Don't Sleep (2017)
What's weird and that much more disappointing about "Don't Sleep" is Zach's not the only one haunted by his past. It literally takes a village to create and be moved by Zach's demons, like when a closet door mysteriously pops open while Shawn undresses before taking a shower. Or how about when Jo is having sex with Vincent, and she sees something terrible over her shoulder? You might think, based on this admittedly selective plot summary, that you were watching a horror movie about the terror of living with a "nice guy" type, someone who nobody is willing to admit is capable of hurting the women in his life. You don't even need to dig that far to find that subtext in "Don't Sleep." What else are we supposed to think when Jo drops a random truth bomb on Vincent, and recalls an urban legend that Mr. Marino once told her about a Crusades-era warrior who becomes a monster after his wife is repeatedly raped during his war-time absence? If this movie isn't about the nightmare of living with an unreflective white knight, what is it about?
Don't Sleep (2017)
A newer sleep classification system developed by the American Academy of Sleep Medicine has only three stages of NREM sleep: lighter sleep (Stages N1 and N2) and deeper sleep (or SWS; Stage N3).10 The major changes with the newer classification system are focused on electroencephalogram (EEG) derivations and the merging of Stages 3 and 4 into Stage N3.11 In a comparison of the two sleep classifications, only minor differences were noted for total sleep time, sleep efficiency, and REM sleep, but the choice of classification impacted the measurement of wake after sleep onset and the distribution of NREM sleep stages.11
Sleep disruption is frequently attributable to a sleep disorder, such as obstructive sleep apnea26,27 and restless legs syndrome, which is related to altered dopamine and iron metabolism; >50% of idiopathic cases of restless leg syndrome have a positive family history.28,29 Many major medical conditions have been associated with sleep disruption, particularly those that require nighttime medical monitoring (eg, continuous glucose monitoring for individuals with diabetes)38 or hospitalization, especially in an intensive or critical care unit.39,40
A recent review by Meerlo et al52 surveyed the evidence that showed that disrupted sleep is a major causal factor in the development of depression. An experimental study that compared the effects of forced nocturnal awakenings with restricted sleep opportunity and uninterrupted sleep showed that partial sleep loss from sleep continuity disruption was more detrimental to positive mood than partial sleep loss from delaying bedtime.53 Adult subjects experiencing forced awakenings had significantly less SWS after the first night of sleep deprivation than other participants. Furthermore, in adults who completed the Personality Assessment Inventory, self-reports of recurring sleep problems were associated with symptoms of depression and anxiety.54 The reported frequency of sleep disturbance was closely linked with the severity of the self-reported symptoms. Among primary care physicians, disrupted sleep was associated with high burnout levels.55
Sleep disruption alters cognition and performance in many domains, including attention/vigilance, executive function, emotional reactivity, memory formation, decision-making, risk-taking behavior, and judgment.56 An experimental study showed that SWS disruption resulted in slower or impaired information processing, impaired sustained attention, less precise motor control, and erroneous implementation of well-practiced actions.57 Younger, middle-aged, and older adults were similarly affected by SWS disruption. In another study, poor sleep quality negatively affected the emotional valence of memories.58
The coexistence of obesity, elevated BP and glucose levels, and low levels of high-density lipoprotein cholesterol defines the metabolic syndrome.91 An observational, cross-sectional study compared global scores on the PSQI with concurrently collected measures of metabolic syndrome components.91 Poor global sleep-quality scores on the PSQI were related significantly to the presence of metabolic syndrome, and the PSQI global sleep-quality score was significantly related to waist circumference, BMI, percentage of body fat, serum levels of insulin and glucose, and estimated insulin resistance.
A mutation in CRY1 makes our internal clock run slower, contributing to delayed sleep phase disorder, according to the research. Whereas people with typical sleep tend to fall asleep around midnight and wake around seven or eight in the morning, people with DSPD typically fall asleep three to four hours later and wake up around 11 a.m. to noon. This has ramifications beyond sleep.
The Nobel Prize, and continuing research, highlight how far sleep research has come: For many decades it had been neglected by the medical community, even though sleep, especially lack of it, can contribute to disease and cost society billions of dollars, a recent New Yorker magazine piece noted. Forty-seven million U.S. adults do not get a restorative sleep at night; workplace injuries and decreased productivity resulting from sleep deprivation are estimated to cost the United States billions annually; and tired drivers cause 20 percent of all car crashes, more than 1 million crashes a year.
"There definitely are correlations between this late sleep pattern and a variety of secondary diseases, not all of which we understand," said Alina Patke, a research associate at Rockefeller University and the lead author on the night owl study conducted at Young's lab. "People who have this preferred late chronotype, this night owl behavior," tend to score higher on measures of depression and are also more likely to suffer from other serious conditions, including heart disease, diabetes and obesity.
Outside of good sleep hygiene, including turning off screens before bed, there aren't many treatment options for DSPD, although scientists are beginning to explore novel treatments targeting the biological clock for sleep disorders, and related health conditions.
Commercial mail-in DNA testing service 23andMe doesn't currently screen for this particular genetic variation, so it won't show up in their results. But Patke also stresses that even without a CRY1 mutation it is possible to have a sleep disorder, including DSPD.
About 9 million, or 1 in every 25 Americans, take prescription sleep medication, spending $41 billion on sleep aids in 2015. The industry is supposed to reach $52 billion by 2020. Typical sleep meds, including Ambien and Lunesta, work by targeting neurotransmitters, the chemical signalers in the brain, either by enhancing the effects of calming neurotransmitters or diminishing the effects of those involved in arousal.
Rather than producing sleep medications, however, both companies are primarily focused on developing medications for the serious, secondary diseases associated with disordered sleep. "The same mechanism that drives circadian rhythm those rhythms exists in pretty much every cell in your body," explained Ross Bersot, president and CEO of Reset Therapeutics, based in San Francisco, which has developed drug compounds aimed at treating diabetes, non alcoholic fatty liver disease, hepatitis and other metabolic disorders by targeting CRY1 and other genes that control the sleep/wake cycle.
When we go to sleep and when we wake up has a cascading effect on the rest of the body's clocks, altering hormone levels throughout the day and impacting when the liver starts secreting certain enzymes, which affects the timing of when we get hungry, as well as glucose tolerance, insulin sensitivity and other factors that can contribute to the development of disease.
Another currently available option is Melatonin, a "darkness hormone" associated with sleep in humans, but that also exists in nocturnal animals. Studies have shown moderate effects on improving sleep for jet-lag sufferers and for night-shift workers taking melatonin, but not with insomnia and other sleep disorders. The effects of the hormone, which is available without a prescription, vary because each human body metabolizes it differently.
People who suspect they may have DSPD, and most people, should avoid late-night screen time and practice overall good sleep hygiene: Avoid caffeine before bedtime, turn off electronics, and avoid lingering in bed in the morning. Also skip late-night eating and keep to a meal schedule, Patke said, as the "clocks" in the liver and rest of the digestive system can also have a reciprocal effect on the sleep/wake cycle.
Most people with DSPD often don't get to live according to their internal clock because of the constraints of daily life, work and school, which can result in them not getting enough sleep. "If it's at all possible and compatible with your lifestyle and the pressures with your everyday life, you are better off sleeping in accord with internal clock," Patke said. Forcing yourself into society's box may be a large part of what is causing these problems in the first place.
The CDC recommends starting school later, which was found to imrpove academic performance, quality of life and physical health in adolescents. They tend to need more sleep than adults and younger children, and their success may be hindered by early school start times.
Society will still run, as morning people take the morning shifts. But the up to 10 percent of the population that has DSPD and other sleep disorders will be able to function at their best, even if the latest breakthroughs in sleep genetics don't turn into blockbuster sleep-aid drugs.
Study objectives: To document trends in self-reported sleep duration for the noninstitutionalized U.S. civilian population from 2004 to 2017 and examine how sleep trends vary by race/ethnicity.
Results: The prevalence of short sleep duration was relatively stable from 2004 to 2012. However, results from multinomial logistic regression models indicated that there was an increasing trend toward short sleep beginning in 2013 (b: 0.09, 95% CI: 0.05-0.14) that continued through 2017 (b: 0.18, 95% CI: 0.13-0.23). This trend was significantly more pronounced among Hispanics and non-Hispanic blacks, which resulted in widening racial/ethnic differences in reports of short sleep. 041b061a72
