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Sleep Hygiene

Sleep Hygiene is the conscious act of cultivating sleep habits through sleep strategies supported by science and emerging research.  

This is a place to explore those topics. 

Updated periodically, come back often!

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Sleep Medicine: A History

Author: Rose D.

Sleep Hygiene is the practice of cultivating habits that lead to advantageous sleep through behavioral and environmental methods. While the concept of Sleep Hygiene was not coined until the early 1970's, by psychologists, who began experimentation to address narcolepsy and mild to moderate insomnia. While previous knowledge on sleep disturbances were based on self-experience and self-reporting; or from the observation of perceived strange behaviors of individuals during sleep such as sleep walking or sleep terrors. [2]

In 1863, Dr. Ernst Otto Heinrich Kohlschütter, a German Physician, was one of the first to systematically investigate the change of awakening thresholds across the night. Kohlschütter studied the type, duration, and frequency of sound stimuli, required for waking. The study utilized systematic varied acoustic stimuli, in order, to measure physiological changes and processes during sleep including distribution of blood volume, muscular fatigue, and 24-hour rest-activity cycle was investigated. [1]

Though his study was hypothesis driven, it was able to generate a sleep depth curve, highlighting areas of optimal sleep, for his dissertation called, Measurements on the Firmness of Sleep- "Messungen der Festigkeit des Schlafes". Retro-analysis of his methods found his study well-designed, despite not having the modern invention of electroencephalography (EEG) or later polysomnography, also known as a sleep study. 

Human electroencephalogram (EEG) is a test that records, tracks and evaluates electrical activity in the brain through strategically placed electrodes. An EEG can be used to help detect potential problems associated with brain wave activity. It provides insight from observations of electrical processes near the brain surface, which is the outer brain layer called the cerebral cortex. The cerebral cortex is believed to be responsible for cognition; such as, perception, memory, thinking, emotions, actions, and behaviors. [3]

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The onset of Sleep Medicine began with advances in neuroscience and behavioral sciences, surrounding the study of the brain and cerebrum’s lobes. Advances and studies around frontal lobes were understood in greater depth, around the early 1800’s, due to the discoveries of the frontal lobes higher faculties around function and linguistics.  

There were several advancements in the 20th century, due to observations related to frontal lobe functions. These were acquired from observations from psychosurgery along with contributions by, behavioral neurology, neuroimaging, and neuroanatomy. [2] These fields provided information to delineating frontal regions, circuits, and networks, relevant to specific cognitive and emotional operations. [3]

Later, the development of Polysomnography, a test, that includes EEG technology and recordings of electric activity and brain waves, in association, with physiological metrics; such as, the oxygen level in blood, heart rate, breathing, and eye & leg movements. These advances have allowed for the development and advances in Sleep Medicine, and thus further development of Sleep Hygiene related strategies. 

References:

[1] Bonnet, Michael H. and Johnson, Laverne C. (1978).  Relationship of Arousal Threshold to Sleep Stage
          Distribution and Subjective Estimates of Depth and Quality of Sleep. Sleep, 1(2): 161-168.

[2] Filley, Christopher M. (2009). Chapter 35 The Frontal Lobes. Handbook of Clinical Neurology, 95: 557-570.
     

​[3] Schulz H, Salzarulo P. (2016). The development of sleep medicine: a historical sketch. Journal of Clinical Sleep
           Med, 12 (7): 1041–1052.

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