Oh sleep! it is a gentle thing
http://edu-observatory.org/olli/Sleep/index.html



Oh sleep! it is a gentle thing, 
Beloved from pole to pole! 




The Rime of the Ancient Mariner (text of 1834)
By Samuel Taylor Coleridge
  https://www.poetryfoundation.org/poems/43997/the-rime-of-the-ancient-mariner-text-of-1834   

  PART V 
  Oh sleep! it is a gentle thing, 
  Beloved from pole to pole! 
  To Mary Queen the praise be given! 
  She sent the gentle sleep from Heaven, 
  That slid into my soul. 
  
  The silly buckets on the deck, 
  That had so long remained, 
  I dreamt that they were filled with dew; 
  And when I awoke, it rained.  




OUTLINE Why Sleep is Necessary Monitoring Sleep Problems Sleeping Possible Sleep Problem Solutions Insomnia (inability to sleep) Sleep Apnea (stopped breathing) Restless legs syndrome (RLS)

Why Sleep is Necessary
NIH: What Makes You Sleep? https://www.nhlbi.nih.gov/health/sleep-deprivation/body-clock NIH: Why Is Sleep Important? https://www.nhlbi.nih.gov/health/sleep/why-sleep-important https://www.nhlbi.nih.gov/resources?f%5B0%5D=language%3AEnglish Sleep Foundation: Why Do We Need Sleep? https://www.sleepfoundation.org/how-sleep-works/why-do-we-need-sleep https://www.youtube.com/watch?v=0LNdsTrQJCs (2+ min) https://www.youtube.com/watch?v=eTgNgGO_bLs (2+ min) Sleep is an essential function that allows your body and mind to recharge, leaving you refreshed and alert when you wake up. Healthy sleep also helps the body remain healthy and stave off diseases. Without enough sleep, the brain cannot function properly. This can impair your abilities to concentrate, think clearly, and process memories. Most adults require between seven and nine hours of nightly sleep. Children and teenagers need substantially more sleep, particularly if they are younger than five years of age. Work schedules, day-to-day stressors, a disruptive bedroom environment, and medical conditions can all prevent us from receiving enough sleep. A healthy diet and positive lifestyle habits can help ensure an adequate amount of sleep each night.

Monitoring Sleep
Mayo Clinic: Sleep-tracking devices: Dos and don'ts https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/sleep-tracking-devices-dos-donts/art-20481371 Sleep trackers may help improve your sleep, but don't jump to conclusions based on your data. Get the facts from a Mayo Clinic wellness specialist. Adults need seven to nine hours of sleep a night, yet many people don't get enough. A cascade of sleep-tracking devices has recently hit the market. But can you trust the data? And do they help improve your sleep? Mayo Clinic Healthy Living Program wellness exercise specialist Thomas M. Rieck weighs in on the do's and don'ts of sleep trackers. Track your sleep on Apple Watch and use Sleep on iPhone https://support.apple.com/en-us/HT211685 Track your sleep with Apple Watch https://support.apple.com/guide/watch/track-your-sleep-apd830528336/watchos The Apple Watch uses motion sensors and its accelerometer to monitor your rest, and while that may seem insanely retro, it works. We're continually comparing and testing the best sleep trackers, and the Apple Watch is up there with the most accurate devices in terms of tracking sleep duration. We've used it extensively, and crucially, it does get that sleep duration figure right. Many smartwatches will offer a sleep duration that's eerily close to your time in bed, while the Apple Watch is sensitive enough to discount wake-ups and disturbances to give you an accurate sleep duration figure. Its figures are in the same ballpark as Fitbit and Whoop - two of the leading sleep trackers from our testing - and accuracy is one of the Apple Watch's strengths in this regard. The Apple Watch also uses the heart rate sensor to track blood oxygen and heart rate, this isn't factored into the assessment of your sleep - but you can check stats like blood oxygen saturation and heart rate during sleep in the Apple Health app, and keep an eye for any worrying trends. Again, the likes of Fitbit, Withings, and Whoop make this a core part of the sleep-tracking experience. Apple, on the other hand, keeps things focused on duration and consistency. Some Sleep Data Understanding Sleep Stages While you're sleeping, your body goes in and out of different stages of sleep. In general, a sleep stage is determined by the types of brain waves you produce. Most people will cycle through the different stages several times during a sleep session. While scientists and doctors can recognize which stage you're in, they're still working to fully understand the impact each stage has on the body. Awake You may find yourself awake during parts of a sleep session. It's normal for people to wake up on occasion. It's possible that you will fall right back to sleep and not remember waking up during the night. REM Sleep This stage of sleep may play a role in learning and memory. During this stage, your muscles are the most relaxed and your eyes move rapidly from side to side. This is also when most of your dreams occur. Core Sleep Sometimes referred to as light sleep, this stage is considered just as important as the others. This stage often represents most of your time asleep each night. Brain waves that may be important for cognition occur during this stage. Deep Sleep Also known as slow wave sleep because of the brain wave patterns, this is the stage where body tissues are repaired and essential hormones are released. This stage typically happens in longer periods during the first half of your sleep session. During deep sleep, the body is so relaxed that it can be more difficult to wake up from this stage than others. Understanding Your Sleep Stages There are many misconceptions around sleep stages and the quality of sleep. While some may need more deep sleep, others may not. Scientists and doctors are continuing to explore the purpose of the different stages and the impact they have on the body. By tracking your sleep stages and paying attention to how you feel each morning, you may gain insight into your own sleep.

Problems Sleeping
NYT: Why Do I Feel More Anxious at Night? https://www.nytimes.com/2023/03/23/well/mind/anxiety-night-sleep.html 1. Establish a caffeine cut-off 2. Put your worries onto paper 3. Give yourself something to look forward to Incorporating a few of these suggestions might help quiet your bedtime thoughts, experts explained, but if you're consistently waking up tired, ask your doctor to refer you to a sleep medicine specialist who can help you explore potential causes. And, if your sleeplessness is stressing you out, Dr. Pelayo had some words of comfort: "I want people to know that they don't have to feel this way," he said. "I tell my patients all the time, 'If you've ever slept well, you can sleep well again.'" CDC: Key Sleep Disorders https://www.cdc.gov/sleep/about_sleep/key_disorders.html Insomnia Insomnia is characterized by an inability to initiate or maintain sleep. It may also take the form of early morning awakening in which the individual awakens several hours early and is unable to resume sleeping. Difficulty initiating or maintaining sleep may often manifest itself as excessive daytime sleepiness, which characteristically results in functional impairment throughout the day. Before arriving at a diagnosis of primary insomnia, the healthcare provider will rule out other potential causes, such as other sleep disorders, side effects of medications, substance abuse, depression, or other previously undetected illness. Chronic psychophysiological insomnia (or "learned" or "conditioned" insomnia) may result from a stressor combined with fear of being unable to sleep. Individuals with this condition may sleep better when not in their own beds. Health care providers may treat chronic insomnia with a combination of use of sedative-hypnotic or sedating antidepressant medications, along with behavioral techniques to promote regular sleep. Narcolepsy Excessive daytime sleepiness (including episodes of irresistible sleepiness) combined with sudden muscle weakness are the hallmark signs of narcolepsy. The sudden muscle weakness seen in narcolepsy may be elicited by strong emotion or surprise. Episodes of narcolepsy have been described as "sleep attacks" and may occur in unusual circumstances, such as walking and other forms of physical activity. The healthcare provider may treat narcolepsy with stimulant medications combined with behavioral interventions, such as regularly scheduled naps, to minimize the potential disruptiveness of narcolepsy on the individual's life. Restless Legs Syndrome (RLS) RLS is characterized by an unpleasant "creeping" sensation, often feeling like it is originating in the lower legs, but often associated with aches and pains throughout the legs. This often causes difficulty initiating sleep and is relieved by movement of the leg, such as walking or kicking. Abnormalities in the neurotransmitter dopamine have often been associated with RLS. Healthcare providers often combine a medication to help correct the underlying dopamine abnormality along with a medicine to promote sleep continuity in the treatment of RLS. Sleep Apnea Snoring may be more than just an annoying habit - it may be a sign of sleep apnea. Persons with sleep apnea characteristically make periodic gasping or "snorting" noises, during which their sleep is momentarily interrupted. Those with sleep apnea may also experience excessive daytime sleepiness, as their sleep is commonly interrupted and may not feel restorative. Treatment of sleep apnea is dependent on its cause. If other medical problems are present, such as congestive heart failure or nasal obstruction, sleep apnea may resolve with treatment of these conditions. Gentle air pressure administered during sleep (typically in the form of a nasal continuous positive airway pressure device) may also be effective in the treatment of sleep apnea. As interruption of regular breathing or obstruction of the airway during sleep can pose serious health complications, symptoms of sleep apnea should be taken seriously. Treatment should be sought from a health care provider. Mayo Clinic: Sleep disorders https://www.mayoclinic.org/diseases-conditions/sleep-disorders/symptoms-causes/syc-20354018 A sleep disorder can affect your overall health, safety and quality of life. Sleep deprivation can affect your ability to drive safely and increase your risk of other health problems. Some of the signs and symptoms of sleep disorders include excessive daytime sleepiness, irregular breathing or increased movement during sleep. Other signs and symptoms include an irregular sleep and wake cycle and difficulty falling asleep. There are many different types of sleep disorders. They're often grouped into categories that explain why they happen or how they affect you. Sleep disorders can also be grouped according to behaviors, problems with your natural sleep-wake cycles, breathing problems, difficulty sleeping or how sleepy you feel during the day.

Possible Sleep Problem Solutions
AASM: Healthy Sleep Habits https://sleepeducation.org/healthy-sleep/healthy-sleep-habits/ CDC: Tips for Better Sleep https://www.cdc.gov/sleep/about_sleep/sleep_hygiene.html Mayo Clinic: Sleep tips: 6 steps to better sleep https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/sleep/art-20048379 You're not doomed to toss and turn every night. Consider simple tips for better sleep, from setting a sleep schedule to including physical activity in your daily routine. Many factors can interfere with a good night's sleep - from work stress and family responsibilities to illnesses. It's no wonder that quality sleep is sometimes elusive. You might not be able to control the factors that interfere with your sleep. However, you can adopt habits that encourage better sleep. Start with these simple tips. 1. Stick to a sleep schedule 2. Pay attention to what you eat and drink 3. Create a restful environment 4. Limit daytime naps 5. Include physical activity in your daily routine 6. Manage worries Asked ChatGPT: What are effective ways to fall back asleep after waking up in the middle of the night? ChatGPT Replied: Here are some effective ways to fall back asleep after waking up in the middle of the night: 1. Relaxation techniques - Practice relaxation techniques like deep breathing or progressive muscle relaxation. This can help calm your mind, reduce anxiety and help you fall back to sleep. 2. Avoid screens - Avoid watching TV, using your phone, or computer as the light can keep you awake. Instead, do something quiet and calming like reading a book. 3. Keep your bedroom dark and cool - Make sure your bedroom is dark and quiet, and keep the temperature cool. A comfortable environment can help you sleep better and faster. 4. Avoid caffeine and alcohol - Stay away from food or drinks containing caffeine or alcohol, as they can keep you awake. 5. Get up and try again later - If you can't fall back asleep after 15-20 minutes, get up and do a quiet and calming activity. Only go back to bed when you feel sleepy again. 6. Stick to a routine - Sticking to a regular sleep schedule, including the time you go to bed and wake up, can help regulate your internal body clock and improve sleep quality.

Insomnia (inability to sleep)
Progressive Muscle Relaxation Script https://www.therapistaid.com/worksheets/progressive-muscle-relaxation-script Progressive muscle relaxation is an exercise that reduces stress and anxiety in your body by having you slowly tense and then relax each muscle. This exercise can provide an immediate feeling of relaxation, but it's best to practice frequently. With experience, you will become more aware of when you are experiencing tension and you will have the skills to help you relax. During this exercise, each muscle should be tensed, but not to the point of strain. If you have any injuries or pain, you can skip the affected areas. Pay special attention to the feeling of releasing tension in each muscle and the resulting feeling of relaxation. Free Relaxation Scripts https://www.innerhealthstudio.com/relaxation-scripts.html The free relaxation scripts provided here allow you to learn to quickly and easily relax at home. You can use these written materials to record your own relaxation audio or learn to relax. The scripts here are for personal use, or they may be used to facilitate relaxation sessions at no charge to clients. Brief structured respiration practices enhance mood and reduce physiological arousal https://doi.org/10.1016/j.xcrm.2022.100895 Mayo Clinic: How to manage daylight saving time https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/how-to-manage-daylight-saving-time

Sleep Apnea (stopped breathing)
Resvent iBreeze Auto CPAP Machine Review 2022 https://cpapsupplies.com/blog/resvent-ibreeze-auto-cpap-machine-review Continuous positive airway pressure (CPAP) therapy is a common treatment for obstructive sleep apnea. The Resvent iBreeze Auto CPAP machine has emerged as an innovative, feature-packed option for sleep apnea treatment in recent months. This is great news for those who have had a hard time finding a CPAP machine after Philips Respironics machines being recalled, which included many DreamStation models. The resulting surge in demand for ResMed AirSense 10 machines created a shortage of those products, and now users are left with fewer options. Fortunately, the iBreeze APAP machine has been granted emergency use authorization by the FDA. iBreeze series machines are now widely accessible for people who are newly diagnosed with sleep apnea, or who simply need to replace a worn out machine. While commonly referred to as an auto CPAP machine, the Resvent iBreeze is actually an APAP machine, which provides automatic positive airway pressure as opposed to continuous positive airway pressure. The difference is that an APAP machine automatically adjusts the pressure level on a breath-by-breath basis to meet your needs rather than providing the same fixed level throughout the night. This makes it easier for people who struggle to adjust to standard CPAP therapy. Mary Greeley Medical Center Home Medical Equipment issued a Resvent iBreeze Auto CPAP machine to me, as I was diagnosed with moderate to severe sleep apnea last fall. The CPAP info screen shows that on the night beginning on 3/31/2023 the CPAP was in use for 8.1 hours and recorded an average apnea-hypopnea index rate of no more than 0.1 events per hour. The fresh filtered (and humidity controlled) air for comfortable quiet sleeping, is a joy. I embraced this new way of sleeping on the very first night--actually in the first five minutes. Smiling!

Restless legs syndrome (RLS)
Mayo Clinic: Restless legs syndrome https://www.mayoclinic.org/diseases-conditions/restless-legs-syndrome/symptoms-causes/syc-20377168 Restless legs syndrome (RLS) is a condition that causes an uncontrollable urge to move the legs, usually because of an uncomfortable sensation. It typically happens in the evening or nighttime hours when you're sitting or lying down. Moving eases the unpleasant feeling temporarily. Restless legs syndrome, also known as Willis-Ekbom disease, can begin at any age and generally worsens as you age. It can disrupt sleep, which interferes with daily activities. Simple self-care steps and lifestyle changes may help relieve symptoms. Medications also help many people with RLS. NIH: Restless legs syndrome https://www.ninds.nih.gov/health-information/disorders/restless-legs-syndrome Asked ChatGPT: How to minimize the occurance of Restless leg syndrome (RLS). ChatGPT Replied: Restless leg syndrome (RLS) can be a challenging condition, but there are some steps that may help minimize its occurrence. Here are some suggestions: 1. Maintain a consistent sleep schedule: Stick to a regular sleep schedule by going to bed and waking up at the same time each day. Being consistent with your sleep routine can help reduce symptoms of RLS. 2. Exercise regularly: Exercise is an effective way to help manage RLS symptoms. It promotes healthy blood flow, reduces stress, and enhances sleep quality. 3. Avoid caffeine, alcohol, and tobacco: These substances can all exacerbate RLS symptoms. Try limiting your intake of caffeine, alcohol, and tobacco to minimize RLS occurrences. 4. Practice stress-reducing techniques: RLS symptoms can sometimes be triggered or worsened by stress. Consider practicing relaxation techniques, such as meditation, deep breathing, or yoga. 5. Take care of your iron levels: Iron deficiency can contribute to RLS, so it's important to maintain healthy iron levels. Consider including iron-rich foods in your diet, such as meat, seafood, beans, and leafy greens. Talk to a doctor or a registered dietitian about supplements or other treatments if you have low iron levels. 6. Consider medications: In some cases, medications can help manage RLS symptoms. Consult with a doctor or a sleep specialist to determine if medication is appropriate for you. It's important to note that RLS can be a complex condition that affects each person differently. These suggestions may not work for everyone, so it's always best to work closely with a doctor or a sleep specialist to find a treatment plan that works for you. sam.wormley@gmail.com