night and future ahead.

REST IS R

chapter one

Rest Is Renewal

RENEWAL

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The Importance of Sleep Essential for a person’s health and wellbeing

» Sleep is essential for a person's health

problems with sleepiness a few days and wellbeing, according to the National a week or more. Also, studies show that Sleep Foundation (NSF). Yet still 69 percent of kids experience one or millions of people today just do not get more sleep problems as well each week. enough quality sleep and can suffer Everyone’s individual sleep needs and from lack of sleep. For example, surveys sleep schedules can vary. conducted by the NSF, from 1999 » In general, most healthy adults are to 2004, an reveal that over 40 million built for 16 hours of wakefulness and need Americans now suffer from over 70 an average of eight hours of sleep a different sleep disorders and 60 percent night. However, some individuals are still of adults report having sleep problems able to function without sleepiness a few nights a week or more. Most of those or drowsiness after as little as six hours with these problems go undiagnosed of sleep. Others can not perform at and untreated. In addition to that, more their peak unless they’ve slept ten hours. than 40 percent of adults experience And, contrary to myth, the need for day time severe sleepiness to disturb with sleep doesn’t decline with age, however their daily activities at least a few days the ability to sleep for six to eight each month with 20 percent reporting hours at one time may also be reduced.

Healthy brain function, » Sleep helps your brain work properly at all times. While you're sleeping, your brain is preparing for the next day. It's physical forming new pathways to help you learn and recall info.

Studies show that a good night's sleep improves your learning. health, Whether you're learning math, how to play the piano, how to perfect your golf swing, or how to drive a car, sleep helps and enhance your learning and problem-solving skills. Sleep also helps you pay attention, make decisions, and be creative. daytime » Studies also show that sleep deficiency alters activity in some parts of the brain. If you are a sleep deficient, you also may have performance trouble making decisions, solving problems, controlling

your emotions and behavior, and coping with change. Sleep deficiency also has been linked to depression, suicide, risk taking behavior and other symptoms. » Children and teens who are sleep deficient may have also problems getting along with others. They may feel angry and impulsive, have mood swings, feel sad or depressed, or lack motivation. They also may have problems paying attention, and they may get lower grades and feel stressed, and most cases sleep deficientcy is undiogsoised. » Sleep plays an important role in your physical health. For example, sleep is involved in healing and repair of your heart and blood vessels. Ongoing sleep deficiency is linked to an increased risk of heart disease, kidney disease, high blood pressure, diabetes, and stroke. » Sleep deficiency also increases the risk of obesity. For instance, one study of teenagers showed that with each hour of sleep lost, the odds of becoming obese went up. Sleep deficiency increases the risk of obesity in other age groups too. » Sleep helps maintain a healthy balance of the hormones that make you feel hungry (ghrelin) or full (leptin). When you don't get enough sleep, your level of ghrelin goes up and your level of leptin goes down. This makes you feel hungrier than when you're well-rested. Sleep also affects how your body reacts to insulin, the hormone that controls your blood glucose, or sugar, level. Sleep deficiency results in a higher blood sugar level, which also may increase your risk for diabetes. » Sleep also supports healthy growth and development. Deep sleep triggers the body to release the hormone that promotes normal growth in children and teens. This hormone also boosts muscle mass and helps repair cells and tissues in children, teens, and adults. Sleep also plays a role in fertility.

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» Your immune system always relies on sleep to stay healthy.

This system defends your body against foreign and or harmful substances. Ongoing sleep deficiency can change the way in which your immune system responds. For example, if you're a sleep deficient, you may additionally have trouble fighting against most common infections. » Getting enough quality sleep at the right times helps you function well through the day. People who are sleep deficient are found less productive at work and school. They take longer to finish tasks, have a slower reaction time, and make more mistakes which affects all aspects of life. » After several nights of losing sleep even a loss of just 1–2 hours per night your ability to function suffers as if you haven't slept at all for a day or so. Lack of sleep may lead to microsleep.

Microsleep refers to brief moments of sleep that occur when you're normally awake. You can not control microsleep, and you might not be aware of it. For example, have you ever driven somewhere and then not remembered part of the trip?

If so, you may have experienced microsleep. Even if you're not driving, microsleep can affect how you function. If you are listening to a lecture, for example, you might miss some of the information or feel like you don't understand the point.

In reality, though, you may have slept through part of the lecture and not been aware of it. » Some people aren't aware of the risks of sleep deficiency.

In fact, they may not even realize that they're sleep deficient at all. Even with limited or poor-quality sleep, they may still think that they can function well. For example, drowsy drivers may feel capable of driving. Yet, studies show that sleep deficiency harms your driving ability as much as, being drunk.

It's estimated that driver sleepiness is a factor in about 100,000 car accidents each year, resulting in about 1,500 deaths.

Drivers aren't the only ones affected by sleep deficiency.

It can affect people in all lines of work, including health care workers, pilots, students, lawyers, mechanics, and more. » As a result, sleep deficiency is not only harmful on a very personal level, it also can cause large-scale damage. For example, sleep deficiency has played a role in human error linked to tragic accidents, such as nuclear reactor meltdowns, grounding of large ships, and aviation accidents. However, with proper education, active awareness of sleep patterns, and also conscious control of sleep, disasters could be prevented.

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How environment and behavior affect a person’s sleep

» Stress is the number one cause of short-term sleeping difficulties, according to sleep experts. Common triggers can include school- or job-related pressures, a family or marriage problem and a serious illness or death in the family.

Usually the sleep problem disappears when the stressful situation passes. Although, if short-term sleep problems such as insomnia are not managed properly from the start, they can persist long after the original stress event has passed. » Drinking alcohol or beverages containing caffeine in the afternoon or evening, exercising close to bedtime, following an irregular morning and nighttime schedule, and also working or doing other mentally intense activities right before or after getting into bed can disrupt sleep. If you are among the twenty percent of employees in the United States of America who are shift workers, sleep maybe especially elusive. Shift work forces you to try to sleep right when activities around you, and your own “biological rhythms” - signal you to be awake. A study shows that shift workers are two to five times more likely than employees with regular, daytime hours to fall asleep on the job. Traveling can also disrupts sleep, especially jet lag and traveling across several time zones.

This can and will upset your biological or “circadian” rhythms. » Environmental factors such as a room that’s too hot or cold, too noisy or too brightly lit can be a barrier to sound sleep.

And interruptions from small children or other family members can also disrupt sleep. Other influences to really pay attention to are the comfort and size of your bed and the habits of your sleep partner. If you have to lie beside someone who has different sleep preferences, snores, can’t fall or stay asleep, or has other sleep difficulties, it often becomes your problem too! Having a 24/7 lifestyle can also interrupt regular sleep patterns: the global economy that includes round the clock industries working to beat their competition; widespread use of nonstop automated systems to communicate and an increase in shift work makes for sleeping at regular times difficult. Be mindful of external factor.

SLEEP PA

chapter two

Sleep Patterns

ATTERNS

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Sleeping Rhythm Today Unnatural sleep cycles in the modern world

» Our bodies require sleep in order

night. But what exactly happens when to maintain proper function and health. we drift off to sleep?

In fact, we are programmed to sleep » Prior to the era of modern sleep each night as a means of restoring our own research in the early 1920s, the scientists bodies and minds. Two interacting regarded sleep as an inactive brain systems—the internal biological clock and state. It was widely accepted that as night the sleep-wake homeostat—largely fell and sensory inputs from the determine the timing of our transitions environment diminished, so too did the from wakefulness to sleep and vice brain function. In essence, scientists versa. These two factors also explain why, thought that the brain simply shut down under normal conditions, we tend during sleep, only to restart again to stay awake during the day and sleep at when the actual morning came around.

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Electroencephalograms

» In 1929, an invention that enabled scientists to record

Waves of Rest at Night

» In healthy adults, sleep typically begins with NREM

brain activity challenged this way of thinking. From particular sleep.The pattern of clear rhythmic alpha activity associated recordings known as electroencephalograms (EEGs), many with wakefulness gives way to N1, the first stage of sleep, researchers could see that sleep was a dynamic behavior, one in which is defined by a low-voltage, mixed-frequency pattern. which the brain was highly active at times, and not turned The transition from wakefulness to N1 occurs seconds off at all. Over time, sleep studies using EEGs and along with to minutes after the start of the slow eye movements seen when other instruments that measured eye movements, muscle a person first begins to nod off. This first period of N1 activity would reveal two main types of sleep. These were defined typically lasts just one to seven minutes. The second stage, or N2, by characteristic electrical patterns in a sleeping person's which is signaled by sleep spindles and/or K complexes brain, as well as the presence or absence of eye movements. in the EEG recording, comes next and generally lasts 10 to 25 » The two main types of sleep are Rapid-Eye-Movement minutes. As N2 sleep progresses, there is a quite gradual (REM) sleep and Non-Rapid-Eye-Movement (NREM) sleep. appearance of the high-voltage, slow-wave activity characteristic On an EEG, REM sleep, often called "active sleep," is of N3, the third stage of NREM sleep. This stage, which identifiable by its characteristic low-amplitude (small), while generally lasts 20 to 40 minutes, is referred to as "slow-wave," high-frequency (fast) waves and alpha rhythm, as well as "delta," or "deep" sleep. As NREM sleep progresses, the eye movements for which it is named. Many sleep experts the brain becomes less responsive to external stimuli, and it also today think that these rapid eye movements are in some becomes increasingly difficult to awaken someone from sleep. way related to dreams. Typically, when people are awakened » Following the N3 stage of sleep, thus a series of body from REM sleep, they report that they had been in fact movements usually signals an "ascent" to lighter NREM sleep been dreaming, often extremely vivid and sometimes bizarre stages. Typically, a 5 to 10 minute period of N2 precedes dreams. In contrast, people report dreaming a lot less the initial REM sleep episode. REM sleep consists of about 20 frequently when awakened from NREM sleep. Interestingly, to 25 percent of total sleep in a typical healthy adults, during REM sleep the muscles in the arms and legs are however varies depending on overall quality of the solid sleep. temporarily paralyzed. This is thought to be a neurological » NREM sleep and REM sleep continue to alternate barrier that prevents us from "acting out" our dreams. throughout the night in a cyclical fashion. Now most slow-wave » NREM sleep can be broken down into three distinct stages: NREM sleep occurs in the first part of the night; REM N1, N2, and N3. In the progression from stage N1 to N3, brain sleep episodes, the first which may last only one to five minutes, waves become slower and more synchronized, and the eyes generally become longer through the night. During a remain still. In stage N3, the deepest stage of NREM, EEGs can typical night, N3 sleep occupies less time in the second cycle in reveal high-amplitude (large), low-frequency (slow) waves comparison the first and may disappear altogether from and spindles, this stage is known as "deep" or "slow-wave" sleep. later cycles. The average length of the first NREM to REM sleep cycle is between 70 and 100 minutes; the average length of the second and later cycles is about 90 to 120 minutes. The reason for such a specific cycling pattern of NREM and REM sleep across the night is unknown. Some scientists now speculate that specific sequences of NREM and REM sleep optimize both physical and mental recuperation as well as some aspects of memory consolidation occur during sleep, but this has not been confirmed. More research into sleep still continues to develop.

EEGs WHEN AWAKE AND ASLEEP electroencephalogram records of electrical activity in the brain

Awake - low voltage - random and fast

Drowsy - 8 to 12 cps - alpha waves

Stage 1 - 3 to 7 cps - theta waves

Stage 2 - 12 to 14 cps - sleep spindles - K complexes

Stage 3 - ½ to 2 cps

- delta waves >75uV

REM Sleep - low voltage - random, fast with sawtooth waves

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Awake low voltage high frequency

SLEEP CYCLES changes with age statistical study, Nov.1, 2004

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AGE 20

AGE 40

AGE 60

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AGE 80

TIME TO FALL ALSEEP

16 mins

17 mins

18 mins

18.5 mins

19 mins

TOTAL SLEEP TIME

7.5 hrs

7 hrs

6.2 hrs

6 hrs

5.8 hrs

TIME IN STAGES 1-2

47%

51%

53%

55%

57%

TIME IN STAGES 3-4

20%

15%

10%

9%

7.5%

TIME IN REM SLEEP

22%

21%

20%

19%

17%

TIME ASLEEP IN BED

95%

88%

84%

82%

79%

SLEEP CYCLES the pattern your brain goes through each night

Stage 1 low voltage mixed frequency

Stage 2 sleep spindles & K complexes

Stage 3

R.E.M.

mostly slow waves

[Rapid Eye Movement] low voltage with mixed frequency

Stage 4

rapid eye movement & muscle atonia

slow waves

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TIME OF SLEEP

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However, a plethora of internal and external factors can dramatically influence the delicate balance of this sleep-wake system. Changes in the structure and function of the brain during development can have profound, if gradual, effects on sleep patterns. The amount of sleep we obtain generally decreases and becomes more fragmented throughout our life span also due to a variety of influences. » Other factors that affect sleep include stress and many medical conditions, especially those that cause chronic pain and or other discomfort. External factors, such as what we eat and drink, the medications we take, and even the environment in which we sleep can also greatly affect the quantity and quality of our sleep. In general though, all of these factors tend to increase the number of awakenings and limit sleep quality.

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Shifting sleep Sleep in the Real World » The internal mechanisms that regulate our almost endless patterns cycles of sleep and wakefulness make up a remarkable system.

Shifting Sleep Patterns

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age, the amount of recent sleep or wakefulness, the time of the day or night relative to an individual’s internal clock, other behaviors prior to sleep such as exercise, stress, environmental conditions such as temperature and light, and also various chemicals. For example, for the first year of life, sleep often starts in the REM state. The cyclical alternation of NREM-REM sleep in newborns is present from birth but 50-60 minutes is much shorter than the 90-minute cycles that occur in adults.

Consolidated nocturnal sleep and fully developed EEG patterns of the NREM sleep stages emerge after two or so months. » Sleep history—the quantity and quality of an individual’s sleep in recent days, can also have dramatic effects on one's sleep patterns. Repeatedly missing a night’s sleep, an irregular sleep schedule, or frequent disturbance of sleep can result in a redistribution of sleep stages, prolonged and deeper periods of slow-wave NREM sleep. Drugs may affect sleep stages as well.

For example, alcohol before sleep tends to suppress REM sleep early in the night. As the alcohol is metabolized later in the night, REM sleep rebounds. However, awakenings can also become more frequent during this time.

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Light's Effect

» Light is one of the most important external factors that can affect sleep. It does so both directly, by making it difficult for people to fall asleep, and also indirectly, by influencing the timing of our internal clock and thereby affecting our own preferred time to sleep. Light influences our internal clock through specialized "light sensitive" cells in the retina of our eyes.

These cells, which occupy the same space as the rods and cones that make vision possible, also tell the brain whether it is daytime or nighttime, and sleep patterns set accordingly. » Due to the invention of the electric light-bulb in the late nineteenth century, today we are now exposed to much more light at night than we had been exposed to throughout our evolution. This relatively new pattern of light exposure is almost certain to have affected our patterns of sleep.

Exposure to light in the late evening tends to delay the phase of our internal clock and lead us to prefer later sleep times.

Exposure to light in the middle of the night can have much more unpredictable effects, but can certainly be enough to cause our internal clock to be reset, and may make it hard to return back to sleep once again.

Jet Lag and Shift Work

» Normally, light serves to set our internal clock to the appropriate time. However, problems can happen when our exposure to light changes due to a shift in work schedule or travel across time zones. Under normal conditions, our own internal clock strongly influences our ability to sleep at various times over the course of a 24-hour period, also which sleep stages we experience when we do sleep. » Individuals who travel across time zones or work the night shift typically have two symptoms. One is insomnia when they're trying to sleep outside of their internal phase, and another is excessive sleepiness during the time when their internal clock says that they should be asleep. About half of all night shift workers regularly report nodding off and or falling asleep occasionally when they are at work. This should be seen as a concern both for individuals and society, given that airline pilots, air traffic controllers, physicians, nurses, police, and other public safety workers are all employed in professions in which peak functioning during a night shift may be critical.

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SLEEP IN

chapter three

Sleep Interrupted

NTERRUPT

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Disruption of sleep-time causes discomfort

Âť We know sleep is required to provide energy for physical and mental activities.

The sleep-wake cycle is complex as we have learned, made of different stages of active consciousness: rapid eye movement (REM) sleep, non-rapid eye movement (NREM) sleep, and also wakefulness. As persons age increases the amount of time spent in REM sleep then diminishes. The amount of rest that individuals need varies with age and personal characteristics. In general the demands for sleep decrease with age.

Disruption in the individual's usual diurnal pattern of sleep and wakefulness may be temporary or chronic. Such

disturbances may result in both subjective distress in addition to apparent impairment in functional abilities.

Sleep patterns can be affected by external environment. Such sleep disturbance is a significant stress in the intensive care unit (ICU) and can affect recovery.

Other factors that can affect sleep patterns include temporary changes in routines such as in traveling, the jet lag, sharing a room with another, use of medications, alcohol ingestion, night shift rotations that change one's individual circadian rhythms, acute illness, or emotional problems such as depression or anxiety and other issues.

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Sleep Pattern Disturbance

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sleep? » Psychologists and other scientists who study the causes of

sleep disorders have shown that such problems can directly or indirectly be tied to abnormalities in the following systems:

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· Immune system · Brain and nervous system · Metabolic functions · Cardiovascular system · Physiological systems » Furthermore, unhealthy conditions as well as disorders and diseases can also cause sleep problems, including: pathological sleepiness, insomnia and accidents Hypertension and elevated cardiovascular risks (MI, stroke) Emotional disorders (depression, bipolar disorder) Obesity; metabolic syndrome and diabetes Alcohol and drug abuse.

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The consequences of insufficient sleep

Identifying Sleep Disorders

» If you spend a great deal of time lying awake in bed at night or notice you frequently nod off during the day, you may have a sleep disorder. A variety of sleep disorders can cause similar symptoms, such as excessive daytime sleepiness. If you suspect you have a sleep disorder, it is important to seek the expert opinion of your physician and/or find a sleep specialist. A sleep doctor can help determine not only the origin and severity of a sleep problem, but can recommend therapies too that may help you obtain better sleep.

Insomnia

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difficulty falling asleep, staying asleep, or wake earlier than they would like and cannot get back to sleep. These are the major symptoms of insomnia, the most common category of sleep disorders. Although many people with insomnia may accept their symptoms as a part of life, poor quality sleep takes a toll. Studies show that people with insomnia are more likely to become clinically depressed, can suffer from poor concentration, and have accidents. Many people have experienced periods of short-term, or acute, insomnia due to stress environmental changes, such as job loss or jet lag.

Fortunately, for most people these disruptions in sleep may last only a few nights. But in some cases, sleep disruptions persist for long periods and evolve into chronic insomnia.

Causes of Chronic Insomnia

» Insomnia often results from poor sleep habits, such as an overstimulating nighttime routine, or consuming too much alcohol or caffeine near bedtime. Certain medications, such as antidepressants, steroids, and allergy and cold products can also bring on bouts of insomnia. » In many people, insomnia is caused or made worse by a psychiatric or medical condition. For example, insomnia is a common symptom of many psychiatric disorders, such as anxiety and depression. It may also arise from painful and or uncomfortable medical conditions, such as arthritis, or those that affect breathing, such as asthma. A condition called primary insomnia, where no clear environmental, the psychiatric experts suspect that individual differences in brain function may result in an overactive alerting signal that continues long after an individual would like to fall asleep.

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Excessive Daytime Sleepiness (EDS)

» It is not unusual for people to have days when they struggle to stay awake. However, suddenly falling asleep on the job or while driving is not normal—and can be highly dangeous.

Excessive daytime sleepiness is a symptom that can be seen in several sleep disorders, including obstructive sleep apnea, narcolepsy, and periodic limb movement disorder.

Obstructive Sleep Apnea (OSA)

» is an extreme form of snoring in which an individual’s airway becomes partially or completely blocked several times during a night of sleep, leading to repetitive awakenings.

As we sleep, muscles in the throat relax. In some people, this relaxation causes tissue at the back to the throat to block the airway. In someone with a severe form of OSA, this may occur hundreds of times per night, interrupting breathing for 30 seconds or more during each instance. » The result of this interrupted breathing pattern is severely disrupted sleep, as the individual must wake up enough times to regain muscle control in the throat and to reopen the airway. Surprisingly, despite dozens or even hundreds or more of awakenings per night, most individuals with OSA have no recollection of these events. In fact, often the only evidence of this serious condition is daytime fatigue and reports of loud snoring from bed partners and close-ones. » One of the biggest risk factors for OSA is obesity. This may be because excessive weight increases the amount of tissue in the throat and thus makes airway obstruction more likely. Other risk factors include inherited traits, such as small jaw size or large overbite, as well as behavioral factors such as the use of alcohol before sleep. » OSA is a serious condition that can lead to high blood pressure, heart disease, and mood and memory problems. As such, those who suspect they may have OSA should always consult their primary care physician, who may refer to a sleep specialist for an overnight sleep evaluation. There are treatments that may help.

Narcolepsy

» is best known as an almost uncontrollable need to fall asleep at various times throughout the daytime. Although excessive day time sleepiness is common among people with narcolepsy, the sudden onset of sleep, "sleep attacks," are less so. Affecting approximately one in two thousand people today, narcolepsy is a central nervous system disorder in which the brain cannot properly regulate cycles of sleep and wakefulness. This results in an inability to stay awake for extended periods of time, and sleep itself can also be quite disturbed.

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Periodic Limb Movements of Sleep (PLMS)

» is a condition affecting approximately 34 percent of adults over the age of 60. This condition here causes involuntary kicking and jerking movements of the legs and arms, often repeated hundreds of times during the night. Like people with sleep apnea, people with PLMS are usually unaware of their multiple nightime awakenings unless they are witnessed by a bed partner. In extreme cases, these brief arousals following the leg movements disturb sleep so much that they can cause excessive daytime sleepiness. In that situation, this is called periodic limb movement disorder (PLMD) and the treatment may help with the symptoms of EDS. Patients with restless legs syndrome (an uncomfortable urge to move the legs) often have periodic limb movements during sleep as well.

Excessive Daytime Sleepiness (EDS)

» It is not unusual for people to have days when they struggle to stay awake. However, suddenly falling asleep on the job or while driving is not normal—and can be extremely dangerous. Excessive daytime sleepiness (EDS) is a symptom that can be seen in several sleep disorders, including obstructive sleep apnea, narcolepsy, and periodic limb movement disorder.

Parasomnias

» Sleep can be a painful time for people who experience parasomnias. The symptoms of these disorders range from the mundane to the horrifying, and worrying about what might happen during a night of sleep can cause some people who experience parasomnias to want to avoid sleep all together. » Sleepwalking—Once thought to be an acting out of dreams, sleepwalking actually takes place during deep sleep (not REM sleep, when dreams typically occur). Sleepwalkers often perform routine activities such as dressing and cleaning.

Sleepwalking is quite common in children and affects approximately 1 percent of adults. Bouts of sleepwalking can be triggered by stress, anxiety, excessive alcohol, or epilepsy. » Night terrors—These severe attacks cause people, usually children, to appear to wake up and scream in fear and or panic.

However, these individuals are typically inconsolable, and tend to have no recollection of the event the following day. » Sleep-eating disorders—These episodes, like sleepwalking, occur during partial awakenings from deep sleep and cause many individuals to eat without any knowledge of what they are doing, or any memory of what they have done.

SET YOU

chapter four

Set Your Rhythm

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Reset Your Internal Clock The power of circadian rhythm

» Circadian rhythms rule our lives,

That is why some people are called regulate our sleep and tell us when to get “morning people,” while others function up in the morning. Understanding best in the evening. Your circadian your body's internal clock is the first step rhythm can also change as you age. When to a better sleep. This complex time you were a teenager, for example, keeper is controlled by an area of the brain your body was programmed (so to speak) that responds to light, which is why to sleep for more total hours, as well humans are most alert while the sun is up as go to bed and wake up later. and are ready to sleep when it’s dark. » If you follow your body’s natural » Your circadian rhythm causes your cues of when to go to sleep and wake up, level of wakefulness to rise and descend your circadian rhythm should stay throughout the day. Most people balanced, but a change in your schedule feel the strongest desire to sleep between (like if you stay up late pulling long 1:00pm and 3:00pm (a.k.a. the hours at work one day or sleep in another post-lunch, afternoon crash) and then Saturday morning), can disrupt your again between 2:00am and 4:00am, circadian rhythm, body clock. Therefore but this can vary from person to person. affecting your quality of sleep and life.

Follow a regular » Erratic sleep patterns can leave you feeling out of whack, so a regular sleep schedule may be exactly what you need. Just a few sleep adjustments to your daily routine can help you go to bed and wake up at the same time every day. routine Be Consistent. to » Pick a bedtime and a wake-up time—and stick to them as much as possible. Life will inevitably interfere, however try not live to sleep in for more than an hour or two, tops, on Saturdays and Sundays so that you can stay on track. That way, your body’s a internal clock—also called a circadian rhythm (body clock) A daily rhythmic activity cycle, based on 24- hour intervals. This happier, is often called your "body clock." healthier Make Gradual Adjustments. » You won’t be able to change your sleep schedule overnight. life The most effective tactic is to make small changes slowly. If you

are trying to go to sleep at 10:00pm, rather than midnight, for example, try this: For the first three or four nights, go to bed at 11:45pm, and then go to bed at 11:30pm for the next few days. Keep adjusting your sleep schedule like this. By working in 15-min segments, your body will have an easier time adjusting.

See the Morning Light.

» Your body’s internal clock is sensitive to light and darkness, so getting a dose of the sun first thing in the morning will help you wake up. Opening the curtains to let natural light in your bedroom or having a cup of coffee on your sun-drenched porch will cue your brain to start the day.

Dim the Nightlights.

» Likewise, too much light in the evenings can signal that you should stay awake. Before bedtime, dim as many lights as possible and turn off bright overhead lights. Avoid computers, tablets, cell phones, and TV about an hour before bed, since your eyes are especially sensitive to the blue light from electronic screens.

(If there’s something good on TV at night, DVR it so you can watch it another time.)

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Skip the Snooze Button.

» Though it’s certainly tempting to hit the snooze button in the morning to get a few extra winks, resist. The first few days of getting up earlier won’t be easy, but post-snooze sleep isn’t high quality. Instead, set your alarm to the actual time that you need to get up and remember that it may take a few minutes for your body to adjust to a daytime rhythm. If you can, skip the alarm altogether. Your body should wake naturally after a full night’s sleep—usually seven to nine hours—and you’ll feel most alert if you wake up without an electronic aid.

Food for Thought.

» It’s not just what you eat—it’s when you eat. While you know that it’s not a good idea to go to bed on an empty stomach, being stuffed is just as bad. Having dinner around the same time every night will help keep your whole body on track.

Also, limit how much you drink before bedtime to avoid trips to the bathroom in the middle of the night. A good rule of thumb is to eat your last meal two to three hours before bedtime. If you must eat before bed try a small snack that blends carbohydrates and protein together, such as cereal with a banana, cheese and crackers, or wheat toast with natural peanut butter. You should also avoid nicotine, caffeine, and alcohol in the evenings, since those stimulants can take hours to wear off. » A hormone that’s made by the pineal gland in the brain, melatonin helps control your daily sleep-wake cycles. Your body’s internal clock (is also known as your circadian rhythm) influences how much melatonin the pineal gland makes, and so does the amount of light that you’re exposed to each day.

Typically, your melatonin levels start to rise in the mid-to-late evening, after the sun has set. They stay elevated for most of the night while you’re in the dark. Then, they drop in the early morning as the sun rises, causing you to awaken. » At drugstores and natural-food stores, you can buy melatonin supplements, which are often used by those who suffer from jet lag, shift-work-related sleep troubles, or insomnia, etc.

These supplements come in pill, liquid, chewable, or even lozenge forms, in doses ranging from one to 10 milligrams. For insomnia, it’s best to take a melatonin supplement 30 to 60 minutes before bedtime. That way, it can put you in the mood to snooze by the time you want to turn out your lights for the night. Keep in mind, though, that melatonin supplements can negatively interact with many different medications, so be sure to always check with your doctor or a sleep specialist before taking the sleep-inducing aid.

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How to get a good nights sleep

» According to sleep researchers, a night’s sleep is divided into five continually shifting stages, defined by types of brain waves that reflect either lighter or deeper sleep. Toward morning, there is an increase in REM sleep, when the muscles are relaxed and dreaming occurs, and recent memories may be consolidated in the brain. Sleep experts say that hitting a snooze alarm over and over again to wake up is really not the best way to feel rested. “The restorative value of rest is diminished, especially when the increments are short,” said psychologist Edward Stepanski, PhD who has studied the sleep fragmentation at the Rush University Medical Center in Chicago. This on and off again effect of dozing and waking causes shifts in the brain-wave patterns. Sleep-deprived snooze-button addicts are likely to shorten their quota of REM sleep, thus impairing their mental functioning during the day. Certain therapies, like cognitive behavioral therapy teach people how to recognize and change patterns of thought and behavior to solve their problems. Recently this type of therapy has been shown to be very effective in getting people to fall asleep and conquer insomnia. » Cumulative sleep debt is robbing individuals of a shaper mental performance, thus robbing us of our overall productivity. It’s preventing athletes from performing at their best. And it’s a barrier between you and overall optimal performance. The answer is simple: get more sleep.

Keep a regular sleep/wake schedule Minimize use of stimulates during the day Don’t smoke, especially near bedtime or if you awake in the night Avoid alcohol and heavy meals before sleep Get regular exercise daily Minimize noise, light and excessive temperatures near where you sleep Develop a regular bed time Try and wake up without an alarm clock Attempt to go to bed earlier every night for certain period Avoid cell phone and computer screen usage before bed

Bibliography

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"An Overview of Sleep Disorders." An Overview of Sleep Disorders. Division of Sleep Medicine at Harvard Medical School, n.d. Web. 07 May 2015.

"External Factors That Influence Sleep." External Factors That Influence Sleep. Division of Sleep Harvard Medical School, n.d. Web. May 2015.

Arkin, Arthur M., John S. Antrobus, and Steven J. Ellman. "The Mind in Sleep: Psychology." Hillsdale, NJ: Lawrence Associates, 1978. Print.

Gallagher, Michela, Rand J. Nelson, and Irving B. Weiner. "Handbook of Psychology Biological Psychology."

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"The Mind in Sleep: Psychology and Psychophysiology." Hillsdale, NJ: Lawrence Erlbaum Associates, 1981. Print.

Hammerson, John R."Sleep." Http:// www.apa.org. American Psychological Association and Columbia University, n.d. Web. 17 Apr. 2015.

Carney, Paul R., Richard B. Berry, and James D. Geyer. "Clinical Sleep Disorders." Philadelphia: Lippincott Williams & Wilkins, 2005. Print.

Hull, Elaine M., James W. Kalat, and Juan Dominguez. "Study Guide: Biological Psychology." 10th ed. Belmont, CA: Wadsworth, 2009. Print.

Clear, James. "The Beginner's Guide to Getting Better Sleep." Entrepreneur Online Magazine. N.p., 21 April 2014.

Web. 07 May 2015.

Kalat, James W. "Biological Psychology, Wakefullness And Sleep." 10th ed.

Belmont, CA: Wadsworth, Cengage Learning, 2009. Print.

Epstein, Lawrence J., and Steven Mardon. "The Harvard Medical School Guide to a Good Night's Sleep." New York: McGraw-Hill, 2007. Print.

Lee-Chiong, Teofilo L., Hal Windserspoon. "Sleep: A Comprehensive Handbook." 2nd ed. Vol. 1. Hoboken, NJ: Wiley-Liss, 2006. Print.

Martin, Paul. "Counting Sheep: The Science and Pleasures of Sleep and Dreams." New York: Thomas Dunne / St. Martin's, 2004. Print.

Scott, Cyril, and Jay Zalat.

Sleeplessness: Its Prevention and Cure

by Natural Methods. Northampton: Athene Pub., 1999. Print.

Moorcroft, William H., and Paula Belcher. "Understanding Sleep and Dreaming." New York: Kluwer Academic/Plenum, 2003. Print.

"Sleep and Disease Risk." Sleep and Disease Risk. Division of Sleep Medicine at Harvard Medical School, Dec. 2007. Web. 07 May 2015.

Morin, Charles M., and Colin A. Espie. "The Oxford Handbook of Sleep and Sleep Disorders." Oxford: Oxford UP, 2011. Print.

"The Natural Patterns of Sleep." The Natural Patterns of Sleep. Division of Sleep Medicine at Harvard Medical School, n.d. Web. 17 Apr. 2015.

"National Sleep Foundation - Sleep Research & Education." National Sleep Foundation - Sleep Research & Education. N.p., n.d. Web. Apr. 2015.

Thorpy, Michael J., James T. Person, and Jan Yager. "The Encyclopedia of Sleep and Sleep Disorders." New York: Facts On File, 2001. Print.

Nezu, Arthur M., Christine M. Nezu, and Pamela A. Geller. "Handbook of Psychology, Health Psychology." N.P.: Wiley, 2012. Print.

Terman, Michael, and Ian McMahan.

"Chronotherapy: Resetting Your Inner Clock to Boost Overall Quality Sleep."

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Rosenzweig, Mark R. "Biological Psychology: Behavioral, Cognitive, and Clinical Neuroscience." Sunderland, MA: Sinauer Associates, 1999. Print.

"Why Sleep Is Important, And When You Don't Get Enough." Http:// www.apa.org. American Psychological Association, n.d. Web. 17 Apr. 2015.

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Colophon

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ACADEMY OF ART UNIVERSITY School of Graphic Design San Francisco, California Spring 2015 DESIGNER: Reanna Day Wright PRINTER: Reanna Day Wright EMAIL: Reannaday@gmail.com INSTRUCTOR: Ariel Grey CLASS: Typography 3 TYPEFACES: The body copy and subheads are set in Mrs Eaves, by Emigre Foundry. The headings and in-text subheadings are set in Kievit, by FontFont Foundry. The numbers only are set in DinPro, also by FontFont Foundry.

PAPER: Red River 50lb. Premium Matte Double Sided Paper PUBLISHER: Guilford Publications, Inc. BINDING: American Office Service SOFTWARE: Adobe Creative Cloud,

InDesign, Illustrator, and Photoshop EQUIPMENT: MacBook Pro Retina Display 15-inch: 2.7 GHz Intel Core i7 Epson Stylus Pro R2000 ABOUT THE PROJECT: This is a student project only. No part of this book or any other part of the project was produced for commercial use or purpose.

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00:00am

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» Circadian rhythms rule our lives, regulate our sleep and tell us when to get up in the morning. Understanding your body's internal clock is the first step to a better sleep. This complex time keeper is controlled by an area of the brain that responds to light, which is why humans are most alert while the sun is up and are ready to sleep when it’s dark. » This book is an artistic look into the Biological and Psychological affects that sleep and sleeplessness have on the human body. Explore the cycles of rest to learn the art of sleep and urgency of balancing your own circadian rhythm, for a better night and future ahead.