Sleep

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As we remember MLK’s historic vision, let’s discuss the importance of a dream/sleep. Most people know the general guidelines for healthy sleep patterns (try to eliminate lights & sounds in the area, 8 hours is a good timeframe to aim for, etc). In order for the body to perform its most basic functions, it needs enough sleep to supplement that activity. Too little sleep, often referred to as sleep debt, doesn’t allow for adequate energy production and results in reduced cellular efficiency, creating mental & physical consequences (according to Harvard Medical School). Too much sleep is associated with the following conditions: Type 2 diabetes, heart disease, obesity, depression & headaches (according to John Hopkins Medicine). Sleep debt recovery is a theory that has been researched actively recently to see if lost sleep can be made up in the forms of napping and oversleeping.

Sleep is a naturally occurring cycle set and regulated by the hypothalamus of the brain. This structure has multiple connections to other brainstem areas (predominantly the reticular activating system) to help influence sleep & arousal patterns via brain activity and hormonal/neurotransmitter releases. GABA, an inhibitory neurotransmitter, globally floods the cerebral cortex and thalamus to begin subduing the conscious activity of the central nervous system as the pineal gland releases melatonin, a natural hormone which promotes sleep. This release is largely affected by our circadian rhythm, the biological clock in humans that associates environmental cues (such as the sun going down, external temperature dropping, etc) with reducing cortisol levels and promoting melatonin releases. This system can commonly be aberrant in chronic migraine syndromes.

Sleep can be broken down into stages of REM (rapid eye movement) and non-REM sleep. Each has specific types of brain waves & activity associated with them (Stage 1- alpha, Stage 2- theta, Stage 3- delta, Stage 4- REM), as humans go through multiple cycles each night. Most dreaming occurs in the REM stage, when brain activity becomes more alert and awake than the other stages. Synchronicity and time spent in each stage is paramount to efficiency of sleep patterns.

Concussions can dramatically impact the brain’s ability to regulate sleep patterns. According to the Department of Child Neurology and Sleep Medicine at Geisinger Medical Center, sleep disturbances are not only a symptom of post-concussion syndrome, but also a predictor of concussion recovery (1). Active rehabilitation to not only alleviate dysfunction from a traumatic brain injury, but also to aid in sleep restoration can be tremendously effective in improving overall function and reducing the probability of long-term insomnia. Without sleep, the brain cannot adequately promote autophagy, at process the body undergoes to remove and repair damaged cells. This “pruning” activity allows for the brain to clear “debris” and create new, effective connections in the brain.

There are great parameters for testing sleep cycles today, including technology with sleep applications and centers specializing in sleep studies. Having a schedule, regular exercise, sessions of mindfulness meditation including body scans, reduction of caffeine use late in the day and cessation of light activity shortly before bed are all great tools to improve sleep. 

https://www.health.harvard.edu/womens-health/repaying-your-sleep-debt

https://www.hopkinsmedicine.org/health/wellness-and-prevention/oversleeping-bad-for-your-health

https://www.ninds.nih.gov/disorders/patient-caregiver-education/understanding-sleep

  • Morse AM, Kothare SV. Sleep disorders and concussion. Handbook of clinical neurology. https://www.ncbi.nlm.nih.gov/pubmed/30482340. Published 2018.
Dr. Benjamin Terrano DC, DACNB, CCEP

Dr. Benjamin Terrano DC, DACNB, CCEP

Dr. Terrano, born and raised in California, specializes in post-concussion syndrome, movement disorders, chronic pain and athletic performance.

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