José Antonio R. Piedrabuena —— Sleep from a medical point of view

From childhood to old age, you should get seven or eight hours of sleep, plus a nap. It is not true that older people have to sleep less, but teenagers suffer from a readjustment of their circadian rhythm and are sleepy later on.

Sleeping less for days in a row attacks the immune system, doubles the chance of developing cancer, determines the development of dementia, and alters blood glucose levels because it increases the resistance of the cells to use it and the endothelium of the coronaries becomes fragile.

The less you sleep, the shorter your life

Sleep is necessary to improve memory, the ability to learn and make logical decisions because it recalibrates emotional circuits. Remember the peace we feel after a good nap.

A quality sleep keeps the bacterial flora balanced among the thousands of families that make it up. It lowers blood pressure, which increases in the second part of the night, so the best way to treat hypertension is to take your medication at night.

Like all of nature, we depend on circadian rhythms that regulate metabolic, cardiovascular, temperature, hormonal processes and, to a large extent, births and deaths. Such regulation depends on a central, supraquiasmatic nucleus in connection with the hypothalamus, with its 20,000 cells inside the skull and then in each cell, which activates during the day many brain and body mechanisms, decreasing their activity during the night – it serves to increase survival. Light at dawn reaches the eyes and this slows down the pineal gland in the production of melatonin, which informs the brain and body that sleep is over.

We don’t have any drugs that really produce good sleep, as they all have some drawback. For example, melatonin in a pill will have no effect on some people. I usually prescribe tryptophan because it is a precursor of serotonin which is a sedative neuromodulator.

We all drink coffee, but caffeine has a half-life of up to seven hours, and with age this elimination is prolonged. We would need eight hours to get all the phases of sleep going.

We have deep non-REM sleep and less, as well as REM. During the first 90 minutes we have both non-REM and REM, but in the second part the latter predominates. What does this gibberish mean?

During the day the activity of the brain is frenetic, the waves that register the global activity oscillate up to forty times per second without any pattern. And this is due to the fact that different fragments of information have to be coordinated, attended to, recorded, activated, stopped and processed; and remodeled, cohabiting one hundred and twenty semi-autonomous structures, noting and participating in the autonomous functions of the body. All the waves of the electroencephalogram are asynchronous, chaotic and thus continue in the initial non-REM sleep part, but in the deep non-REM sleep they descend to two or four waves per second. From there, peace is established.

What has happened during sleep is that the prefrontal brain has been communicating in back and forth waves with the occipital, visual brain. The chaos in which we live during the day and part of the night has disappeared because thousands of cells have decided to join and emit-receive at the same time, opening communication between remote regions. It’s one of the reasons why sleep improves the brain.

This will move memory packages from immediate memory – hippocampus – to long-term memory in the cortex. According to some studies it is the calming and organizing effect of a good group therapy, when the collective brain waves are synchronized. It has already been demonstrated that, in moments of collective work, the waves of all the components of the group are synchronized. Therefore, group therapy produces a profound healing effect and changes in mental and physical health. They also synchronize unfortunately for genocide, for barbarism and fanaticism.

What happens during sleep is that we have a gateway to the five senses and to the signals from all over the body that come to a power station called the Thalamus, and that during sleep it does not give way to all these signals to the upper part of the brain, which relaxes and processes fragments of information at different speeds, which means that consciousness ceases.

The awakening occurs because in the oldest part of the brain -the brain stem- there is a layer of scattered cells -reticular formation- which will activate the thalamus and from there the hypothalamus so that they give way, again, to the millions of messages it receives; thus we pass to the waking state. Curiously, during the deep REM sleep, only the signals involving emotions, motivations, memories will be given course, which will pass to the visual and auditory cortexes, to integrate, purify and work them into dream forms. Thus, during this phase, the emotional system is remodeled. Little REM sleep, little emotional control and little creativity because in this phase of sleep relationships are created between unrelated brain areas.

Alcohol eliminates REM sleep. In fact, there are false diagnoses of dementia that are actually due to the lack of deep, restful sleep. If we sleep less than six hours, learning cannot be restored and we will fail in school. If at any age the hours of sleep are reduced for a week, the blood sugar level is altered and the appetite is altered. Today’s obese children, it seems that 30% have to do with this lack of sleep.  Lack of sleep in children and adolescents strangles the final phase of sleep that is rich in memory consolidation phases. We subject children to early morning sleep that limits the beneficial effects of sleep

The growth hormone is very active, in the deep non-REM, which by the way is the moment when the signal of prolonged calm and moderation of the sympathetic system is produced, avoiding the escalation of stress, as well as the calming effect on the heart rate. If we deprive children and adolescents of this process, the anatomical dialogue established between short and permanent memory will be interrupted. This is how school failure becomes, which the Government will try to camouflage by lowering academic quality and standards and by reducing school absenteeism. They do not seem to be interested in investigating this lack of interest in study in depth.

During the REM the brain has sent an order of total paralysis of our muscles, that is why in some dreams we live with anguish not being able to escape from some attack. We have no connection with the voluntary muscular system, there is a total muscular flaccidity.

We are intuiting that what we call modern frenetic life is not such, but that our brain is a chaos in itself, with each part demanding its energetic ration and its space. That is why one day therapy will be mandatory to have a better brain and a better life. Well, that is not going to happen because millions of people do not know how, nor can they, nor do they want to stop to order and find meaning in their actions, in their emotional life, in their emotional failures; what is more, they are against it, they do not know how, they do not want to, they disdain the possibility of regulating and knowing emotions, which is a feature of emotional intelligence.

Sleeping little, less than six hours, means that physical capacities are reduced by up to 20%, as well as muscular strength, cardiovascular, metabolic and respiratory capacities, and oxygen saturation is reduced. Moderate exercise when getting up improves all of this.

Sleep is the basis for a good diet and exercise. No organ of the body escapes the damage of lack of sleep. The less, the more likely you are to suffer from heart attacks, especially from middle age onwards. Lack of sleep, bad sleep is also due to the sympathetic system, which activates all the systems in a state of alert, incites, agitates and keeps an alert out of consciousness which prevents sleep, nightmares and bad quality of sleep.

The growth hormone is very active in the first stage of sleep, those who go to bed late or leave the house lose it. It intervenes and regulates growth in young people, the general metabolism and increases the transformation of body fat into energy and decreases fat deposits, so you can get fat if you do not sleep; it increases the uptake of protein and maintains muscle mass and strength. It also intervenes in the repair and construction of new cells.

As for the denigrated nap, it is a great medicine for the body and mind throughout the day

Television is causing a pandemic of sleep loss, the WHO has reported for all industrialized countries, and links it to the rise in physical and mental illness and disorders. They are manifested in social extremism, attacks on monuments of despair to find a culprit for social unrest. One consequence among many of the blindness in electing, worldwide, leaders who sponsor social segmentation, with no long-term vision, with whom their voters identify and vote. Perhaps I am not right and it is all the result of society’s low level of education, of fear, of the need to locate causes to give meaning to collective anguish and despair, of the lack of a common ideal for which we do not have leaders on any continent, but the polarization was always made by leaders and citizens – Hitler found the Jews, others found capitalism. These are all clearly paranoid symptoms if they occur in an isolated individual.

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José Antonio Rodríguez Piedrabuena
Specialist in Psychiatry, and in management training, group and couples therapy



José Barros


Consultor y periodista especializado en Comunicación Institucional, Política y Asuntos Públicos. José tiene además una amplia experiencia en campañas electorales, donde ha trabajado en la definición de estrategias y en la preparación de innumerables intervenciones públicas. Estas funciones reflejan su competencia para transformar datos e información de muy variada procedencia en conocimiento cualificado y estructurado tanto para atraer la atención del gran público como para conseguir una acción eficaz. Entre los puntos más relevantes de su carrera profesional, destaca su labor como asesor en dos Gabinetes de Presidencia -Gobierno de España y Comunidad de Madrid-, así como su faceta de articulista sobre Relaciones Internacionales y Cultura en algunos de los principales periódicos españoles.