Tuesday, May 04, 2010

Are You Able To Get Back To Sleep After Waking Up?

image by lampelina, sxc.hu

Nocturnal Awakenings May Point To Deeper Malaise

Depending on age, we all reach the point when our sleep gets broken deep in the night or early in the morning. It could be nature's call, sudden shortness of breath, or some other underlying cause - or even an external stimulus such as the milkman's footsteps - that can break it. All of which is fine. The question is, after having resolved the reason for waking up, do you get back to sleep? Or do you keep staring at the ceiling, waiting for sleep to come, which it seldom does?

image by hoefi, sxc.hu

There is a subtle difference between general insomnia and nocturnal awakenings. You are in a different physiological state when you lie down in bed at the usual time, after a hard day's work, and sleep eludes and you keep tossing and turning. But when you wake up in the night, you have physiologically passed the sleep process already. The brain still wants sleep, there is still some quota of sleep left, there is an existing demand in the body to complete the balance sleep, and yet there is something that prevents the brain from fulfilling its own demand.

image by trublueboy, sxc.hu

It is no comfort that about 35.5% of the population has episodes of nocturnal awakenings at least three nights per week, and that the ladies encounter this experience more than the gents. It is also no comfort that this tendency tends to increase as you grow older, especially after 65 years of age. It doesn't help to learn that about 13% people wake up for four or more times in the same night. Nocturnal awakenings invariably translate into feeling drowsy and sleepy the following day, significantly impairing productivity and the general quality of living during the waking hours. Those who can afford can get by with naps during the day. Those who cannot, have no other choice but to take sick leave whenever possible. Don't we all resort to sleeping pills when the frequency of nocturnal awakenings within one night or across several nights increases? And then after some time, we discover that the pills are proving inadequate in their job, and so we either increase their potency or change over to some other brand.

image by porah, sxc.hu

The key finding of the paper that reported on nocturnal awakenings is that not being able to return to sleep after waking up in the night is associated with underlying malaise such as:

- overweight and obesity
- large alcohol intake
- hypertension
- gastro-esophageal reflux
- heart diseases
- bipolar disorders
- depressive disorders
- chronic pain
- restless legs syndrome
- obstructive sleep apnea

image by nelso47, sxc.hu

The direction of the association is still unclear: whether the disorder leads to the difficulty in resuming sleep, or vice versa, is not known. Unfortunately, most of the time we find it too trivial to report to the physician about our inability to resume sleep after waking up. However, if we do report, there is a chance that any problem that has remained undetected so far will come to light.

image by shawnisa, sxc.hu

Working back, therefore, and in a very simplistic way without getting into the nitty-gritty, if you have any of these issues which you may have been largely ignoring or overlooking, you might consider paying attention to them and bring them under control, first and foremost. This should bring down the episodes of nocturnal awakenings. So, the next time you meet your physician, tell them how you cannot go back to sleep after visiting the bathroom in the night.

image by paulmt, sxc.hu

[The sun rises in the east and sets in the west. It is a cyclic rhythm that the earth completes in tango with the sun and the moon, and this rhythm is synchronized with our wake-sleep cycle in inextricable ways. Call it the geometry of motion of these celestial bodies, but time appears to us to be circular, even if it moves forward in the direction of the future and never touches a point which it has once traversed and crossed. So we have the chronometer on our wrist and the calendar on the wall to give us that comfort of the deja vu, even if in reality there is no deja vu. An article dwells on the philosophical dimension of time as we perceive it in the reality of our particular universe: "The Cyclicity Of Time".]

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