Importance of deep refreshing sleep

[62milestogojoe]

Hi, I mentioned a breakthrough moment in Ayurvedic treatment regarding N3 sleep (former stage 4) which I thought was critical in other posts on the forum. I went back to an essay I posted in the blog and have pasted it below.
Regarding the material I've put up on PET scans and neuroinflammation it is worth pointing out that IL-6 levels increase as a result of diminished sleep quality-this reinforces the inflammatory positive feedback loop.

Happy for anybody to pick this up and run with it.

'Normal sleep patterns consist of 3 non REM phases. Each phase is characterized by specific changes in Electroencephalography (EEG) (43). There follows a period of Rapid Eye Movement (REM) sleep. The four phases in total makes up one cycle of normal sleep of approximately 90 minutes duration.(44).


The phase of sleep that is most relevant to normal functioning is N3 deep sleep(45). This phase is characterized by slow, large delta waves (previously denoted as stage 4 sleep). It is concomitant with "refreshing sleep"(46). The N3 stage is considered to be of greatest physiological importance(47) because deprivation of N3 leads to physical, mental and emotional fatigue and diminished ability to perform higher level cognitive functions.(48). Lack of refreshed sleep has been shown to course neuronal degradation from the activity of free radicals (and an increase in glucocorticoids)(49).

During sleep, most body systems are in a heightened anabolic state - accentuating the growth and rejuvenation of immune, nervous and muscular skeletal systems(50). Further, secretion of Growth Hormone, which is pulsatile with episodic bursts, occurs in N3 stage sleep. This is precisely the phase of sleep which is deregulated in CFS/ME(51). There is evidence that Alzheimer's disease may be the result of chronic sleep debt(52).

Patients suffering from CFS/ME report refreshed sleep deprivation being the norm, suffered continuously not occasionally. Profound fatigue results(53).

Warwick University studies (54) indicate lack of sleep can double the risk of death from cardiovascular disease. Direct results of sleep deprivation include memory lapse, impaired judgement, impaired immune system, risk of Type 2 diabetes developing, increased reaction time in muscle and tremor(55).


Studies of sleep deprivation in CFS/ME clearly show disruption of N3 stage sleep.(56). Hence, the metabolic benefits of refreshed sleep are lost, for example increased glymphatic clearance of metabolic waste products produced by neural activity in the brain (57). Sleep combats the accumulation of free radicals in the brain, in which glial cells are restored with glucose (via activity of GH)(58). N3 stage sleep is necessary for survival. (59)


Does dysregulation of N3 stage sleep implicate disruption of hypothalamic function? Sleep is highly dependent on the activity of the hypothalamus and reticular formation (RF) (60). The RF cholinergic system is linked to the hypothalamus and and has active involvement in the generation, timing and execution of sleep and the regulation of transition between the different sleep stages.(61).

Projection neurons in the RF modulate EEG waves(62). The hypothalamic suprachiasmatic nucleus (brain's biological clock) controls diurnal cycles thus regulating the timing of sleep and wakefulness(63). Prostaglandins are released to generate sleep(64). Also of note is that the adrenergic system (medulla) generates wakefulness (65). If the hypothalamus is indeed damaged in its normal functioning capacity this "wakefulness" system could be compromised.'

 

[Cheesus]

I've had two occasions since I became sick when I had AMAZING sleep. I would go to bed and fall into the most wonderfully relaxing and restful seep - the kind of thing you have forgotten actually exists once you have had this disease for a few years.

Both times, I woke up the next morning not only feeling refreshed but actually feeling measurably better. I've always wondered how I would feel if I could keep up that quality of sleep for, say, a month. The change was like night and day after one night of meaningful sleep, so I wonder if repair could happen rapidly if that kind of sleep could be attained regularly.

 

[lansbergen]

For quite some while now I sleep like a baby and awake refreshed but I still get easely fatique and pain when I do things.

 

[TenuousGrip]

I had overnight polysomnography. It revealed that only 1.6% of my sleep was Stage III Non-REM. Normal is between 15 and 20%.

And I'm a hot mess, so ... I do believe that non-restorative sleep can start a downward health spiral.

 

[Mij]

I've experienced restful/restorative sleep for many years in a row since becoming ill 26 yrs ago. It made no difference in my illness.

 

[caledonia]

I've been in sleep deprivation hell since last year. I took me quite awhile to even realize that my drop off in energy was due to my sleep. I believe I've developed sleep apnea. It does run in my family. Still working on getting a viable sleep test completed so I can find the cause for sure (long story :-(

If apnea or PLMD etc. isn't the reason, my doc said something about using 1 to 2mg of sinequan (doxepin) to help get into stage 3 and 4 sleep.

 

[NelliePledge]

I went back to an essay I posted in the blog and have pasted it below.

hi @62milestogojoe can you post a link to the blog so we can see the footnotes/links

 

[markielock]

I struggle to get to sleep regardless of what I try to remedy it. Perhaps I'm doing something wrong but I noticed if I can't sleep until after 2am and even still get 8-9 hours, my symptoms are 10 times worse and I feel sleep deprived all day... but then I can't get to sleep at a good time the next evening! (UGGGGHH). I think I must be clashing with my body's natural rhythm to get deep sleep... That's just my guess on why it makes my symptoms worse but I have no idea how they're so closely tied as they're there regardless of whether I sleep well or not.

Like others, I've not woken up feeling refreshed from an amazing sleep in years .

 

[sarah darwins]

I struggle to get to sleep regardless of what I try to remedy it. Perhaps I'm doing something wrong but I noticed if I can't sleep until after 2am and even still get 8-9 hours, my symptoms are 10 times worse and I feel sleep deprived all day... but then I can't get to sleep at a good time the next evening! (UGGGGHH). I think I must be clashing with my body's natural rhythm to get deep sleep... That's just my guess on why it makes my symptoms worse but I have no idea how they're so closely tied as they're there regardless of whether I sleep well or not.

Like others, I've not woken up feeling refreshed from an amazing sleep in years .

There's definitely something in that. I hate going to bed early but I do seem to feel somewhat better when I do it. Late nights, even if you 'make up' the sleep, seem to be bad for a lot of us.

Having said that, I think 62milestogojoe is right that there's something about the quality of sleep we get that is important. I used to dream vividly and remembered plenty of dreams. In the years since I became ill I've only remembered a handful of dreams. It's as though I hardly dream at all. I sleep easily enough, but it's lousy sleep.

 

[caledonia]

I struggle to get to sleep regardless of what I try to remedy it. Perhaps I'm doing something wrong but I noticed if I can't sleep until after 2am and even still get 8-9 hours, my symptoms are 10 times worse and I feel sleep deprived all day... but then I can't get to sleep at a good time the next evening! (UGGGGHH). I think I must be clashing with my body's natural rhythm to get deep sleep... That's just my guess on why it makes my symptoms worse but I have no idea how they're so closely tied as they're there regardless of whether I sleep well or not.

Like others, I've not woken up feeling refreshed from an amazing sleep in years .

Two "sleep hygiene" things I've found that seem to help are -

1) Get off the computer by early in the evening, say, 7-8pm. (The blue light from screens in the evening tells your body to wake up, so you may stay up late because of it. Your body is expecting amber light in the evening.)

2) Go outside in the morning and get 5-10 minutes of morning sunlight. (which is the blue light at the right time)

These will help reinforce your natural circadian rhythm. There seems to be a lag time between getting light exposure and the effect of it. So something you do on Monday won't take effect until Tuesday.

 

[Cheesus]

I've had two occasions since I became sick when I had AMAZING sleep. I would go to bed and fall into the most wonderfully relaxing and restful seep - the kind of thing you have forgotten actually exists once you have had this disease for a few years.

Both times, I woke up the next morning not only feeling refreshed but actually feeling measurably better. I've always wondered how I would feel if I could keep up that quality of sleep for, say, a month. The change was like night and day after one night of meaningful sleep, so I wonder if repair could happen rapidly if that kind of sleep could be attained regularly.

Bit weird replying to myself, but anyway...

It just occurred to me that the reason I felt better might not have been because I slept well, but rather I slept well because my disease process very briefly abated. This actually make more sense.

 

[62milestogojoe]

I've had two occasions since I became sick when I had AMAZING sleep. I would go to bed and fall into the most wonderfully relaxing and restful seep - the kind of thing you have forgotten actually exists once you have had this disease for a few years.

Both times, I woke up the next morning not only feeling refreshed but actually feeling measurably better. I've always wondered how I would feel if I could keep up that quality of sleep for, say, a month. The change was like night and day after one night of meaningful sleep, so I wonder if repair could happen rapidly if that kind of sleep could be attained regularly.

Hi Cheesus, how are you doing after your 'excursion'? The first time I achieved N3 sleep was a revelation too- and having been down the chamomile tea, valerium, zopiclone, melatonin, fluoxetine etc route the only things that got me to 2.8 out of N3 is GABA and low dose mirtazapine (mirth-as-a-pea!).

What got me to regular N3 was I think the shirodhara treatment, which is Indian ayurvedic treatment aimed specifically as a therapy of the brain. There are pictures of it in the albums section. When I was first confronted with lying on a wooden bench for an hour with my eyes covered while a therapist poured hot oil in a endless pattern across my forehead-well I was skeptical to say the least.

An hour later I could hardly speak-the effect was profoundly strange, almost transcendental, very deep. I had 5 of these sessions and on the 3rd night and then on for 3 months I slept normally for the first time in 5 years. It was bliss. I am still below 3 but once in a while dip into a lovely 3-you know it when you've had it!

When I questioned the doctor about this shirodhara technique his explanation was that the liquid put a therapeutic pulse through the brain. How did the dambusters destroy dams? Not through high explosive but through the power of vibration. How are brain problems being treated on the cutting edge for autism? Transcranial magnetic pulse stimulation. It would be positive to see a trial of this technique for ME patients.

 

[62milestogojoe]

I've experienced restful/restorative sleep for many years in a row since becoming ill 26 yrs ago. It made no difference in my illness.

Hi Mij, non-restorative sleep is one of the major diagnostic factors in ME. Can you say what other debilitating diagnostic factors you still have?

 

[62milestogojoe]

hi @62milestogojoe can you post a link to the blog so we can see the footnotes/links

Hi NelliePledge, I don't know how much energy you have but if you search the sentence in the passage you will find the reference in google and be able to go to the abstracts/papers. They are all genuine, and may have been added to over the last 2 years. Sorry.

I've looked through the 3 handwritten draft copies and can't find them and my wife can't find the one typed up. When you locate them and more contemporary research I would be interested to hear what you've learned.

 

[62milestogojoe]

There's definitely something in that. I hate going to bed early but I do seem to feel somewhat better when I do it. Late nights, even if you 'make up' the sleep, seem to be bad for a lot of us.

Having said that, I think 62milestogojoe is right that there's something about the quality of sleep we get that is important. I used to dream vividly and remembered plenty of dreams. In the years since I became ill I've only remembered a handful of dreams. It's as though I hardly dream at all. I sleep easily enough, but it's lousy sleep.

Hi, I still remember the 'acute' stage of sleeping 22 hours a day, every day and waking up to feel like I'd had 2 minutes sleep. Horrible.Debilitating.

 

[62milestogojoe]

hi @62milestogojoe can you post a link to the blog so we can see the footnotes/links

Here is the link-
http://forums.phoenixrising.me/index.php?entries/paper-on-cfs-me-the-brain.2088/

Good luck

 

[62milestogojoe]

I've had two occasions since I became sick when I had AMAZING sleep. I would go to bed and fall into the most wonderfully relaxing and restful seep - the kind of thing you have forgotten actually exists once you have had this disease for a few years.

Both times, I woke up the next morning not only feeling refreshed but actually feeling measurably better. I've always wondered how I would feel if I could keep up that quality of sleep for, say, a month. The change was like night and day after one night of meaningful sleep, so I wonder if repair could happen rapidly if that kind of sleep could be attained regularly.

Here is a link to a photo of shirodhara-normally, the patients' eyes would be covered
http://forums.phoenixrising.me/index.php?useralbums/aurvedic-2.137/view

 

[Mij]

Hi Mij, non-restorative sleep is one of the major diagnostic factors in ME. Can you say what other debilitating diagnostic factors you still have?

Well let's see . . . PEM is the big one. I was diagnosed with 'atypical' M.E' by an M.E specialist. I've never had severe insomnia or pain.

 

[62milestogojoe]

Well let's see . . . PEM is the big one. I was diagnosed with 'atypical' M.E' by an M.E specialist. I've never had severe insomnia or pain.

Thanks, does that malaise include cognitive dysfunction? Pain has never been a major issue with me most of the time but it's interesting that sleep disruption does not feature in your ME.

 

[Mij]

Yes, the cognitive function is included, but that only started 10 years after the onset of illness.