What are the common side effects of LEEP procedure. How long does LEEP recovery typically take. Can LEEP affect future pregnancies. What precautions should be taken after LEEP. When to seek medical attention following LEEP.

Understanding the LEEP Procedure and Its Purpose

LEEP, which stands for Loop Electrosurgical Excision Procedure, is a crucial medical intervention used to treat abnormal cervical cells. This procedure plays a vital role in preventing cervical cancer by removing potentially precancerous tissue from the cervix.

How Does LEEP Work?

During a LEEP procedure, a thin wire loop heated by an electric current is used to carefully excise abnormal cervical tissue. This precise method allows doctors to remove the affected area while preserving healthy tissue, promoting proper healing and cervical function.

Common Side Effects of LEEP: What to Expect

While LEEP is generally considered safe and effective, it’s important to be aware of potential side effects. Most patients experience mild discomfort and some changes in their body following the procedure.

• Cramping: Mild to moderate cramping is common for a day or two after LEEP.
• Discharge: Watery discharge, sometimes with a slight odor and traces of blood, may persist for several weeks.
• Light bleeding: Some spotting or light bleeding is normal during the recovery period.

Are these side effects cause for concern? In most cases, these symptoms are a normal part of the healing process and should subside gradually. However, it’s crucial to monitor your symptoms and report any severe or prolonged issues to your healthcare provider.

LEEP Recovery: Guidelines for Optimal Healing

To ensure a smooth recovery and minimize the risk of complications, it’s essential to follow post-procedure guidelines carefully.

1. Avoid douching or using tampons for at least 3 weeks after the procedure.
2. Refrain from sexual intercourse or inserting anything into the vagina for 3 weeks, unless otherwise instructed by your doctor.
3. Use pads or panty liners for any discharge or light bleeding.
4. Stay hydrated to replace fluids lost through discharge.
5. Take over-the-counter pain relievers like ibuprofen or acetaminophen if needed for discomfort.

How long does LEEP recovery typically take? Most patients find that their symptoms improve significantly within a few weeks, though complete healing may take up to 4-6 weeks.

Potential Risks and Complications of LEEP

While serious complications from LEEP are rare, it’s important to be aware of potential risks.

• Pelvic infection
• Damage to surrounding pelvic organs or vaginal wall
• Heavy bleeding
• Adverse reaction to local anesthesia
• Cervical stenosis (narrowing of the cervix)

Do these risks outweigh the benefits of LEEP? For most patients, the potential to prevent cervical cancer far outweighs the small risk of complications. However, it’s essential to discuss your individual case with your healthcare provider.

LEEP and Future Pregnancies: Important Considerations

One concern that often arises regarding LEEP is its potential impact on future pregnancies. Research has shown that LEEP may slightly increase the risk of preterm birth in subsequent pregnancies.

Should women planning to become pregnant avoid LEEP? The decision to proceed with LEEP should be made in consultation with your doctor, weighing the risks of untreated cervical abnormalities against the potential impact on future pregnancies. If you’ve had LEEP and become pregnant, inform your obstetrician to ensure appropriate monitoring throughout your pregnancy.

When to Seek Medical Attention After LEEP

While most LEEP recoveries proceed without incident, it’s crucial to recognize signs that may indicate a complication.

Contact your healthcare provider immediately if you experience:

• Severe abdominal pain
• Fever (temperature of 100.4°F or higher) or chills
• Foul-smelling vaginal discharge
• Heavy vaginal bleeding (soaking through a pad in an hour)

Is it normal to feel anxious about potential complications? It’s natural to feel concerned, but remember that serious complications are rare. Being vigilant and communicating with your healthcare team can help ensure prompt treatment if issues arise.

Alternative Treatments for Cervical Abnormalities

While LEEP is a common and effective treatment, there are other options available for managing cervical abnormalities.

Cryotherapy

This method uses extreme cold to freeze and destroy abnormal cervical cells, allowing healthy tissue to grow back. How does cryotherapy compare to LEEP? Cryotherapy is often used for smaller areas of abnormal cells and may have a quicker recovery time, but it may not be suitable for all cases.

Laser Therapy

A focused laser beam is used to remove abnormal cervical tissue. Is laser therapy more precise than LEEP? While laser therapy can be very precise, the choice between laser and LEEP often depends on the specific case and the surgeon’s expertise.

Cone Biopsy

This surgical procedure removes a cone-shaped piece of cervical tissue for examination. When is a cone biopsy preferred over LEEP? Cone biopsies are often used when cancer is suspected or when a larger tissue sample is needed for diagnosis.

Long-Term Follow-Up After LEEP

After undergoing LEEP, ongoing monitoring is crucial to ensure the procedure’s success and to detect any recurrence of abnormal cells.

What does long-term follow-up typically involve?

• More frequent Pap tests and/or HPV tests
• Regular colposcopies to visually examine the cervix
• Continued discussions with your healthcare provider about your cervical health

How long should this increased monitoring continue? The duration of intensified follow-up varies but often lasts for several years to ensure no recurrence of abnormal cells.

Emotional and Psychological Aspects of LEEP

Undergoing a LEEP procedure can be emotionally challenging for many women. The diagnosis of abnormal cervical cells and the subsequent treatment can cause anxiety, stress, and concerns about future health and fertility.

What strategies can help cope with the emotional impact of LEEP?

• Open communication with your healthcare provider
• Seeking support from friends, family, or support groups
• Educating yourself about the procedure and its outcomes
• Practicing stress-reduction techniques like meditation or yoga
• Considering professional counseling if anxiety persists

Is it normal to feel anxious or depressed after LEEP? These feelings are common and valid. However, if they persist or interfere with daily life, it’s important to seek professional help.

LEEP and Cervical Cancer Prevention: The Bigger Picture

While LEEP is an important tool in preventing cervical cancer, it’s part of a broader strategy for cervical health.

The Role of HPV Vaccination

HPV vaccines can prevent infection with the types of HPV most likely to cause cervical cancer. How does HPV vaccination complement LEEP in cervical cancer prevention? Vaccination can prevent the initial HPV infection that leads to abnormal cervical cells, potentially reducing the need for procedures like LEEP.

Regular Screening

Routine Pap tests and HPV tests are crucial for early detection of cervical abnormalities. How often should screening occur? Guidelines vary based on age and risk factors, but generally, women should begin cervical cancer screening at age 21 and continue at intervals recommended by their healthcare provider.

Lifestyle Factors

Certain lifestyle choices can impact cervical health. What lifestyle changes can help prevent cervical abnormalities?

• Quitting smoking
• Practicing safe sex to reduce HPV exposure
• Maintaining a healthy diet and exercise routine to support overall immune function

Advances in LEEP Technology and Techniques

As medical technology progresses, improvements in LEEP techniques and equipment continue to enhance patient outcomes and experiences.

Computer-Aided LEEP

Advanced imaging and computer guidance systems are being developed to improve the precision of LEEP procedures. How might these technologies benefit patients? They could potentially reduce the amount of healthy tissue removed, minimize side effects, and improve long-term outcomes.

Pain Management Innovations

New approaches to pain management during and after LEEP are being explored. What advancements are being made in this area? Techniques such as targeted nerve blocks and long-acting local anesthetics are being studied to enhance patient comfort and reduce post-procedure pain.

Tissue Preservation Techniques

Researchers are investigating methods to preserve cervical function while effectively treating abnormal cells. How might this impact future fertility concerns? These techniques aim to minimize the impact on cervical structure, potentially reducing the risk of pregnancy complications associated with LEEP.

LEEP in Special Populations

While LEEP is a standard procedure for many women, special considerations may apply to certain groups.

LEEP in Young Women

For younger women who may desire future pregnancies, the approach to LEEP may be more conservative. How do doctors balance treatment needs with fertility preservation? They may opt for more frequent monitoring or less aggressive treatments when appropriate, to minimize potential impacts on future pregnancies.

LEEP in Postmenopausal Women

Postmenopausal women may have different considerations when it comes to LEEP. What unique factors come into play for this group? Changes in cervical anatomy and healing processes may influence the procedure and recovery. Additionally, the risk-benefit analysis may differ given the reduced concern about future pregnancies.

LEEP in Immunocompromised Patients

Women with compromised immune systems, such as those with HIV or on immunosuppressive medications, may require special attention. How does immunocompromise affect LEEP planning and recovery? These patients may be at higher risk for complications and may require more intensive follow-up and potentially prophylactic antibiotics.

The Future of Cervical Cancer Prevention

As our understanding of cervical cancer and HPV continues to evolve, so too do our prevention and treatment strategies.

Advancements in HPV Testing

More sensitive and specific HPV tests are being developed. How might these new tests change cervical cancer screening and the use of LEEP? They could potentially allow for more targeted interventions, reducing the need for procedures like LEEP in some cases.

Immunotherapies

Research into immunotherapies that target HPV-infected cells is ongoing. Could these therapies someday replace or complement LEEP? While still in early stages, these treatments hold promise for non-invasive management of cervical abnormalities.

Artificial Intelligence in Cervical Screening

AI algorithms are being developed to assist in the interpretation of cervical screening tests. How might AI impact the diagnosis and treatment of cervical abnormalities? These tools could potentially improve the accuracy of diagnoses, leading to more appropriate use of procedures like LEEP.

As we look to the future, it’s clear that while LEEP remains an important tool in cervical cancer prevention, ongoing research and technological advancements continue to refine our approach to cervical health. By staying informed about these developments and maintaining open communication with healthcare providers, women can play an active role in protecting their cervical health and overall well-being.

What Are the Side Effects of the LEEP Procedure?

In This Section

• Cervical Cancer

• How do I know if I have cervical cancer?

• What’s a Pap test?

• What’s an HPV test?

• What is a colposcopy?

• What happens after my colposcopy?

• What is cryotherapy?

• What happens after cryotherapy?

• What’s LEEP?

• What happens after LEEP?

• What if I’m diagnosed with cervical cancer?

After LEEP you’ll have some cramps and discharge. There are things you can do to make yourself more comfortable.

What do I need to do after LEEP?

You may have mild cramping for a day or so after LEEP. If you’re uncomfortable, you can take over-the-counter pain medicine (like ibuprofen or acetaminophen).

You’ll probably also have watery discharge for several weeks. It may be heavy and have a little blood in it. It also may smell a little bad. You can wash your vulva with plain water a few times a day, but don’t wash or put anything inside your vagina. And drink lots of fluids to replace the water you’re losing in your discharge.

To speed up your LEEP procedure recovery and prevent infection, follow these guidelines:

• Don’t douche or use tampons for at least 3 weeks. You can use pads or panty liners.

• Don’t have vaginal sex or put anything in your vagina (like fingers or sex toys) for 3 weeks, unless your doctor or nurse tells you otherwise.

Your nurse or doctor will probably want to do testing more often to monitor your cervix carefully. The problem could stay the same, get worse, or go away on its own or after treatment. Your doctor or nurse can discuss your best treatment plan with you.

Is LEEP safe?

Most people don’t have any serious problems after LEEP. Very rarely, serious problems happen. These include:

• pelvic infection — especially if you have vaginal sex before your cervix heals

• damage to other pelvic organs or the wall of your vagina

• heavy bleeding

• reaction to local anesthesia

Call your doctor right away if you have

• severe belly pain

• fever (temperature of 100.4 F) or chills

• vaginal discharge that smells very bad

• unusual vaginal bleeding or bleeding that’s heavier than the heaviest day of your period

LEEP may increase the risk of preterm birth in future pregnancies. Talk with your doctor or nurse  if you plan on getting pregnant in the future, and if you get pregnant, let your doctor know that you’ve had LEEP.

In a small number of cases (10%), LEEP doesn’t completely cure the problem. If this happens to you, you might need to have another LEEP or a different treatment.

LEEP During Pregnancy

Doctors usually wait until after you give birth to treat abnormal cervical cells. Delaying treatment is usually safe because it generally takes a long time for abnormal cervical cells to turn into cancer.

Are there other treatments that prevent cervical cancer?

Yes. Other treatments include:

• Cryotherapy — using a chemical to freeze abnormal cells off your cervix so normal ones can grow back

• Laser — using a laser beam to remove abnormal cells.

• Cone biopsy — cutting a cone-shaped wedge of tissue out of your cervix and testing it in a lab.

   

More questions from patients:

What are the LEEP procedure side effects?

LEEP is an effective and safe treatment to prevent cervical cancer.

The LEEP procedure side effects are usually mild. During the procedure, you may feel a little discomfort or cramping. Because numbing medicines are used, though, a lot of people don’t feel anything.

After LEEP, you may have mild cramping for a day or so. Over-the-counter pain medicine can help. You’ll probably also have watery discharge for several weeks. It may be heavy and have a little blood in it. It also may smell not so great. If this happens, wash your labia (the lips outside your vagina) with plain water several times a day for a few days.

To speed up healing and prevent infection after LEEP, follow these guidelines:

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What Is It, Side Effects and Recovery

This page was reviewed under our medical and editorial policy by

Ruchi Garg, MD, Chair, Gynecologic Oncology, City of Hope Atlanta, Chicago and Phoenix.

This page was reviewed on January 12, 2022.

A loop electrosurgical excision procedure, or LEEP, helps with the diagnosis and treatment of abnormal cells or cancer found in the cervix.

What is a LEEP (loop electrosurgical excision procedure)?

LEEP is a procedure in which the care team uses a thin wire loop that’s heated by an electric current to remove abnormal tissue. The wire loop comes in different sizes and acts as a surgical knife, cutting away at the abnormal tissue. The tissue is then sent to a laboratory for further analysis.

Why do I need a LEEP?

There are a few reasons the doctor may recommend a LEEP:

• To diagnose precancerous changes in the cervix and cervical cancer (precancer refers to abnormal cells that could become cancer)
• To figure out the cause of an abnormal Pap test result
• To treat precancerous conditions and early-stage cancer in the cervix

How to prepare for a LEEP

There are a few things women can do ahead of a LEEP appointment:

• Make sure to schedule the LEEP when menstruation isn’t likely to happen.
• The patient should tell the cancer care team about all of her current medications, as well as any herbal supplements. Patients who use blood-thinning medicines, aspirin or other drugs that affect blood clotting may be asked to stop them temporarily before the procedure.
• Patients should let the care team know if they are or might be pregnant.
• Don’t use douches, tampons or vaginal creams before the procedure. The care team will indicate how far in advance to stop these.
• Don’t have vaginal sex before the procedure.
• Ask whether it’s a good idea to take pain-relieving medication beforehand. Follow any instructions on which type of medication to use.
• Consider taking a sanitary napkin to wear home when the LEEP is done. Women may experience some bleeding or discharge.

What to expect from a LEEP (loop electrosurgical excision procedure)

The LEEP is usually performed in the doctor’s office, though at times, some providers may choose or prefer to perform it in the operating room. The procedure lasts a few minutes.

Before the procedure, the patient will remove all clothes from the waist down and empty her bladder. She will then lie down with her legs in stirrups, similar to what occurs during a pelvic examination. The doctor places a speculum in the vagina to open the vaginal canal.

• The doctor typically administers local anesthesia intravenously. This type of anesthesia is used to numb just the cervical area.
• Many doctors use a colposcope, which is an instrument with a special lens, to better visualize the tissues. This device is placed at the vaginal opening, but it doesn’t go inside the patient’s vagina. The doctor may take photos using the colposcope for the patient’s health records.
• The doctor may place a special vinegar solution on the cervix to make any abnormal tissues easier to see. Then, the loop is inserted through the vagina and to the cervix. The loop can remove abnormal tissue and take a tissue sample for analysis.
• Once finished, the patient may have a paste-like medicine, called Monsel’s paste, applied to her cervix to help control bleeding.

During the LEEP, the patient may feel some dull cramping. It’s also possible that she may feel as if she’s going to faint. If this happens, alert the doctor.

LEEP procedure recovery

Most women can resume their normal activities after one to three days. However, the doctor may advise the patient to not have sex, take baths, douche or use tampons for about two to four weeks after the LEEP. The patient may also need to avoid strenuous activities and heavy lifting for a period of time.

Most women find that the timing of their menstrual period isn’t interrupted following the LEEP procedure.

Side effects of LEEP

The benefit of the LEEP is that it can help remove precancer or early-stage cancers from the patient’s cervix or vagina.

There are some LEEP-related side effects, including:

• Cramping similar to that during menstruation
• Dark brown discharge in the first week. This is from the solution that may be used on the cervix
• Small amounts of blood from the vagina in the following three weeks

The LEEP also may cause more serious side effects, though these aren’t as common. They include:

• Fever, intensifying pain and discharge from the vagina that has a bad smell (these may indicate a possible infection)
• Heavy bleeding
• Pain that doesn’t subside with medicine

Let the doctor know right away if any of these more serious side effects occur.

Long-term side effects of LEEP

A small number of women may have trouble getting pregnant after undergoing the LEEP. Rarely, though, it is also possible to experience changes to menses, like having more painful periods.

In addition, women who underwent a LEEP procedure in the past may deliver a baby earlier if they get pregnant. This is particularly true of women who have a large amount of tissue removed or who undergo more than one LEEP procedure, since these factors can weaken the cervix.

Reviewing the results of a LEEP

The doctor sends any tissue samples to a pathologist, who can study them under a microscope. The pathologist writes a report stating whether the tissue samples are normal or indicate precancer or cancer. Discuss any questions with the care team.

Depending on the results, the patient may need to have additional tests or treatments to make sure all abnormal tissue was removed or doesn’t recur. The doctor may ask the patient to return for more frequent Pap tests after having a LEEP.

Short-term restless sleep – symptoms, diagnosis, treatment in Zheleznodorozhny

04/22/2017

Sleep disturbance is a fairly common problem. Frequent complaints of poor sleep are made by 8-15% of the adult population of our planet, and 9-11% use various sleeping pills. This figure is even higher among the elderly. Sleep disorders can be found at any age, and each age category has its own disorders. There are sleep disorders that begin in childhood and do not leave a person all his life, for example, narcolepsy.

Sleep disturbance can be primary, which is not associated with organ pathology, or secondary, resulting from other diseases. Sleep disorders occur as a result of various diseases of the central nervous system or mental disorders. A number of somatic diseases cause insomnia in patients under the influence of shortness of breath, pain, angina attacks, coughing or arrhythmia, frequent urination, itching, etc. Intoxication of various origins, including in patients with oncology, causes drowsiness. Sleep problems that are pathological in nature can develop due to hormonal abnormalities, for example, during the pathology of the hypothalamic-mesencephalic region (tumor, epidemic encephalitis, etc.).

Classification of sleep disorders

1. Insomnia is insomnia, a violation of the process of falling asleep and sleeping.

• Psychological refers to the psychological state, can be situational (temporary) or permanent.

• As a result of taking alcohol or drugs:

1. chronic alcoholism;

2. prolonged use of drugs that activate or depress the central nervous system;

3. syndrome of withdrawal of sleeping pills, sedatives or other drugs;

1. syndrome of decreased alveolar ventilation;

2. sleep apnea syndrome;

2. Hypersomnia, which is increased sleepiness

• Psychophysiological, which is associated with the psychological sphere, can be permanent or temporary

• As a result of taking alcohol or medications;

• As a result of mental illness;

• As a result of various breathing disorders during sleep;

• Narcolepsy

• As a result of other pathological conditions

3. Wrong mode of wakefulness and sleep

1. slow sleep syndrome

2. premature sleep syndrome

3. syndrome in which there is no 24-hour cycle of sleep and wakefulness

4. Parasomnia, which is characterized by impaired functioning of systems and organs associated with sleep or awakening:

Sleep disturbance symptoms

Symptoms of sleep disorders can be varied and are determined by the type of disorder. However, regardless of sleep disturbance, in a short period of time it can lead to a change in the emotional background, performance and attentiveness of a person. Children at school age have learning problems, they learn new information worse. It is not uncommon for a patient to come to the doctor complaining of worsening health, while not realizing that this is related to disturbed sleep.

Psychosomatic insomnia. Insomnia is situational when it lasts no more than three weeks. People who suffer from insomnia are less likely to fall asleep, often waking up in the middle of the night, and find it difficult to get back to sleep. They are characterized by early morning awakening, feel the lack of sleep after sleep. Because of this, they experience irritability, emotional instability, overwork. The situation is complicated by the constant worries of patients about disturbed sleep and the anxious expectation of the night. The time during which they try to fall asleep lasts twice as long for them. Situational insomnia is caused by the emotional state of a person under the influence of certain psychological phenomena. Often after the effects of stressful conditions cease, sleep returns to normal. But in certain cases, difficulties in falling asleep, as well as nighttime wakefulness, become commonplace, and the fear of insomnia further worsens the situation, which leads to the formation of regular insomnia.

Insomnia resulting from the use of alcoholic beverages or medications. Long-term regular consumption of alcohol can lead to deviations in the organization of sleep. There is a shortening of the phase of REM sleep and the patient often wakes up in the middle of the night. After the alcohol intake is stopped, the problem usually disappears after two weeks.

Disturbed sleep may be a side effect of medications taken that excite the nervous system. Long-term use of sleeping pills and sedatives also leads to insomnia. Over time, the effect of the drug declines, and increasing the dose leads to a short-term improvement in the situation. Due to disturbed sleep, aggravation is possible, despite increased doses. In such situations, systematic short-term awakenings are noted, and a clear boundary between sleep phases also disappears.

When a mentally ill person has insomnia, he has a constant feeling of intense anxiety at night, quite sensitive and superficial sleep, frequent awakenings, daytime apathy, and fatigue.

Sleep apnea or sleep apnea is a short-term interruption in the flow of air into the upper respiratory tract that occurs during sleep. Such a pause in breathing is usually accompanied by snoring or restlessness. There are obstructive apneas, which begin as a result of the closure of the lumen of the upper respiratory canals during inspiration, and central apneas, related to deviations in the work of the respiratory center.

Insomnia during restless legs syndrome begins to develop as a result of a feeling that forms in the depths of the calf muscles, which requires movement of the legs. The desire to move the legs appears before sleep and disappears when walking begins, but then it may resume again.

Diagnosis of sleep disorders

Polysomnography is the most common way to study sleep disorders. This examination is carried out by a somnologist in a specialized laboratory in which the patient spends the night. While the patient is sleeping, various sensors simultaneously record the bioelectrical activity of the brain (EEG), cardiac activity (ECG), respiratory actions of the anterior abdominal wall and chest, the air flow that is inhaled and exhaled, oxygen saturation of the blood, etc. Everything that happens in the ward is filmed and a doctor is on duty. Thanks to this examination, it is possible to examine the state of brain activity and the work of the main body systems during each five stages of sleep, to establish deviations and find the cause of disturbed sleep. Another way to diagnose sleep disorders is to study the average sleep latency (SLS). It is used in identifying the causes of drowsiness and plays an important role in the process of diagnosing narcolepsy. The study includes five attempts to fall asleep that are made while awake. Each attempt is given 20 minutes, the interval between these attempts is two hours. The average sleep latency is the time it takes the patient to fall asleep. When it is more than 10 minutes, this is normal, from 10 to 5 minutes is a borderline indicator, less than 5 minutes already indicates pathological drowsiness.

Treatment

Depending on the cause of sleep disturbance, treatment by a neurologist is prescribed. With somatic pathology, therapy is directed to the underlying disease. The reduction in the depth of sleep, as well as its duration, which occurs in the elderly, is a natural process and often only needs an explanatory consultation with the patient. Before resorting to sleeping pills, it is recommended to monitor compliance with the basic principles of healthy sleep: do not go to bed in a state of excitement or anger, do not eat before bedtime, do not drink alcohol, strong tea, coffee at night, do not fall asleep during the day, do not forget about the lesson sports, but do not exercise at night, keep the bedroom clean. Patients who have disturbed sleep are advised to go to bed and wake up at the same time every day. If you haven’t been able to fall asleep for 30-40 minutes, you need to get up and keep busy until sleep appears. Evening relaxing treatments will be useful: a warm bath or a walk. Psychotherapy, various soothing techniques often help to solve the problems of disturbed sleep.

In the medical treatment of sleep disorders, benzodiazeline drugs are often used. Tablets with a short period of exposure – triazolam, midazolam are prescribed when the process of falling asleep is disturbed. However, their reception is often accompanied by side reactions: confusion, agitation, disturbed morning sleep, amnesia. Long-acting sleeping pills – diazelam, chlordiazepoxide, flurazelam are used for frequent nocturnal or early morning awakenings. But, they often cause daytime sleepiness. In such situations, they resort to the help of drugs of the average period of exposure – zolpidem and zopiclone. These drugs have a lower risk of developing dependence or tolerance.

Another group of drugs that are used for sleep disorders are antidepressants: doxelin, amitriptyline, mianserin. They are not addictive, they are suitable for aged patients, patients who have a depressive state or suffer from chronic pain syndrome. However, due to the large number of side effects, its use is limited.

If the case is severe and the drugs could not give the desired result, then they resort to antipsychotics that have a sedative effect: chlorprothixene, levomepromazine, promethazine. When mild pathological drowsiness is diagnosed, mild CNS stimulants are prescribed: ascorbic and glutamic acid, calcium-containing drugs. When the violations are pronounced – psychotonic drugs: imipramine, iproniazid.

10 health facts about sleep

• Rachel Schraer, Joey Durso
• BBC

October 29, 2017

9 0004 Sign up for our ”Context” newsletter: it will help you understand the events.

Image copyright Getty Images

In countries where clocks are changed from daylight saving time this Sunday, people will get an extra hour of sleep. But how much do we really know about sleep and its impact on various areas of our lives?

1. The well-known “eight hours of sleep”

We often hear that you need to sleep eight hours a day. This recommendation is given by national health organizations around the world, from the British NHS to the American National Sleep Foundation. But where did this advice actually come from?

Studies conducted in different countries to determine how often diseases affect different populations come to the same conclusion: people who suffer from sleep deprivation, like those who sleep too much, are more prone to numerous diseases and live in less on average.

However, it is difficult to say whether sleep disorders are the cause of diseases, or vice versa – a symptom of an unhealthy lifestyle.

“Sleep too short” usually means less than six hours, “too much sleep” is more than nine to ten hours.

Click to see content: sleep_and_morbidity_Eng

Children who have not reached puberty are usually recommended to sleep at night up to 11 hours, and infants – up to 18 hours a day. Night sleep of teenagers is considered to be up to 10 hours.

Shane O’Mara, Professor of Experimental Brain Research at Trinity College Dublin, says that while it’s hard to definitively say whether sleep deprivation is a cause or a consequence of ill health, the two influence each other.

For example, people who do not pay enough attention to physical exercises sleep worse, because of which they become more tired and, as a result, there is no energy left for sports – and so on.

We know that scientists have again and again linked chronic sleep deprivation – that is, lack of sleep for one or two hours for an extended period of time – with poor health: to notice the negative impact of lack of sleep, it is not necessary to stay up for several days in a row.

2. What happens to your body when you don’t get enough sleep?

Lack of sleep can lead to a number of diseases.

Results from 153 studies involving over five million people clearly link sleep deprivation to diabetes, high blood pressure, cardiovascular disease, coronary disease and obesity.

Studies have shown that lack of sleep for just a few nights in a row can bring a healthy person into a pre-diabetic state. Moderate sleep deprivation reduces the body’s ability to control blood glucose levels.

Insufficient sleep reduces the effectiveness of vaccines, lack of sleep has a devastating effect on immunity, making us vulnerable to infections.

In one study, participants who slept less than seven hours were three times more likely to get colds than those who slept seven or more hours.

Sleep deprivation people produced too much ghrelin, the hormone responsible for hunger, and not enough leptin, the satiety hormone, thus increasing the risk of obesity.

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Sleep deprivation has also been associated with reduced brain activity and even, in the long term, dementia.

Professor O’Mara explains that toxic substances accumulate in the brain during the day and are removed during sleep. If you don’t sleep long enough, your condition “resembles a mild concussion.”

The effects of too much sleep are less studied, but it is also known to be associated with a number of disorders, including brain damage in older adults.

3. Different types of sleep help the body recover

Our sleep consists of cycles that are divided into several stages. Each cycle lasts from 60 to 100 minutes. Each stage plays a part in the numerous processes that go on in our body while we sleep.

The first stage in each cycle is a drowsy, relaxed state between wakefulness and sleep. Breathing slows down, muscles relax, pulse slows down.

The second is a slightly deeper sleep, during which you can sleep, but still think that you are awake.

The third stage is deep sleep, when it is very difficult to wake up, any activity in the body at this moment is at a minimum level.

The second and third stages enter the phase of slow sleep, usually at this time a person does not dream.

After deep sleep, we return to the second stage for a few minutes, and then move on to REM sleep, which is usually accompanied by dreams.

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Thus, during the full cycle sleep, a person goes through all stages from the first to the third, then briefly returns to the second stage, and then comes the fourth stage – the phase of REM sleep.

During the following cycles, the length of REM sleep increases, so the lack of sleep affects it to a greater extent.

4. Shift workers with sleep disorders are more likely to get sick

Shift work can cause a lot of health problems. Researchers have found that those who work shifts and get too little sleep at the wrong time may be at an increased risk of developing diabetes and obesity.

Shift workers are significantly more likely to rate their health as poor or fair, a 2013 NHS survey found.

Researchers have also found that people in this group are much more likely to suffer from chronic diseases than those who work on a standard schedule.

Click to see content: shift_work_sickness_rates_eng

Shift workers are much more likely to miss work due to illness, statistics show.

The gap between those who do physical and mental work is even wider, and in addition, lack of sleep seems to have a greater effect on those who lead a sedentary lifestyle.

5. Many of us suffer from sleep deprivation more than ever

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Based on media reports, you might think we’re in an epidemic of sleep deprivation. But has sleep deprivation really gone up?

A study in 15 countries showed a very mixed picture. In six countries, scientists recorded a decrease in sleep duration, in seven – an increase, and two more countries gave conflicting results.

There is plenty of evidence that over the past few generations, sleep duration has changed little. However, if you ask people how they rate their lack of sleep, a different picture emerges.

So why do so many people report fatigue? This may be due to the fact that the problem affects certain groups, and the general trend is difficult to identify.

Sleep problems vary significantly by age and gender, a study of 2,000 British adults has found. In the course of it, it turned out that women of almost any age suffer from lack of sleep more than men.

During adolescence, the figures are more or less the same, but then women begin to suffer significantly more from lack of sleep – this may be due to the appearance of children. Then the gap closes again.

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Caffeine and alcohol affect the duration and quality of sleep.

Regularly staying up late due to work or social interactions results in people getting less rest despite getting the same amount of sleep, explains Professor Derk-Jan Dijk from the Sleep Research Center at the University of Surrey.

In addition, some may sleep too little during the week and oversleep on weekends, increasing the average number of hours of sleep. However, in the end, these people still suffer from lack of sleep.

Adolescents can be particularly affected by sleep deprivation, says Professor Dyck.

6. We didn’t always sleep like we do now

Except for unusual cases (Margaret Thatcher, for example, could get a full sleep in four hours), people mostly go to bed in the evening, for seven or eight hours.

But that wasn’t always the norm, says Roger Ekirch, professor of history at Virginia Tech. In 2001, he published a scientific paper on the results of 16 years of research.

His book “When the Day Ends” states that hundreds of years ago people in many parts of the world slept twice.

Ekirch found more than two thousand testimonies in diaries, court records and literature, which prove that people went to bed shortly after dusk, then stayed awake for several hours at night – and went to bed again.

According to him, this means that the body has a natural preference for “segmented sleep”.

Not all scientists agree with him. Some researchers have found modern hunter-gatherer communities that don’t have two stages of sleep even though they don’t have electric lighting. That is, “segmented sleep” is not necessarily the default natural norm.

According to Ekirch, the transition from biphasic to monophasic sleep occurred in the 19th century. Then the possibility of lighting houses led to the fact that people began to go to bed later, while waking up at the same time as before. Improvements in lighting led to a change in the biological clock, and the industrial revolution required people to be more productive.

7. Phones keep teens from sleeping

Sleep experts say teens need up to 10 hours of sleep a day, but nearly half of them sleep significantly less, according to data from the UK health system.

Bedrooms are supposed to be places of relaxation, but there are more and more distractions in them, such as laptops, mobile phones. All this complicates the process of going to bed.

We have more variety of entertainment than ever, and as a result, it becomes tempting to stay awake more.

The blue light emitted from electronic devices makes us less sleepy. And the activity itself – talking with friends or watching TV – stimulates our brain when it should relax.

Experts recommend practicing a “digital detox” – turning off electronic devices 90 minutes before going to bed.

Statistics show that most young people continue to check their phones after they go to bed.

8. More research into sleep disorders

More and more people are coming to the doctor with complaints of sleep problems.

Analyzing data from the British health system in June, the BBC found that the number of studies on sleep disorders in the last decade has grown every year.

There are several factors, but obesity appears to be the most important, says neurologist Guy Leschziner. The most common complaint, according to his observation, is obstructive sleep apnea – a violation of breathing during sleep, which is closely related to the problem of excess weight.

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The media also played a role, as people are more likely to seek therapy after they read an article about sleep problems or search the internet for symptoms, he says.

The recommended treatment for insomnia is cognitive behavioral therapy, and doctors are increasingly coming to the conclusion that pills should not be prescribed in such cases. However, many still do this, because not everyone has the opportunity to undergo treatment without medication, especially outside of big cities.

9. Are there differences between countries?

One study examined the sleep habits of people in 20 industrialized countries. It turned out that the time when people go to bed and wake up can vary up to an hour in one direction or another, but in general it was about the same in different countries.

As a rule, if on average the inhabitants of the country went to bed later, they woke up later, although not in all cases.

Researchers have concluded that social factors – working hours, school schedules, leisure habits – play a more significant role than the time of day or night.

In Norway, where the duration of darkness can vary from zero to 24 hours, sleep duration varies by only half an hour on average during the year.

Both in countries such as Britain, where the times of sunrise and sunset are highly seasonal, and in countries closer to the equator, where this difference is minimal, the duration of sleep remains constant throughout the year.

And what about the influence of artificial lighting?

A study of three communities without access to electricity in three countries – Tanzania, Namibia and Bolivia – found that the average sleep duration there was about 7.7 hours. That is the same as in industrialized countries.

Thus, the duration of sleep is approximately the same all over the world. In these communities, they also went to bed not as soon as it got dark, but fell asleep about three hours after sunset – and woke up before dawn.

Most studies show that, yes, artificial light delays sleep time, but does not necessarily shorten it.

10. “Larks” and “owls”

There have always been “morning” and “evening” people. We even have genetic evidence to support this.

Artificial light seems to exacerbate this effect – especially for people who prefer to stay up late. If you already tend to be a night owl, the artificial light will encourage you to stay up even later.

Approximately 30% of us tend to be early risers and 30% night owls, with the remaining 40% somewhere in between – although a few more of them prefer to get up earlier than stay up late.

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At the same time, we can partially control our biological clock.