Insomnia Series: Read This If You Wake Up During The Night And Can’t Fall Back Asleep

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It’s frustrating when you collapse into bed at night, only to conk out for a few hours before suddenly finding yourself wide awake and staring at your ceiling. (Or, even worse, listening to your partner snooze away on the other side of the bed.)

The phenomenon is hardly uncommon. A study published in the Journal of Psychiatric Research found that 35 percent of the general population deals with middle-of-the-night insomnia at least three nights a week, and 23 percent wake up at least once every night.

Curious how to halt the issue and get the zzzs you deserve? Below, sleep experts share why you might be waking up at night and some ways to stop it:

The problem: You bring stress into the sheets.

Even if you don’t actively feel stressed when it’s time to sleep, underlying stress may be the reason you’re waking up unprompted in the middle of the night.

To help with this, work on making your bedroom into a sleep sanctuary, said Rebecca Robbins, a postdoctoral fellow at the NYU School of Medicine and a consultant for mattress maker Beautyrest. This doesn’t mean you have to shell out a ton of cash on pricey décor, but you should make sure your bedroom is a place that promotes quiet, calm and darkness.

This might mean swapping shades for room-darkening blinds, or investing in a weighted blanket if you think it would be helpful to decompress at night (there’s little scientific evidence on the effectiveness of these, but many find them comforting regardless).

One thing to investigate is your mattress. A 2009 study published in the Journal of Chiropractic Medicine found that an old mattress can increase stress levels, as back pain and the poor sleep associated with it is linked to increased levels of cortisol (the hormone responsible for stress) in the body.

The Better Sleep Council, an advertising collaborative of mattress manufacturers, recommends replacing your mattress every seven years. An easy test for your pillow is to fold it in half, says the National Sleep Foundation, a sleep research and education nonprofit partly funded by sleep-industry companies. If it stays that way, it’s time for new ones.

As for a racing mind that’s keeping you awake? If it’s been more than 20 or 30 minutes, get out of bed and go to a different room. Otherwise, your brain will start to associate your mattress with being awake, according to Steve Orma, a clinical psychologist and author of Stop Worrying and Go to Sleep: How to Put Insomnia to Bed for GoodYou can also try writing down what’s worrying you as a way to dump out what’s floating around in your brain.

The problem: There’s too much noise or movement.

The stage of sleep you’re in ― whether it’s the rapid eye movement phase (a deep level of sleep) or one of the non-rapid eye movement periods (which can be a lighter stage of sleep) ― will determine how easily you wake up to sound in your bedroom.

Noises like snoring, a loud radiator, or traffic are all sounds that likely won’t affect you during REM sleep, but they can wake you up as you transition through the lighter NREM sleep stages, said Nate Watson, a scientific advisory board member at SleepScore Labs, which sells an array of sleep-related apps and products. Watson also is a former president of the American Academy of Sleep Medicine, a professional group.

When noise awakens you, there are a few things you can do to get back to sleep. Watson recommended a white noise machine, as consistent ambient noise will prevent spontaneous sounds such as snoring, coughing or old creaky pipes from stirring you awake. (A 2005 study published in Sleep Medicine corroborates this suggestion. It found when patients in an intensive care unit used a white noise machine, sleep disruptions caused by high-peak noises where reduced.)

If you sleep with a partner who tends to toss and turn, Watson said having separate mattresses side-by-side instead of one mattress can help prevent disturbances from too much movement. If you go this route, you can buy a foam mattress connector that will keep the bed together, still looking and essentially functioning as one bed.

The problem: You’re drinking too much before bed.

This includes both alcoholic and non-alcoholic drinks. A study published in Alcoholism: Clinical & Experimental Research found that while drinking booze before bed may cause some to fall asleep easier, it can lead to sleep disruptions later in the night, causing you to wake up and have difficulty getting back to sleep.

If you enjoy a glass of wine before bed, keep it to just that, Robbins said. And keep in mind that a standard serving of wine is four ounces, which may be much less than you typically pour yourself. As for fluids in general, try to cut them off 90 minutes before bed. It’ll help minimize your chances of waking up in the middle of the night to go to the bathroom, Robbins added.

The problem: You may have an underlying health issue.

Generally, it’s OK if you have occasional sleep disruption. “Everybody has a bad night’s sleep every now and then,” Watson said. “This is normal and doesn’t require treatment.”

Watson said over-the-counter remedies are fine for these instances, such as products with the ingredient diphenhydramine HCL, like ZzzQuil, or melatonin. Just make sure to monitor how frequently you’re using these. If you lean on them too often, you might have an underlying issue you need to get checked.

“When use of sleep aids becomes regular, it suggests a sleep disorder is present and you should see a health care provider to get to the root cause of the problem,” Watson said.

Talk to your doctor to rule out a condition like obstructive sleep apnea, restless leg syndrome or even something as simple as nighttime heartburn, Watson said.


Insomnia Series: The Purpose Of Sleep

NY Times Article Here

Over the years, scientists have come up with a lot of ideas about why we sleep.

Some have argued that it’s a way to save energy. Others have suggested that slumber provides an opportunity to clear away the brain’s cellular waste. Still others have proposed that sleep simply forces animals to lie still, letting them hide from predators.

A pair of papers published on Thursday in the journal Science offer evidence for another notion: We sleep to forget some of the things we learn each day.

In order to learn, we have to grow connections, or synapses, between the neurons in our brains. These connections enable neurons to send signals to one another quickly and efficiently. We store new memories in these networks.

In 2003, Giulio Tononi and Chiara Cirelli, biologists at the University of Wisconsin-Madison, proposed that synapses grew so exuberantly during the day that our brain circuits got “noisy.” When we sleep, the scientists argued, our brains pare back the connections to lift the signal over the noise.

In the years since, Dr. Tononi and Dr. Cirelli, along with other researchers, have found a great deal of indirect evidence to support the so-called synaptic homeostasis hypothesis.

It turns out, for example, that neurons can prune their synapses — at least in a dish. In laboratory experiments on clumps of neurons, scientists can give them a drug that spurs them to grow extra synapses. Afterward, the neurons pare back some of the growth.

Other evidence comes from the electric waves released by the brain. During deep sleep, the waves slow down. Dr. Tononi and Dr. Cirelli have argued that shrinking synapses produce this change.

Four years ago, Dr. Tononi and Dr. Cirelli got a chance to test their theory by looking at the synapses themselves. They acquired a kind of deli slicer for brain tissue, which they used to shave ultrathin sheets from a mouse’s brain.

How to Get a Better Night’s Sleep

How do you become a more successful sleeper? Grab a pillow, curl up and keep reading to find out.

Luisa de Vivo, an assistant scientist working in their lab, led a painstaking survey of tissue taken from mice, some awake and others asleep. She and her colleagues determined the size and shape of 6,920 synapses in total.

The synapses in the brains of sleeping mice, they found, were 18 percent smaller than in awake ones. “That there’s such a big change over all is surprising,” Dr. Tononi said.

The second study was led by Graham H. Diering, a postdoctoral researcher at Johns Hopkins University. Dr. Diering and his colleagues set out to explore the synaptic homeostasis hypothesis by studying the proteins in mouse brains. “I’m really coming at it from this nuts-and-bolts place,” Dr. Diering said.

In one experiment, Dr. Diering and his colleagues created a tiny window through which they could peer into mouse brains. Then he and his colleagues added a chemical that lit up a surface protein on brain synapses.

Looking through the window, they found that the number of surface proteins dropped during sleep. That decline is what you would expect if the synapses were shrinking.

Dr. Diering and his colleagues then searched for the molecular trigger for this change. They found that hundreds of proteins increase or decrease inside of synapses during the night. But one protein in particular, called Homer1A, stood out.

In earlier experiments on neurons in a dish, Homer1A proved to be important for paring back synapses. Dr. Diering wondered if it was important in sleep, too.

To find out, he and his colleagues studied mice genetically engineered so that they couldn’t make Homer1A proteins. These mice slept like ordinary mice, but their synapses didn’t change their proteins like the ones in ordinary mice.

Dr. Diering’s research suggests that sleepiness triggers neurons to make Homer1A and ship it into their synapses. When sleep arrives, Homer1A turns on the pruning machinery.

To see how this pruning machinery affects learning, the scientists gave regular mice a memory test. They put the animals in a room where they got a mild electric shock if they walked over one section of the floor.

That night, the scientists injected a chemical into the brains of some of the mice. The chemical had been shown to block neurons in dishes from pruning their synapses.

The next day, the scientists put all the mice back in the chamber they had been in before. Both groups of mice spent much of the time frozen, fearfully recalling the shock.

But when the researchers put the mice in a different chamber, they saw a big difference. The ordinary mice sniffed around curiously. The mice that had been prevented from pruning their brain synapses during sleep, on the other hand, froze once again.

Dr. Diering thinks that the injected mice couldn’t narrow their memories down to the particular chamber where they had gotten the shock. Without nighttime pruning, their memories ended up fuzzy.

In their own experiment, Dr. Tononi and his colleagues found that the pruning didn’t strike every neuron. A fifth of the synapses were unchanged. It’s possible that these synapses encode well-established memories that shouldn’t be tampered with.

“You can forget in a smart way,” Dr. Tononi said.

Other researchers cautioned that the new findings weren’t definitive proof of the synaptic homeostasis hypothesis.

Marcos G. Frank, a sleep researcher at Washington State University in Spokane, said that it could be hard to tell whether changes to the brain at night were caused by sleep or by the biological clock. “It’s a general problem in the field,” he said.

Markus H. Schmidt, of the Ohio Sleep Medicine Institute, said that while the brain might prune synapses during sleep, he questioned whether this was the main explanation for why sleep exists.

“The work is great,” he said of the new studies, “but the question is, is this a function of sleep or is it the function?”

Many organs, not just the brain, seem to function differently during sleep, Dr. Schmidt pointed out. The gut appears to make many new cells, for example.

Dr. Tononi said that the new findings should prompt a look at what current sleeping drugs do in the brain. While they may be good at making people sleepy, it’s also possible that they may interfere with the pruning required for forming memories.

“You may actually work against yourself,” Dr. Tononi said.

In the future, sleep medicines might precisely target the molecules involved in sleep, ensuring that synapses get properly pruned.

“Once you know a little bit of what happens at the ground-truth level, you can get a better idea of what to do for therapy,” Dr. Tononi said.