Sleep 1 Sleep: A Personal Perspective Michelle R. Sargent AXIA of UOP Sleep 2 Sleep: A Personal Perspective Sleep, we all need it. It is at the center of who we are. Few people realize how important sleep is! The alarm clock is a permanent fixture in a majority of homes. Through the use of electric lighting, alarm clocks, sleeping pills, and shift-work, we have wreaked havoc on the natural process of sleep. During the latter part of the twentieth century, we have intruded upon a delicate and finely tuned process perfected by several hundred million years of evolution. In this paper I will chronicle a personal episode of sleep deprivation and how it affected my thought process, emotional status and motor skills. A Personal Account For me sleep deprivation is not a choice in the traditional sense but rather a necessity. Over the past two years I have had to find a way to be able to accomplish all that is expected of me in a day. Since August 12, 2007 I have averaged a maximum of 3- 5 hours of sleep daily; excluding crashes of course. Crashes are when my body and mind just seem to give out and I end up sleeping for 14-20 hours. On that faithful day in August I began the decline of sleep. This does not mean I wasn’t exhausted both physically and mentally but rather that I was driven to keep moving, keep doing all the things expected of me as well as deal with the new expectations that came with my daughters diagnosis of a rare disease. Her diagnosis changed my world; everything I thought was set in stone crumbled around me, leaving me no other option but to rebuild in order to accommodate the changes that were happening. I had to rearrange my schedule, rethink my time management strategies and look at the greater picture. Sleep 3 Direct and Indirect Affects Since the first day of surgeries, chemo and radiation for my daughter I began to adapt. However I was prone (and still am at times) to rapid mood swings, reduced focus and slower motor functions. I noticed these affects only over the past year or so as I watched my health decline along with hers. I struggle to remain focused on school, work and everyday chores. This struggle has produced the “list maker” as my husband calls it. I find that the longer I go without sleep the less I am able to recall on demand, so I make lists and leave myself constant notes for the day’s chores, homework and even bill payments. All of these things I used to do almost automatically. Although I have always made lists, budgets, and what not I did not have to rely on them as much as I do now. Before she was diagnosed I was the level headed person everyone went to, always in control of my emotions and always behaved appropriately. Now I have to consciously remind myself to calm down, take ten seconds think it through and let the emotions pass. A perfect example of my mood swing issue is when my daughter was going through yet another pre-op round of testing. We went to the hospital as always only to find that the technician had left early and we would have to go to another facility. So we loaded her in the car and off we went to the next facility. We get there, check in and get her ready only to find out they need extra paperwork we do not have and cannot get until the morning. There was the rub, she was scheduled for her surgery at 8am and the technicians would not be available until 9am. I think it was at that moment that I lost all control of my senses. My mood went from calm and understanding to enraged and looking to wreak havoc on those who were standing in Sleep 4 my way. Let me preface this next part by pointing out that I had already been two days with little to no sleep. I remember calmly putting my purse on my shoulder and putting a protective arm around my daughter; leading her to the car and to another facility. The next think I know I was opening my trunk and removing a crowbar from the trunk, still calm but determined. In found the technicians vehicle in the parking lot and headed towards it with crowbar raised like some crazed woman from a horror film. As I reached the vehicle and wound up for a good swing I heard my husband yell my name and then the next thing I know I was on the ground in a pile of tears and pain. As the situation escalated my mood changed but it did it so steadily that I did not even realize it. I sat on the cold pavement holding the crowbar amazed and scared that I could lose such control, that I was willing to act out so rashly knowing that I would gain no good results. A few minutes later as my husband and sons got me up and guided towards our vehicle a nurse came out and explained that there was a technician waiting for us in another facility and the testing would be done that night. By the time we got the test done it was almost midnight and I was so afraid I wouldn’t wake up in time I refused to go to bed. It would not be until the following night that I would finally sleep but only for a few hours and it was fitful and failed to give me the rest my mind and body so desperately needed. The Recuperative Concept and Long term Sleep Deprivation In our reading we are offered two theories; the recuperation and the circadian theories. The recuperation theory states that sleep is needed in order to restore natural rhythm and function to the brain and body, where the circadian theory states that sleep is a result of an internal mechanism that preprograms us to be nocturnal sleepers. Sleep 5 I am more inclined to agree with the recuperative theory as experience has shown the principles of this to be closer to the actual sleep needs and patterns. In my previous example of sleep deprivation I exhibited reduced reasoning, emotional imbalance, mood swings and even slower motor reactions. Although the event itself seemed to move at a lightening pace for me my actual movements were slow and as my mind sprang back and forth between reason and irrationality the physical and mental exhaustion continued to build. The recuperative theory holds water here as I found a renewed sense of control, some restored focus and motor functions. At the time of the incident my body had been under immense amounts of stress as well as my mind. As we can see through my narrative the long term affects of sleep deprivation cause instability in behavior and as the deprivation period increases so too does the instability. It would be fair to assume that after long periods of sleep deprivation the instability that occurs can become a part of the individual’s permanent personality composition. Conclusion: Sleep Disorders and Treatment My experience with sleep deprivation is one of a chronic nature; exacerbated by the style of life I live and my own personality composition. However there are sleep disorders which run the spectrum from insomnia to narcolepsy. For example because I deal with chronic insomnia, meaning that even when my life is not in utter chaos or I am under immense amounts of stress I still suffer from insomnia or the inability to sleep for more than a few hours. My doctors have prescribed Valium. This is a benzodiazepine; a hypnotic drug and can be an effective therapeutic hypnotic agent in the short term, as a prescription for the treatment of chronic sleep difficulties associated with underlying emotional stressors. However this type of treatment is not recommended for the long term Sleep 6 treatment of sleep disorders as tolerance can and does build up to the drug; requiring the patient to take more in order to achieve the desired effect. The other; and more ironic affects of long term use is that it creates the very condition it is supposed to be relieving. Another solution to sleep deprivation is the use of anti-hypnotic drugs such as stimulants and antidepressants. These drugs increase the activity of norepinephrine, epinephrine and dopamine. Through increasing their release or blocking the reuptake from the synapses. This type of treatment is preferred because they work during the REM stage of sleep. However this stage is highly receptive and many of the drugs used for this purpose have side effects such as sleep walking, or waking behavior while in the REM stage of sleep. Nature also offers us an aid to sleep, Melatonin. This naturally synthesized hormone regulates natural or circadian sleep patterns. It is found in the pineal gland and in most mammals it regulates sleep naturally. Unlike humans who can determine the level or amount of light and stimuli available other mammals are subject to that of nature. This theory is greatly debated as the existence of the pineal gland is only active in the sexual maturity of mammals and the removal of this gland does not create an adverse affect. No matter which theory you believe, which remedy you chose to overcome the occasional or even chronic sleepless nights it still comes down to understanding the basic physiological and psychological response to sleep or rather the lack there of. So if you suffer from lack of sleep or too much; consider all the mitigating factors, all the remedies and most of all what is best for you.