Sleep, Sleep Stages and Sleep Hygiene


In this article, it is planned to explain the concepts of sleep, sleep stages and sleep hygiene. First of all, if we try to define sleep; It is a process in which the brain is active but closed to external stimuli, which covers one third of our lives, has important effects on both our mental and physical health, and is necessary for us to lead a normal and healthy life. It may not be appropriate to make a clear definition of sleep because there are still unknowns about sleep and many researches on sleep are being done. In addition, many studies now agree on the importance of sleep.

It has been proven that sleep is not a simple process of rest and silence, in fact, it has a complex and mysterious structure full of unknowns. Sleep is thought to be important in many functions (Güleç G., 2018). These; It includes functions such as regeneration and growth of the body, preservation of metabolic energy, preservation of intellectual performance, neuronal maturation (REM), learning and memory (REM). It has been determined that the brain is active during sleep, includes neurophysiological regeneration and repair, includes processes such as storing what has been learned and preparation for wakefulness. Sleep is very important for the regeneration of the body and the proper functioning of hormones. Many studies on sleep and memory have proven that sleep is very critical for recording memory (Öztürk & Uluşahin, 2016; p. 478). Sleep deprivation has serious adverse effects, both physiological and psychological. In short, sleep is very important in our life cycle.

Sleep Stages

Sleep basically consists of two phases. Scientific names; They are REM (Rapid Eye Movement) and Non-REM (Non Rapid Eye Movement). Non-REM, on the other hand, consists of four stages. From this point of view, we can say that there are actually five stages of sleep. In a natural sleep, there are 4-5 cycles between REM and NonREM (such as nonREM-REM-NonREM-REM).

REM sleep can also be known as desynchronized sleep, D sleep, reverse, paradoxical and active sleep. During the REM period, brain activities and EEG are similar to the waking state, muscle tone decreases and the physical state is in the most sedentary mode. In addition, the most important feature of REM sleep is rapid eye movements. Dreams are also seen in this process. Pulse, breathing may be irregular and may increase, and there may be irregular muscle movements. “Functional imaging studies show that brain energy metabolism in the REM period can be the same or even higher than in wakefulness” (Öztürk & Uluşahin, 2016, p. 477). In nonREM sleep, brain activity and metabolic rate are low. Sympathetic activities, heart rate decreases. On the other hand, parasympathetic activity increases. Also known as S (synchronized, silent) sleep. NonRem sleep is divided into four stages according to brain activities and EEG changes. In NonREM, Stage 1 is the transition from wakefulness to sleep. Sleep is very light in this stage. Eye movements are slow. Stage 2 is the long sleep stage when sleep begins to deepen. Eye movements slow down even more, muscle movements also slow down. However, sleep has not yet deepened. Stage 3, sleep deepens and a delta wave occurs. In stage 4, delta waves increase more. Sleep is very deep in this stage. Behaviors such as talking, walking, and bedwetting during sleep occur in this stage. Stage 5 can be listed as REM sleep. This sequence can repeat 4-5 times during the night. “In a healthy young person, 2-3% of all sleep is stage 1, 45-55% is stage 2, 3-8% is stage 3, 10-15% is stage 4.” REM period is one-fifth of total sleep. In a normal sleep, the first REM occurs after an average of 90-120 minutes. (Öztürk and Uluşahin, 2016; p. 477). In humans, the sleep cycle and its content vary according to age.

If we briefly touch on the issue of sleep disorders, sleep-related disorders are also diverse, as sleep is a complex process. sleep disorders in DSM-5; insomnia disorder, hypersomnia disorder (narcolepsy), breathing sleep disorders, circadian rhythm sleep and wake disorders, parasomnias, substance or drug-induced sleep disorders, other specified sleep disorder, unspecified sleep disorder (American Psychiatric Association, DSM, 2014) ).

Sleep disorder is an important condition that needs to be examined in detail. As in most medical conditions, the evaluation of sleep disorders begins with a meticulous history” (Pıçak, İsmailoğulları et al., 2010). For this reason, we may need to routinely perform sleep examinations on individuals who apply as clinicians. Generally, the person applying for this issue; It is important that we ask questions about transitioning to sleep (diving), events in sleep (dreaming, grinding teeth, etc.), waking up (early, late, waking up style). In addition to these, processes such as age, drugs used, sleep habits/hygiene, other signs of disease, and sleep laboratory should be examined if necessary (Öztürk & Uluşahin, 2016, p. 478).

Sleep Hygiene

Things to consider for a healthy and natural sleep process are defined as sleep hygiene. Now we see that almost everyone has a little bit of knowledge about sleep hygiene. In this article, the most basic issues to be considered about sleep hygiene are listed below:

  • Sleep discipline is important. Accordingly, consistent/fixed bedtime and wake-up times will increase your sleep quality. Having pre-sleep routines that calm you before sleep will also improve sleep quality (like a warm bath).

  • Adults taking long naps during the day other than nighttime sleep disrupt their sleep routines. Therefore, do not make sleepovers longer than 1 hour.

  • Associate your bed with sleep. Do not do activities such as eating, entertainment, television other than sleep activities in your bed.

  • Your bedroom should be a calm, peaceful place that makes you feel safe. The presence of stimulating items or odors in your bedroom will impair the quality of sleep. Additionally, make sure your bedroom is a dark room or not too light.

  • Getting sunlight during the day, getting enough oxygen and exercising regularly increase the quality of night sleep.

  • Do not consume stimulants such as caffeine and alcohol before sleep. Do not consume food close to sleep. You can consume drinks that will relax you.

  • Do not force yourself to go to bed before you are sleepy.

  • Psychological causes that may affect sleep quality will need to be treated. For example, mental traumas, depression and anxiety problems can impair sleep quality. In such a case, it is necessary to seek support from a professional.

  • It may be helpful to consult a doctor to investigate other causes that may affect sleep. It is known that other diseases also impair sleep quality (American Sleep Association, 2018).

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