Basics of Sleep

What is Sleep?

Sleep is a reversible state of reduced activity for the brain and body characterized by decreased responsiveness to the outside world. There are many physiologic changes that happen during sleep such as heart rate slowing, breathing slowing, oxygen levels dropping slightly, and brain connections behaving in a different way than when awake. Unlike coma or heavy sedation with medications, sleep is quickly reversible with strong enough external stimuli (ie: you can wake someone up from sleep with a loud noise or by shaking them).

Why Do We Sleep?

During sleep our brains do not simply turn off. Instead they dedicate energy to completing processes…


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During times of stress, it is supposed to be an ADAPTIVE response to sleep less deeply and a little less overall. When we are stressed our body releases “fight or flight” type hormones to keep us more alert and ready to act at a moment’s notice. Not surprisingly, such hormones can also prevent us from sleeping as deeply, lest we succumb to the threat we are stressed about during sleep. During these times of stress, we actually have increased alertness in both the night AND day, so, despite sleeping a bit less, we can still maintain vigilance during the day…


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You’re lying in bed, unable to sleep, getting increasingly frustrated. You turned out the lights at midnight and now look at the clock and see that it is 1am. Your brain wanders, thinking about everything you need to do the next day at work. You look at the clock again, which now reads 2am. You are certain you have been awake in bed now for 2 hours and start to worry about how you will feel the next day. You nudge your bed partner awake, stating “I can’t sleep again”. “What are you talking about?” …


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Image Source: https://walandtrusts.org/news/defending-puget-sound-shoreline/

A helpful tool for refocusing your mind and helping to pass time spent awake during the night is to create a vivid, calming and engaging visualization sequence. Once you have created the visualization sequence, you can use it any time you are awake and want to pass the time and refocus your thoughts. The goal of the visualization is not to bring on sleep; it is simply a tool to give you a pleasant way to pass the time and refocus your thoughts. As you review the visualization in your mind, you will notice that your mind wanders. As soon…


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Image Source: https://www.centralpennparent.com/2019/5-tips-for-reducing-parental-anxiety/

Constructive worry is a method for managing the tendency to worry during the quiet time at night when sleep is supposed to be taking over. The goal of this exercise is to create time earlier in the day when you can proactively anticipate and address the worrisome thoughts which take over at night. It takes a few sessions of practice for this technique to work.

Instructions:

  1. Find a quiet time at least 2 hours before your desired bedtime to complete the exercise. It should take less than 15 minutes.
  2. Write down a concern which has been on your mind lately.

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Image Source: https://www.bbvaopenmind.com/en/science/scientific-insights/the-tumultuous-history-of-daylight-saving-time/

As a sleep medicine physician and mother of two (currently ages 4 and 6), I’m keenly aware of the importance of good sleep to our overall health and wellbeing. Twice a year, when our society engages in the great modern experiment of transitioning into and out of Daylight Saving Time, I implement a plan to make the transition as smooth as possible for my children and myself.

For families, the abrupt change in clock timing around Daylight Saving Time can cause problems for both the children and the parents. Children generally have a much more robust internal clock than adults…


(sing to the tune of “Twinkle, Twinkle, Little Star)

Twinkle, twinkle time to sleep

To feel your best, you should keep

A regular bedtime routine

To start, create a calming…


Presented on April 8th, 2019

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Source: https://www.teenagesurvivalcoach.com/teenage-sleep-how-much-is-needed/

Good evening. My name is Michelle Jonelis and I am a Sleep Medicine physician, Mountain View resident and mother of two. I’m standing up here today to advocate to change our high school start times to 9AM or later every single day.

Teenagers have difficulty getting sufficient sleep during the school week because they are biologically hard-wired to stay up late. Changing school start times to later is therefore the best way to make sure that teens have the opportunity to get the sleep they need.

Current estimates are that the average sleep duration for…


Did you know that our sleep changes over the course of our lives? A mis-understanding of normal age-related changes in sleep can lead to over use of sleeping medications and unnecessary worry. Read on to learn what types of changes to our sleep are normal as we age.

Over the course of our lives, from infancy to old age, every aspect of our physiology changes. For instance, let’s look at what happens to our hair as we age: the hair on a newborn baby may fall out a few weeks after birth, then slowly grow back, then darken as the…


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As a sleep medicine physician I am often asked about the effects of commonly ingested substances on sleep. Here is a summary of some of the research regarding the effects of caffeine, nicotine, alcohol and cannabis on sleep.

Caffeine:

Caffeine is a stimulant that helps to improve alertness by counteracting a sleepiness molecule called adenosine which is produced by the brain as it uses energy. Adenosine is supposed to tell the brain that it needs to sleep in order to replenish its energy stores and caffeine blocks the signal from being heard, tricking the brain into thinking that it no…

Michelle Jonelis

I am a sleep medicine physician in Redwood City, CA. My clinical focus is on the non-pharmacologic management of sleep disorders using techniques such as CBT-I.

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