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The Dangers of Not Getting Enough ZZZs

Consequently, certain structures may be fast asleep, while [Pg 11] others are partly awake,—while still other portions of the organism may be in a condition of activity greatly in excess of their ordinary wakeful function. Upon this fact depend the phenomena of dreams and the various forms of somnambulism.

The special senses are usually overcome by sleep before the muscular apparatus yields, and the cerebro-spinal nervous centres are the last of all to succumb. The eyes, for example, cease to see clearly before the eyelids droop, or the muscles of the neck give way in the act of nodding. The senses of touch and of taste fail next in order, as in the case of the infant gourmand, who may be seen falling asleep at supper,—his mouth yet filled with untasted sweets from the table before him. The sense of smell is more persistent, and its exercise is sometimes an obstacle to the invasion of sleep.

Witness the effect of powerful odors upon certain persons. The perfume of flowering plants in the sleeping chamber is sometimes decidedly annoying on this account. A lady of my acquaintance was once awakened out of a sound sleep by the smell of tobacco smoke from the pipe of a thoughtless burglar who had quietly entered a distant apartment of the house. A sudden change of wind, deluging a city with the vapors of a glue-factory or rendering establishment, may in like manner disturb the slumbers of thousands of people.

The sense of hearing seems to be the most persistent of all the special senses. It is not a very uncommon thing for persons to be awakened by the sound of their own snoring; or, if not actually aroused by the noise, to remain in a condition of repose which seems to be sustained and cheered by the regular rhythm of [Pg 12] its own music.

As a general rule, however, it is noteworthy that, when not wholly dormant, each sense finds its sphere of activity greatly narrowed by the fact of sleep. Consequently the range of perception, if not wholly obliterated, is greatly limited during the time of sleep. While it is true that sleep arrests the voluntary activities of the muscles, it is also a fact that all the muscles do not yield at once or in equal degree. The extensors of the neck, and the supporters of the spinal column, are the first to fail.

The patient begins to nod, and is inclined to fall forward, before consciousness ceases. The muscles of respiration and of circulation continue to contract, though at a diminished rate. The vermicular movements of the intestinal coats persist, and in certain conditions of ill-health their exaggerated contractions may become a cause of imperfect repose. Reflex movements may always be excited during natural sleep. Tickling the sole of the foot will cause retraction of the limb; and before the complete establishment of sleep, a certain exaltation of the spinal reflexes may be observed.

Young children may frequently be seen in the act of suction with their lips, as if at the breast; and the smile of the sleeping infant is a matter of daily remark in every nursery. The influence of dreams as an excitant of muscular movement will be hereafter discussed. The variation of intellectual function which appears in sleep serves to measure its profundity and to indicate the extent of its invasion. The act of perception being dependent upon sensation, it is to be observed that the range of perception diminishes so [Pg 13] soon as the organs of sense begin to yield.

Its intensity may not immediately fail, but the breadth of its scope is narrowed. Sometimes, however, the act of conscious perception is arrested before the organs of sense are sealed. The sleepy reader may continue to eye the page before him, perhaps even to read aloud for a considerable time after he has ceased to derive any meaning from the words of the book.

In such cases the organs of perception and conception and association of ideas slumber before the bonds of connection between the will and the muscular organs have been completely relaxed. Such an example affords a valuable illustration of the division of the brain into separate mechanisms which, though most intimately related, are nevertheless partially independent of each other. Sleep may operate like an invasive disease, falling with unequal incidence upon the different structures that make up the mass of the brain, paralyzing one portion, while simply benumbing another, and even arousing to excessive activity a third.

Consequently the intellectual functions may be very unequally disturbed, and the order of their subsidence may be considerably varied; but, as a general rule, the physiological relations of the faculties are respected, so that as sensation diminishes, perception fails, the conception of ideas is correspondingly hindered, and the association of such ideas as are still projected upon the field of consciousness becomes more imperfect.

The loss of the power of association implies the destruction of memory and the impossibility of exercising the reasoning faculty or of forming those judgments upon which every act of volition is based. When the brain [Pg 14] has at length been so far overwhelmed that physical impressions can no longer reach the field of consciousness, all manifestation of intellectual life is at an end, and the sleeper sleeps a dreamless sleep that leaves no trace behind.

It is assumed in the last sentence that the brain may become so far transformed by sleep that it ceases for the time to be capable of function as the instrument of thought. This conclusion has been questioned by the very highest authorities. Sir William Hamilton, Exner, and many others have instituted numerous experiments to test the possibility of a dreamless sleep.

Causing themselves to be suddenly aroused at all hours of the night, they invariably found themselves at the instant of awaking occupied with the course of a dream. Hence it has been inferred that the mind is always alert, even when the body is most thoroughly asleep.

Visual Guide to Sleep Disorders

In explanation of the fact that consciousness contains after deep sleep no trace of such mental activity, it is claimed that the act of dreaming of which we are aware at the moment of waking is proof of intellectual function during the moments which preceded that incident, and that we are merely forgetful of all similar processes that occurred during undisturbed sleep. The unconsciousness of sleep, according to this theory, is not real—it is only apparent through failure of the memory. If this be true, memory is the only intellectual faculty of whose inaction we can be sure.

The period of deep sleep might then be, for all we know to the contrary, a period of the most intense and exalted mental activity. But, if so, it is quite worthless as a constituent of our conscious existence. The process of waking, though often very greatly hurried, is by no means absolutely instantaneous. As we shall learn, the time requisite for the evolution of a dream may be indefinitely brief. Consequently, it seems better in all such instances to assign the period of dreaming to the time of diminishing slumber that corresponds to the disturbance by which sleep was terminated.

The only reason for any hesitation in the acceptance of such a proposition consists in the reluctance of many philosophers to admit the possibility of any interruption in the active life of a spiritual being, such as man is conceived to be. But it is difficult to comprehend any valid reason for the denial of such interruption. Every form of force, of which we have any knowledge, is subject to fluctuations in the course of its phenomenal manifestation. When a physical force ceases to exhibit itself in an active state, and passes into a potential modification, we are not compelled to regard it as extinguished.

It is merely latent or inhibited, but always ready to take its place again among the kinetic forces of nature. In like manner there seems to be no good reason why that spiritual force or congeries of forces which constitutes the mind of man may not experience analogous transformations in successive periods of action and of repose. Such periods of rest occur in sleep, in coma, in disease and disorganization of the brain. The mind sleeps, it does not cease to [Pg 16] exist—probably not even when death dissolves its material substratum.

That the depth of sleep is exceedingly variable is evident in the experience of every one. A German physiologist [17] has made a rough estimate of the soundness of sleep by comparing the loudness of the noises necessary to wake the subject of experiment at regular intervals during the course of the night.

He arranged a gong with a pendulum attachment, and noted the length of the stroke which produced a sound sufficiently loud to awaken the patient. In this way the different degrees of intensity of the awakening noise could be calculated, and the corresponding depth of sleep could be estimated.

It was thus concluded that the depth of sleep increases rapidly during the first hour, at the end of which time it has reached its maximum. During the next half hour it diminishes as rapidly as it had increased in the first half hour.

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During the next hour it still further diminishes, almost as much as it increased during the second half hour. The remaining ten half hours of the experiment were occupied by a comparatively light and gradually diminishing slumber, until the vanishing point of sleep was reached at the expiration of eight hours from its commencement.

This observation corresponds with the general opinion that sleep is deepest in the early part of the night. For the same reason dreams and [Pg 17] wakefulness are most frequent during the early watches of the morning. When considering the causes of sleep it is needful to exclude from view those artificial varieties of sleep that are produced by the various narcotic drugs, as well as the counterfeits of sleep which result from diseased conditions of the body.

It is comparatively easy to frame hypotheses in explanation of such interruptions of our conscious life; but, when we attempt to formulate a theory which shall satisfactorily account for the occurrence of natural sleep in healthy animals, the task becomes exceedingly difficult. First among the causes of sleep may be reckoned the alternation of day and night.

With the disappearance of sunlight all nature sinks into a condition of repose. In this tendency to nightly inaction man shares with all other living creatures. His body thus testifies to the intimacy of its relations with all portions of the solar system. Originated in the tropical regions of the earth, where day and night are nearly equal, we find in all parts of the world the same hereditary need of a period of rest, nearly coincident with the duration of the shorter nights of the tropical year.

What Are Sleep Disorders?

Had the birth-place of primeval man been situated within the Arctic circle, it is probable that his hours of sleep might have differed considerably from the [Pg 18] number now needed by the average individual. So powerful are the necessities thus dependent upon the harmony between our organization and the movements of the earth, that if the habit be formed of sleeping at other hours than those which are usually devoted to that purpose, the full complement of sleep is still needful to satisfy the demand for rest.

Prominent among the causes which predispose to sleep at night is the cessation of a majority of the sensations that are continually pouring in upon the brain during the period of daylight. Hence the necessity for seclusion in darkened rooms, from which the noises of the daytime are shut out, if one would sleep during the long days of the arctic summer, or if one would enjoy a midday nap at any season of the year. II, Part 2, p. Whenever the sound eye and ear were bandaged so as to cut off all communication with the brain, the patient invariably fell asleep in the course of two or three minutes after the interruption of sensation.

In like manner, some people, even in perfect health, are able to sleep at any time by simply lying down and closing the eyes. Such persons, however, are not often very highly gifted in the intellectual sphere. They generally belong to a class of men whose lives are laborious and liable to great irregularity and fatigue.

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As soon, therefore, as they can find a quiet corner from which the commotion of the elements is excluded, it is only necessary to close the eyes—the principal avenue of communication with the outside world—and sleep begins at once. This is especially true if severe bodily exertion has preceded the opportunity for repose. Fatigue of any sort is one of the most energetic causes of sleep.

The impossibility of long sustained exertion is a fact almost too familiar to attract attention. Every muscle must be suffered to rest for a time after contraction before it can be again contracted.

Treatment and care of sleep disorders

Even the heart and the muscles of respiration must be allowed to enjoy regular periods of repose many times each minute. These are examples of local rest, not involving the entire body. But if the whole body participate in any violent action, every part will manifest a consequent disposition to rest. Witness the effects of the venereal act. Every muscle is relaxed; the brain, which has officiated as the supreme source of energy, experiences exhaustion, and sleep frequently terminates the voluptuous paroxysm. In like manner, sensations of severe pain, if sufficiently prolonged, become a cause of sleep.

Prisoners upon the rack have slept through sheer exhaustion while undergoing the horrors of torture. The depressing emotions, even, may so fatigue the brain as to induce sound sleep through reaction from previous [Pg 20] excitement. Every wearied portion of the body must rest; and when the brain thus rests, sleep is the consequence. Impressed by the force of such considerations, certain physiologists [18] have reasoned from the analogies suggested by a study of the results of muscular fatigue, and have suggested an hypothesis accounting for the occurrence of sleep by a supposed loading of the cerebral tissues with the acid products of their own disassimilation during wakeful activity.

How do I best manage insomnia and other sleep disorders in older adults with cancer?

The acid reaction of the brain and of the nerves after exertion, corresponding with the development of acids in the muscular tissues during contraction, suggested the probability that an excessive presence of lactic acid and its sodic compounds might be the real cause of cerebral torpor and sleep. Its administration for this purpose, however, has yielded only the most discordant and unsatisfactory results.

The fatigue theory, moreover, is insufficient, since it furnishes no explanation of the invincible stupefaction produced by cold, nor does it render intelligible the unbroken sleep of the unborn child. Like all other bodily organs, this substance is renovated by the assimilation of nutrient materials derived from the blood.