The ABCs of ZZZs
Do you remember a wonderful nightly activity that involves closing your eyes and remaining horizontal for eight hours until sunrise? If you have a baby, probably not. A poll by the National Sleep Foundation found that 76 percent of parents have frequent sleep problems. Of course, none of this is news -- especially if you have an infant.
Clearly, sleep deprivation, whether it's due to the arrival of a baby, a bout of insomnia, or other problems is nothing to yawn at. The good news is that there are strategies you can use to get the rest you need.
We often think of sleep as one solid, unchanging state of unconsciousness. But there are actually two different types of sleep: rapid eye movement (REM), known as dream sleep, and non-REM. Non-REM is made up of four stages. Stage one is a drowsy state when the body begins to relax and you have a semi-awareness of your surroundings. In stage two, body and eye movements cease and brain waves slow down. This is the stage we call "falling asleep." Stages three and four are deep sleep; breathing is regular and you show no response to what's going on around you. These are the most restorative stages of sleep.
Moving through these four stages takes about 90 minutes, after which the body shifts into REM, the period in which most dreams occur. Your closed eyes begin to dart back and forth, as if you're watching a movie, and brain waves speed up. The entire cycle of four stages and a period of REM sleep is completed about four to six times a night, says Amy Wolfson, PhD, author of The Woman's Book of Sleep (New Harbinger, 2001). REM segments last about 10 minutes at first and increase in length as the night wears on. Most of our deep, restorative sleep normally takes place during the first third of the night, while dream sleep tends to be concentrated toward morning.
The Importance of Sleep
The effect of fragmented sleep goes beyond a tired body -- it also affects how you think and cope. With this kind of sleep deprivation, you're not just shortchanged on deep sleep; you're also getting less dream sleep, says Lauren Broch, PhD, director of education and training at the Sleep-Wake Disorders Center of New York-Presbyterian Hospital.
Dreams provide more than fodder for the next day's musings. In fact, they play a surprisingly important role in our ability to think clearly. During REM sleep, the brain sorts memories and processes the day's events, says Margaret Moline, PhD, director of the Sleep-Wake Disorders Center. Lack of REM sleep can cause memory lapses and make tasks requiring higher cognitive functioning more difficult, leaving you feeling scattered and foggy (as in, "Did I just change a diaper?"). For moms, this makes a range of daily activities problematic -- from balancing the checkbook to conjuring up the patience to deal with a cranky toddler. Indeed, it's much harder to use techniques such as distraction or humor (instead of yelling) when you're exhausted.
Newborn Sleep Patterns
Your infant's sleep patterns are nothing like yours. First, his sleep includes a higher percentage of REM; at 3 months, your newborn spends 50 to 80 percent of sleep time in REM, compared with your 20 percent. Second, his sleep cycles run approximately 50 minutes; yours 90.
All of this means that your newborn will wake up easily, sleep for shorter periods -- no more than three to four hours, and maintain his light, disordered "pattern" around the clock.
Of course, if your baby's awake, so are you, which means you're on call throughout the night to feed and comfort him. This type of sleep deprivation, typical of parents of newborns -- where over the course of eight hours you're up two or three times for 20 minutes (or longer) -- is even more grueling than getting just five hours of straight sleep. Why does the number of awakenings matter more than total hours? For one, sleep fragmentation causes a significant decrease in your deep sleep. That's because each time you get up and then go back to bed, you have to start the sleep cycle all over again, entering the light stages before you return to deep sleep. The result: exhaustion.
Helpful Sleep Tips
Whatever is coming between you and blissful unconsciousness, there are ways to reach your sleep quota:
- Make up for lost sleep. Over a short period of sleep deprivation, it's possible to compensate for some of what you've missed. When a person who's long been bereft of sleep finally gets some shut-eye, the brain will make up both deep and REM sleep, says Moline. You'll spend more time proportionately in deep and REM sleep than normal, at the expense of the lightest stages. Sleeping a bit more on the weekends -- say, two or three hours -- can be beneficial. But don't let a little extra dozing turn into a sleep binge. Overdosing on sleep can start a whole new cycle of deprivation, because then you won't be tired at bedtime.
- Catch a nap. New moms shouldn't try to be more productive during baby's nap time. A 20- to 30-minute nap will refresh you without causing sleep inertia, that groggy, out-of-it feeling when you wake up. Most people, not just new moms, could benefit from a short afternoon nap. But don't sleep any later than 2 or 3 p.m. That may interfere with your bedtime. If your baby isn't on a regular nap schedule, take advantage of offers of help from friends and relatives. Let your mother hold and entertain the baby while you crash for a while.
- Trade off middle-of-the-night feedings. When one half of the new-parent team works outside the home, it's tempting for the at-home half (typically the mother) to do all the feedings so the "working" one can get up in the morning. But taking on round-the-clock feedings can lead to serious sleep deprivation. It may make sense to rotate nights, so one person does all the feedings while the other sleeps. That way, at least one person gets a good night's sleep, instead of both of you getting fragmented sleep. Nursing mothers might consider pumping milk so Dad can take care of at least one nighttime feeding.
- Turn down the monitor. Newborns are active sleepers. If your baby is groaning or whimpering in the night, that doesn't mean you need to leap out of bed. Teach your baby to sleep through the night. By 6 months, most babies are capable of sleeping seven to eight hours at a stretch. To encourage your baby to fall back to sleep on her own in the middle of the night (instead of crying for you), put her to bed while she's still awake. Weaning her from whatever strategies you've been using to soothe her to sleep (nursing or rocking, for instance) will teach her not to rely on these when she wakes up.
Other Sleep Problems
Hormones can also cause sleepless nights. After ovulation, levels of progesterone start off high and then begin to fall. The more quickly levels drop, the more likely you are to have sleep problems.
You may take longer to drift off, have poorer-quality sleep, and feel more lethargic in the phase after ovulation up to the start of your period. The cramps and tender breasts of menstruation can also make you too uncomfortable to sleep well.
Perhaps most frustrating of all is that sometimes we just can't nod off, despite the fact that we're desperate for sleep. Here are some strategies for dozing off:
- Practice good timing. To help prevent insomnia, avoid eating heavy meals right before bed, don't do stressful tasks at night, don't exercise in the two or three hours before sleep (although early in the day is beneficial), and avoid caffeine within six hours of bedtime. A glass of warm milk may help -- warming the milk releases the tryptophan, which helps some people sleep.
- Set the mood. Your bedroom should be a quiet, dark, temperate haven to induce sleep. Use light-blocking window shades, turn a bright alarm clock away from you, and use a white-noise machine if necessary.
- Establish a sleep ritual. Doing the same thing each night before bed, such as reading a book or taking a bath, signals to your body it's time for sleep. Try to make bedtime and wake time the same each day.
- Seek professional help. Tell your doctor about any sleep difficulties you're having. Some problems, such as insomnia, may be a symptom of a physical or emotional illness.
If you're a member of the walking weary because you're a new parent, just remember that the grueling nights do come to an end. Pretty soon, you'll start vaguely recalling that enjoyable horizontal activity.
Reviewed 11/02 by Elizabeth Stein, CNM
All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.