Rest and Stress

By Milton G. Crane, M.D. and Barbara G. Crane, R.D. of Weimar Institute

REST: Adequate rest is an essential for health. It is the means nature provides for restoration of depleted reserves. As long as we are alive we constantly are using up energy. Even without any physical activity we have certain basic caloric needs for cell activity. Our heart continues to beat. The blood courses through our arteries and veins. Breathing takes energy. Our brain is active even during sleep.

Rest and relaxation are extremely important parts of life's rhythm. It is just as important to health as is activity. We look forward to the end of the day or the end of the week when we can stop and change pace, spend time in relaxation, and recharge our body reserves. Our bodies are so designed that they cannot function without adequate periods of rest. To maintain vibrant health, we must have a balance between mental activity and physical labor. Proper activity and relaxation is needed for both natures of mankind.

SLEEP: Much has been learned about the mechanism of sleep and its restorative capabilities. In the last 10 years, more than 10,000 scientific articles have been published on sleep, yet it still retains some mysteries.

If we are to reap the restorative benefits of sleep, we must have two main types of sleep: REM sleep and NREM sleep.

REM sleep is an abbreviation for "rapid eye movement" sleep. This is the first stage we go into when we fall asleep. The eyes more horizontally in rapid sequence. To maintain health, we need 20%-25% of our sleep in this stage.

Deeper sleep is called NREM, "non-rapid eye movement" sleep. In this stage, the eyes are more or less fixed, although there may be occasional movement. About 75% of our sleep falls into this stage. Sleepwalking and night terrors may occur in this stage, but this is rare.

When we go to sleep, we pass rather rapidly to NREM sleep that is divided into four stages according to the depth of sleep. After about 70 minutes, we return to a lighter stage and into REM sleep for 30-45 minutes. Again, we return to NREM for 60-70 minutes. This cycle is repeated three or four times during a seven to eight hour period of sleep.

Drugs and alcohol bypass the REM sleep. These are definitely injurious to the restorative capability of sleep. A strong sedative may keep us asleep eight hours, but when we awake we feel tired and have not received the healing benefit of REM sleep. When we do not get enough REM sleep, the body tries to make up for this lack on the next night of rest. In the case of alcoholic delirium tremens (DTs), the body has been deprived of REM sleep for such a long time that it tries to catch up even while the person is awake. Hallucinations and agitation are "dreams" which occur while a person is awake. Most dreams that we have during sleep occur in the REM stage.

How much sleep do you need? Most adults need seven to eight hours of sleep. Children need more, and babies require as much as 20 hours out of a 24-hour day. As we get past 50, we need less sleep. We may want to get up at four or five in the morning, and many older people do that very thing. If you are going to do that, you should go to bed at nine or ten in the evening.

There are several sleep disturbances. Somnambulism or sleepwalking is one of the rare types. It occurs in the stages of deeper NREM sleep.

The most common sleep disturbance is insomnia – difficulty in going to sleep or difficulty in going back to sleep when one wakes up in the night. Insomnia may be caused by a variety of causes. One common cause is the use of drugs. We all know that stimulants such as tea, coffee, and cola drinks keep us awake because of their caffeine content. Sedatives may also be a cause of insomnia because the body develops resistance to their effect. Psychiatrists call this phenomenon "tolerance." The more sleeping pills that we use, the more we need to get the same effect. Some drug addicts can take 100 times the average therapeutic dose of a "downer" and still do not get much sedation.

Avoid all drugs, and especially alcohol, if you want to get a good night's sleep.
Persistent insomnia can be a serious thing. It may be a symptom of an underlying problem in your body or mind. Early awaking may be a sign of an organic depression that may require psychiatric care. (Do not worry about this if you have had six hours sleep.)

For mild or an occasional spell of insomnia, try the following program:

1. Establish a regular daily schedule. Go to bed at the same time each night whether sleepy or not. Get up at the same time each morning.

2. Eat your meals regularly. Have only a light evening meal or even skip it if you are having a weight problem. Avoid liquids and spices with meals.

3. Avoid drinking any beverages that contain caffeine.

4. Do not drink any alcoholic beverages. Even though some "experts" may disagree or may even prescribe alcohol as a sedative, it is not wise.

5. Have an adequate and regular exercise program.

6. Applying gentle heat to your body is a helpful aid to sleep. Do not take a hot bath before going to bed – it is too stimulating. Take a neutral bath or shower or apply warm fomentations.

7. Try to sleep where it is quiet. You may have to use earplugs.

8. Be sure your room is well ventilated with fresh air. Properly "ionized" oxygen, as found in outside air, can help you get restful sleep.

9. Try counting slowly. Just say: "one…two…three…" Counting one second at a time may get you to sleep in a minute or two.

10. Try to end your day on a low key. Avoid physical or emotional highpoints near the end of the day. Avoid TV, especially the spectator sports.

11. Spend some time in quiet reflection, meditation and prayer. Gratitude leads to sound sleep. Try reading a spiritually uplifting book.

12. Try recalling the last time you had a good night's sleep.

13. Do not get upset if you do not go to sleep. Lie quietly in bed and you will have catnaps without realizing it. Eight hours of lying in bed will give you the equivalent of four hours sleep – and you will break the vicious cycle caused by worry.

14. Do not get discouraged if you cannot sleep. Remember Napoleon. He got less sleep than you do, and he conquered most of Europe. Thomas Edison claimed he slept less than two hours a night. We do not recommend that, but maybe you are a genius.

MICRO-SLEEP: A far more dangerous problem with sleep is what is called, "Micro-sleep." Those of you who drive an automobile or who have worked with machinery may be familiar with what I'm talking about. When we have been sleep deprived or sleep deficient, we may experience brief periods, lasting only a few seconds, of going to sleep and then awakening.

Some people are more prone to do this than others. Know yourself. If you have a habit of going to bed at a certain time or of taking a nap at a certain period of the day, be especially alert to the danger of "micro-sleep" episodes, if you must drive at those times of day.

If "micro-sleep" happens to the person while he or she is driving, it can be very dangerous, even fatal. In our time of freeways of smooth roads, automatic shifting, cruise control, soothing music, soft comfortable seats, and hectic living, it may be fatal.

Caffeine beverages do not prevent the problem. The answer to the problem involves being aware of the possibility, concentrating on being alert, and taking brief naps or rest periods as necessary on long trips. A co-pilot may be needed. The co-pilot should be alert to the status of the driver and call for a change of drivers when the need arises. Don't try to "tough" it out!!

Copyright © 1995-2002 Milton G. Crane, M.D. and Barbara G. Crane, R.D., Weimar Institute, Weimar, CA 95736. All rights Reserved.