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Why do I feel more rested after I get up than when my alarm clock or another person wakes me up? – Calleigh H., age 11, Oklahoma

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We've all been there: You're in the course of a ravishing dream. Maybe you're flying. As you fly through the air, you come across an eagle. The eagle looks at you, opens its beak and – BEEP! BEEP! BEEP!

Your alarm goes off. Keep dreaming, it's time to rise up.

Many people – children and adults alike – notice that they feel more awake once they get up naturally from sleep than when an alarm or one other person, similar to a parent, wakes them up. Why is that?

I’m a neurologist Who studies the brain and specifically what happens within the brain once you sleep? I also care for kids and adults who do stay awake well and wish to sleep higher. In my research, I work with parents to assist them teach their children good sleep habits.

To understand how you can sleep higher and why waking up naturally from sleep helps you are feeling more alert, you first need to grasp sleep cycles.

The sleep cycle

The Sleep cycle consists of 4 stages. One of them is REM, which stands for rapid eye movement. The other three are non-REM stages. When you go to sleep, you first enter a state of sleepiness called non-REM stage 1.

This is followed by deeper sleep phases, the so-called non-REM stages 2 and three. Each non-REM phase is deeper than the previous one. Then, about 90 minutes after you first go to sleep, you enter the fourth stage, REM sleep. This is a phase of lighter sleep where you dream loads. After a number of minutes, you’ll return to non-REM sleep.

These cycles repeat throughout the night, with most individuals alternating 4 to 6 cycles of non-REM sleep and REM sleep each night. As the night progresses, cycles contain less non-REM sleep and more REM sleep. That's why it's necessary to get enough sleep in order that the body can sleep enough of each REM sleep and non-REM sleep.

REM vs. non-REM sleep

How do researchers like me know if an individual is in non-REM or REM sleep? In the sleep laboratory we will see this from their brain waves, eye movements and the strain of their muscles, for instance of their chin. These are measured by placing sensors called electrodes on the scalp, across the eyes and on the chin.

These electrodes detect brain activity starting from low-amplitude waves (the peak of the wave) and comparatively fast to high-amplitude waves (a bigger wave) and comparatively slow. When we’re awake, the wave height is low and the waves are relatively fast. When you sleep, nevertheless, the waves turn out to be higher and slower.

Non-REM stage 3 has the best and slowest waves of all sleep stages. During REM sleep, brain waves are low in amplitude and comparatively fast, and eye movements are also rapid. For a healthy brain, people need each non-REM and REM states to learn and remember.

Wake up naturally

When you get up on your personal within the morning, it normally happens at the top of your sleep period. Think of it like getting off the train once you stop on the station. But being woken up by an alarm or one other person is like jumping off the train between stops, which may feel jarring. That's why it's good to get up naturally at any time when possible.

People can actually train their brains to get up at a consistent time on daily basis, which is a natural stopping point. The brain has an internal 24-hour clock that dictates once you first feel sleepy and once you get up. This is said to ours circadian rhythms.

Train the brain to get up at a consistent time

First, it's necessary to go to bed at a consistent time so that you get enough sleep. Staying up too late doing homework or taking a look at your phone can affect your sleep and leave you counting on an alarm clock – or your parents – to wake you up.

Other things that may make it easier to go to sleep at a healthy time include physical activity through the day and avoiding coffee, soda, or other caffeinated drinks or foods. Physical activity increases the production of brain chemicals that make it easier to go to sleep, while caffeine does the other and keeps you awake.

Secondly, it’s worthwhile to concentrate to the sunshine around you. Too late within the evening light, including from screens, can affect the production of a in your brain Chemical called melatonin this promotes sleep. But within the morning once you get up, it’s worthwhile to be exposed to light.

Morning light helps you synchronize or harmonize your circadian rhythm with the surface world and makes it easier to go to sleep at night. The easiest technique to do that is to open the blinds or curtains in your room. In winter, some people use light boxes to simulate sunlight, which helps them adjust their rhythm.

Benefits of a superb night's sleep

A superb sleep routine features a consistent bedtime and wake-up time in addition to getting enough sleep frequently. That is, normally Sept. 11 hours for school-age children who will not be yet teenagers and 8-10 hours for teenagers.

This will make it easier to learn optimally at school, improve your mood, maintain a healthy weight, and promote many other features of health.

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What is Eastern Equine Encephalomyelitis or Triple E?

Eastern equine encephalomyelitis is a virus that is especially transmitted by certain mosquitoes. It was first discovered in Horses that died of encephalitis along the Mid-Atlantic coast in 1933. It was found that electrical and electronic equipment causes diseases in humans during an outbreak involving horses and humans in southeastern Massachusetts in 1938.

Since then, sporadic cases in humans and horses have been reported almost yearly. Atlantic, Great Lakes and Gulf Coast regions the United States, with major outbreaks in these areas occurring several years apart. The last significant outbreak of human EEE disease occurred in 2019, when over three dozen cases were reportedmostly from Massachusetts and Michigan.

How is it transmitted?

EEE virus exists in a natural cycle between – the black-legged or black-tailed mosquito – lives in eastern freshwater hardwood swamps and certain birds that live in such swamps.

Mosquitoes feed almost exclusively on birds and don’t normally bite humans or horses. However, more common mosquitoes akin to and might sometimes bite infected birds, develop into infected themselves, after which transmit the EEE virus to nearby humans or horses. These mosquitoes are called “bridge mosquitoes.”

In rare cases, the EEE virus has also been Transmission through organ donationTheoretically, transmission can be possible through blood transfusions.

Why are EEEs appearing now?

Typically, about 10 cases are reported in humans every year. Atlantic, Great Lakes and Gulf Coast regions the United States, although there are probably many more mild cases that go unreported. Most human cases happen from July to October in endemic areas.

Much larger outbreaks of EEE disease occur in certain areas every few years. In 2019, for instance, over three dozen cases reported, especially from Massachusetts and MichiganThese cyclical outbreaks are likely on account of a posh interplay between temperature, precipitation, mosquito population, bird immunity and bird migration patterns.

What are the principal symptoms of EEE and the way serious can an infection be?

Researchers cannot estimate exactly how often people develop into sick after being infected with the virus. Our best estimate is that about 95% of those infected have either no symptoms or relatively mild symptoms. Some may develop fever or flu-like illness after an incubation period of 4 to 10 days.

About 5% of individuals infected with the EEE virus can develop a Brain swelling called Encephalitis.

This brain swelling will be particularly severe and require intensive care. About one third of those affected by encephalitis die. The other two thirds could have everlasting neurological deficits including cognitive problems, weakness or movement disorders.

People under 15 and over 50 in addition to individuals with weakened immune systems are higher risk of encephalitis.

Are there treatments or vaccines for EEE?

There are no proven effective treatment for EEE at the moment. Some clinicians have tried steroids to cut back swelling or antibodies to enhance the immune response, with various successHowever, not one of the treatments have been capable of prove their effectiveness in large clinical trials.

Brain swelling may require intensive care, and seizures may require treatment with antiepileptic drugs. Almost all patients who develop encephalitis and survive require prolonged rehabilitation.

There are currently no commercially available vaccines for humans against electrical and electronic alcohols. There are vaccines for horses in endemic areas.

How do you prevent EEE?

In general, if you happen to prevent mosquito bites, They prevent infection with the EEE virus.

You can do several things to forestall mosquito bites:

– Use a Insect repellents registered by the Environmental Protection Agency on exposed skin when you find yourself outside and mosquitoes are around. They are protected and effective when used as directed.

– Wear long-sleeved shirts and pants if possible. It is far more difficult – and even not possible, depending on the material – for mosquitoes to bite through clothing. You may also treat your clothing with the insecticide. Permethrinwhich moreover repels mosquitoes.

– Avoid being outdoors from dusk to dawn. Many species of mosquitoes are most lively at the moment.

– Use fly screens or air con in buildings to maintain mosquitoes out.

– Drain any unused standing water around your property. Mosquitoes wish to breed in standing water. You can use this water to water plants.

Finally, certain local vector control authorities in communities with high infection burden may think about using mosquito repellent to kill mosquitoes.

Is there a “Western” version of the virus within the US?

Yes. Western equine encephalomyelitis or WEE virusis a virus closely related to EEE. Historically, it was endemic within the Western United States and South America.

However, the last WEE outbreak within the United States occurred in 1987, and the last reported case within the United States was in 1999Researchers have no idea why WEE has not occurred within the western United States for nearly twenty years, though resurfaced in Argentina End of 2023.

WEE is taken into account less serious than EEE, but can still cause encephalitis, especially in young children and the elderly. The resurgence of diseases akin to EEE and WEE highlights the importance of public health surveillance.

Cerebrospinal fluid or CSFis a transparent, colorless fluid that plays a vital role in maintaining the health and performance of your central nervous system. It cushions the brain and spinal cord, delivers nutrients, and removes waste products.

Despite their importance, problems related to cerebrospinal fluid often go unnoticed until something goes unsuitable.

I’m a Neurologist and headache specialist. In my work with patients with CSF pressure disorders, I actually have seen many alternative manifestations of those conditions. Here's what happens when your cerebrospinal fluid stops working:

What is cerebrospinal fluid?

CBF consists of Water, proteins, sugars, ions and neurotransmitters. It is principally produced by a network of cells that Choroid plexuswhich is positioned within the ventricles or cavities of the brain.

The choroid plexus produces approx. 500 milliliters of cerebrospinal fluid each daybut within the central nervous system only about 150 milliliters are present at anybody time, because the brain is always being absorbed and replenished. This fluid circulates through the Ventricles of the brainThe Central canal of the spinal cord and the Subarachnoid space across the brain and spinal cord.

CSF has several critical functions. It protects the brain and spinal cord from injury by absorbing shock. Suspending the brain on this fluid reduces its effective weight and prevents it from being crushed by its own mass. In addition, CSF helps maintain a stable chemical environment within the central nervous system, facilitating the removal of metabolic waste and the distribution of nutrients and hormones.

When the production, circulation, or absorption of cerebrospinal fluid is impaired, it might probably cause significant health problems. Two necessary conditions are cerebrospinal fluid leaks and idiopathic intracranial hypertension.

Cerebrospinal fluid leak

A Cerebrospinal fluid leak occurs when fluid escapes through a tear or hole within the dura mater – the tough outermost layer. the meninges that surrounds the brain and spinal cord.

The dura will be damaged by head trauma or punctured during surgical procedures involving the sinuses, brain, or spine, corresponding to a lumbar puncture, epidural, spinal, or myelogram. Spontaneous CSF leaks can even occur with none identifiable cause.

Originally it was assumed that CSF leaks were relatively rare. Incidence of 5 per 100,000 peopleHowever, with increasing awareness and advances in imaging, healthcare providers are discovering increasingly more leaks. They are likely to occur more steadily in middle-aged adults and are more common in women than in men.

Risk aspects for the disease include connective tissue diseases corresponding to Ehlers-Danlos syndrome and postural orthostatic tachycardia syndrome.

Unfortunately, it is not uncommon for healthcare providers Misdiagnosis of a CSF leak than one other disease, corresponding to migraines, sinusitis or allergies. What can Diagnosis of a CSF leak difficult is the broad symptomatology. Most individuals with a CSF leak have a Positional headache This improves when lying down and gets worse when standing. The pain often occurs at the back of the top and might extend to the neck and between the shoulder blades. In addition to the headache, patients may experience ringing within the ears, visual disturbances, memory problems, difficulty concentrating, dizziness and nausea.

Imaging might help with diagnosisincluding an MRI of your brain or entire spine, or a myelogram of the space surrounding your spinal cord. Characteristics of a CSF leak which are visible in a scan are your Brain sags within the skull base and a fluid accumulation outside the dura. However, it’s estimated In 19% of patients with a CSF leak, the scans are normalsubsequently, it can’t be completely ruled out that there’s a leak if there are not any signs in the images.

Conservative treatment If you have got a CSF leak, you need to rest, lie flat, and drink more fluids to offer your spine time to heal the puncture. Increasing your caffeine intake to the equivalent of three to 4 cups of coffee a day can also help. increasing CSF production by stimulating the choroid plexus. Caffeine also relieves pain by interacting with Adenosine receptorswhich play a key role within the body's pain perception mechanisms.

If a conservative approach isn’t successful, Epidural blood patch could also be crucial. This procedure involves drawing blood out of your arm and injecting it into your spine. The injected blood might help form a covering over the outlet and promote the healing process. The headache may improve quickly, but when the patch doesn’t work or the outcomes are short-lived, additional tests could also be needed to raised locate the positioning of the leak. In rare cases Surgery could also be beneficialMost patients with a CSF leak reply to some form of those treatments.

Idiopathic intracranial hypertension

Idiopathic intracranial hypertension is a condition through which excess cerebrospinal fluid increases pressure within the skull and compresses the brain. The term “idiopathic” signifies that the reason behind the increased pressure is unknown.

Most patients with idiopathic intracranial hypertension have a History of Obesity or recent weight gain. Other risk aspects include taking certain medications corresponding to tetracycline, excessive vitamin A, tretinoin, steroids and growth hormones. Overweight middle-aged women are 20 times more likely Patients with idiopathic intracranial hypertension are diagnosed at a better rate than other patient groups. As obesity becomes more prevalent, the incidence of this disease can be increasing.

Patients with idiopathic intracranial hypertension typically experience Headaches and visual disturbancesTinnitus or eye pain. Papilledemaor swelling of the optic disc, is the standard finding in a Funduscopic examination the back of the attention. Doctors can also observe paralysis of the patient's eye muscles.

Brain imaging in patients with suspected idiopathic intracranial hypertension is crucial for Exclusion of other causes of increased cerebrospinal fluid pressure, corresponding to brain tumors or blood clots within the brain. Lumbar puncture or spinal puncture Measuring the pressure and composition of the cerebrospinal fluid can be crucial for diagnosis.

Since high intracranial pressure can damage the optic nerve and result in everlasting vision lossThe most important goal of treatment is to scale back pressure and preserve the optic nerve. Treatment options These include weight reduction, dietary changes and medications to scale back cerebrospinal fluid production. Surgical procedures can even reduce intracranial pressure.

Future directions and unknowns

Cerebrospinal fluid is important for brain health. Despite advances within the understanding of CSF-related diseases, some features remain unclear.

The exact mechanisms resulting in conditions corresponding to CSF leaks and idiopathic intracranial hypertension should not fully understood, but there are many theoriesFurther research is required to enhance diagnostic accuracy and supply more practical treatments for cerebrospinal fluid disorders.