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Dr. Andrew Rynne

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What To Do For Sleeping Disorder?

Sleep problem - I sleep through 8 hours during daytime. But at nighttime, I can't sleep 8 hours...only about 2-3 hours, then, stay awake for 8-10 hours before I can nap during daytime for ~3 hours. I'm unemployed. It seems that if I sleep during daytime, I get more quality sleep. But nighttime sleep pattern change is impossible! It's been years sleeping during daytime. I tried to change but I end up awaking in 2-3 hours later. Because of this trying to sleep less to make change, bowl movement is not well and I got belly.

I've been trying this for about 1 month, but sleep pattern to nighttime persists hard!
Appreciate your help.
Tue, 14 Jul 2015
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Psychiatrist 's  Response
Hi, welcome to health care magic.
Thanks for asking your query here.
I am Dr Alok Sinha, MD psychiatry from India. I will try my best to answer your question.

The problem you are having is called reversal of sleep wake cycle. I will explain it in details.

Let me take this opportunity to educate you a little about sleep. Sleep is an essential biorhythm. It is much needed for a healthy life and healthy mind.

During awake state our brain secrets a sleep producing substance which gradually accumulates and after several hours the level of sleep producing hormone is so high that our brain starts dozing off. About 6-8 hours of sleep is enough for rest and recovery of body. During sleep, activity of sleep producing substance gradually wanes and another chemical (called as sleep inhibiting substance) gets accumulated in mind gradually. After 6-8 hours, the level of this sleep inhibiting substance is so much that it wakes us up and maintains awakening for next many hours.
There are many natural factors which affect sleep. One of them is light. At evening when there is low light condition, our body secrets in mind a sleep producing substance called melatonin. In bright light melatonin secretion is inhibited. So in a normal healthy individual feels sleepy at night and fresh at day time.

Due to excessive use of artificial light, night parties, night shift job, sentries duties etc there is often a lag in induction of sleep. In these cases the persons catch up their sleep at day time and their sleep cycle is reversed.

Now coming to your case, it appears that due to any cause you gradually developed a habit of sleeping less at night causing insufficient sleep and sleep lag. Since your body could not get 6-8 hours of sound sleep, it tried to make up it later on in daytime. Over a period of time a new pattern of sleep wake cycle got set in and your body got habituated to fulfill most of the requirement of sleep at daytime. It is the new adaptation of body, due to which you get more sound sleep at daytime. But this is against nature and in long run it produces many problems in body like indigestion, hormonal changes, poor cognition etc.
Since you are having this habit since years, it may take some time to reverse it. If a person like you comes to my clinic, I ask them to do only one thing that they should leave the bed at 5 am and should not go to bed at day time. On first day the person feels sleepy at daytime but as he does not get sleep at daytime he feels sleepy at evening hours. So at around 7 PM he should go to bed. Definitely due to sleep lag the person goes to have a very sound sleep of about 08 hours. After 8 Hours, say at 0300 hrs the person awakes. On day 2, he is supposed to leave bed again at 5 AM in the morning. At daytime he has to maintain wakeful state anyhow and at evening he has to sleep at 7.30 PM. Now after 08 hours suppose he wakes up at 03.30 AM in the morning. On 3rd day again he has to leave bed at 05 AM, and to go sleep at 8 PM. Thus this gradual delay in onset of sleep is achieved, which finally restores the sleep cycle.

You may try it. Slow and steady wins the race. If you do get any difficulty, get profession help of a psychiatrist.
I hope it answers your question. I wish you all the best.
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What To Do For Sleeping Disorder?

Hi, welcome to health care magic. Thanks for asking your query here. I am Dr Alok Sinha, MD psychiatry from India. I will try my best to answer your question. The problem you are having is called reversal of sleep wake cycle. I will explain it in details. Let me take this opportunity to educate you a little about sleep. Sleep is an essential biorhythm. It is much needed for a healthy life and healthy mind. During awake state our brain secrets a sleep producing substance which gradually accumulates and after several hours the level of sleep producing hormone is so high that our brain starts dozing off. About 6-8 hours of sleep is enough for rest and recovery of body. During sleep, activity of sleep producing substance gradually wanes and another chemical (called as sleep inhibiting substance) gets accumulated in mind gradually. After 6-8 hours, the level of this sleep inhibiting substance is so much that it wakes us up and maintains awakening for next many hours. There are many natural factors which affect sleep. One of them is light. At evening when there is low light condition, our body secrets in mind a sleep producing substance called melatonin. In bright light melatonin secretion is inhibited. So in a normal healthy individual feels sleepy at night and fresh at day time. Due to excessive use of artificial light, night parties, night shift job, sentries duties etc there is often a lag in induction of sleep. In these cases the persons catch up their sleep at day time and their sleep cycle is reversed. Now coming to your case, it appears that due to any cause you gradually developed a habit of sleeping less at night causing insufficient sleep and sleep lag. Since your body could not get 6-8 hours of sound sleep, it tried to make up it later on in daytime. Over a period of time a new pattern of sleep wake cycle got set in and your body got habituated to fulfill most of the requirement of sleep at daytime. It is the new adaptation of body, due to which you get more sound sleep at daytime. But this is against nature and in long run it produces many problems in body like indigestion, hormonal changes, poor cognition etc. Since you are having this habit since years, it may take some time to reverse it. If a person like you comes to my clinic, I ask them to do only one thing that they should leave the bed at 5 am and should not go to bed at day time. On first day the person feels sleepy at daytime but as he does not get sleep at daytime he feels sleepy at evening hours. So at around 7 PM he should go to bed. Definitely due to sleep lag the person goes to have a very sound sleep of about 08 hours. After 8 Hours, say at 0300 hrs the person awakes. On day 2, he is supposed to leave bed again at 5 AM in the morning. At daytime he has to maintain wakeful state anyhow and at evening he has to sleep at 7.30 PM. Now after 08 hours suppose he wakes up at 03.30 AM in the morning. On 3rd day again he has to leave bed at 05 AM, and to go sleep at 8 PM. Thus this gradual delay in onset of sleep is achieved, which finally restores the sleep cycle. You may try it. Slow and steady wins the race. If you do get any difficulty, get profession help of a psychiatrist. I hope it answers your question. I wish you all the best.