Additionally, after a thirty-hour shift without sleep, residents make a whopping 460 percent more diagnostic mistakes in the intensive care unit than when well rested after enough sleep. Throughout the course of their residency, one in five medical residents will make a sleepless-related medical error that causes significant, liable harm to a patient. One in twenty residents will kill a patient due to a lack of sleep.
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 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.
Sleep medications, which are most useful for short-term sleeplessness, do require some caution, because they can result in hangovers the next day, or, even worse, lead you to eat, amble about, and even drive while asleep, with no memory of having eaten, ambled about, or driven. The FDA suggests that if you take Ambien, in particular, and at certain dosages, you shouldn’t drive the next day, or take part in other activities that necessitate your being completely awake, because the drug can remain in your system at levels that may affect your functioning.
Another method for determining your sleep need is to take a "sleep vacation." During a two-week period, when you have a flexible schedule or perhaps are on vacation, pick a consistent bedtime and do not use an alarm clock to wake up. Chances are that for the first few days or week you will sleep longer because you'll be paying off your "sleep debt"—the amount of sleep deprivation that you've accumulated over a period of time. If you continue going to bed at the same time and allowing your body to wake up naturally, you will eventually establish a pattern of sleeping essentially the same amount of time each night, probably in the range of 7 to 9 hours. Congratulations! You've identified the amount of sleep that you need.
That doesn’t mean that you should never use medication, but it’s important to weigh the benefits against the risks. In general, sleeping pills and sleep aids are most effective when used sparingly for short-term situations, such as traveling across time zones or recovering from a medical procedure. If you choose to take sleeping pills over the long term, it is best to use them only on an infrequent, “as needed,” basis to avoid dependence and tolerance.
Everyone needs sleep, but its biological purpose remains a mystery.  Sleep affects almost every type of tissue and system in the body – from the brain, heart, and lungs to metabolism, immune function, mood, and disease resistance.  Research shows that a chronic lack of sleep, or getting poor quality sleep, increases the risk of disorders including high blood pressure, cardiovascular disease, diabetes, depression, and obesity.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.
For those who have difficulty with insomnia, there are a handful of options to help you sleep. One treatment option is sleep restriction. This involves limiting the amount of time that you spend in bed (often to 7-8 hours) so that the time you are there you are more likely to spend asleep. It can also be useful to observe a behavioral change called stimulus control. Stimulus control helps break the association between your bedroom and not being able to sleep.
Cognitive behavioral therapy for insomnia (or CBT-I) is shown to be incredibly effective for chronic sleep problems, according to the Mayo Clinic. While sleeping pills and other sleep aids may only treat the symptoms of insomnia, CBT-I helps identify the root of the problem, but it takes time and dedication, with regular visits to a clinician who may give you various sleep assignments to try at home and ask you to keep a sleep diary.
Another common anxiety that lurks in the wee-hours of a sleepless night is the mounting awareness that you're not asleep when you should be. Stress and frustration – not typically emotions that welcome relaxation – escalate as you fret about how you need to be up for work in four (or three or two) hours. The experts' suggestion? Get rid of time cues. "No clock watching," Walia says, "That's a big no-no. Turn the clock around."

lenetstan/shutterstockInsomniacs, prepare for the best night’s sleep ever. That’s right: No more tossing and turning into the wee hours of morning. No more counting sheep on Sunday evenings. And no more lying, wide-eyed, in the dark after waking up in the middle of the night. There’s now an easy—and expert-approved—way to fall asleep in less than a minute.
Sometimes counting sheep just doesn't get the job done. For over-the-counter support for a good night's sleep, Good Sense's Sleep Aid Doxylamine could be just what you need to get you over the hurdle and off to Dreamland. The active ingredient, doxylamine, helps calm the brain and lets you forget about all the things going on in your world. Each tablet contains 25 mg of doxylamine succinate.
Valerian research is more contradictory than that pertaining to melatonin. One valerian study found no benefit to taking the herb at the 14-day mark but discovered that it “greatly improved sleep” after 28 days. Dr. Goldstein confirmed this, noting that, while valerian will work for some “super sensitive” people the first time they take it, for others it may need to build up in their system for weeks before they start to notice any changes (though she notes that the same has been said about melatonin).
Goel, N., Kim, H., & Lao, R. P. (2016, October 27). An olfactory stimulus modifies nighttime sleep in young men and women. Chronobiology International, 22(5), 889–904. Retrieved from https://www.researchgate.net/profile/Namni_Goel/publication/7469424_An_Olfactory_Stimulus_Modifies_Nighttime_Sleep_in_Young_Men_and_Women/links/5811f6b408ae9b32b0a34d4b.pdf

SOUND: We focus on sound a lot. Quiet environments are going to improve your sleep quality. Your brain has these micro arousals throughout the night without you being consciously aware of it—even an air-conditioning unit turning on wakes up your brain. So blocking out noises is a low-hanging fruit to improve your sleep quality. Bose just released an earbud that you can sleep with, for example.


You've followed the usual tips for getting enough sleep — sleeping on a regular schedule, avoiding caffeine and daytime naps, exercising regularly, avoiding lighted screens before bed, and managing stress. Still, it's been weeks and a good night's sleep remains elusive. Is it time for an over-the-counter sleep aid? Here's what you need to know if you're considering medication to help you sleep.


Medicate with caution. Whether prescription or over-the-counter, Walia and Olson do not recommend drugs as a first choice for relieving sleeplessness. Ideally, the tips above and improved sleep hygiene should do the trick. But, should you choose a sleep aid, Olson reminds people that, of course, they make you sleepy. This grogginess is great at 11 p.m., but not at 7 a.m. – when you have to drive a car.
Probably not all people will be able to fall asleep this quickly all the time, especially on days when you might be upset or anxious near bedtime for whatever reason. Your best bet is not to try just one or two strategies from the article, but as many of the strategies as you can at the same time, and keep up this routine for several weeks or more.
This third one is what I study. The “synaptic homeostasis hypothesis” is this idea that during the day, we make all these connections with the world around us. It used to be like, “Don’t go over there—the lions live there now.” Now it’s like, “What did Barbara say to me in the office?” These excitatory connections we make during the day result in the neurons in our brains getting overall higher activation. Then during the nighttime when we sleep, we have a downregulating process where the things that didn’t really matter to your survival sink to the bottom, and the things that are most relevant to your survival rise to the top. What deep sleep does is all the neural processing, and what REM sleep [rapid-eye-movement sleep] and light sleep do is basically integrate that into your long-term personality and understanding of the world.

It’s actually pretty normal to wake up during the night, anyway. In The Canterbury Tales, one of the oldest manuscripts in English culture, they describe “second sleep.” There’s some evidence that we used to go to bed when the sun went down, then wake up for a little bit at night—putter around, make sure we’re not getting eaten by a lion—and then go back to sleep. So it’s pretty normal to like wake up in the middle of the night and use the bathroom or whatever.


Exercise has long been associated with higher quality sleep. While the research has mainly been done on those who don’t have insomnia, studies are suggesting that staying committed to a regular exercise routine can indeed improve the quality and duration of your sleep if you do. A study published in October 2015 in the Journal of Sleep Research showed that after six months of exercising 150 minutes a week, participants reported significantly reduced insomnia symptoms. They also had significantly reduced depression and anxiety scores. 
Watch something boring. Just about everything you read about improving sleep advises you to avoid screen time before bed. But the truth is, a lot of people do it anyway. If you’re going to watch TV or your laptop in bed, watch something unexciting. Think a Ken Burns documentary, or an episode of House Hunters. No scary movies, thrillers, or the 11 o’clock news. If it’s likely to get your pulse racing, turn it off. There’s even a website for it — Napflix, which serves up the most snooze-worthy videos on YouTube (think Bonsai tree pruning or tropical fish swimming in an aquarium).
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