Why am I so restless in my sleep?

Tips for better sleep Aggressive sleep: what's behind it?

Falling asleep badly, waking up in the middle of the night, snoring, gasping for breath. Those who sleep poorly at night are not alone: ​​Millions of people in Germany suffer from insomnia. The causes are usually very diverse and require different treatment measures.

Effective therapies for sleep disorders

Mild sleep disorders can often be successfully treated with high-dose phytopharmaceuticals, i.e. with herbal preparations. The combination of hops with valerian and lemon balm is particularly promising. The herbal therapy often only takes effect after four or five weeks. But the world of sleeping herbs encompasses much more: The sweet orange blossom, for example, has the advantage that it tastes delicious too. In addition, it not only helps you fall asleep, but also loosens the muscles.

REM sleep behavior disorder

Anyone who speaks or screams in their sleep at night, lashes out, distributed kicks and sometimes injures themselves and their bed partner is not naturally aggressive. Rather, those affected suffer from a so-called dream sleep behavior disorder. It occurs in REM or dream sleep and therefore mainly occurs in the second half of the night. The disease was first described in 1986 and usually begins after the age of 50. The disease is rare, affecting only one in 200,000 people. Men (87.5 percent) are affected much more often than women.

REM is the abbreviation for "Rapid Eye Movement". All sleepers make rapid eye movements during the nightly dream phases. In healthy people, the striated muscles or locomotor muscles are completely paralyzed during REM sleep. In people with REM sleep disorder, this protective mechanism against injury is disrupted. Muscle relaxation is eliminated during sleep. At the same time, aggressive, often violent dream content occurs. The patients kick and punch to defend themselves against persons and creatures in the dream. They often attack their bed partner while they are asleep, injure themselves by falling out of bed or hitting the edge of the bed.

Early signs of neurodegenerative diseases

REM sleep behavior disorder is an early sign of some neurodegenerative diseases. For example, 60 to 70 percent of patients who suffer from it develop Parkinson's disease or the less common neurodegenerative disease multiple system atrophy (MSA) after 10 to 30 years. Any signs of neurodegenerative diseases should definitely be clarified after the diagnosis.

Therapy possible, but little researched

Antidepressants, the benzodiazepine clonazepam or melatonin are used for treatment, although large therapeutic studies are still lacking for the substances. At the St. Hedwig Hospital in Berlin, doctors have been using melatonin for REM sleep behavior disorder for over 20 years - with great success. It takes about 10 to 14 days for the hormone to work. The advantage: if the patients stop taking melatonin after a certain period of time, the symptoms only return after weeks or months for many, and not at all for some patients. Melatonin may be more than a purely symptomatic treatment - and influence the disease process as such.

Sleep phases and sleep rhythm

In the first half of the night the focus is on deep sleep, in the second half of the night on dream sleep. Since deep sleep is the most restful sleep, the first half of the night is particularly important in order to regenerate. After three and a half or four hours, we have most of the deep sleep behind us and relieved the greatest sleep pressure.

Our current sleep rhythm between 11 p.m. and 7 a.m. only emerged in modern times. You used to go to bed after sunset, sleep until midnight, then stay awake for an hour or two. The second round of sleep lasted until dawn. So even nowadays it is perfectly fine if someone has arranged their night sleep in such a way that they are interrupted by knitting breaks, listening to audio books or the radio or watching television. So nobody has to put themselves under pressure if they wake up in between.

Why are sleep problems increasing?

Researchers see the changed day-night rhythm as an important cause of sleep disorders, which can be traced back to the use of artificial light. Scientists speak of light pollution. Street lights, luminous billboards, shop windows and illuminated apartments make big cities shine even at night. That has consequences. Light and darkness help the body know whether to sleep or be awake. The artificial light disrupts the hormonal balance and thus the internal clock. In the evening, light shifts the release of the sleep hormone melatonin and thus good quality sleep to the back.