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How the brain's activity, energy use and blood flow change as people fall asleep

179 points| XzetaU8 | 4 months ago |massgeneralbrigham.org

88 comments

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[+] tartoran|4 months ago|reply
During my 20s I developed a severe insomnia, probably due to not knowing how to handle stress. It was so bad that I had to go to the ER because I haven't had any sleep in days and didn't know what else to do. They gave me ambien and it helped at the time, but I knew that it was not something to take long term. I then started to experiment with various methods to help me fall asleep and sleep hygene such as hot/cold showers, warm baths, relaxing exercises and meditation, lowering the room temperature, removing sources of light (especially those blue LEDs). In my 40s now and am happy to report that I no longer have any insomniac episodes and I rarely have a hard time falling asleep. Out of all the techniques I found that forcefully yawning for a couple of minutes is the most efficent way for me to induce sleep.
[+] maksimur|4 months ago|reply
Would be interesting to know why yawning induces sleep at all.
[+] dpeckett|4 months ago|reply
I'm pretty sure at this point I have familial advanced sleep phase syndrome of an unknown genetic etiology [1].

Wake up stupid early in the morning, get drowsy very early in the evenings etc. For a long time due to social pressure/habit I'd just power through the evening drowsiness. That lead to me only being able to sleep six hours or so (due to waking up stupid early), which over time lead to a substantial sleep debt.

Going to bed early helps a lot, but over time it seems like I easily start drifting earlier and earlier. I've recently had some success stabilizing my rhythm using sublingual melatonin when I first waken at 2-3am. Let's me get a couple extra hours of additional quality sleep which is a lifesaver. Wears off quick enough that by 9am or so it's basically out of my system.

I've actually been tinkering/hacking the last year or so on sleep tracking wearables. Initially focused on EEG/HRV monitoring but I'm taking a very modular approach and ultimately want to build a full set of sensors/effectors/etc.

I've recently been experimenting a lot with skin temperature gradients, turns out in the lead up to sleep it's not just blood flow in the brain that is altered [2].

1. https://en.wikipedia.org/wiki/Advanced_sleep_phase_disorder#...

2. https://journals.physiology.org/doi/pdf/10.1152/ajpregu.2000...

[+] soulofmischief|4 months ago|reply
You might know this, but sleep debt doesn't just keep piling on. Eventually, and rather quickly, you may begin to experience permanent brain damage after a few nights of sleep deprivation.

https://www.ahajournals.org/doi/10.1161/STR.0000000000000453

From one insomniac to another... In the past I've been lucky if I get 3 hours total of sleep in a night due to physical pain disorders. I have deep trouble getting into NREM. I lucid dream often and my brain is active even when I'm supposed to be sleeping. In my dreams, I have to be careful not to be too energetic or overstimulated, or I will wake up.

I've had insomnia and night terrors since before I was regularly forming memories. An abusive childhood intensified that. I'm in my early 30s now and the damage is clear, both physically and to my life in general.

As much as I fear them, sleeping medication seems like the only way to save myself from early onset dementia or not accomplishing certain goals due to a perpetually low energy budget. It also has prevented me from losing weight. Sleep studies have shown that people who get frequently woken up while sleeping can burn around 50% less fat.. In my case, that's my entire calorie deficit which means in order to lose weight I have to basically starve myself. Melatonin, etc. have never worked for me.

All this to say... Don't wait for the damage to build up even more. Sleeping medication might change your life. I'm hoping it restores mine.

[+] buzzardbait|4 months ago|reply
I wonder how much of sleep research is affected by the difference in sleep quality between your own bed and a lab. Even if you're on vacation and the hotel bed is of exceptional quality, your brain knows that it's in a different environment and would naturally be on partial alert, at least for the first couple of nights.

Now imagine sleeping in a lab setting, knowing that your sleep data is being measured. Intellectually you know that you're not at any risk but there must be some difference in the architecture of your sleep.

[+] elisaado|4 months ago|reply
I have been thinking about this too, not just for the bed but also measuring equipment like pulse-oxymeters you would wear during a study.
[+] webnrrd2k|4 months ago|reply
Taking melatonin has been mentioned several times in different threads here, and I just wanted to add my experience...

I find that taking the minimal amount make a big difference here, and it's about 3 micro-grams (not milli-grams) for me. The trick is to get some liquid melatonin drops. There is a brand that has 3 milligrams per 30 drops as a recommended dosage, so I just take 3 or so drops and let them dissolve on my tongue. Using liquid drops this way, there is less of a sleep hangover, and It workes faster that way, too.

I think I read about 3 micrograms as more appropriate for most people on lesswrong, but it might have been somewhere else. It's working really well for me, with frequent breaks from it, for five or more years.

[+] buzzardbait|4 months ago|reply
You emphasized the word "minimal" but it cannot be emphasized enough. I think melatonin is one of those things that quickly backfires if you take too much.
[+] jonahrd|4 months ago|reply
That would be 300 micrograms
[+] mallomarmeasle|4 months ago|reply
As pointed out above me, 250-300 micrograms is what you likely meant. You might have to hunt for such low doses. I split a 1 mg tab in quarters. Repeated studies have shown that there is not an increase in efficacy, but there is an increase in adverse effects when doses are higher. See https://slatestarcodex.com/2018/07/10/melatonin-much-more-th...
[+] geretnal|4 months ago|reply
Just make sure you're getting it as medicine and not supplement, taking it for for my insomia!
[+] hypeatei|4 months ago|reply
What time do you take them? An hour before going to sleep or right before?
[+] J_Shelby_J|4 months ago|reply
Half milligram pills are available online. Wish Costco sold them.
[+] thunderbong|4 months ago|reply
Melatonin has helped, of course. But a few other steps I had read on a Reddit thread [0] also helped me - specifically the point about relaxing facial muscles. For some reason, doing this also seems to calm the mind and reduce random thoughts.

[0]: https://old.reddit.com/r/sleep/comments/1bn2emp/how_do_yall_...

[+] Noumenon72|4 months ago|reply
It is crazy how you can relax your face 4-5 times in a row getting less tense each time, and how well this method works to get you to sleep, especially after it has worked for a while so your body associates the relaxing with sleeping.
[+] buzzardbait|4 months ago|reply
I find that Yoga Nidra helps a lot. It relaxes all your muscles and also has nothing to do with "yoga".
[+] iandanforth|4 months ago|reply
23 healthy adults ... who were able to fall asleep inside an MRI with EEG leads stuck to their heads. That's not an easy feat!
[+] ASalazarMX|4 months ago|reply
TBH the inside of an MRI is one of the most boring places in the world.
[+] pedalpete|4 months ago|reply
Interesting study, but it mostly reinforces what we already know about sleep mechanics.

Of particular importance is how sensory regions remain metabolically active while higher-order regions downshift during NREM sleep. That suggests the benefit of sleep depends less on how long we sleep and more on the specific activation and de-activation of networks during sleep.

I work in neurotech/sleeptech as the founder of https://affectablesleep.com. Our stimulation triggers sensory pathways during sleep to enhance the brain’s restorative function without changing sleep time.

This systematic review [1] covers non‐invasive approaches to enhancing slow‐wave activity in sleep and outlines their physiology and effects. This focused paper [2] explores the neurophysiology of closed‐loop auditory stimulation during sleep.

Though the title of the post suggests the study looks at falling asleep, the study is really focused on what happens during NREM sleep, which has been our focus for the last few years.

Of particular interest to me right now are the processes of waking. Research suggests that different neural networks come online in a specific sequence, and when that sequence is disrupted, we experience sleep inertia or the sense of not being fully restored.

[1]https://doi.org/10.1016/j.smrv.2021.101438 [2]https://doi.org/10.1111/ejn.16132

[+] submeta|4 months ago|reply
Tangential: Have had sleep disorders my whole life. Until I read an article here about melatonin (an article that was about substances that have an effect on longevity). So I started taking melatonin every night, 0.5mg. I must say: Never had this kind of deep sleep. Over such a long period of weeks (since I started taking it). My Garmin watch has a sleep tracker. And it confirms that I get way more deep sleep.
[+] elric|4 months ago|reply
Two things:

1. Too much deep sleep might not be desirable.

2. Sleep staging by activity trackers is generally pretty inaccurate. Garmin is no exception.

[+] v7engine|4 months ago|reply
I am considering taking melatonin supplements. Could you recommend any? I wake up several times in the night.
[+] tmountain|4 months ago|reply
My understanding has always been that you habituate to melatonin after a few days. Is this not true?
[+] jansan|4 months ago|reply
Only slightly related, but I often try to find ways to fall asleep faster. One thing that seems to work in some situations is trying to imagine a void (like a white or gray plane) for a while. However, often enough this does not work and I wonder if anyone knows of tricks that work for her/him (without using Melantonin or other drugs).
[+] Pawamoy|4 months ago|reply
A friend shared his technique with me, and after adapting it to my needs, it works well. None of the other commonly mentioned techniques ever worked for me, because they ask for focus, which is the opposite of what my brain needs to fall asleep.

Here's his technique: pick a letter of the alphabet, and find as much words that start with this letter as you can. Once you can't find words anymore, pick the next letter. Doesn't work for me, my brain won't ever stop.

I noticed I have to visualize stuff in my head to fall asleep so my adaptation is to pick a single letter and a single word, and visualize it in my head, using it, manipulating it, experiencing it, whatever. For example: letter P, word Pineapple, imagine you're holding a pineapple, you feel the roughness of it's skin in your hands, you throw it in the air and catch it again, you take a knife and slice it on a wooden table on the beach, etc.. The dream kicks in seconds. Without external interruptions, after a few minutes I'm asleep (instead of rummaging for hours).

If you notice you're stuck in a loop/pattern (for me anything about text, like reading or writing, and voice, like listening and speaking, or stressful scenarios), just pick a new letter, pick a new word, visualize it.

[+] gjadi|4 months ago|reply
There are several things I use:

- think of past enjoyable moments (for me it's hiking, I usually don't go very far until I fall to sleep)

- box breathing

- hold breath for N sec then release, then N+10, then ...

- try to relax your body from top to bottom (forehead, eyes, cheeks, mouth, ...)

- imagine your body is very light, like your floating in the air

- imagine your body is very heavy, like a block of concrete sinking into your bed

- pick TAOCP and try to solve the exercises ;)

[+] oldestofsports|4 months ago|reply
I have had sleep issues my whole life, but what works for me is: - Get up same time every day - Moderate excersize every other day - Stable diet, homecooked healthy food and no soda/beer/candy whatsoever. - Dim the lights after dinner - No screens after 8pm (e-ink screens are allowed), no podcasts, no digital content consuming. - Actively aim to be bored everyday - Read a good book before bedtime

May sound like a lot, but I sleep now.

[+] CrimsonCape|4 months ago|reply
I have a routine and the crazy part is that it is 100% effective, in that I can be restless, consciously start the routine, and 100% of the time I fall asleep. It is the oddest feeling to begin the routine, which requires conscious mental effort, and suddenly you can't remember anything because you fell asleep. I can only ever recall doing it at times when my mind is racing, so I can't say how well it works when calm as I forget to do the routine when calm.

The routine is basically a game to see if you can "flow" between mental images by envisioning scenes in your mind and then allowing some object in the scene to "pull" you into a different scene. For example, envision the power cable of your lamp, you fly along the power cable up to the light bulb, and then you envision the bulb glass exploding into a million pieces, which becomes snow falling on a ski lodge, you see the warm glow of fire in the fireplace, and a fireball blasts out the chimney into the sky, somehow becomes a perfect flaming sphere, that becomes a meatball and falls into a plate of spaghetti, you are eating it down, you see yourself at a ratty diner table, under the table you see your shoes, and then your shoes are running through rain puddles, you zoom into a single droplet which is actually a massive aquarium tank, fish are swimming in it except we are in the ocean, not a tank, and the fish is so colorful but those colors are actually an explosion of rainbow paint colors dripping down an apartment wall, etc. etc.

It might sound ridiculous when written in words, but that is the gist of it. The game is to lay there and consciously morph and fly between mental images, letting your mind conjure imagery that comes next.

It's crazy because I start doing this with a conscious struggle to envision the next chain-of-events but suddenly my brain catches on and starts unconsciously playing the game and images just kinda flow and BAM asleep.

[+] Propelloni|4 months ago|reply
What works best for me is to take a book, on paper, preferably on a boring topic (depends on you, obviously) and just start reading. Usually my eyes drop in a matter of minutes. Once I wake up, startled by the book falling over, I kill the lights and go to sleep. Works every time, any time.

If I lie in bed and just think stuff, it takes much longer.

[+] AstroNutt|4 months ago|reply
Yeah, melatonin makes me feel like crap after a few days of use and it's hit or miss.

One thing I've done for years is focus on breathing. Get in a comfortable position and totally relax your body. Slowly take a deep breath. Then exhale until you can't no more. Repeat this 10 or 15 times.

For whatever reason, this works for me probably 75% of the time. The other 25%, forget it.

On a side note, I'm sure most of us here can relate to this song. https://youtu.be/vaG4vGsIFMQ

[+] tacone|4 months ago|reply
On a side note, a good way to check your progress towards falling asleep is looking through your closed eyelids. The more movement (points, lights) you see, the more you're actually close to falling asleep.
[+] cube2222|4 months ago|reply
Box breathing (2 secs in, 2 secs hold, 2 secs out, 2 secs hold) or meditation both usually help if I can’t fall asleep. Physical exercise during the day also helps.
[+] paulj5|4 months ago|reply
There are a lot of imaging and thought techniques you can use, eg imagine sittimg beside a small stream, while the water guegles by, watch the leaves and sticks flowing past. or imagine events im yoir life floating by, or imagine being a duck floating by, swimming, or flying, etc. There are also body relaxation techniques ( zen , meditation, etc ) There are many many techniques available.
[+] IsTom|4 months ago|reply
What works for me is to pretend that I'm asleep. And it's good to be able to recognize the first phase of sleep – it's that state that you think that if somebody asked if you're asleep you'd think to yourself "no, I'm not", but have an excuse of "I don't feel like actually talking".
[+] JumpCrisscross|4 months ago|reply
> trying to imagine a void (like a white or gray plane) for a while

Huh, mine is a plane in level flight. (From outside.) Preferably smaller. Depending on my mood it’s retro or like a fighter jet.

[+] rndmio|4 months ago|reply
Sounds trite but my surefire method is to stop thinking. I literally lie down, close my eyes, and stop thinking. Sleep comes quickly.
[+] igleria|4 months ago|reply
sometimes what works for me is literally inventing a movie in my mind. Then the awake part take the backseat...
[+] sys32768|4 months ago|reply
I started intermittent fasting and my sleep improved remarkably when I stopped eating calories after 3PM. Last night it shows I was awake for 16 minutes but in the morning my dream memories seem to be vast.

My mother got Alzheimer's in her early 60s and was always a super light sleeper despite a healthy and happy lifestyle. I suspect her brain's glymphatic system wasn't kicking in often enough to clean her brain.

[+] Rileyen|4 months ago|reply
I used to think sleep was just like shutting off a computer. But after one night of insomnia, my brain felt foggy all day and I could barely speak clearly. That made me realize sleep is not just about resting the body. I have been trying deep breathing before bed and it seems to help a little.
[+] shevy-java|4 months ago|reply
If that damn beast would ever fall asleep!

Still listening to "Insomnia" from Faithless.