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Medical residents after their shift How to get a good night 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 rapid eye movement, or REM sleep, when the muscles are relaxed and dreaming occurs, and recent memories may be consolidated in the brain. The experts say that hitting a snooze alarm over and over again to wake up is not the best way to feel rested. 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, impairing their mental functioning during the day. New York Times, October 12, 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. According to a study published in the October issue of The Archives of Internal Medicine, cognitive behavior therapy is more effective and lasts longer than a widely used sleeping pill, Ambien, in reducing insomnia. The study involved 63 healthy people with insomnia who were randomly assigned to receive Ambien, the cognitive behavior therapy, both or a placebo. The patients in the therapy group received five minute sessions over six weeks. The patients taking Ambien were on a full dose for a month and then were weaned off the drug. At three weeks, 44 percent of the patients receiving the therapy and those receiving the combination therapy and pills fell asleep faster compared to 29 percent of the patients taking only the sleeping pills. Two weeks after all the treatment was over, the patients receiving the therapy fell asleep in half the time it took before the study and only 17 percent of the patients taking the sleeping pills fell asleep in half the time. New York Times, October 5, According to leading sleep researchers, there are techniques to combat common sleep problems: Almost one third of people with insomnia achieve normal sleep and most reduce their symptoms by 50 percent and sleep an extra minutes a night. When insomnia exists along with other psychological disorders like depression, say the experts, the initial treatment should address the underlying condition. From his clinical experience, he has found that most patients with insomnia should be examined for specific behaviors and thoughts that may perpetuate the sleep problems. When people develop insomnia, they try to compensate by engaging in activities to help them get more sleep. They sleep later in the mornings or spend excessive times in bed. These efforts usually backfire, said Edinger. From his clinical work and research on sleep, psychologist Charles M. Bedtime, waking time, time to fall asleep, number and durations of awakening, actual sleep time and quality of sleep are documented by the person suffering from insomnia. A person can develop poor sleep habits i. Some patients also develop a fear of not sleeping and a pattern of worrying about the consequences of not sleeping, said Morin. But behavioral therapies are essential for patients to alter the conditions that perpetuate it. A person can keep a sleep diary for a couple of weeks and a clinician can monitor the amount of time spent in bed to the actual amount of time sleeping. Then the clinician can instruct the patient to either go to bed later and get up earlier or visa versa. This procedure improves the length of sleeping time by imposing a mild sleep deprivation situation, which has the result of reducing the anxiety surrounding sleep. To keep from falling asleep during the day, patients are told not to restrict sleep to less than five hours. Standardizing sleep actually helps a person adjust his or her homeostatic mechanism that balances sleep, said Edinger. This helps a person come back to their baseline and works for the majority. Finally, a person can incorporate relaxation techniques as part of his or her treatment. For example, a person can give herself or himself an extra hour before bed to relax and unwind and time to write down worries and plans for the following day. In CBT, said Morin, breaking the thought process and anxiety over sleep is the goal. Interestingly, the length of the circadian cycle stays roughly the same over the lifespan but the amplitude of the circadian rhythm may decline somewhat with aging.
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