Dreamland: Adventures in the Strange Science of Sleepby David K. Randall is another in the recent stream of accessable science reporting by  journalists, like books by Malcolm Gladwell and Charles Duhigg.

This probe into the science of sleep is for Randall a personal quest to understand his own sporadic sleepwalking. From it we learn that to get better sleep we should:

1. Avoid coffee and alcohol around bedtime
2. Take advantage of the circadian rhythms by getting natural light during the day and lower lights and avoid artificial lights around bedtime
3. Avoid non-sleeping activities in the bedroom
4. Take a cool shower, since, in falling asleep, the body temperature drops and the hands and feet get hotter as they give off heat, it can be helpful to cool down.
5. Exercise,which improves sleep, though some of the effects are more mental than physical.

We learn much more from this fascinating read which I review here. We learn that the advent of the light bulb significantly changed our sleep rhythms. Pre-Edison writings show that people would commonly awake once during the night and would engage in sundry activities before returning to sleep until morning. A study decades ago showed that when isolated from artificial light subjects return to a pattern of first and second sleeps. I have found personally when I get to bed early I will more likely awake in the middle of the night. I am less stressed to know that this is natural and not the sinister sign of insomnia.

Some sleep experts are puzzled as to why people would choose to share a bed with a spouse when it can mean a worse sleep for both of them. Further work confirmed that despite that, the benefits for some of bonding and security take precedence over comfort.

A chapter on dreams is interesting as it follows the theory of dreams from Freud with its pervasively sexual interpretations to modern researchers that ascribe less mysterious motives to our dreams. Many find them to be no more than the nocturnal counterpart to the daydreams that occupy our blank mind. Dreams could be understood by experts as being the brain reviewing and making sense of the previous waking hours. Where dreams are unusual or strange, they still are borrowing information that is present, around us in our daily lives.

A symptom of PTSD is recurring nightmares. One researcher found that some were helpful to take the recurring disturbing images and purposely choose replacement images that they would think about as they fell asleep.

I find the chapter about dreams as a source of source for ideas and breakthroughs to be more interesting. There are examples as diverse as Paul McCartney and Stephanie Meyers (of twilight fame). One theory was that the creative insights were the byproduct of memory housekeeping that occurs while we are in the REM sleep state.

Across the board, sleep helps us learn and solve problems. When we cannot get a full night’s sleep, a nap can provide an improvement in cognitive performance. Some businesses have installed designated napping areas in their offices.

Randall reports that lack of sleep has tragic effects in the military where friendly fire incidents are associated with lack of sleep and battle fatigue. Most military personnel rely on caffeinated drinks,enhanced coffee or even stimulants in pill form to stay alert. Many studies and experiments have tried to overcome man’s need for sleep. The bottom line was that only sleep can reliably overcome the lack thereof.

The chapter on sleep-walking, -driving and even -killing is fascinating. It is sad to think of those who, like the author who are victims of this condition, interesting how the has grappled with deciding how we treat crimes committed during sleep.

A chapter on sleep apnea, where a blocking of the airway routinely during sleep discusses the invention of the CPAP (Continuous positive airway pressure) machine that uses a pressurized face mask to keep the airways of apnea sufferers open as they get much needed sleep.

Insomnia is common. It is challenging, because though sleep is so beneficial for us, concentrating on getting to sleep makes it more elusive. Insomnia might be a cause of depression, not a result. Sleeping pills came in to fix this problem, but they showed a long list of side effects, including loss of memory and sometimes death by accidental overdose. Sleep aids are a big market with about one in four Americans having prescription sleeping pills in their medicine cabinet. Ironically some studies have shown that some products do not offer significant improvement in sleep quality and only a tiny improvement in quantity. Some sleep drugs make it harder to remember tossing and turning during the night. One, Ambien can lead to waking behavior that is embarrassing and vaguely remembered.

Studies showed that changing behaviors, not taking sleep pills are best for long term sleep quality. Though age is a factor in reduction in sleep quality, because REM sleep begins to decline after age 40.

Sleep inertia is the quality of fuzzy headed-ness that we have when we are awaken from sleep. It is a real curse to pilots that doe on long flights and then need to make crucial decisions after awakening abruptly. maybe this is the reason that I cannot feel awake after trying to take a Sunday afternoon nap. Student trying to avoid disrupting sleep at the wrong moment designed a system to track sleep stages (I believe there is now a Iphone app for this). It became a product that gives each sleep session a score from 0 to 120. Using the numbers allows people to do experiments to optimize sleep

Science has found that sleep depends on two things, first, getting the mind to calm down and second becoming comfortable enough that that physical issues are not obstacles

Finally, there is no perfect mattress, each seems to prefer whatever they are used to. An expensive mattress might feel vastly more comfortable, but it will not translate to a significantly better sleep.

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