# RKS: 💤 SLEEP (I) - No Sleep And All 'Play' Makes 'Jack' A Dull Boy!

   

# RKS: 💤 SLEEP (I)

NO SLEEP AND ALL 'PLAY' MAKES 'JACK' A DULL BOY!

RKS / 2025-2026 / Ser 7 / Blog 1

1st April 2025

SLEEP - IS IT AN ENIGMA?

THE SLEEP BASICS

Dear Reader,

Sleep is a natural, reversible state of reduced mental and physical activity, where consciousness is altered and sensory activity is inhibited, which is crucial for overall health and well-being. The average person spends about 26 years sleeping in their life, which equates to 9,496 days or 227,916 hours. That's one-third of our entire lives spent asleep in bed. Surprisingly, one also spends 7 years trying to get to sleep - a total of 33 years or 12,053 days!

The longest medically verified time a person has slept was 11 days, achieved by a 7-year-old boy named Wyatt Shaw (US). On the other hand, the longest period one has been awake is for 11 days straight - 264 hours - a new Guinness World Record in the name Randy Gardner (US) achieved on January 8, 1964.

World Sleep Day, celebrated on the 2nd week Friday of March before the Spring Vernal Equinox, is a global awareness event to highlight the importance of sleep for overall health and well-being, aiming to raise awareness about sleep-related issues and promote better sleep habits. One should be aware of basics of sleep to fathom its goodness for health, wealth and happiness.

SLEEP RHYTHM

The body has several internal clocks, called circadian clocks. These typically follow a 24-hour repeating rhythm, called the circadian rhythm. This rhythm affects every cell, tissue and organ of the body and regulates how they work. Sleep is also regulated by circadian rhythm and typically follows a 24-hour pattern, influenced by light and darkness. 

BIOLOGICAL RHYTHMS OF BODY

There are 4 biological body rhythms which are all controlled by suprachiasmatic nucleus (SCN) (in hypothalamus region of brain) which is the famed human biological clock and is also referred to as an endogenous pacemaker. 

Fig: SCN in brain.

1. DIURNAL: Biological cycles which are repeated once every 24 hours. Circadian are subtype of diurnal rhythms that are synced with day-night phases like sleep. 
2. INFRADIAN: Here the cycles are repeated after longer than 24-hours gaps like the menstrual cycles. 
3. ULTRADIAN: These are shorter duration biological cycles which are repeated multiple times in 24 hours. Classical examples include hormone release and appetite fluctuations.

SLEEP CHARACTERISTICS

Although the best survival rates are in those who sleep 7 hours regularly, there are interesting statistics which have been floated:

• Sleeping eight hours has demonstrated to result in 12% more likelihood of dying within the six year period in comparison to those sleeping seven hours, other factors being equal.
• However, interestingly, those with as little as five hours sleep live longer than those with eight hours or more sleep during the night! 

Sleep has been subdivided into phases and the body cycles through 4 to 6 cycles of one such sleep phase.

SLEEP PHASES

The body cycles though 2 sleep phases:

1. Rapid Eye Movement (REM) sleep
2. Non-Rapid Eye Movement (NREM) sleep

NREM (N) sleep is characterized by slower brain activity, heart rate and breathing whilst REM sleep is associated with increased brain activity, rapid eye movements and dreaming. 

NREM sleep is further subdivided as:

1. N1: Very light sleep
2. N2: Light sleep
3. N3: Deep sleep

The sleep stages progresses in the following order: N1 - N2 - N3 - N2 - REM. Each one complete sleep cycle takes roughly 90 to 110 minutes. 

Fig: Sleep cycle.

Typically, most adults feel the sleepiest between 2 a.m. and 4 a.m., and also between 1 p.m. and 3 p.m.  

Table: Sleep phases differences.

Fig: Electroencephalogram (EEG) brain waves during various sleep stages.

The stages of sleep varies from one individual to another. If the sleep latency period exceeds 20 minutes it foretells the presence of some underlying sleep disorder.

REM SLEEP

REM sleep is called "paradoxical" because of its similarities to wakefulness. Although the body is paralyzed during REM sleep, the brain acts as if it is somewhat awake, with cerebral neurons firing with the same overall intensity as in wakefulness. REM sleep occurs 4 times during a 7-hour sleep period. The first REM is of shorter duration and it can occupy one hour time period during the last cycle of sleep. The dreams during the REM sleep cannot be remembered since these are not transferred to the permanent memory area on account of lack of norepinephrine (noradrenaline) hormone. Vitamin B6 (or pyridoxine) intake has been linked to improved dream recall and can potentially enhance REM sleep.

Fig: Sleep cycles during one night's sleep.

It is interesting to note that N1 phase is present when one goes to bed and dozes off but during sleep one transits from N2 - N3 - N2 - REM sleep in-between two cycles without ever going back to N1 phase. However, when one's sleep is disturbed as whilst getting up to pass urine, the N1 phase occurs again at the beginning of the next new sleep cycle.

SLEEP MECHANISM

Melatonin is the sleep hormone of the body whilst cortisol is the hormone responsible for the state of wakefulness.

AT NIGHT: The SCN sends message to the pineal gland in brain to secrete melatonin hormone when daylight fades away. Melatonin makes one asleep since its concentrations in body are 10 times higher at night than during the morning hours. Melatonin production commences between 8 to 10 p.m., peaks between 1 to 3 a.m. and decreases over 4-5 hours whilst remaining very low during the morning period.

DURING DAY: When daylight strikes, the optic nerve of the eye stimulates the SCN which in turn releases the hormone cortisol from the suprarenal glands above the kidneys. The cortisol concentrations are least from 2 to 4 a.m. and peak at 7 to 8 a.m. because of which one wakes during those morning hours.

POWER NAP

Power napping / cat nap / siesta or NASA nap is a rising trend worldwide. In many cultures, having an afternoon nap is a daily ritual. The Spanish are known to enjoy a daily siesta and some Japanese workers indulge in a lunchtime sleep, known as hirune, or "afternoon nap". Power naps are recommended between 1 to 4 p.m. Napping could be:

1. Brief naps: 10-15 minutes - result in meaningful cognitive and physical boosting.
2. Short naps: 20-30 minutes - provide recovery of alertness lasting upto 155 minutes post napping.
3. Longer naps: 60-90 minutes - help memory consolidation.

The NASA nap is typically a 40-minute nap recommended by NASA Ames Fatigue Countermeasures Group to counter fatigue on account of sleep loss and jet lag.  Experts note 20 minutes is likely the best power nap duration and hence it is also referred to as Stage 2 nap. 

Fig: Benefits of power nap.

Napping after 4 p.m. is not ideal since it interferes with getting quality night-time sleep and interrupts the various circadian rhythms.

SLEEP RECOMMENDATIONS

CONCLUSIONS

A full night's sleep will include five or six cycles, while a disturbed, restless night consists of fewer. If one feels like four cycles is too little (six hours of sleep) but five cycles is too much (7.5 hours of sleep) then try to make sure to awaken in stage 1 or 2 of sleep which are lighter phases of sleep. These 2 stages together do not last more than 30 minutes.

Sleep is non-negotiable for brain and body health. Four hours is generally not enough because it doesn't allow the body and brain to go through essential cycles of sleep which are critical for physical and mental restoration. Studies however suggest that biphasic sleep patterns are relatively harmless. So long as one is still getting approximately seven to nine hours of sleep a night, most research suggests it's fine if that sleep happens in two sessions. The American Academy of Sleep Medicine recommends that adults get at least seven hours of sleep per night and on this basis 5 or even 6 hours sleep daily is insufficient for most adults.

Lack of sleep affects memory and ability to think clearly, and sleep deprivation can lead to neurological dysfunction, such as mood swings and hallucinations. Those who do not get enough sleep are at higher risk of developing obesity, diabetes and cardiovascular disease. Sleep is also believed to be a predictor of the next day's mood. One way to feel energized even with compromized sleep duration is to engage in light exercise, stay away from screens as well as alcohol, and enjoy a 20-minute power nap during the daytime.

Sleep disorder is called insomnia and 30% have complaints of poor sleep. The second part of the '💤 Sleep' blog will dwell on insomnia and its various facets. 

DR R K SANGHAVI

Prophesied Enabler

Experience & Expertise: Clinician & Healthcare Industry Adviser

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