How does it happen?

Social jet lag might best be described through an example. Say you work a typical eight hour workday, one that requires you to wake up around 6AM or so every morning during a typical week. Because you wake up at 6AM during most mornings, your circadian rhythms might align with a natural sleeping pattern designed around waking up at such an early time. Even though you might not like it, you’re more accustomed to waking up at that time than any other time. But when the weekend rolls around, you relish the opportunity to sleep in later, maybe until 8, 9, or 10AM. The discrepancy between those two general wakeup times—weekdays and weekend mornings—can take a toll on your body because it just wants a regular sleeping schedule. Switching around your wakeup times can put a great deal of stress on the body.

In other words, the sudden shift in your sleeping habits is equitable to sleeping in a different time zone: your body suddenly struggles to stick to its circadian rhythms, and this takes a toll on various systems in a body.  Under the sleep-induced strain, your body can’t perform normal metabolic functions as well as when it’s properly rested. Thus, the stress induced by your body from oversleeping (or underseelping) could lead you to gain weight over a period of time.

Social jet lag is a common practice

Perhaps the biggest problem with social jet lag is that it’s a nearly ubiquitous phenomenon, at least in the US. How many times have you said or heard someone else say that they’re looking forward to the weekend to “catch up on some sleep?” Sleeping in late on the weekends is practically a cultural pastime for people in the US, particularly among people who work night shifts, keep long hours, or stay out late at night. If the social jet lag theory proves true, that could mean serious trouble for the health of millions of Americans, and just one more factor in the ongoing obesity epidemic plaguing the country.

What about you?

Do you think that you might be suffering from social jet lag? Would you be willing to sleep in less during the weekend if it meant maintaining a healthy weight? Let me know in the comments below!

About the author:

Amelia Wood contributed this guest post. She pursues freelance writing projects in the medical billing and coding online niche. She especially loves hearing back from her readers. Questions or comments can be sent to wood. amelia1612 @ gmail.com.

“Silently the senses
Abandon all defenses
A place between sleep and awake
End of innocence, unending masquerade”

- From the song “Sleepwalker” by Nightwish

Sleep-walking, also known as Somnambulism is a disorder of arousal that falls under the group of “Parasomnia“. In contrast to dyssomnias, which produce insomnia or excessive sleepiness, parasomnias include those disorders that intrude into or occur during sleep but do not produce a primary complaint of insomnia or excessive sleepiness. Besides sleep-walking, other parasomnias are tooth grinding, sleep talking, nightmares, bed wetting, night terrors, etc.

EXPLANATION THEORIES

The most accepted and scientific theory is “Incomplete NREM arousal“:
Incomplete arousal usually occuring during the deepest stage of nondreaming (NREM) sleep, stages 3 and 4 leading to a split state of consciousness in which there is motor wakefulness and psychic sleeping is the cause of somnambulism. It is during this phase of sleep, when the body will toss and turn or you steal the blanket from your partner. In contrast, sleep paralysis occur during dreaming (REM) sleep leading to psychic wakefulness and motor sleeping.

Other theories:

• Acting out dreams:

In the past, scientists thought that somnambulism is actually a dreamer acting out his/her dream. But this theory has been discarded as the episodes have been found to occur during NREM (non-dreaming) phase of sleep from experiments. This theory has been found to be the basis for REM Sleep Behavior Disorder (RSBD).

• Trance theory of Alien abduction:

Some people believed sleep-walking to be an involuntary and unconscious movement from one place to another during alien abduction.

COMMON FEATURES

1. Eyes remain wide open and staring straight ahead.
2. Before walking the person often sits up in the bed to remain awake and occasionally gets up and walks immediately.
3. Sleep-walkers take no notice of their surroundings. Consciousness of being wide awake is not at all present.
4. Movements are stiff and awkward.
5. Difficult to wake up while in the middle of sleep-walking.
6. Once he or she is awake, the person often is confused and has little recall of the event.
7. Sleep-walking may suddenly end in inappropriate places or the person may return to bed and continue sleeping.
8. Sleep-walking episodes usually occur within 1-2 hours of falling asleep.
9. Span of sleep-walking usually ranges from few seconds to 30 minutes.

Common myths about sleep-walking:

1. Occurs when you are dreaming
2. Waking them up in middle can turn them violent
3. Somnabulists don’t injure themselves when sleep-walking

MOTOR ABILITIES IN SLEEP-WALKING

Sleep-walkers often develop astonishing motor abilities that can more readily be explained by the abnormal waking state than by the sleeping state. They are able to find their way through pieces of furniture placed close to each other, they can walk on op of narrow walls, and even climb around rooftops. Many a sleep-walker has in fact even leaped out of a window and awakened only upon landing on the street with a broken leg.

Some true stories of sleep-walking revealing such astonishing motor abilities that gained publicity:

1. A 15 year old girl from London had climbed the crane and walked across narrow beam, 130 feet above in the air.
2. A day nurse named “Lee Hadwin” is a “sleep artist” who sketches brilliantly in his sleep.
3. A middle-aged woman in Australia had sexual intercourse with strangers in sleep and she didn’t recollect the memory when awake in the following morning (Treated successfully in 2004).
4. A Toronto-man “Kenneth Park” drove about 23 km and murdered his mother in law in sleep in 1987.
5. A nurse got arrested in 2003 when she got drunk and drove and peed in the road but in sleep.
6. A chef named “Robert Wood” walks to kitchen and cooks in sleep.
7. A 51 year old electrician named “Timothy Brueggeman” died of hypothermia as he sleep-walked out of his home only in underwear and fleece shirt.
8. A girl named “Anna Ryan” gained 60 pounds due to habit of sleep-eating.
9. A girl named “Rachel Ward” in 2009, leaped out of window of the first floor and landed on the floor in sleep without breaking a single bone.
10. A woman was reported in 2008 to be sending emails in sleep and even inviting a friend for dinner and drinks.
11. A computer expert named “Ian” mowed the lawn naked at night during sleep.

In all of these cases, the sleep-walker was unable to remember anything about their nocturnal activities. Many of these cases prove that somnabulism is of medicolegal importance.

Prevalence:

• Around 17% of children and 4% adults
• More frequently seen in boys
• Rare in old age

Risk factors:

• Sleep deprivation and Obstructive sleep apnea
• Sleeping pills like Ambien especially when taken with alcohol
• History of confusional arousals in children
• Adults awakened for a brief period of time from sleep but unable to recollect anything in the morning have higher tendency to sleep-walk.
• History of sleep-walking in family.
• Other parasomnias like night terrors and bed wetting.
• Adverse effects of neuro-medications like chlorpromazine, lithium, etc.
• Disorders like schizophrenia, anxiety, parkinsonism, alzheimer’s disease, etc.
• Travel or unfamiliar surroundings
• Stress
• High fever, Migraine headaches
• Head injuries or stroke

Possible harmful effects:

Being in a sleepwalking state in itself doesn’t harm but the danger lies in the possible activities during the episode:

1. Injury to self or others
2. Disruption of other’s sleep

Precautions, Prevention and Treatment:

Precautions:

1. Not to permit persons inclined toward sleep-walking to sleep alone without being watched over.
2. Locate sleep-walker’s bedroom on the main floor and lock the windows.
3. Keep the floor clear of sharps and other harmful objects.

Prevention:

1. Setting a regular sleep schedule
2. Reducing stress
3. Minimizing sleep disturbing factors like noise as they can trigger episode
4. Avoiding drugs and their combination with alcohol

Treatment:

1. Treatment is not necessary except when the sleep-walkers have tendency to harm themselves or others.
2. Diagnosing underlying cause like seizures, stress, anxiety, etc. and treat them
3. Using antidepressants or benzodiazepine sleeping pills to limit episodes and promote sleep

References:

• “Speaking of Sleeping Problems” by Dietrich Langen, M.D.
• American Academy of Sleep Medicine
• Sleepwalking Serendip’s Exchange

“I couldn’t move and I could continuously hear a disorienting buzzing sound in the room but I could not turn to look at it because I couldn’t move, I struggled, I couldn’t cry for help and I could sense a weight on my chest like someone was sitting on it. It was like being awake in a nightmare and I told no one because I thought that there was some kind of demon that came to menace me but people wouldn’t believe me.”

Khyaak - The Demon Of The Dark

One of the commonest experiences of sleep paralysis (once called Old Hag Syndrome) has been quoted above. In its simplest form, sleep paralysis is a condition in which people wake from sleep to find that they are unable to move. In Nepal, experiences similar to that of sleep paralysis are often reported and ascribed to covering of the body by Ghost of the dark “Khyaak” during sleep. Constantly reported about for thousands of years, different cultures at different parts of the world have different figures associated with such kind of experiences. What makes “sleep paralysis” interesting is the fact that it has been associated several uncanny phenomenon like alien abduction, angelic or demonic visitations. Now let us look at it from the perspective of Medical science to make it more interesting. I will not make in truth claims here and leave it for you, dear readers to decide if the explanation makes sense.

MEDICAL CONCEPT

Medically, sleep paralysis is a common condition characterized by the inability to perform voluntary muscle movements occuring either during sleep onset (hypnagogic form) or upon awakening (hypnopompic form) and can often be accompanied by hallucinatory experiences. An attack of sleep paralysis is usually harmless and self-limited. It tends to be over in a minute or two as soon as the brain and body re-establish connections and the person is able to move again. It is most commonly associated with nacrolepsy, a neurological condition causing excessive uncontrollable sleepiness and sleep episodes occuring at anytime of the day. In the absence of nacrolepsy, sleep paralysis is termed as Isolated Sleep Paralysis (ISP) which occurs in otherwise healthy individuals and in some cases can be familial as well.

Classical symptom tetrad of Nacrolepsy:

1. Excessive day time sleepiness
2. Cataplectic attacks (sudden loss of muscle tone triggered by emotional stimuli like anger, fear, etc.)
3. Sleep paralysis
4. Hypnagogic and Hypnopompic hallucinations

Understanding normal sleep pattern:

The depth of sleep changes periodically. During sleep, your body alernates between orthodox or NREM (Non-Rapid Eye Movement) sleep and paradox or REM (Rapid Eye Movement) Sleep and the depth of sleep gradually increases with the beginning of NREM sleep. One cycle of NREM and REM sleep constitutes a sleep rhythm is repeated every 90 to 120 minutes and approximately 5 to 6 times within one night. NREM sleep occurs first and takes upto 75% of your overall sleep time. REM sleep is referred as paradoxical sleep because while the brain and other body systems becomes active (eye movement, accelerated respiratory and heart rate, rise in blood pressure, etc.), muscles become more relaxed. Dreaming usually occurs during each REM phase of sleep due to increased brain activity but only the last dream that took place before spontaneous awakening is remembered. Muslce atonia during dreaming state prevents our body from acting out your dreams.

Relation of REM Sleep with Sleep paralysis:

In a book “Speaking of Sleeping Problems” by Dietrich Langen, he explains about hypnagogic hallucinations:

Sensations occuring during sleep onset consist of optical or acoustic sensory experiences that are not the result of any external stimulus. They include flashes of light, colored rings, waves and other geometric figures, partly disfigured or fragmentary. Whole scenses with action sequences similar to visions also occur. Acoustic phenomenon include the perception of voices, hearing one’s name called or hearing entire fragments of conversation or music.

Sleep paralysis occurs in transition between wakefulness and sleep or vice-versa . The difference from normal REM sleep is that the REM atonia persists but waking consciousness is largely retained in sleep paralysis i.e. your brain is partially conscious and partially in dreamy state and often external environmental stimuli can be remembered. It may be either, a rational mind trying to make sense of dream sensations or a dreamy mind trying to percieve environmental stimuli but the hallucinations often turn horrific due to the fear that sets in due to paralysis.

Here is an Interview with Dr. Irshaad Ebrahim from London Sleep Center to asnwer your sleep paralysis related questions:

1. What is sleep paralysis?
2. Can sleep paralysis have long-term effects?
3. Does sleep paralysis affect many people?
4. At what stage of sleep does sleep paralysis occur?
5. How can you treat sleep paralysis?
6. What is happening to the brain during sleep paralysis?

A LOOK AT OTHER CONCEPTS

1. Demon like Khyaak, Succubus or Incubus sitting on a chest
2. Out of Body Experience (OBE) expained by Astral projection or travelling (separation of soul from the body during sleep)
3. Alien abduction

And in the end, few tips regarding prevention and treatment of sleep paralysis:

1. Improve sleeping habits as it is frequently associated with chronic sleep deprivation, sleep disruptions and irregular sleeping schedule.
2. Avoid stress and alcohol as they can lead to irregular sleep schedule and sleep disruptions.
3. Sleeping by lying on sides as sleep paralysis is mostly experienced in supine position (lying on back).
4. Medications for treatment of depression may be needed.
5. Evaluation and treatment of nacrolepsy may be needed.