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When we sleep at night, we typically go through several sleep cycles. And each one of these cycles consists of 4 different
stages of sleep.
NREM Stage 1
This stage occurs after you have decided to sleep and your eyes are closed. During this stage—which typically lasts
between 1 and 10 minutes—you are lightly asleep, and you can quickly return to being fully awake.

Defining features
 Although you are asleep, you may wake up feeling like you didn’t sleep at all.

 Your body’s muscles are not inhibited yet: your eyes roll a little bit and you may slightly open your eyelids.

 Your breathing slows down and your heartbeat becomes regular.

 Your blood pressure and brain temperature decrease.

 The hypnic jerk we sometimes experience when falling asleep, accompanied or not by the sensation of
falling down, happens during this stage. Some say it is a vestigial reflex humans developed during the
evolutionary process to prevent them from falling off the trees they slept in.

Did you know?

People with irregular sleeping habits tend to have these hypnic jerks more often.
NREM Stage 2
When NREM Stage 2 sleep kicks in, things get serious!

Defining features
 Stage 2 sleep, which usually lasts about 20 minutes, is characterized by a slowing heart rate and a
decrease in body temperature. Your body reduces its activity to prepare you to go into a deep sleep.

 It becomes harder to wake you up.

 Your brain starts to emit larger waves.

 Your blood pressure also decreases, and other metabolic functions slow down too.

 The 2 first stages of NREM Sleep together are often referred to as light sleep.

Did you know?

We spend most of our nights in Stage 2 sleep (around 45% of total sleep duration).
NREM Stage 3
This sleep stage refers to the combined stages of what was previously separated into Stage 3 & 4 sleep.

Defining features
 This stage typically starts 35-45 minutes after falling asleep.

 As electroencephalograms show, our brain waves slow down and become larger.

 At this point, you sleep through most potential sleep disturbances (noises and movements) without
showing any reaction.

 If you actually wake up during NREM Stage sleep, there’s a high probability you are going to feel
disoriented for the first few minutes.
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Did you know?

Other names for this stage include “slow-wave sleep” and “Delta sleep.”
REM Stage 4
This is the final stage of a standard sleep cycle. The first Rapid Eye Movement sleep stage lasts around 10 minutes and
usually happens after having been asleep at least 90 minutes.

Defining features
 As its name indicates, your eyes move rapidly in all directions during Rapid Eye Movement sleep.

 It is during this stage of sleep (the deepest) that powerful dreams usually happen. Same goes
for sleepwalking and bedwetting episodes.

 This stage is also characterized by an increase of the heart and respiration rates, and their rhythms may
become irregular.

 REM stages typically get longer and longer as the night goes by, and the last REM stage can last an hour.

Did you know?

REM sleep is also known as “paradoxical sleep.” This is because the brain waves emitted during this stage seem
contradictory to sleep: Although you are sleeping, your brain waves look at lot like what can be recorded when you are fully
awake. Another aspect of this paradox is the fact that even though your brain shows heightened activity, most of your
muscles are paralyzed.
Sleep disorders
You tuck yourself under the covers, turn out the light, and look forward to eight hours of blissful slumber. But, after turning for
hours you’re still exhausted, and no closer to sleep than when you first got into bed.
Let’s talk toady about sleep disorders. Sleep disorders fall into four basic categories.
The scenario I described, in which you toss and turn because you can’t fall asleep, is called insomnia. Another type of
insomnia is when you wake up in the middle of the night and can’t get back to sleep. Sometimes people get insomnia for a
night or two because they’re stressed out over a big meeting at work, or they’re excited about an upcoming trip. Others can’t
sleep night after night, and that’s called chronic insomnia.
People with the second category of sleep disorders have a hard time staying awake during the day, even if they slept well
the night before. This is called hypersomnia. Sometimes doctors can’t find a cause for hypersomnia. But in many cases, a
health condition like fibromyalgia, a thyroid problem, a disease like mononucleosis, obesity, or obstructive sleep apnea, can
make you sleepy. If you notice a co-worker is nodding off in the middle of meetings, he might have narcolepsy, a sleep
disorder that causes people to sleep uncontrollably at inappropriate times during the day. Narcolepsy isn’t only
embarrassing, it can be dangerous if you nod off behind the wheel of a car.
A sleep rhythm problem means that you can’t stick to a normal sleep schedule. Maybe you work the night shift at your job, or
you’re always traveling to different time zones and are constantly battling jet lag. Well, whatever the cause, the lack of a
normal sleep pattern is called a sleep rhythm disorder.
And finally, there are the types of sleep disorders that wake you up with a jolt in the middle of the night, and, these are called
parasomnias, and they can severely interrupt your sleep. You may walk in your sleep, or act out your dreams. Children often
have night terrors, in which they wake up from a deep sleep in a terrified state.
The good news is that you don’t have to live on fewer hours of sleep, because there are decent treatments for sleep
disorders. If you’re struggling to sleep throughout the night, and dragging through the day as a result, talk to your doctor, who
can refer you to a sleep specialist for an evaluation.
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Insomnia is a sleep disorder that regularly affects millions of people worldwide. In short, individuals with insomnia find it
difficult to fall asleep or stay asleep. The effects can be devastating.
Fast facts on insomnia:

 There are many possible causes of insomnia.

 An estimated 30-40 percent of Americans report experiencing insomnia each year.
 Often, insomnia is due to a secondary cause, such as illness or lifestyle.
 Causes of insomnia include psychological factors, medications, and hormone levels.
 Treatments for insomnia can be medical or behavioral.

What is insomnia?

Insomnia includes a wide range of sleeping disorders, from lack of sleep quality to lack of sleep quantity. Insomnia is
commonly separated into three types:

 Transient insomnia - occurs when symptoms last up to three nights.

 Acute insomnia - also called short-term insomnia. Symptoms persist for several weeks.

 Chronic insomnia - this type lasts for months, and sometimes years, the majority of chronic insomnia cases are side
effects resulting from another primary problem.

Insomnia can affect people of any age; it is more common in adult females than adult males. The sleeping disorder can
undermine school and work performance, as well as contributing to obesity, anxiety, depression, irritability, concentration
problems, memory problems, poor immune system function, and reduced reaction time.

Causes of insomnia

Insomnia can be caused by physical and psychological factors. There is sometimes an underlying medical condition that
causes chronic insomnia, while transient insomnia may be due to a recent event or occurrence. Insomnia is commonly
caused by:

 Disruptions in circadian rhythm - jet lag, job shift changes, high altitudes, environmental noise, extreme heat or cold.

 Psychological issues - bipolar disorder, depression, anxiety disorders, or psychotic disorders.

 Medical conditions - chronic pain, chronic fatigue syndrome, congestive heart failure, angina, acid-reflux disease (GERD),
chronic obstructive pulmonary disease, asthma, sleep apnea, Parkinson's and Alzheimer's
diseases, hyperthyroidism, arthritis, brain lesions, tumors, stroke.

 Hormones - estrogen, hormone shifts during menstruation.

 Other factors - sleeping next to a snoring partner, parasites, genetic conditions, overactive mind, pregnancy.

Media technology in the bedroom

Several small studies in adults and children have suggested that an exposure to light from televisions and smartphones prior
to going to sleep can affect natural melatonin levels and lead to increased time to sleep.

In addition, a study conducted by Rensselaer Polytechnic Institute found that backlit tablet computers can affect sleep
patterns. These studies suggest that technology in the bedroom can worsen insomnia, leading to more complications.
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Medications

According to the American Association of Retired Persons (AARP), the use of some medications can cause insomnia in
some patients.

Signs and symptoms of insomnia

Insomnia itself may be a symptom of an underlying medical condition. However, there are many signs and symptoms that
are associated with insomnia:

 Difficulty falling asleep at night.

 Waking during the night.

 Waking earlier than desired.

 Still feeling tired after a night's sleep.

 Daytime fatigue or sleepiness.

 Irritability, depression, or anxiety.

 Poor concentration and focus.

 Being uncoordinated, an increase in errors or accidents.

 Tension headaches (feels like a tight band around head).

 Difficulty socializing.

 Gastrointestinal symptoms.

 Worrying about sleeping.

Sleep deprivation can cause other symptoms. The afflicted person may wake up not feeling fully awake and refreshed, and
may have a sensation of tiredness and sleepiness throughout the day.

Having problems concentrating and focusing on tasks is common for people with insomnia. According to the National Heart,
Lung, and Blood Institute, 20 percent of non-alcohol related car crash injuries are caused by driver sleepiness.

Treatment options for insomnia

Some types of insomnia resolve when the underlying cause is treated or wears off. In general, insomnia treatment focuses
on determining the cause. Once identified, this underlying cause can be properly treated or corrected.

In addition to treating the underlying cause of insomnia, both medical and non-pharmacological (behavioral) treatments may
be used as therapies.

Non-pharmacological approaches and home remedies for insomnia include:

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 Improving "sleep hygiene" - not sleeping too much or too little, exercising daily, not forcing sleep, maintaining a regular
sleep schedule, avoiding caffeine at night, avoiding smoking, avoiding going to bed hungry, and ensuring a comfortable
sleeping environment.

 Using relaxation techniques - such as meditation and muscle relaxation.

 Cognitive therapy - one-on-one counseling or group therapy.

 Stimulus control therapy - only go to bed when sleepy. Avoid watching TV, reading, eating, or worrying in bed. Set an
alarm for the same time every morning (even weekends) and avoid long daytime naps.

 Sleep restriction - decrease the time spent in bed and partially deprive the body of sleep, this increases tiredness ready
for the next night.

Medical treatments for insomnia include:

 prescription sleeping pills

 antidepressants

 over-the-counter sleep aids

 antihistamines

 melatonin

 ramelteon

Who gets insomnia?

Some people are more likely to suffer from insomnia than others; these include:

 travelers - particularly through multiple time zones

 shift workers with frequent changes in shifts (day vs. night)

 the elderly

 drug users

 adolescent or young adult students

 pregnant women

 menopausal women

 those with mental health disorders