Let's Talk About Sleep

There are so many aspects of the brain that we do not understand. We may never understand it because, if you think about it, we cannot just take someone's brain and start poking around. We cannot see how electrical impulse and changing chemical concentrations translates into thoughts. It's a complex network of nerves that are challenging to understand. Our brain performs actions that we are not even aware of such as heart rate, breathing, digesting our lunch, etc. It is constantly aware of everyday life without us even knowing. At the same time, we chose when to move our arm, what motor motions need to happen to hit a ball, or typing this paper. Our brain never shuts off. It is constantly running day and night. Isn’t it interesting that our brain never shuts completely down? Not even while we are sleeping. Your brain is still functioning to keep alive. Sleep is another mystery that plays into the brain. Sleep is a way for our brain to “rest” and process memories. If we can get good sleep there are restorative properties for the brain and consistently bad dreams can be harmful to our overall health.

As I have worked as a sleep tech, I have been able to more fully understand the effects that sleep has on our health and the brain. There are four stages of sleep and we call them N1, N2, N3, and REM. Throughout the night your body cycles through these stages multiple times. N1 and N2 are what is considered “garbage” sleep. This is a light sleep and there are no real benefits from these two stages. When you wake up feeling tired after getting 8 hours of sleep, it may be because most of your sleep was in N1 and N2. N3 and REM are deeper sleep and these stages have restorative properties. These are the stages we want people to get into because they will wake up feeling refreshed, at the same time, their brain has had the time to recover and restore memory. Memory loss, mood, and chronic fatigue are all effects of inadequate sleep.

A common problem with sleep is what is called sleep apnea and most of the people that we see at the sleep center usually have sleep apnea. Sleep apnea is when breathing stops and starts. Many times sleep apnea happens because the tongue falls to the back of the throat blocking the airway. Another type of sleep apnea is called central sleep apnea and this is where the brain does not tell your body to take a breath. When apneas occur there is usually an arousal. What I mean by this is that it can pull you from a deep sleep stage into a lighter stage or it can prevent someone from getting into a deep sleep. Without that deep sleep, your brain cannot restore itself and the processing of your day by the brain does not occur as efficiently. When sleep apnea goes untreated it has been linked to dementia and Alzheimer’s because the problem with sleep is causing memory problems which can further into these types of neurodegenerative. If you know you snore at night or you wake up gasping for air then you should go see if you have sleep apnea. The earlier you get diagnosed the risk of forming neurodegenerative diseases decreases. Sleep apnea is not the only sleep disorder, however, it is very common.

Sleep problems can also affect mood leading to depression or anxiety. One thing we did talk about in my abnormal psychology class was the idea of the usage of drugs in treating depression. Depression is very much a biological mental health issue that affects much of the brain, more specifically, brain chemistry. Our professor mentioned that there are two neurotransmitters that are part of depression. One is a serotonin and the other is norepinephrine. Serotonin is a hormone that plays roles in mood, food, sleep, and sex drive. Norepinephrine is the hormone that I would call the “stress” hormone; it is the hormone that runs the fight or flight response. Both of these together have their effects in causing or maintaining depression symptoms. The only thing we know is that these hormones are linked, however, we do not know how they interact and affect one another. That is why there are so many antidepressants. Some increase serotonin levels only and others only increase norepinephrine. It can take people years to find a drug that aids in the symptoms of depression because there is a balancing act that takes place with the serotonin and norepinephrine that then stabilizes someone's mood. The limit with only antidepressants is that they are a short-term treatment and maybe should not be for the long term. The only reason I do not think that they should be used long term is that once we start providing our body with something it is supposed to make we are no longer allowing our body to function at its peak. Most people can agree that good sleep could help depression but I think most of the time Ambien, a sleep aid, is prescribed. Ambien does help someone sleep but by just giving a sleep aid we do not fully understand the problem of why they are not sleeping. Again, Ambien also may not be a long term treatment. I wonder if part of the answer for a long term treatment for depression would be helping someone create a good sleep environment. Serotonin plays an important role in sleep by synthesizing melatonin. With norepinephrine, sleep could give the body rest and allow the body time to restore norepinephrine levels. A sleep study could be effective in understanding how a person sleeps, where they are having problems in their sleep, and if finding a solution to get good sleep would be effective for that person. One difficulty with this approach is social perception. I think many times people think they need a drug to be curried and would almost laugh at any doctor that said trying to prescribe them an effective sleep environment. Is it the misunderstanding of our society that almost creates more problems when it comes to one's health? It is time everyone looks at their health from a perspective of holistic medicine and less drug pushing nature. Not all doctors are pushing patients to take pills, however, many of them are. I think this is because a patient would not take a liking to a doctor who says “okay, I would like you to come in for sleep study so we can improve your sleep which will help with our depressive symptoms.” It also plays into the belief people have about being cured. If a patient walks in with high hopes and believes that sleep could fix their symptoms, sleep will make a substantial difference in their life. On the other hand, if a patient walks in believing nothing can help them, even the most advanced drugs would have limitations in resolving their symptoms.

In conclusion, the brain is a complex organism that we know little about. Sleep has been linked to dementia, Alzheimer's, depression, and anxiety. Sleep will not cure dementia but if we seek help early when we have difficulty with sleep, good sleep has been linked to reducing the risk of developing the neurodegenerative disease. With depression and anxiety, questions get asked about sleep but it is easier to push medications that dig deep into how sleep could reduce their symptoms. Sleep is important to more areas than one and sleep should have greater consideration for preventing and reducing symptoms of many diseases.