Sleep 101

This page is meant to help you by providing a simple guide to some of the terms that you may see associated with sleep problems.


During sleep we become less engaged and less conscious of the external world. Instead we find ourselves in a more detached state. And although we may be asleep throughout the night, we can actually waken, quite a few times. Sleep invariably takes us through differing stages from the primary ‘just about to sleep’ to deeper, restorative and eventually dream states.

Stage 1 – This is where we feel drowsy and as if we’re dropping off. We’re not quite disconnected, but not fully awake either. At this stage we may feel as if our bodies are giving in to the weight of the bed or whatever structure’s supporting us.

Stage 2 – This sees our body temperature drop and our breathing slow. We begin to move in to a light sleep and this is where the beginning of restorative sleep takes place.

Stages 3 + 4 – These states occupy NREM (Non-Rapid Eye Movement). During this phase, sleep sees us moving seamlessly from one state into the next. This deeper level of sleep is where deep restoration takes place.

Stage 5 – This is the REM (Rapid Eye Movement) state. Here our brain is relatively active. We’re processing thoughts and it’s where we’re likely to dream. Although each REM cycle may only last for a short time (up to an hour) it is an important and significant stage.

Throughout the night we will move between NREM and REM states. We may find that at times we’re slightly awake or even that we get up and are fully awake before going back to sleep.

Tired Vs Fatigued

Being tired invokes a feeling or desire to rest or sleep. This can often be resolved after undertaking either activity. It can also occur when our brains are lacking oxygen. It can therefore often be improved by getting out into the fresh air or doing some deep breathing.

Fatigue differs. Unlike being tired, fatigue can be a prolonged state often causing our muscle tissue to become heavy, agitated or inactive. Energy levels and desire can be greatly diminished and rest or sleep will not always initially improve the situation.

Tired All the Time (TATT)

This is an umbrella diagnosis which may be given to people who are experiencing extreme fatigue with little resolve as seen in Chronic Fatigue Syndrome (CFS) or Myalgic Encephalomyelitis (ME). But it may also be due to a metabolic condition such as an underactive thyroid, or hormonal issues relating to menstruation or anaemia. It can also be linked to muscle disorders or muscle weakness, autoimmune conditions or mental conditions such as depression or chronic stress.

Body clock

Our body clock or circadian rhythm is the body’s 24 hour internal clock which is receptive to everything that happens within our internal and external environments.


This signifies a non-sleep state where we’re alert, receptive and conscious.

Jet lag

This is a condition brought on largely by travel through differing time zones. This experience of disorientation can result in our body clock being set off balance. It can radically alter our sleep pattern and our ability to get any form of restful sleep for a short period. In some cases it can be prolonged.


Most doctors will advise that although sleep medication may aid sleep, it is not the answer to resolving long term sleep problems. Prolonged use of some medications can create dependencies and have uncomfortable side effects. Here are some of the common medications prescribed:

Benzodiazepines – These are actually anti-anxiety medications used to relieve tension and agitation. Both of these symptoms may appear prior to or during periods of sleep disturbance or insomnia.

  • Diazepam (Valium) – This is used as an anti-anxiety and anti-convulsant medication. The side effects can be drowsiness, confusion and muscle weakness
  • Lorazepam – This is used for short-term anxiety. The side effects can range from talkativeness and excitement to aggressive and antisocial behaviour

Melatonin – Melatonin is a hormone which is released in the body when it becomes dark. It creates a relaxed state which helps us move into sleep. It is created as a medication to re-align the nocturnal circadian rhythm. This is why it is also prescribed for severe jet lag. Its side effects can induce significant drowsiness. It is not available in the UK.

Zopiclone (Zimovane) – This is a specified sleep medication used for short-term relief from insomnia. It works by invoking soothing feelings. Its side effects may include a dry or bitter taste in the mouth and day time sleepiness.

Zolpidem – This is a specified sleep medication used for short-term relief from insomnia. It works by invoking soothing feelings. Its side effects may include diarrhoea, nausea, vomiting and dizziness.

Antihistamines – Although these are largely prescribed for allergic reactions. They can also at times be prescribed to relieve short-term insomnia.

  • Diphenhydramine – This works by inducing a low sedative effect. It can interact with some benzodiazepines and side effects may be tiredness and dizziness.
  • Clomethiazole – This is prescribed for short-term use for severe insomnia and to relieve restlessness and severe agitation. The side effects may include headaches and nasal congestion.

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