Time change - Problems with disruptions to sleep patterns

[lindy]

I always have a terrible time when Daylight Savings Time begins and ends. You wouldn't think that a one hour time shift would cause trouble but it really throws me through a loop. The time change used to cause me to have a grand mal every change but, fortunately (knock on wood), that seems to be in the past now that I have control over my seizures but the change still makes me feel strange and out of sorts. Anyone else have this problem?

[Bernard]

Hi lindy, it's good to hear that you are not so sensitive to the disruption in your sleep pattern anymore. For myself, I do not have an established routine, so daylight savings really does not affect me too much.

According to this Sleep Deficit, Fatal Accidents, and the Spring Shift to Daylight Savings Time page (emphasis mine):

The average young adult, today, reports sleeping about 7 to 7« hours each night. When we compare this to sleep patterns in 1910, before Edison's modern coiled tungsten filament light bulb, was introduced, we find that the average person slept 9 hours each night. This means that today's population sleeps 1« to 2 hours less than people did early in the century (Webb & Agnew, 1975). Based upon data like this, some researchers have claimed that society is chronically sleep deprived, and even small additional reductions in sleep time may have consequences for safety (see Coren, 1996a for a review). Coren (1996b) apparently confirmed this by showing that the shift to Daylight Savings Time (DST) had an impact on accident rates. The spring shift to daylight savings time results in a loss of one hour of sleep while the fall shift provides an additional hour which can be used for sleep. Using data from two years of Canadian traffic accident records, he found that on the Monday following the shift to DST in the spring, there was an increase in traffic accident rates of about 7 percent, while in the fall there was a decrease in accident rate of about the same magnitude.

According to the NIH (emphasis mine):

Most hormone secretion is controlled by the circadian clock or in response to physical events. Sleep is one of the events that modify the timing of secretion for certain hormones. Many hormones are secreted into the blood during sleep. For example, scientists believe that the release of growth hormone is related in part to repair processes that occur during sleep. Follicle stimulating hormone and luteinizing hormone, which are involved in maturational and reproductive processes, are among the hormones released during sleep. In fact, the sleep-dependent release of luteinizing hormone is thought to be the event that initiates puberty. Other hormones, such as thyroid-stimulating hormone, are released prior to sleep.

It seems to me that disrupting the sleep pattern (and circadian rhythm) could cause problems with hormone levels which, IIRC, has been identified as a possible trigger for seizures in some people.

The NIH page (which is a very comprehensive and interesting read) also says this:

In general, the human circadian clock appears better able to adjust to a longer day than a shorter day. For example, it is easier for most people to adjust to the end of daylight savings time in the fall when we have one 25-hour day than to the start of daylight savings time in the spring, when we have a 23-hour day. ...

... Loss of sleep creates an overwhelming and uncontrollable need to sleep and affects virtually all physiological functions. Sleep loss causes problems with memory and attention, complex thought, motor responses to stimuli, performance in school or on the job, and controlling emotions. Sleep loss may also alter thermoregulation and increase the risk for various physical and mental disorders.

[lindy]

That was so interesting about differences in the amount of sleep that the "average" person gets now as opposed to a century ago. I've found that I need 9 hours of sleep a night. Stress and being overly tired set off my seizures more than anything else and I discovered that less than 9 hours a night left me dragging around during the day. I thought that I was just one of those odd people who needs more sleep than the norm but I guess that I really am an old fashioned girl!

[Bernard]

I wish I could force myself to get 9 hours of sleep every night right now. I always feel better and am more productive when I do. Some time ago, I read somewhere that sleeping follows a repetitive cycle that takes 3 hour blocks, so it was best to sleep either 6 or 9 hours, but not 7,8,10, etc. I don't recall the details on who wrote that or what research backed it, but the NIH says different:

During sleep, we usually pass through five phases of sleep: stages 1, 2, 3, 4, and REM (rapid eye movement) sleep. These stages progress in a cycle from stage 1 to REM sleep, then the cycle starts over again with stage 1 (seefigure 1). We spend almost 50 percent of our total sleep time in stage 2 sleep, about 20 percent in REM sleep, and the remaining 30 percent in the other stages. Infants, by contrast, spend about half of their sleep time in REM sleep.

...

The first REM sleep period usually occurs about 70 to 90 minutes after we fall asleep. A complete sleep cycle takes 90 to 110 minutes on average. The first sleep cycles each night contain relatively short REM periods and long periods of deep sleep. As the night progresses, REM sleep periods increase in length while deep sleep decreases. By morning, people spend nearly all their sleep time in stages 1, 2, and REM.

...

The amount of sleep each person needs depends on many factors, including age. Infants generally require about 16 hours a day, while teenagers need about 9 hours on average. For most adults, 7 to 8 hours a night appears to be the best amount of sleep, although some people may need as few as 5 hours or as many as 10 hours of sleep each day. Women in the first 3 months of pregnancy often need several more hours of sleep than usual. The amount of sleep a person needs also increases if he or she has been deprived of sleep in previous days. Getting too little sleep creates a "sleep debt," which is much like being overdrawn at a bank. Eventually, your body will demand that the debt be repaid. We don’t seem to adapt to getting less sleep than we need; while we may get used to a sleep-depriving schedule, our judgment, reaction time, and other functions are still impaired.

Brain Basics: Understanding Sleep

[lindy]

It is during REM sleep that serotonin is taken up by the brain so it's a very important part of sleep. It seems to me that I wasn't able to consistently get enough sleep every night until my children grew up and left home!

[Bernard]

Stacy had a lot of problems with her sleep pattern after delivering our second son because she chose to breastfeed him (lasted a year). She had to wake 2-3 times a night to feed him and I'm sure that didn't help her with her seizure threshold!

[lindy]

Tell me about it! I breastfed both of my kids and there is absolutely no way to get a good night's sleep, although it really is worth it in the long run. It's funny talking about this - my son (who is 27) arrived for a visit last night and I look at this huge (6' 2") gorgeous man and it's hard to believe that this is my baby!! He'll be here until Monday and then heads back to CT. Wish that he lived closer but it's still better than my daughter who lives in CA! At least he can come for a visit every couple of months. I haven't seen my daughter since October.

[Bernard]

I haven't seen my daughter since October.

Give her a web cam for the next gift giving occasion. Get yourself one too. According to ZDNet, the Logitech QuickCam Pro 4000 is highly rated. Then you can both see each other more often. :wink:

[lindy]

Doubt if it would do any good. She has such a busy life that we're lucky if we get an email a week. She's an editor for a company called Upper Deck (remember the baseball cards with bubble gum? That's Upper Deck and now they're into card game development) and she isn't always working on local time (she's in CA and we're in VT so we're never on the same time anyway). Last weekend, she was on Amsterdam time because one of their games was being premiered!

[John-Forrest]

Speaking of REM: I definitely get the sense that my sense of "having enough sleep" is contingent on how well I've dreamed. Sometimes I can get by with only 5-6 hours actual sleep, having spent the other 2-3 hours lying awake worrying about one thing or the other. I generally remember having a lot of dreams on nights like that, especially towards early morning. Other nights, I might sleep 8-9 hours, but wake feeling like "something's missing", and can't remember any dreams at all. Those tend to be times I am more likely than usual to seize.

Lately, I've noticed that the quality of my dreams seem to have something to do with this. If I have very rich, detailed dreams, I will feel much better rested. I've been developing a tendency to come wide awake around dawn, still having 2-3 hours yet to sleep. Sometimes I can get back to sleep by trying to remember a dream I was having, and imagining I'm back in the dream again. Or if it was a bad dream, I try to imagine a happier ending to the dream. (Actually, this is something known as "lucid dreaming", consciously editing dreams while asleep.)

Also, I notice more meaningful dreams that have some kind of plot or goal, ideally achieved in end - tend to make me feel better rested. Whereas those dreams that are complete gibberish tend to make me awaken feeling very groggy and out of it.

It does seem obviouis that quality REM sleep has much to do with mental health and seizure thresholds. So what are ways to increase REM?

Addendum: 5-HTP sounds promising, said to increase REM 25%. See http://www.holisticonline.com/Remedi..._nutrition.htm

[Bernard]

Yeppers -> 5-HTP discussion.

[stringbean]

I just cannot seem to keep a scheduled sleep pattern.
1 week about all I can do is sleep, like 16 hours and be up for 8.
another week, I am hardly able to sleep at all.
most days I am up before 5am. on some of those days I can stay awake all day until around 8pm, if that late, then out for the night. other days I have to lay down for an afternoon nap that may last as long as 4 hours and other days my husband has to wake me up to eat something to be able to take my night meds and he has to sit beside me and keep me awake because I will even fall asleep while trying to eat. and then right back out until morning.

But then, one of my antidepressents is Trazadone, because if I don't take it then through the night I am awake every 1/2 hour to hour all night long.

Hard to figure out for me. Just never know from day to day how many hours I will sleep verses how many hours I will be able to stay awake.

[Bernard]

Drugs can complicate the picture for sure. Establishing a routine of going to bed at the same time every night (no matter what) can help train the body/brain/system to expect/follow the routine.

Perhaps something in here will be helpful: insomnia tips

[TeeTees]

I get that 'vicious circle' when I can't sleep because I may have general life problems where you just can't sleep because you're worrying about something...I then have a seizure the following day or night....which in turn wakes me up EARLY the following morning...I then become sleep deprived AGAIN, which guess what ?....yep, you got it....I have another seizure, which then leads to another sleep deprived night, blah, blah...

[Bernard]

... Dinges says people who are chronically sleep deprived, like people who've had too much to drink, often have no sense of their limitations. They believe they've trained themselves. "I think it's a convenient belief. For the millions of people who don't get enough sleep because their commute to work is too long, or they spend too many hours at work, or they just want this lifestyle of go, go, go, it's convenient to say, 'I've learned to live without sleep.' But you bring ‘em into the laboratory - and we have an open challenge to any CEO or anyone in the world, come into the laboratory - we don't see this adaptation," he says.

One thing sleep researchers do see is that their sleep-deprived volunteers often have mood swings: they get short-tempered, then become almost giddy, sometimes within seconds.

"We took a group of young college undergraduates and we deprived them of sleep for about 35 hours straight. And then we placed them inside a MRI scanner and we showed them increasingly negative and disturbing images," says Matthew Walker, who devised a study to look at what was going on inside their brains. "And what we found was that in those people who had a good night of sleep, the control group, they showed a nice, modest, controlled response in their emotional centers of the brain."

"But, when we looked in the sleep deprived subjects, instead, what we found is a hyperactive brain response," he says.

And what's more, in the sleep-deprived subjects, Walker discovered a disconnect between that over-reacting amygdala (a region of the brain) and the brain's frontal lobe, the region that controls rational thought and decision-making, meaning that the subjects' emotional responses were not being kept in check by the more logical seat of reasoning. It's a problem also found in people with psychiatric disorders.
...
Eve Van Cauter, an endocrinologist at the University of Chicago School of Medicine, studies the effect of sleep on the body. At her lab, healthy, young volunteers like Jonathan Mrock are paid to come one at a time and have virtually every system in their bodies monitored while their sleep is interfered with.

"We did a study where we restricted sleep to four hours per night for six nights," Van Cauter explains. "And we noticed that they were already in a pre-diabetic state. And so, that was a big finding."

The study's subjects were on the road to diabetes in just six days, and that’s not all - they were also hungry. Van Cauter has made a radical discovery: that lack of sleep may be contributing to the epidemic of obesity in this country through the work of a hormone called leptin that tells your brain when you’re full.

"We observed that the volunteers, they actually had a drop in leptin levels," Van Cauter explains. "Leptin was telling the brain, 'Time to eat. We need more food.'"

"Even though they’d eaten," Stahl remarks.

"But in fact they had plenty of food," Van Cauter agrees.
...
Van Cauter and Tasali are investigating a novel theory that some of the health problems we typically associate with old age may in fact be caused by the loss of deep sleep.

"We lose deep sleep at a very early age. So a young, healthy person may have 100 minutes of deep sleep, and at 50 years old it may be as little as 20 minutes. So it really… goes down very quickly," Van Cauter explains.

Tasali's goal is to turn 19-year-old Jonathan, sleep-wise, into a 70-year-old.

The next morning - 346 sounds later - it's time for testing. Now Jonathan's going to have fat extracted from his body for analysis, go through a PET scan to see how his brain is metabolizing sugar, and between procedures, he’s answering questions about how he feels. His doctors assure 60 Minutes that Jonathan will be fine once he goes back to his normal sleep routine, but after four nights without deep sleep they have found that, like prior study subjects, he is hungrier, less alert, and most importantly, his body is no longer able to metabolize sugar effectively, putting him temporarily at increased risk for Type 2 diabetes.

"We usually think of diabetes as something that's a disease of old age. But really it may be a disease of sleep deprivation," Stahl remarks.

"I would say that sleep deprivation may be a new risk factor for diabetes," Van Cauter says. "Not just aging, not just being overweight or obese, not just having a family history of diabetes, which are the three major risk factors. But this is an added one. And we have really an epidemic of diabetes now. And Type 2 diabetes is now occurring in children, in adolescents. And, you know, adolescents and children too are also being sleep deprived. Maybe high schoolers are amongst the most sleep deprived individuals in our society, because they have an enormous sleep need - nine to ten hours. Yet they sleep less than seven hours per night."

She says this research proves we all need to rethink what we consider essential for good health - that the diet and exercise formula also has to include sleep.
...

The Science Of Sleep

The role of leptins in seizures was mentioned in Zoe's Leptin Diet thread.