So when you're in REM sleep, your brain is very active, our body is quiet, but your brain is really processing a lot of things, a lot of emotions; we dream the most in REM sleep. And then you go back down in the deep stages, and so on and so forth.
So we go through in the beginning of the night, we go into the really deep stages of sleep and we actually cycle through. So, when you go down to the deep stage, then you go back up and you actually come into something called REM sleep, which is after about 90 minutes.
So people only focus on getting the really deep sleep, but in reality, we spend almost 60% of the night in the stage two sleep.
In general, there are patients with insomnia who - many patients with insomnia will actually over report the lack of sleep that they are getting.
We'll work on relaxation strategies and also changing the times you go to bed will actually make them sleep a little bit less for a few nights so their body's natural sleep drive starts to kick in. That is very effective in about 60% to 70% of patients who do it, four to eight sessions, not even every week; it works for 60% to 70% of patients.
So if somebody has chronic pain, we want to manage the pain, but we still want to treat the insomnia separately. So what we'll tend to do in our sleep lab is we'll do a thorough evaluation and we usually have myself, who is a Psychologist and a Sleep Behavioral Sleep Specialist, I treat the patients first.
When they [people with insomnia] start worrying about not sleeping, I'll say, "Say the mantra to myself; if I don't sleep tonight, I'll likely sleep tomorrow, and if not tomorrow then definitely the third" because our body has a way of naturally catching up.
Some patients are still having insomnia, but it's seems worse to them than actually it is. So, if they say they're sleep deprived, they haven't slept at all in three days; if we actually take them into a lab, most of the time we actually do see they're sleeping on and off here and there.
So you have Sleep Stage One, Two, and then Three/Four. One is a little bit lighter stage of the quiet, non-REM sleep and then Three/Four is really deep, deep sleep. And what you want is, you actually want a number of - you want to go through all of these stages throughout the night.
