After a long day at work, many people have dinner and collapse on the couch to watch their favorite series on a TV platform. streaming. But they don’t always manage to finish the episode because they fall asleep on the couch. Then they go to bed, and immediately become awake and unable to fall asleep. What is happening?
The complex problem of sleep onset
Our sleep-wake cycle is governed by an internal clock in our brain, which maintains an approximately 24-hour rhythm, or circadian rhythm. This internal clock is synchronized by internal stimuli, such as light in the morning and darkness at night. For this reason, so much emphasis is placed on sleep hygiene, which includes maintaining regularity in schedules, keeping the bedroom dark and exposing oneself to sunlight when waking up, among other things.
However, these measures are not always enough to have quality sleep. “Sleep hygiene recommendations are not effective for the treatment of insomnia,” says Dr. Miguel Ángel Sánchez González, a psychiatrist specialized in sleep disorders. “They are healthy things so that someone who sleeps well continues to sleep well. “We can make almost no statement about anything related to sleep that applies to everyone,” he adds.
The apparent contradiction of falling asleep in the chair and later staying awake in bed can, therefore, have multiple causes depending on each case, and only a detailed study by a professional can help clarify the problem. A possible explanation is based on the so-called theoretical model “of the two processes”.
The two-process model proposes that sleep results from the interaction of two biological processes: the 24-hour circadian rhythm, which is valid for the vast majority of living beings, and a homeostatic process in which the body attempts to maintain sleep. balance between sleep and wakefulness depending on external factors. As the researcher explains Alexander Borbély from the University of Zurichthis model has its origins in animal studies from more than four decades ago, and has been validated through more recent studies in humans.
“The circadian rhythm is like a wave: of the 24 hours of the day, there are five in which it is more favorable to sleep,” explains Dr. Sánchez. “Homeostatic factors say that you are more likely to sleep the longer it has been since you last slept.”
Here comes the first possible explanation of the phenomenon of staying up late in bed after sleeping on the couch. The homeostatic process is regulated mainly by accumulation of the neurotransmitter adenosine in the brain. The more your concentration increases, the sleepier we get. Caffeine blocks adenosine receptors and therefore keeps us alert.
“Circulating adenosine is eliminated very quickly with sleep, that is, in very few hours, even minutes after starting to sleep,” explains Dr. Sánchez. If we have fallen asleep on the couch, a good part of the adenosine will have been eliminated, “you no longer have a homeostatic need to sleep,” he clarifies.
Homeostatic factors say that you are more likely to sleep the longer it has been since you last slept.
Miguel Ángel Sánchez González
— sleep psychiatrist
One factor that can influence us to fall asleep in front of the TV is distraction. Watching a series distracts us from worries, but when we are in bed without distractions, rumination is activatedcircular thoughts about everything that worries us, something also related to the symptoms of depression. Among these obsessive thoughts is also the worry about not sleeping.
“You have to try to convince the individual who suffers from insomnia not to give it so much importance, because the more importance you give it, the more aware you are of sleep, the more you are going to scare it away,” explains Dr. Sánchez.
When we associate the bed with insomnia
Our brain learns automatic behaviors from internal stimuli. For example, we can establish a psychological association with the sofa as a place of relaxation and leisure. However, for those who suffer from insomnia, the bed is no longer linked to sleepingbut with “eating the roof”, spending hours spinning your head without being able to fall asleep.
“It is an explanation that comes from Pavlov’s classical theory. Insomnia is a conditioned ‘unlearning’,” explains Dr. Sánchez. “When you sleep well, the bed, the room and the moment are associated with sleep, but that same moment and that same environment can be associated with insomnia. “One part of the treatment is to remove these stimuli from the environment, that is, to disassociate the bed from wakefulness.”
This means that, if we are in bed without sleeping, it is necessary to get out of bed. “You have to go and worry somewhere else,” says Dr. Sánchez. “Insomniacs sometimes tell you that they have gone to a hotel and slept wonderfully, of course, because they have changed the environment and have not suffered that conditioning. And that could also explain why they are in the living room watching Netflix and they fall asleep and go to bed and that conditioned reflex against sleep wakes up.”
What can we do to break these associations that keep us up at night? The Sleep Foundation’s sleep hygiene recommendations include leaving one or two hours of relaxation before going to sleep, turn the lights on low, take a bath, prepare a relaxing infusion, read and avoid screens and stimulating activities.
When you sleep well, the bed, the room and the moment are associated with sleep, but that same moment and that same environment can be associated with insomnia.
Miguel Ángel Sánchez González
— sleep psychiatrist
“We have to tell people not to sleep somewhere else before going to bed,” insists Miguel Ángel Sánchez. “We say that we should only sleep in bed, and when we are in bed, only sleep—or have sexual relations.”
Human beings, like all animals, develop habits to adapt to our environment and establish associations between stimuli and our activities, whether sleeping, eating, exercising or working. But when these associations are established with the right stimulus, we can find ourselves asleep on the couch and worrying in bed, which is precisely the place where we should really let go of our worries.
*Darío Pescador is editor and director of the Quo magazine and author of the book your best self Posted by Oberon.
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