🎙️ Introduction

Hello and welcome to Cadabam’s Insights.
One more series, one more episode, and one more very important topic.

Today, we’re talking about one of the most fundamental aspects of human life—sleep. An activity so essential that it is as important as, if not more important than, the food we eat.

To help us understand sleep better, we are joined by Dr. Tejus, Consultant Psychiatrist based in Bangalore.
Dr. Tejus completed his MBBS and post-graduation in Psychiatry and has a special interest in sleep and sleep disorders.

Welcome to Cadabam’s Insights, Dr. Tejus.

🧠 What Is Sleep?

Dr. Tejus:
Sleep is a recurrent, physiological state of rest where an individual appears unconscious and non-responsive, but significant mental activity continues in the background.

Although the body is resting, the brain remains active—processing information, restoring functions, and preparing us for the next day.

Sleep is restorative, particularly for the brain.

🐾 Is Sleep Unique to Humans?

Sleep is not unique to humans. Almost every animal sleeps.

What is unique about humans is that we are the only species that willfully deprives itself of sleep.

Sleep Duration Across Age Groups

• Newborns: 13–16 hours/day
• 1 year old: ~12 hours/day
• 10 years old: ~10 hours/day
• Adults: 7–10 hours/day

Sleep patterns and structure change significantly with brain development.

👶 Why Do Babies Sleep More?

In newborns, the arousal system in the brainstem is not fully developed.
As a result:

• Sleep is fragmented
• Babies wake up frequently
• Sleep cycles are irregular

As the brain matures (around 6–12 months), sleep patterns begin to resemble adult sleep.

🌙 Stages of Sleep Explained

Sleep is divided into two major types, cycling every 90–120 minutes throughout the night:

1️⃣ Non-REM Sleep

• N1: Light sleep, awareness fades, muscle jerks may occur
• N2: True sleep begins, awareness fully diminishes
• N3: Deep sleep (hard to wake), most restorative phase

2️⃣ REM Sleep (Dream Sleep)

• Rapid eye movements
• High brain activity
• Dreams occur
• Memory consolidation happens here

🧠 REM sleep is crucial for learning and memory

🎓 Why Sleep Matters for Students

• REM sleep consolidates what we learn during the day
• Sleep deprivation before exams reduces learning efficiency
• Students may study hard but fail to retain information without adequate sleep

🔄 How Sleep Cycles Work

• First half of the night: Deep non-REM sleep dominates
• Second half: REM (dream) sleep increases

Missing the second half of sleep = missing REM = poor memory consolidation

⚠️ What Happens When We Don’t Sleep?

Short-Term Effects

• Poor concentration
• Irritability
• Slower reaction time
• Reduced judgment (similar to being legally drunk)

Long-Term Effects

• Increased cortisol (stress hormone)
• Weak immunity
• Higher risk of:
  • Anxiety
  • Depression
  • Diabetes
  • Heart disease
• Emotional instability
• Impaired decision-making

🛑 Sleep debt cannot be fully recovered on weekends

🚨 Sleep Deprivation & Major Disasters

Studies link sleep deprivation to:

• Road accidents (1 in 6 accidents)
• Chernobyl nuclear disaster
• Challenger space shuttle explosion

Sleep loss affects judgment, reaction time, and decision-making.

😴 What Is Insomnia?

Insomnia is defined as:

• Difficulty initiating sleep
• Difficulty maintaining sleep
• Poor sleep quality
• Feeling unrefreshed despite adequate opportunity to sleep
  → Leading to daytime dysfunction

Types of Insomnia

• Primary insomnia: Genetic, neurochemical imbalance (low GABA)
• Secondary insomnia: Due to physical or mental illness

🩺 Types of Sleep Disorders

1. Insomnia
2. Sleep-related breathing disorders (e.g., sleep apnea)
3. Hypersomnia (excessive daytime sleepiness)
4. Circadian rhythm disorders
5. Parasomnias (sleepwalking, night terrors)
6. Sleep-related movement disorders

🚶 Sleepwalking (Somnambulism)

• Occurs during deep non-REM sleep
• Muscle tone is intact
• No memory of events
• Can be dangerous (even driving has been reported)

⚠️ Treatment is necessary if safety is compromised.

🧪 How Are Sleep Disorders Diagnosed?

• Clinical assessment
• Sleep questionnaires
• Polysomnography (Sleep Study)
• Multiple Sleep Latency Test (for hypersomnia)

🍷 Alcohol & Sleep: A Dangerous Myth

• Alcohol may induce sleep initially
• But it disrupts sleep architecture
• Suppresses REM sleep early → rebound anxiety later
• Leads to dependency and worsening sleep

❌ Alcohol is not a solution for sleep.

🛏️ Sleep Hygiene: First Line of Treatment

• No caffeine after 4 PM
• Avoid tobacco before bed
• No daytime naps
• Avoid screens 1–2 hours before sleep
• Use bed only for sleep
• Exercise in the morning, not evening
• Maintain consistent sleep schedule

🧠 CBT-I: Gold Standard Treatment

Cognitive Behavioral Therapy for Insomnia

• Long-term benefits
• More effective than medication alone
• Corrects sleep habits and thought patterns

💊 Role of Medication

• Used when necessary
• Short-term support
• Gradual tapering once sleep stabilizes
• Always combined with behavioral interventions

❌ Common Sleep Myths (Debunked)

• “My body adjusts to less sleep” → ❌ False
• “Snoring is harmless” → ❌ False
• “Naps compensate for poor sleep” → ❌ False
• “Only overweight people get sleep apnea” → ❌ False
• “The brain shuts down during sleep” → ❌ False

🌟 Closing Message

Sleep is not optional.

It is foundational to:

• Mental health
• Physical health
• Emotional regulation
• Learning and productivity

If sleep is disturbed, seek professional help early.

Thank you, Dr. Tejus, for an enlightening and impactful discussion.

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