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Karla Ganger
Human African trypanosomiasis, also known as sleeping sickness, is a vector-borne parasitic disease. It is caused by protozoans of the genus Trypanosoma, transmitted to humans by bites of tsetse flies (glossina) which have acquired the parasites from infected humans or animals.
Behavior changes learned through cognitive behavioral therapy are generally the best treatment for ongoing insomnia. Sleeping on a regular schedule, exercising regularly, avoiding caffeine later in the day, avoiding daytime naps and keeping stress in check also are likely to help. But there are times when the addition of prescription sleeping pills may help you get some much-needed rest.
All prescription sleeping pills have risks, especially for people with certain medical conditions, including liver or kidney disease, and for older adults. Always talk with your health care provider before trying a new treatment for insomnia.
Always ask your health care provider about potential side effects before deciding which sleeping pills to consider taking. Depending on the type, prescription sleeping pills may include side effects such as:
Prescription sleeping pills (and even some nonprescription sleeping aids), as well as certain antidepressants, may not be safe if you are pregnant, breastfeeding or an older adult. Sleeping pill use may increase the risk of nighttime falls and injury in older adults. If you're an older adult, your health care provider may prescribe a lower dose of medicine to reduce your risk of problems.
If you live anywhere affected by the recent heatwaves, you may well have spent your nights tossing and turning, trying out different sleeping positions in an attempt to get comfortable. But what does the evidence say about which sleeping positions are actually the best?
First you need a way of working out which position people are sleeping in. You can ask them of course, but we only really remember the way we were lying when we were trying to fall asleep and the position we wake up in. To find out more, researchers have tried a variety of techniques including filming people while they sleep or getting them to use wearable technology that monitors their movements.
Researchers in Denmark used small motion-sensor detectors attached to volunteers' thighs, upper backs and upper arms before they went to sleep to establish their favoured sleeping position. They found that during their time in bed, people spent just over half their time on their sides, around 38% on their backs and 7% on their fronts. The older the people were, the more time they spent on their sides.
This bias towards sleeping on our sides is something we develop only as we become adults, because children over the age of three spend on average an equal amount of time sleeping on their sides, back and fronts.
So sleeping on your side is the most common position and we could trust the wisdom of the crowd to choose the position where they sleep best, but what about the data? A very small observational study in which people could sleep however they preferred found that those who slept on their right side slept slightly better than those on their left, followed by those on their backs.
If you find it easy to sleep on your side, then it's probably also best for anyone else trying to get to sleep nearby. On one occasion, while touring a submarine for a radio programme I was making, the submariners showed me their sleeping quarters, where the bunks were stacked so closely on top of each other that it was hard to turn over. That meant they tended to sleep on their backs, so they told me it was a race to get to sleep first before the whole cabin was full of snoring men.
Some snoring is caused by severe obstructive sleep apnoea, where breathing stops and starts while the person is sleeping. This has been found to be more common in people who consistently sleep on their backs.
By contrast, lying on your side helps to clear the upper airway and prevents the uvula (the fleshy bit that hangs down in the back of your throat) and the tongue from obstructing the throat, leading to less snoring. Indeed, in some cases, a move from sleeping mainly on your back to mainly sleeping on your side has been shown to solve the problem of sleep apnoea altogether.
But this doesn't mean sleeping on your side works for everyone or is a panacea for all aches and pains. It depends on your ailment and the exact position you adopt during sleep. Researchers in Western Australia monitored volunteers' bedrooms for 12 hours a night using automatic cameras and found that those who said they regularly woke up with a stiff neck spent more time sleeping in what the researchers refer to as "provocative side sleeping positions".
This phrase might conjure up all sorts of possibilities in your mind, but what it means in this context is sleeping on your side in a twisted position, for example, with your top thigh reaching across the other thigh, twisting the spine. By contrast, people who slept in a straighter, more supported side position reported having less neck pain.
What the design of this study couldn't ascertain of course is whether sleeping in the "provocative" position was causing the neck pain or whether people were adopting this position because it was the only way they could get comfortable because of neck pain.
In a study conducted with older people taking part in a fitness programme in Portugal, people with back pain were instructed to sleep on their sides and those with neck pain to try sleeping on their backs. Four weeks later 90% of the participants said their respective pains had reduced.
For one medical issue, it's not just a question of whether to lie on your back or side, but rather, which side you lie on. In acid reflux, gastric juices come up from the stomach, causing an intense burning in the chest. Sometimes doctors advise people to try sleeping on propped-up pillows in an attempt to relieve this very unpleasant kind of pain.
If the discomfort happens repeatedly it is known as gastro-oesophageal reflux disease, which can have serious consequences. Why this should have happened is not entirely clear, but one possible explanation is that sleeping on the left keeps the junction between the stomach and oesophagus above the level of the gastric acid. Sleeping on the right relaxes the lower oesophageal sphincter, allowing the acid to escape.
So the idea is to impose the least strain possible on your face while you sleep and that rules out sleeping face down. And if preserving your skin is most important to you than sleeping better or dealing with aches and pains or reflux, then sleeping on your side isn't ideal either.
Generally speaking, the longer an organism is awake, the more it feels a need to sleep ("sleep debt"). This driver of sleep is referred to as Process S. The balance between sleeping and waking is regulated by a process called homeostasis. Induced or perceived lack of sleep is called sleep deprivation.
There is disagreement on how much sleep debt is possible to accumulate, and whether sleep debt is accumulated against an individual's average sleep or some other benchmark. It is also unclear whether the prevalence of sleep debt among adults has changed appreciably in the industrialized world in recent decades. Sleep debt does show some evidence of being cumulative. Subjectively, however, humans seem to reach maximum sleepiness 30 hours after waking.[31] It is likely that in Western societies, children are sleeping less than they previously have.[39]
The quality of sleep may be evaluated from an objective and a subjective point of view. Objective sleep quality refers to how difficult it is for a person to fall asleep and remain in a sleeping state, and how many times they wake up during a single night. Poor sleep quality disrupts the cycle of transition between the different stages of sleep.[61] Subjective sleep quality in turn refers to a sense of being rested and regenerated after awaking from sleep. A study by A. Harvey et al. (2002) found that insomniacs were more demanding in their evaluations of sleep quality than individuals who had no sleep problems.[62]
Sleep also influences language development. To test this, researchers taught infants a faux language and observed their recollection of the rules for that language.[89] Infants who slept within four hours of learning the language could remember the language rules better, while infants who stayed awake longer did not recall those rules as well. There is also a relationship between infants' vocabulary and sleeping: infants who sleep longer at night at 12 months have better vocabularies at 26 months.[88]
Research suggests that sleep patterns vary significantly across cultures.[138][139][140] The most striking differences are observed between societies that have plentiful sources of artificial light and ones that do not. The primary difference appears to be that pre-light cultures have more broken-up sleep patterns. For example, people without artificial light might go to sleep far sooner after the sun sets, but then wake up several times throughout the night, punctuating their sleep with periods of wakefulness, perhaps lasting several hours.[138] During pre-industrial Europe, biphasic (bimodal) sleeping was considered the norm. Sleep onset was determined not by a set bedtime, but by whether there were things to do.[141]
The boundaries between sleeping and waking are blurred in these societies. Some observers believe that nighttime sleep in these societies is most often split into two main periods, the first characterized primarily by deep sleep and the second by REM sleep.[138]
In some societies, people sleep with at least one other person (sometimes many) or with animals. In other cultures, people rarely sleep with anyone except for an intimate partner. In almost all societies, sleeping partners are strongly regulated by social standards. For example, a person might only sleep with the immediate family, the extended family, a spouse or romantic partner, children, children of a certain age, children of a specific gender, peers of a certain gender, friends, peers of equal social rank, or with no one at all. Sleep may be an actively social time, depending on the sleep groupings, with no constraints on noise or activity.[138]
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