Medsarticles. Medical Weblog » Anti Depressants-Sleeping Aid

LEARN TO SLEEP: MULTIPHASIC PATTERN

admin — Fri, 08 May 2009 09:28:52 +0000

Sleep is a modified innate activity. Young babies sleep for about 16 hours a day, waking up about five to six times in the 24 hours for feeding. This multiphasic sleep pattern may be the innate pattern of sleep. Gradually, as we become older, we learn to sleep more at night and to stay awake more in the day. At about one year of age, we wake up only once or twice at night, but stay awake most of the day. When we reach school age, we go to bed at about 8 p.m. and wake up at about 7 a.m. the next day. When we are adults, most of us sleep for seven to eight hours each night at one stretch. Hence, through learning, we change from a multiphasic pattern to a monophasic pattern of sleep. In some countries there is a sleep in the afternoon called the siesta or midday nap. Sleeping at two different times in the 24 hours is known as a biphasic sleep pattern and is more natural and refreshing than a monophasic pattern since it more closely resembles the innate pattern of multiphasic sleep.

Hence learning a sleep pattern is like toilet training. We learn to sleep at certain times of the night. Our parents expect us to sleep at night, and our teachers expect us to stay awake in class. We are modifying the innate ability to sleep in order to fit in with society, the majority of which shows a monophasic sleep pattern.

Nowadays, with the help of the sleep laboratory, we can demonstrate that there is a recurrent 90 minute sleep cycle, discussed in detail in chapter 5 on Two Kinds of Sleep. Every 90 minutes throughout the 24 hours there is a few minutes of sleepiness which has been called the 90 minute window. During this window we can fall asleep easily if we want to. Can this be a vestige of the innate multiphasic sleep pattern?

Since sleep is a modified activity and we learn to sleep when we are very young, various problems are created. We learn a lot of bad sleeping habits. Bad habits are certain behaviours we pick up and incorporate into our routine.

We watch television in bed, we eat in bed, we stay up late at night, and wake up at all sorts of hours in the morning. Yet we expect to be able to sleep well whenever we want to. If we want to have better sleep, these bad habits have to be unlearned and eliminated.

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COMMON CAUSES OF ANXIETY: PROBLEMS OF EMOTIONAL REMOTENESS AND OF TOO CLOSE RELATIONSHIP AND SEXUAL PLEASURE IN CAUSING PAIN

admin — Wed, 29 Apr 2009 10:19:24 +0000

Because of their different personalities different individuals express their feelings of affection in varying degrees of emotional and physical closeness. The shy and inhibited introvert habitually defends himself by withdrawing from people. In the early stages of marriage he is simply unable to tolerate a very close relationship. If his partner is emotionally freer, and is not sensitive enough to perceive his need for emotional distance, she may produce extreme tension in the introvert by trying to come too close either emotionally or physically. On the other hand, if the introvert’s partner allows their relationship to develop slowly and easily, he will mature and come to make freer patterns of response which at first would have been quite impossible.

Sexual Pleasure in Causing Pain-The sex act evokes a different mental attitude in the man to that in the woman. The man is active and in a way aggressive, while she is essentially passive and accepting. In men, being active and aggressive may become associated with sexual feelings; but in another way aggressive action is associated with fighting and inflicting pain. In this way sexual pleasure may become unconsciously associated with causing pain, a condition known as sadism. The man with mild sadistic tendencies is rough with his sexual partner, and likes to penetrate roughly and deeply as if to hurt her. Conversely the passive and receptive elements in the woman may be associated with the idea of being hurt. She comes to experience sexual pleasure in being caused pain in her sexual relations. This is known as masochism. If the husband has marked sadistic traits, and if the wife is lacking in the corresponding masochistic elements, there will be tension and anxiety. If on the other hand these attitudes are reversed in an unnatural way so that the woman has the sadistic tendencies, then the tension is likely to be so much the greater because it conflicts more acutely with the male personality.

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HOW CAN I MONITOR MY RESPONSE TO ST JOHN’S WORT?

admin — Wed, 29 Apr 2009 08:52:43 +0000

Depression is by its very nature a discouraging condition and the response to anti-depressants in general is often not smooth and linear. Your mood can bob up and down and it may be hard to tell just where you are compared to where you were before you started treatment. In my practice I have used a very simple way to help my patients monitor their mood over time. Just as when you diet it is helpful to weigh yourself regularly so as to see the pattern of response, so it can be very helpful to chart your mood on a daily basis after you start a new type of anti-depressant treatment. And just as when you diet you can gain a pound or two on a particular day, perhaps as a result of water retention, even though you are succeeding in losing weight over the long run, so it is possible to have one or two bad days even though your mood may be better overall. Being able to refer to the chart is helpful in illustrating this overall improvement. Alternatively, if you are not improving, you might be inclined to try and kid yourself that you are. Referring to the chart may reveal this not to be so and prompt you to shift your strategy in finding a different way out of your depression.

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