Between 20 and 48% of the Spanish adult population has difficulty initiating or maintaining sleep, according to data from the Spanish Society of Neurology. In at least 10% of cases there is a chronic and serious sleep disorder. Temperature, noise, light or the use of mobile devices, among others, play a very important role, as we already know, when it comes to having good quality sleep.
One of the problems is this inability to sleep the hours needed continuously, without frequent and annoying nighttime awakenings. What is more important: having a deep sleep, even if it means sleeping fewer hours, or sleeping more total hours, even if we wake up? What does it really mean to have quality sleep?
“Going through each of the phases of sleep for the necessary time is what makes your sleep quality, the quantity does not matter so much. Approximately, we would have to spend 25% of sleep in the REM phase and the rest in the non-REM phase,” explains physicist and neuroscience doctor Sara Teller, author of Neurocuídate (Aguilar), in her book.
Teller explains the different types of insomnia that exist, and one of them is sleep maintenance insomnia: “When you wake up in the middle of the night, you stay awake for a while and then you go back to sleep. You may have several nighttime awakenings that cause you to have poor quality sleep.”
For Javier Albares, specialist in clinical neurophysiology, member of the Spanish Sleep Society (SUS) and the European Sleep Research Society, “it is not only important how many hours we sleep, but how deeply. It is relevant that there is a lot of slow wave phase (phase three or deep sleep), REM sleep.”
“It is important, therefore, the number of hours of sleep, the depth and also the continuity, that there are no sleepless nights. If there are awakenings, the sleep is of lower quality and is less restorative,” says Albares, who is also coordinator of the sleep problems care team at the Teknon Medical Center.
How do constant sleepless nights affect our body? There may be different repercussions. According to Albares, “a fractionated and poor quality sleep can affect all the functions of sleep, that is, its ability to cleanse toxins and waste, its very important capacity for memory and concentration, the immune system, the cardiovascular system, the mood, performance… Fractional sleep will be worse than continuous sleep for our body in all these aspects.”
Odile Romero speaks in the same sense. She is head of the Neurophysiology section of the Sleep Unit of the Vall d’Hebron Hospital and member of the insomnia working group of the Spanish Sleep Society. According to this specialist, “if we wake up during superficial sleep, we will not go deeper into sleep, and this means that it will be a lower quality sleep.”
As the Vall d’Hebron specialist points out, the consequences of sleep deficiency are diverse: “more cardiovascular risk, more metabolic risk, increased stress level… At the same time, this level of stress will cause more awakenings, arousals, as we call them. And we can end up entering a loop if the cause of the sleeplessness is excessive activity or a high level of alertness during the day. “This daily anxiety will cause you to perpetuate awakenings at night. It is a vicious circle that we must try to break, combating this stress and anxiety.”
The causes of continuous awakenings during the night are varied, and are not limited only to stress. “It can be due to stress, excessive activity during the day, anxiety… But also an emotional disorder, a physical cause such as sleep apnea (stopping breathing during the night), restless legs syndrome, nightmares… It must be “find out the cause to find the solution,” says Dr. Albares.
And physiologically, what explanation does it have for us waking up? “We don’t sleep the same all night,” explains Odile Romero. As the doctor comments, we complete a couple or three sleep cycles, and each of these cycles includes three phases: a shallow slow phase, a deep slow phase, and a REM phase. The first two repair physical fatigue, while the third, REM, restores memory and intellectual activity.
This first sleep cycle lasts a maximum of three hours and, from here on, “the level of alertness and the ability to wake up is more fragile.” And that’s why we wake up. The second cycle will come naturally and, in some cases, also the third, but the specialist in clinical neurophysiology says that the problem is that then we have already slept a few hours and our body’s need is not the same as at the time. the one we have put to sleep. That is why it is difficult for us to get back to sleep, and even more so if we get nervous and start thinking about what is worrying us.
This article was originally published on RAC1.