7 Comments
User's avatar
Lindsey Smith Taillie, PhD's avatar

As a 20+ year insomniac this post is so helpful and I have many questions! First, is it known what is the biological mechanism between SSRI/NI use and reduced REM?

Second, am I interpreting it correctly that if you routinely wake up at the same time (even if it is before your naturally preferred wake time), your body will adjust its REM sleep accordingly?

Westley Spiro MD's avatar

I believe the mechanism is related to SSRIs artificially suppressing the more organic relationship between serotonin and REM.

For your second question - we are circadian creatures. Each individual has their own circadian rhythm, but my understanding is that it's quite difficult to 'artificially' change your organic clock externally. This is partly why shift workers have lower life expectancy, etc.

The Way of the Hidden Mountain's avatar

The last third of the sleep night is when the apnea hits me so then I feel like #%,! the rest the day. If I get up after 6 hours rest, not ideal I know, I feel much better. PS the cpap machines don’t work as I tear them off in my sleep and the same with the alternatives that have come out.

The Way of the Hidden Mountain's avatar

I’m open to suggestions as in regards to sleep I feel between a rock and a hard spot

Westley Spiro MD's avatar

I'm going to publish a sleep guide for paid subscribers over the back half of the summer with all my tips and tricks, if interested.

Mike's avatar

One thing I didn't see. The first 2 cycles of the evening are the most important for clean up even though they are shorter. It is now thought that that the first cycle should BEGIN (that means A S L E E P) before ten pm . Every minute after ten you are eating into the most valuable window of healing. Do you die if you go to bed at 11 Every night. Heavens no.. but prime time begins at ten.

David Iler LMT CPT's avatar

Everyone optimizes falling asleep.

Nobody audits their alarm. I know plenty of athletes who wear the 4:45 wake-up as a badge. Worth asking what it costs.