Answers to High School Student Questions about Sleep
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 that they cannot complete while you are out and about.
Think about the 4 Rs:
- Repair Damage/Remove Toxins. While we are active during the day we get small tears in our muscles and skin, DNA damage from UV light, free radical build-up from metabolic processes, lactic acid builds up in the muscles, beta amyloid builds up in the brain. We repair this damage and clear out toxins at night.
- Replenish Energy. Our brains and bodies break down ATP to adenosine for energy during the day. At night we need to replenish our stores of ATP.
- Reorganize. We are constantly taking in new information during the day. At night our brains sort through the information that has come in, deciding what is important to keep and what we should forget. Important information is connected with similar information in the brain to make it more accessible. Dream content may be formed during some of this reorganization.
- Recalibrate. Each day we reset our cardiovascular system, metabolic system, circadian clock, nervous system and immune system, trying to make it better prepared for the next day based on what it encountered the previous day.
Your body and brain cannot fully complete the 4 Rs while you are awake and interacting with your environment, which is why we need to have a sleep period each day.
What Happens When We Don’t Get Enough Sleep?
You cannot appropriately complete the 4 Rs. Without sufficient sleep our bodies will not function optimally and learning will be impaired.
How Much Sleep Do I Need?
There is population variability in how much sleep a person needs and the amount of sleep that you need changes with age. Most teenagers need to average 8–10 hours in bed per night to be fully rested. From our early 30s through old age most healthy adults need to spend 7–9 hours in bed each night in order to obtain 6–7.5 hours of sleep per night.
Average recommended time in bed duration for kids of different ages.
How Can I Tell if I am Getting Enough Sleep?
You should be able to wake up each day without an alarm clock. During the day you should mostly feel alert and awake without having to ingest large amounts of caffeine. You should not be getting sleepy while driving.
Human alertness level does vary some over the course of the day so it can be normal to wake up and feel a bit sluggish and it can be normal to have a dip in your alertness and energy level in the afternoon.
The Opponent Process Model of alertness: Throughout the day and night, the brain produces 2 opposing signals, process H (sleepiness) and process C (wakefulness), which combine to determine our level of alertness. [Source: O. A. Habbal & A. A. Al-Jabri (2009) Circadian Rhythm and the Immune Response: A Review, International Reviews of Immunology, 28:1–2, 93–108, DOI: 10.1080/08830180802645050]
Is It Normal To Wake Up During the Night?
Even if you have the impression that “slept through the night”, the human brain does not actually stay asleep for 8 continuous hours. Humans sleep in approximately 90 minute cycles, moving through different types or stages of sleep within each cycle. After a sleep cycle is complete, the brain wakes up partially or fully, briefly checks in with your body and environment and changes your body position before beginning the next sleep cycle. If you get up to use the bathroom during the night this usually occurs between sleep cycles and doesn’t typically reduce your sleep quality for the night. If you develop a habit of checking the clock or an electronic screen during the night this will draw your attention to these natural awakenings and may prolong them. We also sleep less deeply the closer we are to the morning and can start to have some awareness of our surroundings in the final sleep cycles. Our sleep is also less deep and more easily reversible when we sleep in a new environment or feel anxious.
Above is an idealized “hypnogram” (sleep graph) for a young adult. Researchers can tell what stage of sleep a person is in by looking at the pattern of brainwaves collected from electrodes on the person’s scalp. We alternate through the different stages of sleep throughout the night with a brief awakening after each 90 minute cycle. (Source: https://uc-lab.in.htwg-konstanz.de/blogging/sleep-vital-signals-during-sleep-and-sleep-disorders.html)
How Do I Know if my Sleep is Normal?
Pop media often gives you the impression that normal healthy sleep only looks 1 way: You fall asleep as soon as your head hits the pillow, sleep deeply throughout the night, and suddenly wake up 8–8.5 hours later feeling fully restored, fully awake and ready to take on the day. While it is true that some healthy people do have this sleep pattern, there is natural variation in the population in how we sleep. Some people have lighter sleep than others and are more aware of natural awakenings during the night. Other people sleep very deeply and have difficulty awakening even during a crisis. Some people need less sleep or more sleep than the average person. All human traits have variability within the population to help ensure survival of the species and sleep is no exception. If you have healthy life habits (including diet, exercise, social connection, sense of purpose), healthy sleep habits (regular sleep schedule, sufficient time for sleep, a bedroom that is cool, dark and quiet at night), have techniques to manage stress and anxiety and feel alert during the day the chances are good that your sleep is normal, regardless of how it looks.
The bell shaped curve above represents the distribution of various traits in a population. Below the curve are some sleep traits that we know to be variable in the population.
Is the Sleep of a Teenager Different than the Sleep of an Adult?
Yes. Like the rest of human physiology, sleep changes throughout our lives. Sleep generally gets lighter as we age and the amount of sleep that we need decreases. You can see this illustrated in the hypnograms below. Additionally, our preferred timing of sleep changes by about 2 hours over the course of our lives, getting later and later during puberty, then earlier and earlier again starting in the mid-20s. This age-related change in sleep timing is seen in cultures around the world and even in some other primates. This means that as a teenager it is very hard to fall asleep before 11AM and to wake up before 8AM. Sleep researchers advocate for high schools to start at 9AM or later in order to accommodate this change in biology.
As we age, there are more awakenings during the night and the amount of deep sleep decreases, especially in the second half of the night. (Source: Challamel M.J., Thirion M. and Appleton & Lange, Kandel, Schwartz, Jessell, Principles of Neural Science.)
This graph shows how preferred timing of sleep changes with age, with higher “chronotype” values representing later bedtimes and wake up times. The average preferred bedtime is about 2 hours later at age 20 compared to at age 50. Filled circles represent females; open circles represent males; the grey line shows the averages for the entire population. (Source: Roenneberg T, Kuehnle T, Juda M, Kantermann T, Akllebrandt K, Gordijn M, Merrow M. Epidemiology of the human circadian clock. Sleep. Med. Rev. 2007;11:429–438.)
Is it Better to Pull an All-Nighter Studying or to Study Less and Get Some Sleep?
Sleep! Staying up all night studying is actually counterproductive. Numerous studies have shown that you need sleep in order to be able to remember what you have learned. Even a short nap boosts performance on an afternoon test after a morning study session compared with staying awake. Cognitive performance is also impaired after a night without sleep. This means that after an all night cram session you will not be able to think clearly when you take the test and are unlikely to be able to remember the last-minute knowledge you have tried to cram in.
Why Do I Get Sleepy While Driving?
Sleepiness while driving is extremely dangerous. Common causes of drowsy driving include insufficient nocturnal sleep, driving late at night or very early in the morning when you are used to being asleep, an undiagnosed sleep or medical disorder, medications and/or elicit substances. The National Highway Traffic Safety Administration conservatively estimates that 100,000 police-reported crashes are the direct result of driver fatigue each year. This results in an estimated 1,550 deaths, 71,000 injuries, and $12.5 billion in monetary losses. (Source: https://drowsydriving.org/about/facts-and-stats/) If you ever start to feel sleepy while driving, pull over immediately and let someone else drive or take a short nap or get out of the car and walk around to wake yourself up, and/or have caffeine. Turning on the radio, calling a friend, eating, opening the window are not sufficient to prevent you from falling asleep and crashing your car. Once you are safely home, analyze why you were so sleepy during the drive and try to figure out ways to prevent it from happening again (for instance by avoiding driving at that time in the future, getting more sleep on a nightly basis, taking a short nap before driving).
Improving Sleep
How Can I Improve My Sleep Quality?
The secret to good sleep is actually the same as the secret to good overall health: healthy lifestyle habits. The healthy lifestyle habits we normally think of are eating a healthy diet (a whole food plant based diet is best) and getting regular exercise. For sleep in particular we also think about adopting healthy sleep habits. Healthy sleep habits include the following:
- Keeping a regular sleep schedule that allows for sufficient sleep, ideally allowing you to wake up naturally each day without an alarm clock. Aim to have a 2 hour range of bedtimes and a 1 hour range of wake times during the week and weekends. (such as bedtime 10PM-Midnight, wake time 7AM-8AM)
- Spend at least 2–4 hours outdoors each day with appropriate sun protection. Keep indoor lighting as bright as possible during the hours when the sun is in the sky.
- Use warmer tinted or blue free artificial lights in the 2 hours before bed and try to avoid using an electronic screen during this time. If you must use an electronic screen, try to reduce your exposure to blue light by setting the screen to a dim level and warm tint or wearing orange/amber-colored glasses.
- Avoid reading news or social media for 1 hour before bedtime.
- Keep your smartphone away from the bed, charging it either across the room or in another room. Turn off all notifications at night, do not check your phone during the night.
- Cool your bedroom over the course of the night to a minimum of 58–65 degrees by the morning.
Can I Catch Up on Sleep by Sleeping in on Weekends?
No, you can partially reverse some of the deficits caused by insufficient weekday sleep by allowing for more sleep on weekends but you cannot completely catch up. We now know that sleep schedule regularity is as important as obtaining sufficient sleep each night. You should aim to keep the same sleep schedule every day of the week, varying your bedtime by no more than 2 hours and your wake time by no more than 1 hour. We typically have little control over our wake time during the week but we have a lot of control over our weekend bedtimes. One of the best things you can do for your sleep is go to sleep at the same time on weekends as on weekdays (or even earlier if you can manage it). This may feel like a huge bummer but it will help to keep your sleep as healthy as possible. Allow yourself a major fluctuation from your typical sleep pattern no more than once per month.
Above is a diagram of a typical teenage sleep schedule. The black bars represent weekday sleep and the white bars represent weekend sleep. Notice how the teen shifts his/her schedule dramatically each weekend. This type of sleep schedule is referred to as “social jetlag” and is incompatible with optimal sleep quality. (Source: Russell G. Foster, Stuart N. Peirson, Katharina Wulff, Eva Winnebeck, Céline Vetter, Till Roenneberg, Chapter Eleven — Sleep and Circadian Rhythm Disruption in Social Jetlag and Mental Illness, Progress in Molecular Biology and Translational Science, Academic Press, Volume 119, 2013, Pages 325–346)
How Can I Help Myself Fall Asleep Faster at Night?
The best way to help yourself fall asleep quickly at night is to keep the same bedtime every night of the week, including on weekends. Staying up later on weekends makes it very difficult to get to sleep during the school week. Other helpful techniques are avoiding blue light from artificial lighting and screens for 1–2 hours before bed (including when you are in the bathroom), avoiding afternoon caffeine, avoiding social media and news before bed and creating a calming bedtime routine. Your bedtime routine can include stretching, mindfulness/meditation or deep breathing, writing down a gratitude list (see https://www.winona.edu/resilience/Media/Gratitude-Journal-Worksheet.pdf), writing a to-do list, writing in a journal, writing down any worries you have been thinking about, reading a physical book with a blue-free booklight, listening to music, listening to a podcast or any other activities you find relaxing. Browsing your phone or watching YouTube videos before bed is not recommended, even if it feels relaxing.
How Can I Help Myself Wake Up More Easily in the Morning?
The most helpful way to wake up more easily is to keep the same wake time every day of the week, including on weekends. Once you wake up, make things as bright as possible, opening up all the window shades and turning on all the lights. Splash cold water on your hands and face and/or take a cold shower. If you can manage it, going for a 30 minute walk outdoors within the first hour of waking is a great way to wake up more easily in the morning.
Is it Good to Take Naps?
In general, yes. A short afternoon nap can be restorative and improve alertness and memory for the rest of the day. Napping for more than 30 minutes, however, can make you feel more sleepy when you wake up and can make it harder to fall asleep at night.
Sleep and Health
Have I Permanently Harmed my Brain if I did not Get Enough Sleep as a Teenager?
No! It is never too late to adopt healthy sleep habits. If you are not getting proper sleep you are not functioning optimally but you can improve your function immediately with further gains over time by starting to get sufficient sleep.
What Happens if You Don’t Sleep for a Week Straight, are There any Side Effects?
In 1964, 17-year-old Randy Gardner stayed awake for 11 days and 25 minutes (264.4 hours) in a successful attempt to break the world record for longest time spent awake. The previous record holders all apparently used amphetamines to stay awake, but Randy did not and relied on his friends and Stanford Sleep Professor William Dement to keep him awake. He likely did sleep for very short periods of time throughout this experiment (“microsleeps”). He had some difficulties with concentration and mood during the experiment and may have experienced some paranoia and hallucinations. Overall though, he appeared to emerge from the experiment mostly unscathed and went back to his baseline sleep pattern after just 2 nights of recovery sleep. He does report having insomnia later in life, which he attributes to his sleep deprivation experiment. (See https://en.wikipedia.org/wiki/Randy_Gardner_(record_holder). In general, however, prolonged periods of sleep deprivation are not recommended. Acute, prolonged sleep deprivation also impairs your ability to make decisions, impairs your balance and coordination, impairs your metabolism (making you crave and eat more unhealthy foods), impairs your immune system, and puts you at risk of injury due to suddenly falling asleep without warning. In animals, death occurs after a very extended period of total sleep deprivation for reasons that are still not completely understood. There have been several media reports of deaths in video game addicts after prolonged video game marathons.
Is Caffeine Bad for You?
In short, we are not sure. Caffeine is a stimulant that works primarily by blocking the adenosine receptors in your brain, keeping your brain from receiving the signal that it is tired. Moderate amounts of caffeine intake from natural sources (coffee and tea) have not been clearly found to be associated with any adverse health outcomes. However, because around 90% of adults in America consume caffeine daily this research is somewhat limited (Source: Fulgoni. AJCN. 2015). Drinking pure caffeine extract in an energy drink, soda or taking a caffeine pill is not recommended. Unfortunately, our brains become “tolerant” to caffeine after just a few days of use, meaning that we will no longer feel an increase in alertness. Once we have been drinking caffeine on a regular basis, our brain begins to expect that it will get caffeine and we will feel sluggish if we do not receive the expected dose at the expected time. When our brain finally does get the expected dose of caffeine, it will simply return to its baseline level of alertness, the same level it functioned at before we ever ingested any caffeine. In order to produce another boost in alertness we will need to increase the amount of caffeine ingested (for instance going from 1 to 2 cups of coffee). If a person habitually consumes a certain amount of caffeine, reducing the amount of caffeine consumption on a given day or abstaining from caffeine entirely is likely to result in withdrawal symptoms including headache, fatigue, depression, lack of motivation, sleepiness. Many sleep researchers (including myself) choose to stop drinking caffeine because we do not like being dependent on a substance in order to feel alert.
Is it Healthier to Go To Bed Early?
In general it is best to keep the sleep schedule that feels most natural to you. Some people are more morning people and some people are more night owls. Try to keep a schedule that matches your natural tendencies. Remember that bedtime and wake time preferences get naturally later during puberty. Most teenagers do well with a bedtime around 11PM and a wake time of around 8AM. Most people can shift their sleep schedule earlier by getting more sunlight in the first half of the day and reducing blue light in the evening. People with strong night owl tendencies can often reset their internal clock to earlier with a weekend camping trip (due to getting continuous sunlight during the day and eliminating artificial lighting at night).
What is the Relationship between Sleep and Mental Health Problems?
Sleep difficulties are an early symptom of mental health disorders and insufficient sleep can also predispose to mental health problems. We know that teenagers who get less sleep engage in more risk taking behaviors compared with well rested teens. Depression, anxiety, ADHD and suicide are more common in teens who report getting insufficient sleep.
What is Melatonin and Should I Take It?
Melatonin is our body’s natural darkness hormone. Melatonin is released by the pineal gland in the brain when the eyes stop detecting sunlight (in particular the blue/green part of the visible light spectrum). Melatonin circulating in your blood helps the organs in your body know that it is nighttime. Rather than taking melatonin by mouth at night you should try to get your body to make as much natural melatonin as possible by keeping the lights dim and free of blue light for 2 hours before bed. Getting plenty of sunlight during the day (with appropriate sun protection) also helps release melatonin at night.
When our eyes detect blue-green light, they send a signal directly to a “master clock” deep within our brain which regulates the release of hormones into our blood, letting the rest of the body know the time of day. The release of melatonin into the blood is suppressed by sunlight. Once the sun goes down, melatonin levels begin to rise, peaking around the midpoint of sleep and declining again as we approach the morning. (Source: https://www.researchgate.net/figure/The-circadian-clock-in-mammalsa-A-hierarchical-organization-of-the-circadian-clock_fig3_221682652; https://www.sandhillsneurologists.com/melatonin-and-sleep/)
Do Cannabis and Alcohol Improve Sleep?
No. Cannabis (both THC and CBD) and alcohol can make you feel relaxed and lead you to believe that you are sleeping better. Research shows, however, that if you look at the entire night of sleep it is worse after using cannabis or alcohol. Chronic users of cannabis and alcohol have worse sleep than people who are not chronic users and this is felt to be due to these substances worsening sleep quality over time.
Does Sleep Help with Having Good Skin?
Yes! Repair of skin damage from UV radiation and micro-traumas during the day is part of what occurs during sleep. Without proper sleep you will not be able to optimally maintain your skin health.
Common Sleep Disorders
We often use an overnight sleep study or “polysomnography” to diagnose sleep disorders. For this test, superficial electrodes are attached to the head and body to monitor brain waves, breathing, and movements. (Image Source: https://www.verywellhealth.com/what-to-expect-in-a-sleep-study-3015121)
Obstructive Sleep Apnea (OSA)
OSA is a common sleep disorder where the upper airway narrows abnormally during sleep, intermittently blocking the airflow from the nose and mouth. OSA is most commonly associated with being overweight or obese and/or having a very small jaw. The symptoms of OSA are snoring and/or a bedpartner hearing pauses in breathing during the night. A person with OSA may be overly sleepy or fatigued during the day or be overactive or inattentive (similar to attention deficit hyperactivity disorder). Patients with OSA are usually not aware of these breathing problems until they are told about them by a bedpartner or neighbor. The treatment for OSA is using a breathing machine at night called CPAP (Continuous Positive Airway Pressure).
In patients with Obstructive Sleep Apnea the upper airway collapses intermittently throughout the night, blocking the flow of air. A Continuous Positive Airway Pressure (CPAP) machine corrects this problem by providing a steady stream of pressurized air, stenting the airway open.
Insomnia
Insomnia is difficulty falling or staying asleep accompanied by a feeling of impaired daytime function due to these sleep difficulties. The most common causes of insomnia are Obstructive Sleep Apnea, stress, anxiety, depression, alcohol and/or cannabis dependence, and poor sleep habits, especially keeping a different sleep schedule on weekends. The treatment for insomnia is a program called Cognitive Behavioral Therapy for Insomnia where you learn to better understand your sleep, reduce nocturnal stress and anxiety, and to manipulate your sleep and wake habits to improve your sleep quality. Any contributing sleep or psychiatric disorders should also be addressed (such as OSA, anxiety, depression). Use of over-the-counter (diphenhydramine, cannabis, CBD) or prescription sleep medications is falling out of favor as these substances do not improve overall health or daytime function.
Hypersomnia
Hypersomnia is being overly sleepy during the day, quickly falling asleep during low stimulation activities or when you do not intend to fall asleep. People with hypersomnia may also require extremely long overnight sleep durations. The most common cause of hypersomnia is simply insufficient nighttime sleep or a very irregular sleep/wake schedule. Other causes are Obstructive Sleep Apnea, Narcolepsy Type 1 (an autoimmune disorder that destroys wakefulness-promoting cells in the brain), psychiatric disorders such as Bipolar disorder, or medications used to treat psychiatric disorders. Hypersomnia is most commonly treated by helping a patient figure out how to get sufficient sleep at night on a regular schedule. Scheduled naps may be helpful. Medications are often needed to treat Narcolepsy Type 1.
Circadian Rhythm Disorders/Disturbances
A “circadian rhythm” is a biologic process that repeats every 24 hours at approximately the same time. In Sleep Medicine, circadian rhythm disorders are when a patient’s internal clock does not align with the clock of the world around them. Patients with circadian rhythm disorders may have difficulty falling asleep at night and waking up in the morning (Delayed Sleep Phase Syndrome) or fall asleep earlier and wake up than they would like (Advanced Sleep Phase Syndrome) or have an irregular sleep/wake rhythm (Irregular Sleep Wake Disorder or non-24). The most common cause of a circadian rhythm disorder is the biologic phase delay of adolescence, where the natural wake and rise time of adolescents gets later and later from the start of puberty through the early-mid 20’s. Neurologic disorders such as Parkinson’s and Alzheimer’s disease are another common cause. Lack of adequate sunlight during the day and too much bright light at night are also major contributors. Treatment for circadian rhythm disorders typically involves timed bright light exposure, timed dim light exposure and/or oral melatonin.
Parasomnias
A parasomnia is any abnormal or unusual behavior that occurs during the night. Some common parasomnias are sleep talking, sleep walking, sleep paralysis, catathrenia and REM Sleep Behavior Disorder. The most common causes of parasomnias are an irregular sleep-wake schedule and genetics. Treatment involves regularizing one’s sleep-wake schedule, allowing for sufficient sleep, improving one’s sleep environment and sometimes medications such as melatonin (used primarily for REM Sleep Behavior Disorder).
Restless Leg Syndrome (RLS)
RLS is a feeling of discomfort or restlessness in the legs, typically occurring in the evening and early night and accompanied by an irresistible urge to move. Telling a patient with RLS to stay still will exacerbate the feeling to the point of severe discomfort and their legs may begin to kick involuntarily. Patients with RLS usually also have increased leg movements during sleep called Periodic Limb Movements of Sleep. The most common causes of RLS are an irregular sleep-wake schedule, alcohol and other substances, poor diet, excessive sugar intake and genetics. The treatment of RLS involves improved dietary quality, improved sleep habits, cessation of alcohol use and sometimes supplemental iron by mouth or intravenously.
Dreams
What is Lucid Dreaming?
Lucid dreaming is where you become aware that you are dreaming during a dream. Most people can train themselves to be able to lucid dream if they are interested in doing so. Here is a link: https://theconversation.com/im-a-lucid-dream-researcher-heres-how-to-train-your-brain-to-do-it-118901
Why do We Dream and Why Do We Have Nightmares?
No one really knows for sure why we dream. It is unclear if dreaming is just a byproduct of work that our brains need to do at night, reorganizing data that was acquired during the day, or whether the dream content has a purpose of its own. Typically the emotional feeling behind a dream reflects our emotional state that evening: for instance, if we are anxious about an upcoming project we may have a dream that we are running late to catch a plane, or packing for a trip but forget to bring many items. The specific content of the dream may be influenced by things we have encountered in real life recently, such as people we met who reminded us of other people we know but haven’t seen recently. For example, I once had a dream about penguins and couldn’t figure out why. The next day on my drive to work I realized there was a sign with a penguin on it at a stoplight where I frequently had to wait. I think my subconscious brain saw the penguin and wove it into a dream. Our brains may also use dreaming to practice firing a sequence of neurons that is needed to execute specific movements. Our brain paralyzes our bodies during Rapid Eye Movement Sleep (about 20% of the night) which may be so we can practice these movement pathways without actually moving.
Nightmares may occur if we are feeling afraid during the day, or if we need to process a trauma which happened recently or in the remote past. Sometimes nightmares happen for no clear reason. There is some evidence that having nightmares soon after a trauma is helpful in allowing your brain to recover from the trauma. When the nightmares after a trauma continue to occur long after the trauma or cause significant distress to the person having the nightmares, that person may need treatment. The recommended treatment for persistent nightmares is a type of therapy called Imagery Rehearsal Therapy.
Other Questions about Sleep
Why Do I Sometimes Feel Like I’m Falling?
When we fall asleep at night or wake up during the night we can have something called “hypnic jerks” where our legs kick, or we feel like we are falling, or we feel a weird shock in our head, a shaking in our body or even hear a short noise. These phenomena are poorly understood but are felt to be caused by changes the brain and body need to make during the transition between sleep and wakefulness. Hypnic jerks are more common when we are sleep deprived, keeping an irregular sleep schedule or are stressed.
Why Do Growth Hormones Activate When We are Sleeping?
Growing requires a lot of resources from our brain and body and we can’t adequately mobilize these resources while awake. In fully grown adults, growth hormone release at night helps to keep our muscles, fat and metabolism healthy.
Can You Sleep with Your Eyes Open?
Yes! If you are sleep deprived enough you can sleep with your eyes open and even while walking (for very brief periods of time). The quality of this sleep will be severely impaired but it will still provide a bit of restorative function. Some people’s eyes don’t close completely and therefore they constantly sleep with their eyes partially open (called nocturnal lagophthalmos). When the eyes don’t fully close for sleep your eyes can dry out too much, leading to vision problems.
About Me and My Career Path as a Sleep Medicine Physician:
I first became interested in sleep as a child when I experienced intermittent insomnia, having difficulty falling asleep at night or waking up during the night with difficulty falling back to sleep. In high school and college instead of insomnia I mostly experienced self-imposed sleep deprivation, staying up late to complete homework and extracurricular activities. A turning point was in college when I realized that I was falling asleep during some of my classes and missing important things. I started listening to my body and sleeping when I was tired at night, even if that meant less time for studying, and rapidly experienced improvements in how I felt physically, in my mood and my academic performance. After college, I went to medical school and took a year off to do research on the cognitive effects of sleep deprivation. Doing sleep research was really fun and part of the job involved keeping subjects awake at night so we could study them in a sleep deprived state. During my medical training I again experienced extreme sleep deprivation first-hand and also continued to experience intermittent insomnia. After completing my training in Neurology (a medical specialty which helps people with disorders of the nervous system) I decided to do a fellowship in Sleep Medicine, which would allow me to treat patients with sleep disorders. I loved my fellowship and decided to make Sleep Medicine my permanent job.
My job as a Sleep Medicine doctor involves seeing patients in clinic who report being too sleepy (hypersomnia), not sleepy enough (insomnia), have breathing problems during the night (snoring and sleep apnea), have difficulty keeping the sleep schedule they want to keep (circadian rhythm disorders), or do unusual things during the night (parasomnias). To diagnose what problem a patient is having we often have to do an overnight sleep study, either in the sleep lab (polysomnography) or at home (home sleep test) or have them track their sleep with a clinical grade sleep tracker and/or sleep diary. I help these patients by prescribing a CPAP machine if they have breathing problems or, for most other sleep problems, by helping them better understand their sleep patterns and learn tools to improve their sleep. I almost never prescribe medications to patients because we have now learned that the secret to healthy sleep is actually the same as the secret to overall good health: healthy diet, healthy lifestyle, a regular sleep/wake schedule, and helpful coping mechanisms when stressors come up.
Getting Help
Who Can I Talk to if I Think I Have a Sleep Problem?
A good place to start is by talking to your pediatrician. You can also use google to find a Sleep Medicine Physician in your area. Feel free to email me at mjonelis@redwoodpulmonary.net and I can help you find someone who can help you.
Online Resources:
https://www.cdc.gov/sleep/index.html
https://www.sleepfoundation.org
