• Published on: Sep 23, 2020
  • 4 minute read
  • By: Dr Rajan ( Medical Second Opinion Cell)

The Mystery Of Sleep

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The mystery of sleep

Sleep is a critical part of our daily lives. Out of the fixed 24 hours in a day, about a third of it is taken up by sleep. It's not something we can live without, and even short periods of sleep deprivation can have a noticeable impact on us. We tire, our brains do not work as well, and it has a negative impact on our general health. Sleep is so important that all animals need sleep. Mammals, birds, fish, even insects sleep. During this time, they cannot eat, drink, reproduce, they are defenceless to predators and cannot fend for themselves unless woken up. Prolonged sleep deprivation has even been shown to cause death in rats, dogs, fruit flies, even in people. To risk being in such a vulnerable state, and to cause so much damage without it, sleep must have an essential function, one that cannot be skipped. So what is it?

We cannot say for certain. But we are getting closer to finding out.

WHAT IS SLEEP?

We have managed to measure the effect sleep has on the brains of people, mammals and birds by measuring the brain activity directly. We can see changes in activity patterns, different voltage spikes as the neurones in our brains change how they fire. But at its core, sleep is defined by the behaviour changes. It is a dormant behaviour state, one in which the animal is found immobile, less responsive to the stimuli of the outside world, with reduced sensory intake. Unlike hibernation or a coma, it is possible to rapidly reverse this and enter an alert state. When an alarm goes off or failing that someone pours water on your face in the morning.

We can observe sleep states in most animals, our pets, in birds that roost at night. But even insects have been shown to have inactive periods. The common cockroach was the first to display this inactive state. Many experiments on core biological functions are performed on fruit-flies. These insects have a brain with just 100,000 neurones (compared to the human’s 100 billion) but even these simplistic brains need their sleep. If we go even simpler, the nematode worm C elegans has just 302 neurones in its entire body, all of which have been mapped to completion. It takes just 3 days for it to transition from an egg to an adult. And even it needs sleep.  If sleep can be traced back to such simplistic, basic life forms, it must be essential to the core health of a living being.

SLEEP STAGES

Not all sleep is the same type of sleep. At night our brains cycle through many different stages of sleep, each with its own characteristics. They are split into two basic types. Rapid eye movement (REM) sleep and non-REM sleep.

  • Stage 1 non-REM is when we transition from wakefulness to sleep. In this short period our heart rate, breathing and eye movements slow, and muscles relax. Our brain waves slow down from their normal wake patterns.
  • Stage 2 non-REM is light sleep, before transitioning to deep sleep. As our heart rate and breathing slowly, even more, our body temperature also drops, and eye movements stop altogether. Our brain activity is slow, with occasional bursts of activity. This is the stage in which we spend the most amount of time
  • Stage 3 non-REM is deep sleep. This is what you need to feel refreshed in the morning. It occurs the longest during the first half of the night. At this point, it can be difficult to wake a person.

REM sleep occurs about 90 minutes after falling asleep. Your eyes move rapidly from side to side underneath your eyelids, and your brain becomes quite active, similar to that seen when awake. Breathing is faster and irregular, as is your heart rate. Its during this time people dream. Your muscles become temporarily paralysed to prevent them from acting out the dream. The functions of dreams is not known, and studying it is so complex we cannot cover it in this blog.

WHY DO WE NEED SLEEP?

This is the most important question and one we struggle to answer. Studying sleep is difficult. When a person is sleeping, they naturally can’t respond to questions. Animals are even worse at answering these questions.

Trying to measure brain activity non-invasively is hard. Wearing electrodes on your head can show electrical activity, but it is very difficult to know which parts of the brain the activity corresponds to. Using an MRI machine, it is possible to see changes in blood oxygen levels in different parts of the brain. This can show which parts are actively consuming oxygen, and therefore very active, but it isn’t able to tell us when these activities are occurring. Finally sleep deprivation studies are unethical, especially due to the harm they can cause. So that’s out the picture.

From what we have managed to piece together there are two leading theories on the function of sleep.

  1. It allows repair and clearance needed to correct and prevent neuronal damage
  2. It allows the brain to reorganise neurones and engrain our learning.

Both of these activities require a time when the brain is not highly active, and sleep provides the perfect time for this to happen.

When we are awake the neurones in our brain are highly active. This can lead to a build-up of metabolites that can damage the neurones. An excessive build-up of these ages than lead to protein damage, the build-up of dangerous toxins and poorer neuronal health. As we sleep, the metabolic requirements for the brain drop, providing the optimal time to clear these toxins. When we sleep the fluid that surrounds our brain increases in volume and circulation, clearing out these damaging toxins.

Secondly, when we are awake, we are laying down new memories, experiences and learning points. These memories exist as junctions between neurones. The more memory or skill is used, the stronger that junction becomes. Our brain can form erroneous junctions as well, for tasks that are not used often or not useful at all. If this “noise” is kept, it impairs the functioning of our brain and the maintenance and retention of the important memories and skills.

When we sleep, our mind plays back the important memories and skills we wish to retain. This appears to be one of the reasons why we dream, and why our dreams are influenced by our previous actions. This consolidation also prunes the junctions and neuronal links for memories and tasks we don’t use, ones that are not useful to us. This constant pruning hones our brain to keep only what we require. 

SLEEP AND HEALTH

Most people need about 8 hours of sleep a night. This differs between people and also by age. Not achieving the required amount can make a person tired and irritable throughout the day. But if this is maintained for long periods, it can have serious negative effects on your ability to concentrate. This in turn can lead to poor performance at work, increasing stress, and make you prone to accidents.

Whilst we have spoken about why your brain needs sleep; your body needs it too. Without it, you can become more prone to medical conditions such as obesity, heart disease, high blood pressure and diabetes. It even has noticeable effects on your fertility, by reducing the secretion of reproductive hormones.

Sleep is an interesting topic and one we hope to cover again in the future. There is a lot to learn about sleep, and a lot the medical community still needs to discover regarding its uses. From this blog, you should have at least learnt about the basics of sleep, its critical importance as well as why your brain needs it so much.

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Vitamin D

Vitamin D Deficiency Symptoms: Signs Your Body May Be Lacking Vitamin D

Vitamin D is an essential nutrient that plays a vital role in maintaining strong bones, supporting the immune system and regulating several important functions in the body. Despite its importance, vitamin D deficiency is one of the most common nutritional deficiencies worldwide.

In India, vitamin D deficiency has become increasingly prevalent due to lifestyle factors such as limited sunlight exposure, indoor working environments and dietary habits. According to the Indian Council of Medical Research (ICMR), a significant percentage of the population may have insufficient vitamin D levels.

Recognizing the symptoms of vitamin D deficiency early is important because prolonged deficiency can lead to serious health complications affecting bones, muscles and overall wellbeing.

What Is Vitamin D and Why Is It Important?

Vitamin D is often called the “sunshine vitamin” because the body produces it when the skin is exposed to sunlight. It plays a key role in calcium absorption, which is essential for maintaining healthy bones and teeth.

In addition to bone health, vitamin D supports several important functions including:

immune system regulation
muscle function
inflammation control
hormonal balance

Low levels of vitamin D can disrupt these functions and contribute to various health problems.

Common Symptoms of Vitamin D Deficiency

Vitamin D deficiency can manifest through several symptoms, many of which are often overlooked or mistaken for other health issues.

Persistent Fatigue

Constant tiredness or low energy levels may be one of the earliest signs of vitamin D deficiency. Even after adequate rest, individuals with low vitamin D levels may continue to feel exhausted.

Vitamin D plays a role in cellular energy production, and insufficient levels may contribute to chronic fatigue.

Bone and Back Pain

One of the most well-known effects of vitamin D deficiency is bone discomfort. Vitamin D helps the body absorb calcium, which is essential for maintaining bone strength.

Low vitamin D levels may cause:

bone pain
lower back pain
increased risk of fractures

Persistent bone discomfort should be evaluated by a healthcare professional.

Muscle Weakness

Vitamin D is important for muscle health and function. Deficiency can lead to muscle weakness, cramps or general muscle fatigue.

Older adults with vitamin D deficiency may also experience reduced mobility and increased risk of falls.

Frequent Illness or Infections

Vitamin D plays a key role in supporting the immune system. Individuals with low vitamin D levels may experience frequent colds, infections or slower recovery from illness.

Research suggests that adequate vitamin D levels help strengthen immune defenses against respiratory infections.

Mood Changes and Depression

Vitamin D may influence brain function and mood regulation. Some studies have found a connection between low vitamin D levels and mood disorders such as depression or anxiety.

People experiencing persistent mood changes should consider evaluating vitamin levels as part of a broader health assessment.

Hair Loss

Severe vitamin D deficiency may contribute to hair thinning or hair loss. While hair loss can have multiple causes, nutritional deficiencies including vitamin D deficiency may play a role.

Slow Wound Healing

Vitamin D contributes to the body’s inflammatory response and tissue repair processes. Individuals with deficiency may notice slower wound healing or delayed recovery from injuries.

Who Is at Risk of Vitamin D Deficiency?

Several factors can increase the risk of vitamin D deficiency.

Limited Sun Exposure

People who spend most of their time indoors or use strong sun protection regularly may not receive enough sunlight to produce sufficient vitamin D.

Urban lifestyles and indoor work environments contribute to this problem.

Older Adults

As people age, the skin becomes less efficient at producing vitamin D from sunlight. Older adults may therefore require additional dietary intake or supplements.

Individuals with Darker Skin

Melanin reduces the skin’s ability to produce vitamin D from sunlight. Individuals with darker skin tones may require longer sun exposure to produce adequate levels.

Poor Dietary Intake

Few foods naturally contain vitamin D. Diets lacking fortified foods, dairy products or fatty fish may contribute to deficiency.

Medical Conditions

Certain medical conditions such as kidney disease, liver disease or digestive disorders can affect vitamin D absorption and metabolism.

How Is Vitamin D Deficiency Diagnosed?

Vitamin D deficiency is diagnosed through a simple blood test that measures the level of 25-hydroxyvitamin D in the bloodstream.

Doctors may recommend testing for individuals who experience symptoms of deficiency or belong to high-risk groups.

Early diagnosis allows healthcare providers to recommend appropriate treatment and lifestyle adjustments.

How to Improve Vitamin D Levels

Sunlight Exposure

Regular sunlight exposure is one of the most effective ways to increase vitamin D levels. Experts generally recommend 10 to 30 minutes of sunlight exposure several times per week, depending on skin type and location.

Dietary Sources of Vitamin D

Although limited, certain foods contain vitamin D, including:

fatty fish such as salmon and mackerel
egg yolks
fortified milk and cereals
mushrooms

Including these foods in the diet can help maintain healthy vitamin D levels.

Vitamin D Supplements

In cases of significant deficiency, doctors may recommend vitamin D supplements. The dosage depends on the individual’s vitamin levels, age and health status.

It is important to take supplements under medical supervision to avoid excessive intake.

Preventing Vitamin D Deficiency

Maintaining adequate vitamin D levels requires a balanced combination of sunlight exposure, proper nutrition and regular health monitoring.

Routine health checkups and vitamin testing can help identify deficiencies early and prevent complications.

Adopting a healthy lifestyle with balanced nutrition and outdoor activity can significantly improve vitamin D status and overall health.

Conclusion

Vitamin D deficiency is a common but often overlooked health concern. Symptoms such as fatigue, bone pain, muscle weakness and frequent infections may indicate low vitamin D levels.

Early detection and proper management are essential to prevent long-term health complications. By ensuring adequate sunlight exposure, maintaining a balanced diet and undergoing regular health checkups, individuals can support healthy vitamin D levels and improve overall wellbeing.

Recognizing the warning signs of vitamin D deficiency and seeking timely medical advice can help protect long-term health and maintain optimal body function.

References

  • Indian Council of Medical Research (ICMR) – Nutritional Deficiency Reports

  • World Health Organization (WHO) – Micronutrient Deficiency Guidelines

  • National Institute of Nutrition (NIN) India – Vitamin D Research Reports

  • Lancet Public Health – Nutritional Health Studies

  • National Institutes of Health (NIH) – Vitamin D Fact Sheets for Health Professionals

See all

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