Sleep induction

Sleep induction, the deliberate effort to bring on sleep by various techniques or medicinal means, is practiced to lengthen periods of sleep, increase the effectiveness of sleep, and to reduce or prevent insomnia.

Alcohol

An alcoholic drink or nightcap is a long-standing folk method which will induce sleep, as alcohol is a sedative. However, when the alcohol blood level subsides, there is a rebound effect: the person becomes more alert and so tends to wake up too soon. Also, if they continue to sleep, REM sleep is promoted, and this may cause vivid nightmares which can reduce the quality of the sleep.^[1]

Guided imagery

To relax and so promote sleep, a meditation in the form of guided imagery may be used. The stereotypical method is by counting sheep, imagining sheep jumping over a fence, while counting them.^[2]

In most depictions of the activity, the person envisions an endless series of identical white sheep jumping over a fence, while counting the number that do so. The idea, presumably, is to induce boredom while occupying the mind with something simple, repetitive, and rhythmic, all of which are known to help humans sleep. It may also simulate REM sleep, tiring people's eyes.

According to a BBC^[3] experiment conducted by researchers at Oxford University, counting sheep is actually an inferior means of inducing sleep. Subjects who instead imagined "a beach or a waterfall" were forced to expend more mental energy, and fell asleep faster than those asked to simply count sheep. Sleep, by the same token, could be achieved by any number of complex activities that expend mental energy.

Darkness and quiet

Dim or dark surroundings with a peaceful, quiet sound level are conducive to sleep.^[4] Retiring to a bedroom, drawing the curtains to block out daylight and closing the door are common methods of achieving this. When this is not possible, such as on an airplane, other methods may be used, such as masks and earplugs which airlines commonly issue to passengers for this purpose.

Hot bath

The daily sleep/wake cycle is linked to the daily body temperature cycle. For this reason, a hot bath which raises the core body temperature has been found to improve the duration and quality of sleep. A 30-minute soak in a bath of 40 degrees C which raises the core body temperature by one degree is suitable for this purpose.^[5]

Sex

Sex, and specifically orgasm, may have an effect on the ability to fall asleep for some people.^[6] The period after orgasm (known as a refractory period) is often a time of increased relaxation, attributed to the release of the neurohormones oxytocin and prolactin.^[7]

Sleeping pills

Main article: Hypnotics

Hypnotics, sometimes referred to as sleeping pills, may be prescribed by a physician, but their long-term efficacy is poor and they have numerous adverse effects including daytime drowsiness, accidents, memory disorders and withdrawal symptoms.^[8] If they are to be taken, the preferred choices are benzodiazepines with short-lasting effects such as temazepam or the newer Z-medicines such as zopiclone.^[9]

Nonprescription medications

A number of nonprescription medications have shown effectiveness in promoting sleep. the amino acid Tryptophan and its related compounds 5-HTP and Melatonin, have common use, with the prescription medication Rozerem (Ramelteon) operating on the same biochemical pathway.^[10] An urban legend states that certain foods, such as turkey and bananas, are rich in tryptophan and thus assist sleep. This has not been confirmed by research. The herb Valerian, from which the drug Valium was derived, has effects similar to the benzodiazepine family.

Warm milk

A cup of warm milk or a milk-based drink is traditionally used for sleep induction.^[11] Hot chocolate is traditionally a bedtime drink but this contains high levels of xanthines (caffeine and theobromine), which are stimulants and so may be counter-productive.^[12]

Yawning

Yawning is commonly associated with imminent sleep, but it seems to be a measure to maintain arousal when sleepy and so prevents sleep rather than inducing it.^[13] Yawning may be a cue that the body is tired and ready for sleep, but deliberate attempts to yawn may have the opposite effect of sleep induction.

See also

• Postprandial somnolence
• Postprandial dip
• Caffeine-induced sleep disorder

References

1. ^ Marc Galanter (1998), The consequences of alcoholism, p. 210 et seq., ISBN 9780306457470, http://books.google.com/?id=MlvZGm16RMEC&pg=PA210 
2. ^ P Martin (2005), Counting sheep: the science and pleasures of sleep and dreams, St. Martin's Griffin 
3. ^ "Counting sheep keeps you up". BBC News. 2002-01-24. http://news.bbc.co.uk/cbbcnews/hi/sci_tech/newsid_1780000/1780803.stm. Retrieved 2010-05-12. 
4. ^ Seymour Diamond, Donald J. Dalessio (1992), The Practicing physician's approach to headache, p. 53, ISBN 9780683025064, http://books.google.com/?id=f8BrAAAAMAAJ 
5. ^ Judith Floyd (1999), "ch 2. Sleep Promotion in Adults", Annual Review of Nursing Research, 17, ISBN 9780826182364, http://books.google.com/?id=IZL_eUNZN8UC 
6. ^ Saltz, Gail (2007-07-11), Jump in bed: Sex can help you stay healthy, http://today.msnbc.msn.com/id/19696794/, retrieved 2009-08-29, "Having fun in bed is not only good for a relationship, but also good for you" 
7. ^ Exton MS, Krüger TH, Koch M, et al. (April 2001). "Coitus-induced orgasm stimulates prolactin secretion in healthy subjects". Psychoneuroendocrinology 26 (3): 287–94. doi:10.1016/S0306-4530(00)00053-6. PMID 11166491. 
8. ^ "Sleep complaints: Whenever possible, avoid the use of sleeping pills.", Prescrire Int. 17 (97): 206–12, 2008, PMID 19536941 
9. ^ Sleeping tablets, NHS, http://www.nhs.uk/Conditions/Insomnia/Pages/Treatment.aspx 
10. ^ Wurtman RJ, Hefti F, Melamed E (1980). "Precursor control of neurotransmitter synthesis". Pharmacol. Rev. 32 (4): 315–35. PMID 6115400. http://wurtmanlab.mit.edu/publications/pdf/466.pdf. 
11. ^ Martin Reite, John Ruddy, Kim Nagel (2002-03-27), Concise guide to evaluation and management of sleep disorders, p. 98, ISBN 9781585620456, http://books.google.com/?id=sutrAAAAMAAJ 
12. ^ Laurel A. Eisenhauer, Lynn Wemett Nichols, Roberta Todd Spencer (1998), Clinical pharmacology and nursing management‎, p. 360 
13. ^ Ronald Baenninger (1997), "On Yawning and its functions", Psychonomic Bulletin &Review 4: 198–207, http://www.baillement.com/texte-baenninger-yawning.pdf