It’s the middle of the night, and you’re staring at the ceiling, thinking about work, or bills, or the kids. Sleep just won’t come, so you reach for a sleeping pill. But did you know that sleep medications are rarely meant for more than short-term use? They can cause dependence and tolerance, and the benefits don’t always outweigh the risks. Learn what you need to know about the side effects and safety concerns of common sleep medications—as well as effective insomnia treatments that don’t come in pill form.
The brain stem, at the base of the brain, communicates with the hypothalamus to control the transitions between wake and sleep. (The brain stem includes structures called the pons, medulla, and midbrain.) Sleep-promoting cells within the hypothalamus and the brain stem produce a brain chemical called GABA, which acts to reduce the activity of arousal centers in the hypothalamus and the brain stem. The brain stem (especially the pons and medulla) also plays a special role in REM sleep; it sends signals to relax muscles essential for body posture and limb movements, so that we don’t act out our dreams.
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Many medications can interfere with sleep and turn into sleep aids that actually cause insomnia, including beta-blockers, thyroid medication, decongestants, medications containing caffeine, and certain antidepressants. If you’re having trouble sleeping, talk to your doctor about changing dosages or medications. Now, find out the 8 little changes you can make to sleep better in just one day.
Other potential health benefits: Glycine has been shown to improve both memory and attention in young adults. Scientists are actively investigating the use of glycine in the treatment of neurodegenerative disorders such as Alzheimer’s disease. Higher levels of glycine have been associated with a lower risk of heart attack, and there’s some evidence that glycine may help protect against high blood pressure. It also may help strengthen bones and joints, and guard against arthritis.
“This is a stimulus control theory,” says Meltzer. “Everything in life has a stimulus value, even your bed,” meaning your body should recognize that lying in bed means it’s time to go to sleep. To give your bed that value, the only things you should be doing in it are sleep and sex, she explains. “Getting out of bed if you can’t sleep is the hardest one to do, but it’s so important. If you’re spending 10 hours in bed, but only sleeping six, that’s really bad. Your bed becomes a place for thinking, worrying, watching TV, and not for sleeping.”
Your need for sleep and your sleep patterns change as you age, but this varies significantly across individuals of the same age. There is no magic “number of sleep hours” that works for everybody of the same age. Babies initially sleep as much as 16 to 18 hours per day, which may boost growth and development (especially of the brain). School-age children and teens on average need about 9.5 hours of sleep per night. Most adults need 7-9 hours of sleep a night, but after age 60, nighttime sleep tends to be shorter, lighter, and interrupted by multiple awakenings. Elderly people are also more likely to take medications that interfere with sleep.
During deep sleep, you get these long-burst brainwaves that are called delta waves, but during REM, your brainwaves are actually functioning very similarly to waking life. Your body is also paralyzed during REM—it’s a very noticeable physiological difference. You also lose thermo-regulation, meaning if it’s hot in your environment, your body gets hot, kind of like you’re a chameleon.
Insomnia usually becomes a problem if it occurs on most nights and causes distress or daytime effects such as fatigue, poor concentration, and irritability. It predisposes to mental disorders such as depression, anxiety disorders, and psychotic disorders; to physical problems such as infections, high blood pressure, obesity, and diabetes; and to motoring and other accidents. The relationship between insomnia and psychological symptoms is far from simple, as insomnia can both cause, and be caused by, depression, anxiety, and stress, opening up a vicious circle.
It’s tempting to reach for coffee when we’re tired after a poor night’s sleep, but drinking caffeine can make it harder for us to fall asleep at night, creating a vicious cycle. Effects of caffeine on sleep and cognition. Snel J, Lorist MM. Progress in brain research, 2011, Aug.;190():1875-7855. Can’t quit cold turkey? Try limiting caffeine intake to earlier in the day so it’s out of your system by bedtime.
See a Doctor. While lifestyle changes are the first line of treatment for sleeplessness, if you’re still not getting enough rest after improving your bedtime routine and trying a variety of relaxation strategies, a physician may be able to help determine if your sleeplessness is merely a symptom of another health concern, and prescribe appropriate treatment.