The Impact of REM Phase Disruption on Well-Being

Have you ever wondered why we sleep? Well, you may already know that sleep is super important to allow our bodies and minds to rest. But sleep isn't just about resting our bodies; it'salso super important for our brains. It's during sleep that our brains do a lot of important work.

So, what happens when there are disruptions in sleep and what kind of effect can it have on us? Let’s find out!  

Understanding REM Sleep

Sleep itself is not a linear path. There are distinct stages during sleep that form a cycle, going through the different stages over and over again. These stages include the waking stage (where you are conscious and aware of things around you), N1 to N3 stages (also called the non-rapid eye movement or NREM stage), and finally, the REM (rapid eye movement) stage [1].

A complete cycle through all the stages of sleep may take between 90 to 110 minutes, with about 3 quarters of the time spent sleeping being in the non-REM stages. The first REM period is short (around 10 minutes long) but gets longer as the night progresses, reaching up to an hour long by the final cycle [1]. The image below shows the sleeping stages and how they cycle through the night.

Image retrieved from https://www.sleepfoundation.org/stages-of-sleep on April 15th, 2024.

One of the most fascinating things about the REM stages is that brain activity follows a similar pattern to that as when you are awake, but you are still sleeping. It is also the stage where dreaming occurs and even though the rest of your body doesn’t move, the eyes may be flickeringwhile closed. Hence, why it is called the ‘rapid eye movement’ stage of sleep [1].

The REM stage is important for several reasons including [2]:

1. Dreaming: REM sleep is when most of our dreaming occurs. Dreams are thought to be a way for our brains to process emotions, memories, and experiences, allowing us to make sense of our lives and solve problems while we sleep.

2. Memory Consolidation: During REM sleep, our brains process and consolidate memories from the day. This helps us retain information, learn new things, and improve our cognitive abilities.

3. Emotional Processing: REM sleep plays a crucial role in regulating emotions and processing emotional experiences. It helps us cope with stress, process traumatic events, and maintainemotional balance.

4. Brain Restoration: While our bodies may be resting during REM sleep, our brains are highly active. This activity helps restore and rejuvenate brain function, preparing us for the mental challenges of the day ahead.

5. Physical Restoration: Although REM sleep is not as restorative for the body as non-REM sleep, it still plays a role in muscle relaxation and repair. It allows our bodies to recover from the day's activities and prepare for the next day's demands.

Given the importance of the REM stage in maintaining proper functioning of the activities listed above, this would suggest that any disruptions that occur during this stage of sleep will have a related impact on these activities [3]. For example, disruptions in REM sleep may lead to difficulties with memory consolidation, making it harder to learn new information or remember important details from the day. Or can contribute to emotional instability, increasing the risk of mood disorders such as depression and anxiety.

Causes of REM Phase Disturbance

REM sleep is a delicate stage in the sleep cycle and can be easily influenced by a variety offactors that can disrupt REM sleep, ultimately leading to REM phase disturbance [4]. Some factors that may disrupt sleep include:

1. Stress: One of the primary culprits behind REM phase disturbance is stress. Both acute stress, such as a looming deadline or an upcoming presentation, and chronic stress, like ongoing work pressure or relationship issues, can disrupt the normal progression of REM sleep. Stress triggers physiological arousal, leading to increased brain activity and fragmented sleep, which can interfere with REM sleep cycles.

2. Medications: Certain medications, particularly those that affect neurotransmitter levels in the brain, can interfere with REM sleep. Antidepressants, antipsychotics, stimulants, and some allergy medications are known to suppress REM sleep or alter its duration and intensity. Additionally, medications that induce drowsiness, such as sedatives and sleeping pills, may disrupt the natural sleep cycle, leading to REM phase disturbance.

3. Sleep Disorders: Various sleep disorders can significantly impact REM sleep. Obstructive sleep apnea, a condition characterized by repeated episodes of interrupted breathing during sleep, can lead to fragmented REM sleep and reduced overall sleep quality. REM sleep behavior disorder, where individuals act out their dreams physically, can disrupt the normal progression of sleep stages and lead to REM phase disturbance.

4. Substance Use: The use of certain substances, including alcohol, caffeine, and nicotine, can interfere with REM sleep. While alcohol may initially promote sleep onset, it disrupts the normal sleep cycle, leading to fragmented REM sleep and increased awakenings throughout the night. Caffeine and nicotine, on the other hand, act as stimulants, increasing brain activity and suppressing REM sleep.

5. Psychological Factors: Psychological conditions, such as anxiety, depression, and post-traumatic stress disorder (PTSD), can disrupt REM sleep patterns. These conditions often manifest with heightened arousal levels, intrusive thoughts, and emotional dysregulation, which can interfere with the ability to enter and maintain REM sleep. Plus, peopleexperiencing psychological distress may have more frequent and intense dreams during REM sleep, further disrupting sleep continuity.

Clearly, the consequences of REM phase disturbance go beyond simply affecting sleep quality, they also affect various aspects of psychological well-being. Over time, these effects can take a toll on overall quality of life and contribute to a cycle of sleep deprivation and long-term psychological distress.

 

Psychological Interventions

Addressing REM phase disturbance usually requires a combination of techniques, with psychological interventions playing a crucial role in restoring healthy sleep patterns [5]. Sleep hygiene practices such as maintaining a consistent sleep schedule, creating a relaxing bedtime routine, and optimizing your sleep environment can help improve sleep quality and may be the easiest way to promote REM sleep. When this route fails, relaxation techniques may be an alternative approach. This technique involves deep breathing exercises and progressive muscle relaxation which can help reduce stress and make it easier to fall asleep.

When both these techniques are unable to restore issues in sleep, psychological interventions like cognitive-behavioural therapy for insomnia (CBT-I) may be recommended. CBT-I is provided by a doctor or therapist and aims to identify and challenge negative beliefs about sleep, improve sleep hygiene practices, and develop relaxation skills to promote better sleep quality. CBT-I also targets behaviours that may disrupt REM sleep, such as excessive worrying, rumination, and excessive caffeine or alcohol consumption before bedtime.

Now that you know more about the kinds of things that can impact sleep and the long-term consequences of impaired sleep, make sure to take care of your sleep habits and environment. Prioritize relaxation before bedtime, create a soothing sleep environment, and seek help if you'restruggling with sleep disturbances. Remember, getting enough good quality sleep is essential for your overall health and well-being, so make it a priority in your daily routine. Your body and mind will thank you for it!

Sources Used

1. Patel, A. K., Reddy, V., Shumway, K. R., & Araujo, J. F. (2024). Physiology, Sleep Stages. In StatPearls. StatPearls Publishing.

2. Peever, J., & Fuller, P. M. (2016). Neuroscience: A Distributed Neural Network Controls REM Sleep. Current biology: CB, 26(1), R34–R35. https://doi.org/10.1016/j.cub.2015.11.011

3. Khawaja I, Spurling BC, Singh S. REM Sleep Behavior Disorder. [Updated 2023 Apr 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534239/

4. Feriante J, Araujo JF. Physiology, REM Sleep. [Updated 2023 Feb 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK531454/

5. Jiménez-Jiménez, F. J., Alonso-Navarro, H., García-Martín, E., & Agúndez, J. A. G. (2021). Current Treatment Options for REM Sleep Behaviour Disorder. Journal of personalized medicine, 11(11), 1204. https://doi.org/10.3390/jpm11111204