Decoding Microsleep - How to Not Let Your Brain Sleep When it Needs to be Awake?

We all make tight plans. Plans like returning from a holiday on a Monday morning and rushing straight to the office from the airport or being up all night watching movies and rushing to attend college classes at 8 in the morning.

But, right in the middle of the day we lose steam. Our exhausted bodies cry for sleep and we go into brief periods of sleep lasting from a few to several seconds. That’s when we experience nodding-heads and closed eyelids, making us wonder how long have we been asleep. Such brief episodes of sleep are called Microsleeps.

While such episodes aren’t a problem when we are on our couch watching TV, they have serious implications when we are tasked with something more important that requires constant alertness like driving or operating heavy machinery.

Microsleep can happen in the daytime while performing serious tasks and comes most of the time without the person knowing it. It occurs when the brain unexpectedly shifts between wake and sleep states, shutting down parts of the brain. It is caused by not only lack of proper sleep but also by other conditions like sleep disorders and side effects of some medications.

Symptoms of Microsleep:
The most common symptoms of microsleep are visible behavioral indicators. These behaviors include:

- Blank stares
- Sudden body jerks
- Eyelid drooping
- Nodding head
- Short episodes of snoring
- Difficulty remembering the last few minutes
- Attention-deficit

Symptoms of microsleep can also be observed in a clinical setup while performing sleep research. Such research has demonstrated that the brain activity that controls consciousness and wakefulness reduces significantly while microsleep episodes.

Triggers of Microsleep
Microsleep is triggered mostly because of inadequate sleep. It may be because of sleep disorders like insomnia, sleep apnea, narcolepsy, hypersomnia, schizophrenia, or due to factors that are a part of people’s lifestyles like long work times and night-shifts. One can witness frequent episodes of microsleep at undesired times if she is not getting enough sleep for any other reason.

Microsleep episodes can also result from some medications, that can have sedating side-effects, especially the dopamine-stimulating drugs like in Parkinson's Disease. Dopamine is a brain chemical responsible for wakefulness and increased dopamine generally leads to less quality sleep, which results in frequent episodes of microsleep. In studies, dopamine-stimulating drugs are known to cause sudden onset of sleep in half of the patients taking them while they are driving.

Apart from medications with sedating side-effects, some recreational drugs have also been known causes of drowsiness in people. Drugs like opioids, cannabis and even excess alcohol result in reduced concentration and excessive sleepiness.

However, microsleep is not limited only to the conditions mentioned above. Even when people get enough 7-9 hours of sleep, and they aren’t on medications or drugs, they tend to witness episodes of microsleeps. This happens especially when people are performing dull, repetitive tasks which leads to bouts of boredom. Such tasks can be sitting in a meeting when there is not much to contribute, caregiving to others, watching children, sitting in a boring seminar, or attending a slow lecture.

Microsleep episodes are also frequent in specific times of the day. The times that are most associated with microsleeps are dawn, afternoon, and late-nights. As per some studies, vehicular accidents are more likely to happen in certain times intervals like 1 to 4 AM and 1 to 4 PM, when people are susceptible to sleep.

Detection of Microsleep
Scientists have been using various ways to detect microsleep for long with the lack of consensus on the best way to recognize and classify microsleeps. The simplest ways used to identify microsleeps have been psychological tests, speech tests, and behavioral tests.

There have been other complex tests too like  EEG, fMRI, EOG, and PSG that are tied to various software programs. These tests have also shown some success in correctly identifying the microsleep episodes.

Despite these numbers of tests, the objective analysis of microsleep in a clinical set-up has been elusive for scientists. When tests are conducted in a controlled environment, individuals themselves are not aware of their level of sleepiness. Therefore, we require more objective means to ascertains microsleeps to accumulate more scientific data on what causes them and how the brain functions before, at the time, and after the episodes of microsleep.

The Sleep and Wake Dilemma
The brain reacts differently when one experiences a microsleep episode. The transition for sleep to wakefulness is controlled by a variety of chemicals in the brain. The feeling-sleepy part is likely led by Adenosine and the wakefulness part is led by Dopamine.

In an experiment conducted in 2015, researchers kept people awake for fatiguing 22 hours and monitored their brain activity using a dark fMRI machine. A unique phenomenon came into light when the test subjects went into brief episodes of microsleep. Brain thalamus - part of the brain responsible for regulating the sleep-wake cycle - saw reduced activity during those episodes of microsleep.

On the other hand, the researchers saw heightened activity in other parts of the brain that regulate our attention paying capacity. The brain kept shouting and working towards keeping people off sleep.

Therefore, the activity in the brain heightens when people feel drowsy at inappropriate times. The need for higher alertness is highlighted by the brain, but at some point - based on the underlying conditions of drowsiness - the sleep takes over and the brain succumbs and slips into microsleep.

Risks of Microsleep
Microsleep episodes can be alarming if they occur at times when extreme alertness is required. Such episodes have led to fatal accidents like airplane and train crashes in the past. Driving accidents due to microsleeps are way too common and the world sees thousands of fatal injuries every year due to the driver’s drowsiness.

What’s more dangerous is when the person on high-alertness task is unaware of the episode of microsleep. That produces a sense of being in control while the brain is certainly dozing off. In such a situation if the person continues to perform the task, the risk of accident reaches an alarmingly high level.

Some major disasters across the world like the Waterfall train disaster in Australia, the Air France plane crash of 2009, and the Chernobyl nuclear disaster of 1986 were said to be caused due to the overworked crew that felt drowsy during the essential work hours. In the Air France crash, the pilot stated that he didn’t get enough sleep the night before the crash, and handed over the plane to two co-pilots who were not able to control when the plane slipped into trouble.

The effects of drowsiness and microsleep are much more severe in truck and heavy vehicle drivers. A sleep-deprived person driving a truck in the night is more likely to succumb to microsleep due to perfect conditions for sleep. The driver would be tired, in a monotonous job, and full of boredom, making the shift to the state of microsleep pretty easy.

Therefore, microsleep poses the biggest threat when the inattentiveness can be a safety hazard. This is when the task at hand involves ensuring the safety of other people. Pilots, car drivers, truck drivers, locomotive operators, heavy machinery operators, nuclear plant operators are some of the important functions where microsleep can be a hazard to not only the person performing the job but also to the general public.

Here are some statistics that implicate the severity of microsleeps and drowsiness in general.

- As many as 44 percent of truck drivers become dangerously sleepy during late night
- Fatiguing work obligations increase the probability of accidents from 0% to 35%
- 4.7% of people reported being drowsy once in a month while driving, as per a U.S. survey
- In the U.S., 2.5% of fatal crashes and 2% of injuries involve sleepy driving
- Fatigue has been a cause in 250 air fatalities in the last decade and a half

Microsleep is also risky when it is associated with medications. Frequent microsleeps due to sedating side-effects of medicines can reduce the efficiency and impact day-to-day functioning of workers. This might result in reduced productivity and unwillingness to show up at work. Employers may be averse to hiring or keeping such workers because of their sub-optimal output.

Warning Signs of Microsleep
Almost always, there are clear warnings before people witness the microsleep episodes. Differing behavioral traits are observed when people are extremely worked up and begging for sleep. Some visible signs in such times include:

- Excessive yawning
- Excessive blinking
- Increased desire for brain stimulants like caffeine and sugar
- Focus-deficit
- Feeling of sleepiness
- Inability to keep eyes open

The best course of action when these signs are observed is to take off and get some sleep. People should avoid the steering wheels, because driving drowsy is equivalent to drunken driving, when people lose the most important cognitive functions and struggle to stay awake.

How to Prevent Microsleep
Microsleep is most often the direct consequence of inadequate sleep. Sleep-deprived individuals are always at a higher risk of dozing off. Therefore, the elimination of sleep deprivation is the first step towards reducing and eliminating the microsleep episodes.

An adult should get at least 7 to 9 hours of sleep to avoid work time drowsiness. To sleep that many hours, perfect sleep conditions like dark, quiet, and peaceful and comfortable environment are quite essential. It becomes a little more difficult to sleep with the lights on and with too much sound like loud music, the sound of heavy machinery operating in the neighborhood, or kids playing around the sleep space.

Sleep discomfort emanating from unsuitable mattresses also results in lesser quality sleep. If not addressed, this discomfort results in perennial problems like insomnia, thus initiating a vicious cycle that leads to multiple lifestyle issues like fatigue, anxiety, and increased weight.

Apart from simply sleeping more, improving the overall sleep efficiency can also be helpful in overcoming sleep deprivation. Too much stimulation of the brain before sleeping also leads to inefficient sleep. That happens when going to bed happens right after taking a heavy screen dose - looking into laptop and smartphone screens for long.  Such activities don’t let the brain rest while sleeping and keep it stimulated posing difficulty in getting an efficient sleep.

Overdose of stimulants like caffeine and alcohol, and overeating in the evening also impacts the efficiency of sleep.

Taking adequate naps before a long drive or flight also helps in bringing down the episodes of microsleep. As per a study by NASA back in 1994, a 40-minute nap before a test flight for pilots resulted in only 34 microsleeps against 120 of that in the non-napping group. Therefore, getting a good nap right before the task cuts the risk of accidents by three-fourths while performing the task.

Sleep inefficiency also happens due to mental conditions like anxiety and depression. When people are too excited or too worried, they have difficulty getting sleep. Therefore, taking care of the sleep is the first thing mental health professionals do for episodes of anxiety and depression that does not let the brain go to sleep at the right times.

The use of medications is not only helpful in curing sleep-deprivation due to mental conditions, but also in other sleep disorders like insomnia and hypersomnia. Behavioral therapies are also helpful in treating disorders like insomnia to help chronic patients get an efficient, proper sleep.

When medications are causing the sleep-deprived microsleep episodes, switching to medication with lesser sedating side-effects is recommended.

The Final Word
The most likely and easily addressable cause of microsleep is sleep-deprivation. When people fail to get enough sleep when they should be getting it, they tend to sleep at the other times when they should not be sleeping. Therefore, getting enough and efficient sleep eliminates most of the risks associated with microsleep.

Adequate sleep is important for not only the best cognitive and physical performance, but also for general well being. Deliberately depriving oneself of sleep for whatever reason is counterproductive and does more harm than good.

When it comes to mattress related sleeping issues, there is no one size fits all and suitable mattresses vary for different people based on weight, height, body structure, and other factors. It is extremely hard for people to determine their suitable mattress type on their own. Which is why, Kingkoil - the oldest global mattress brand - took it on itself to develop a scientific formula that helps people figure out the best suitable mattress based on a number of known variables about one’s sleeping habits, body type, and sleeping postures. Known as the SleepID, the formula uses exclusive technology that analyses the way people sleep, to help them find the right mattress for themselves. Kingkoil also has a wide range of mattresses, each one of them crafted using cutting edge mattress technology to give you the best night's sleep.

Getting adequate sleep is a long-term fix for drowsiness and microsleeps. In the immediate-term, the best course of action is to step back and take rest. That means pulling off instead of drowsy driving and taking days off instead of continued plowing of bulldozers. This becomes even more important when the lives of other people are dependent on someone else’s cognitive activity, that gets killed by drowsiness and microsleeps.

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