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José Antonio R. Piedrabuena -- Sleeping from a medical point of view

From infancy to old age, you should sleep between seven and eight hours, plus a nap. It is not true that older people should sleep less, but adolescents suffer from a readjustment of their circadian rhythm and become sleepy later.

Sleeping less for days at a time 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 cells to use it and the endothelia of the coronary arteries become fragile.

The less sleep you get the shorter your life will be

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

Quality sleep keeps the bacterial flora balanced among the thousands of families that make it up. It lowers blood pressure, which rises in the second part of the night, so the best way to treat hypertension is to take 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. This regulation depends on a central one, the suprachiasmatic nucleus in connection with the hypothalamus, with its 20,000 cells inside the skull and then in every cell, which activates many brain and body mechanisms during the day, decreasing its activity during the night - it serves to increase survival. Light at dawn reaches the eyes and slows down the pineal gland's production of melatonin, which informs the brain and body that sleep is over.

We do not have any drug that really produces good sleep, as all of them 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, moreover, with age this elimination lengthens. We would need eight hours for all the sleep phases to get going.

We have deep non-REM and less deep non-REM sleep, as well as REM sleep. 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 brain's activity is frenetic, the waves of global activity oscillating up to forty times per second without any pattern. And this is because it has to coordinate, attend, register, activate, stop and process different pieces of information; and reshape, coordinate one hundred and twenty semi-autonomous structures, annotate and participate in the autonomous functions of the body. All the waves of the electroencephalogram are asynchronous, chaotic and so continue in the initial non-REM part of sleep, but in deep non-REM they drop to two or four waves per second. It is from there that peace is established.

What has happened during sleep is that the prefrontal brain has been communicating in waves back and forth 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 transmit-receive at the same time, opening communication between remote regions. This is one of the reasons why sleep improves the brain.

This will move memory packets from the immediate memory - hippocampus - to the long-term memory in the cortexes. According to some studies, this is the calming and organising effect of a good group therapy, when the collective brain waves are synchronised. It has already been proven that in moments of collective work, the brain waves of all group members are synchronised. This is why group therapy produces a profound healing effect and changes in mental and physical health. Unfortunately, they are also synchronised for genocide, barbarism and fanaticism.

What happens during sleep is that we have a gateway of the five senses and signals from all over the body coming into a central one called the thalamus, and during sleep it does not pass 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 cerebral trunk - there is a layer of scattered cells - the reticular formation - which will activate the thalamus and from there the hypothalamus so that they can once again give way to the millions of messages it receives; this is how we pass to the waking state. Interestingly, during deep REM sleep, only signals involving emotions, motivations, memories will be processed, which will pass to the visual and auditory cortexes, to be integrated, purified and worked on in the form of dreams. Thus, during this phase, the emotional system is remodelled. With 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 a lack of deep, restful sleep. If we sleep less than six hours, learning cannot be restored, so we will fail at school. If sleep is reduced for a week at any age, blood sugar levels are altered and appetite is altered. Today's obese children, it seems that a 30% is related to this lack of sleep. Lack of sleep in children and adolescents strangles the final phase of sleep rich in memory-consolidation sleep phases. We subject children to early mornings that limit the beneficial effects of sleep.

Growth hormone is very active in deep non-REM, which is the time when the prolonged calm signal is produced and moderates the sympathetic system, preventing 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-term and permanent memory will be interrupted. This will result in school failure, which the government will try to camouflage by lowering academic quality and standards, and truancy. They do not seem to be interested in investigating this lack of interest in studying in depth.

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

We are sensing that what we call modern frenetic life is not such, but that our brain is a chaos in itself, with each part demanding its energy ration and its space. Hence, one day therapy will be mandatory for a better brain and a better life. Well, that is not going to happen because millions of people do not know how to, cannot and do not want to stop to order and find meaning in their actions, in their emotional life, in their emotional failures; indeed, they are against it, they do not know, they do not want, they disdain the possibility of regulating and knowing emotions, which is a feature of emotional intelligence.

Too little sleep, less than six hours, means that physical capacities decrease by up to 20%, as well as muscle strength, cardiovascular, metabolic and respiratory capacities, and oxygen saturation is reduced. Moderate exercise on waking improves all of these.

Sleep is the foundation that underpins good diet and exercise. No organ of the body escapes damage from lack of sleep. The less sleep we get, the more likely we are to suffer cardiac arrest, especially from middle age onwards. Lack of sleep, poor sleep is also due to the sympathetic system, which activates all the systems in a state of alertness, stimulates, agitates and maintains an out-of-consciousness alertness that prevents falling asleep, nightmares and poor sleep quality.

Growth hormone is very active in the first stage of sleep, those who go to bed late or go out are missing it. It is involved in and regulates growth in young people, general metabolism and increases the conversion of body fat into energy and decreases fat deposits, which is why you can put on weight if you don't sleep; it increases protein uptake and maintains muscle mass and strength. It is also involved in repairing and building new cells.

As for the much-maligned siesta, it is a wonderful medicine for the body and mind throughout the day.

Television is causing a pandemic of sleep loss, as reported by the WHO for all industrialised countries and linked to an increase in physical illnesses, mental illnesses and mental disorders. It manifests itself in social extremism, attacks on monuments in desperation to find a culprit for a social malaise. One consequence among many of the blindness in electing, on a global level, leaders who are patrons of social segmentation, without long-term vision, with whom their voters identify and vote. Maybe I am not right and it is all the result of society's low level of education, of fear, of the need to locate causers to make sense of collective anguish and despair, of the lack of a common ideal for which we have no leaders on any continent, but polarisation has always been made by leaders and citizens - Hitler found the Jews, others found capitalism. These are all clearly paranoid symptoms if they were to occur in an isolated individual.

This text may be reproduced provided that PROA is credited as the original source.


 

José Antonio Rodríguez Piedrabuena
Specialist in psychiatry, management training, group and couple therapies.

 

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