Night terrors are in deep sleep, and they're more common in kids, as are nightmares, but what happens in a night terror is like a flash - we think a flash of some image or something happens in the brain. We don't really quite know what. And it usually ends up with the child screaming almost like screaming bloody murder. It's very scary for the parents or whoever else is around.
We've looked at sleep diaries of patients with insomnia, and they'll say that they don't sleep for one or two days. And the body actually has a natural function, after about the third day to start catching up and you get a little bit more sleep the third night. And that's usually what I tell my patients.
I'll work on patient's thoughts about sleep, "So I must get eight hours of sleep tonight or I won't sleep tomorrow." That sometimes - or "I won't function tomorrow." That sometimes makes it very difficult for you to sleep at night
So a lot of people who work rotating shifts and they work at night, their bodies are set to want to be awake during the day and sleep at night. So there are some people who have a lot of trouble adjusting their rhythms and they have trouble working the night shift, they're sleepy, they're drowsy driving home.
So the deeper stages of sleep are really those times of quiescence, you're really restoring your body and we have a few different stages of sleep.
When you're in the more deeper stages of sleep - REM sleep, your body is quiet, but your mind is actually very active. So it's a time when your body and your brain is restoring itself. It's repairing any cell damage that happened during the day, it's really repairing, like I said, repairing your body, but also helps with digestion, helps with memory.
When they [people with insomnia] start worrying about not sleeping, I'll say, "Say the mantra to myself; if I don't sleep tonight, I'll likely sleep tomorrow, and if not tomorrow then definitely the third" because our body has a way of naturally catching up.
It's uncommon, but there are some people who just have a delayed circadian rhythm and they just - they sleep better during the day then they do at night. So they've - a lot of those people with delayed sleep phase disorder they start to work in bars, they work some of the late night shifts, they sort of adjust to doing it more and more as time goes on.
Narcolepsy is a disorder that affects many different areas of life. So in typical patients with narcolepsy, they have something called "excessive daytime sleepiness." So, they're very sleepy during the day. Yet, at night, they're still sleepy, but their sleep is very broken.
So you have Sleep Stage One, Two, and then Three/Four. One is a little bit lighter stage of the quiet, non-REM sleep and then Three/Four is really deep, deep sleep. And what you want is, you actually want a number of - you want to go through all of these stages throughout the night.
So, sleep deprivation, and sometimes an insomnia, which is a little bit of a different form, but just getting a lack of sleep, can lead to a number of different decrements.
So if somebody has chronic pain, we want to manage the pain, but we still want to treat the insomnia separately. So what we'll tend to do in our sleep lab is we'll do a thorough evaluation and we usually have myself, who is a Psychologist and a Sleep Behavioral Sleep Specialist, I treat the patients first.
Night terrors are very different from nightmares. A lot of people will think they're the same, but they're really not. Night terrors - you want to look at the time of night when you're having the problem. Night Terrors happen in deep sleep. Nightmares tend to happen in a lighter REM sleep.
Now narcolepsy is really hard though because they're very tired during the day, they're sleepy during the day and it's managed mostly with medications. So we use medications to help them sleep better at night and to stay away during the day. But there are behavioral things you can do also by changing diet, exercise, having an actual nap schedule.
So people only focus on getting the really deep sleep, but in reality, we spend almost 60% of the night in the stage two sleep.
Workplace accidents with people who are sleep deprived or people who work shifts and they don't get the right amount of sleep during the day or at night.
So we go through in the beginning of the night, we go into the really deep stages of sleep and we actually cycle through. So, when you go down to the deep stage, then you go back up and you actually come into something called REM sleep, which is after about 90 minutes.
There's a new line of research showing that people who don't get enough sleep, they're body doesn't metabolize as well. And so they actually - it leads to weight gain. So if you're not getting enough sleep, you might have difficulty losing weight.
We'll work on relaxation strategies and also changing the times you go to bed will actually make them sleep a little bit less for a few nights so their body's natural sleep drive starts to kick in. That is very effective in about 60% to 70% of patients who do it, four to eight sessions, not even every week; it works for 60% to 70% of patients.
We think is happening in the brain, the way I like to think about it is, it's almost like, you're brain is going through all these stages of sleep and it's developing in children so fast that it's almost like you're shifting gears in a car. And at some point, you actually stall out a little bit, and that's kind of what happens during a night terror.
So when you're in REM sleep, your brain is very active, our body is quiet, but your brain is really processing a lot of things, a lot of emotions; we dream the most in REM sleep. And then you go back down in the deep stages, and so on and so forth.
When you are more awake at nights, they'll toss and turn, they'll think more, they get frustrated. And when that starts to happen, you really don't sleep even more because you're making your body tense and your mind is getting more and more active.
So someone who is a child usually goes to bed about 8:00 or 9:00 at night, but then when they have a circadian rhythm shift, it shifts later. And this is natural. And they start to go to bed at 11:00, 12:00, 1:00 and they want to sleep later. So we see this a lot in teens.
Sleep paralysis is something that is actually very common. Many people have it, I've had it myself. And what happens is, when you're in that REM stage of sleep, your brain is very active. You're dreaming your most during that stage, you're mind, your eyes are moving, there's a lot going on. It's like fireworks going on in your brain.
People tend to remember their dreams in the morning a little bit better and if earlier in the night, when you're in a lot of deep sleep, if someone wakes you, or the phone rings or something, you're really confused.
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