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Last change: October 31, 1998.

Sleep and sleep disorders

This document was edited during october 1998. The dreaming and nightmares chapters were removed as the new article on nightmares contains more up to date information.

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Sleep patterns

Light sleeping cat You can roughly divide sleeping into light sleep and REM sleep. To explain these stages I very much like the sleeping cat examples originally used by the sleep researcher Pouvet. Most of us have seen cats sleep and the two sleep stages can be easily observed in them.

The first stage is light sleep. You can see how the body relaxes somewhat and respiration slows down. This is what you would expect of sleep. It is still rather easy to wake someone up in this stage.

The second stage is REM sleep. The body completely looses all tonus but respiration increases, the famous bursts of rapid-eye-movements show up and occasionally you can see strong almost spastics movements of the limbs. Research on brain activity shows that contrary to the stage of light sleep, the brain is as active as in the waking state. In all, there's a puzzling contradiction between the retension of muscular tension and all the activity that nonetheless is going on. This is why REM sleep has also been called paradoxical sleep. Waking someone up from REM sleep is much harder than from light sleep.

REM sleeping cat Each following cycle of light and REM sleep tends to shift more focus to the REM stage. With humans, the first cycle has a relatively small REM component that only shows up after more than an hour of light sleep. However, at the end of a six to eight hour sleeping period most time tends to be spent in REM sleep.

Sleep disorders

Experiments with sleep deprevation showed that people cache up not so much by sleeping longer but by spending more time in the REM stage of sleep. This suggests that REM sleep is somehow the vital stage for staying healthy. Research with CFS-patients has shown that getting enough REM sleep can be a problem. A doctor with over 10 years of experience with CFS-patients wrote me that quality of sleep is a good measure for chances of recovery. If you sleep well through the night, there's a good chance you're recovering. On the other hand, due to lack of REM-sleep

"the patients do not have a relaxed state of their muscles and develop a condition called fibromyalgia, which is chronic muscle pain. Most patients with this wake up tired and achy and continue with aches. They are often not aware that they are not sleeping deeply and often wake up for a few seconds or minutes and fall back to sleep not remembering."

I would like to add that medication can interfere with sleeping patterns too. Especially sleeping medication is notorious for its bad effects on REM sleep. It is said that people who stop their sleep medication start dreaming a lot, as if to compensate for all the dreams that couldn't be dreamed. I don't know if it's true, but it sounds plausible. Be aware, not only sleeping medication interferes with sleeping patterns. And some medication may as a side effect actually increase REM sleep, probably noticeable as an increase of vivid dreams and nightmares.

As far as I know there isn't any medication available aimed at restoring REM sleep with CFS-patients. However, one thing comes to my mind. Some lucid dreamers claim to get better dreams while using melatonin (Melatonin and Dreams, Melatonin Central: Complete reference center and info source), a chemical substance that stimulates REM sleep. Negative side-effects are not known. But as said lucid dreamers use it to get more vivid dreams, which may be something you will be less comfortable with.

Finally, there are several sleep disturbances not specific for CFS patients. Here are a few you had better make sure you don't have them:

  • Insomnia. Difficulty falling or staying asleep, waking earlier than you want. Insomnia can be caused by medical factors. I've heard from a CFS patient who had hypoglycemia and was told by her doctor to eat carbohydrates each hour. There are said to be many other medical factors causing insomnia. Often more likely explanations are behavioral factors such as stress, shift-work or poor sleep habits. Don't drink gallons of coffee just before going to sleep, stick to a sleeping ritual, don't stay in bed if you can't sleep, etc.
  • Sleep apnea. Pauses of breathing causing you to wake up. This is serious stuff so in case of doubt check my annotated links for additional information and visit your doctor.
  • Narcolepsy. This means you fall asleep at unexpected moments against your will and without regard for the circumstances. See my remark under sleep apnea.

Harry Bosma is looking forward to comments, email him at hbosma@xs4all.nl. For dream interpretations please visit the Mythwell.com site for the Alchera dreaming software.

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