How long does inducing take

Induced labour | Pregnancy Birth and Baby

What is an induced labour?

Labour normally starts naturally any time between 37 and 42 weeks of pregnancy. The cervix softens and starts to open, you will get contractions, and your waters break.

In an induced labour, or induction, these labour processes are started artificially. It might involve mechanically opening your cervix, breaking your waters, or using medicine to start off your contractions — or a combination of these methods.

In Australia, about 1 in 3 women has an induced labour.

What are the differences between an induced and a natural labour?

An induced labour can be more painful than a natural labour. In natural labour, the contractions build up slowly, but in induced labour they can start more quickly and be stronger. Because the labour can be more painful, you are more likely to want some type of pain relief.

If your labour is induced, you are also more likely to need other interventions, such as the use of forceps or ventouse (vacuum) to assist with the birth of your baby. You will not be able to move around as much because the baby will be monitored more closely than during a natural labour.

You will only be offered induced labour if there is a risk to you or your baby's health. Your doctor might recommend induced labour if:

you are overdue (more than 41 weeks pregnant)
there is a concern the placenta is not working as it should
you have a health condition, such as diabetes, kidney problems, high blood pressure or pre-eclampsia
the baby is making fewer movements, showing changes in its heart rate, or not growing well
your waters have broken, but the contractions have not started naturally
you are giving birth to more than one baby (twins or multiple birth)

Not everyone can have an induced labour. It is not usually an option if you have had a caesarean section or major abdominal surgery before, if you have placenta praevia, or if your baby is breech or lying sideways.

Can I decide whether to have an induced labour?

If you are overdue, you might decide to wait and see if labour will start naturally. However, if there is a chance you or your baby are at risk of complications, you might need to consider induced labour before your due date.

When making your decision, discuss the risks and benefits with your doctor. Do not be afraid to ask lots of questions, such as:

Why do I need an induction?
How will it affect me and my baby?
What will happen if I do not have the induction?
What procedures are involved and how will you care for me and my baby?

You might need to consider several other health concerns. For example, there is a higher risk of stillbirth or other problems if your baby is not born before 42 weeks, and an increased risk of infection if your waters break more than 24 hours before labour starts.

What can I expect with an induced labour?

During the late stages of your pregnancy, your healthcare team will carry out regular checks on your health and your baby's heath. These checks help them decide whether it is better to induce labour or to keep the baby inside. Always tell your doctor or midwife if you notice your baby is moving less than normal.

If they decide it is medically necessary to induce labour, first your doctor or midwife will do an internal examination by feeling inside your vagina. They will feel your cervix to see if it is ready for labour. This examination will also help them decide on the best method for you.

It can take from a few hours to as long as 2 to 3 days to induce labour. It depends how your body responds to the treatment. It is likely to take longer if this is your first pregnancy or you are less than 37 weeks pregnant.

What options are there to induce labour?

There are different ways to induce labour. Your doctor or midwife will recommend the best method for you when they examine your cervix. You may need a combination of different strategies. You will need to provide written consent for the procedure.

Sweeping the membranes

During a vaginal examination, the midwife or doctor makes circular movements around your cervix with their finger. This action should release a hormone called prostaglandins. You do not need to be admitted to hospital for this procedure and it is often done in the doctor's room. This can be enough to get labour started, meaning you will not need any other methods.

Risks: This is a simple and easy procedure; however, it does not always work. It can be a bit uncomfortable, but it does not hurt.

Oxytocin

A synthetic version of the hormone oxytocin is given to you via a drip in your arm to start your contractions. When the contractions start, the amount of oxytocin is adjusted so you keep on having regular contractions until the baby is born. This whole process can take several hours.

Risks: Oxytocin can make contractions stronger, more frequent and more painful than in natural labour, so you are more likely to need pain relief. You will not be able to move around much because of the drip in your arm and you will also have a fetal monitor around your abdomen to monitor your baby.

Sometimes the contractions can come too quickly, which can affect the baby's heart rate. This can be controlled by slowing down the drip or giving you another medicine.

Artificial rupture of membranes ('breaking your waters')

Artificial rupture of membranes (ARM) is used when your waters do not break naturally. Your doctor or midwife inserts a small hook-like instrument through your vagina to make a hole in the membrane sac that is holding the amniotic fluid. This will increase the pressure of your baby's head on your cervix, which may be enough to get labour started. Many women will also need oxytocin to start their contractions.

Risks: ARM can be a bit uncomfortable but not painful. There is a small increased risk of a prolapsed umbilical cord, bleeding or infection.

Prostaglandins

A synthetic version of the hormone prostaglandins is inserted into your vagina to soften your cervix and prepare your body for labour. It can be in the form of a gel, which may be given in several doses (usually every 6 to 8 hours), or a pessary and tape (similar to a tampon), which slowly releases the hormone over 12 to 24 hours. You will need to lie down and stay in hospital after the prostaglandins is inserted. You may also then need ARM if your waters have not broken, or oxytocin to bring on the contractions.

Prostaglandins gel is often the preferred method of inducing labour since it is the closest to natural labour. Tell your midwife or doctor straight away if you start to experience painful, regular contractions 5 minutes apart for your first baby, or 10 minutes apart for subsequent babies, or if your waters break, because these are both signs that your labour is beginning.

Risks: Some women find their vagina is sore after the prostaglandin gel, or they might experience nausea, vomiting or diarrhoea. These side effects are rare and there is no evidence that induction using prostaglandin is any more painful than a natural labour.

Very rarely, the contractions can come too strongly, which can affect the baby's heart rate. This can be controlled by giving you another medicine or removing the pessary.

You need to let your doctor or midwife know immediately if you start bleeding, or if your baby is moving less, because this could be a sign that something is wrong.

Cervical ripening balloon catheter

A cervical ripening balloon catheter is a small tube attached to a balloon that is inserted into your cervix. The balloon is inflated with saline, which usually puts enough pressure on your cervix for it to open. It stays in place for up to 15 hours, and then you will be examined again.

Tell your midwife or doctor straight away if you start to experience painful, regular contractions 5 minutes apart for your first baby, or 10 minutes apart for subsequent babies, or if your waters break, because these are both signs that your labour is beginning.

You may also need ARM or oxytocin if you are using a cervical ripening balloon catheter.

Risks: Inserting the catheter can be a bit uncomfortable but not painful.

You also need to let your doctor or midwife know immediately if you start bleeding, or your baby is moving less, because this could be a sign that something is wrong.

Can I have pain relief during induced labour?

Induced labour is usually more painful than natural labour. Depending on the type of induction you are having, this could range from discomfort with the procedure or more intense and longer lasting contractions as a result of the medication you have been given. Women who have induced labour are more likely to ask for an epidural for relief.

Because inductions are almost always done in hospital, the full range of pain relief should be available to you. There is usually no restriction on the type of pain relief you can have if your labour is induced.

Are there any risks with inducing labour?

There are some increased risks if you have an induced labour. These include that:

it will not work — in about 1 of 4 cases, women go on to have a caesarean
your baby will not get enough oxygen and their heart rate is affected
you or your baby get an infection
your uterus tears
you bleed a lot after the birth

What happens if the induction does not work?

Not all induction methods will work for everyone. Your doctor may try another method, or you might need to have a caesarean. Your doctor will discuss all of these options with you.

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Are You Being Induced? Here's How Long It Takes & What To Expect

Did you just find out that you’re going to be induced?

Do you want to know what it entails and what to expect?

You are in the right place! I have personally induced over 500 women!

In this post, you will learn:

What an induction of labor is and what to expect,
How your labor gets induced, and
How long a typical induction of labor takes.

Are you excited?

Let’s get started.

Disclaimer

***READ FIRST***

Although I am a doctor, I am not your doctor. This information is for informational purposes only and should not substitute the advice from your healthcare professional. All kinds of exercise and dietary changes are potentially dangerous, and those who do not seek counsel from the appropriate health care authority assume the liability of any injury which may occur. Please read my full Disclaimer for more information. Also, this post may contain affiliate links: meaning I may receive a commission if you use them.

Ok, moving on.

What to expect when you’re being induced

When you are being induced there are several things you should expect:

Expect the entire process to take anywhere from 24-48 hours.
Depending on the type of induction, expect to have regular painful contractions (every 2-3 minutes).
Expect to have a vaginal exam every 4-6 hours.
Expect to have electronic continuous monitoring of your baby’s heart rate.
Expect to not be able to eat solid foods (you will likely be placed on a clear liquid diet)
Expect to not be able to walk around after your cervix reaches a certain level of dilation or after your amniotic membranes have been ruptured.
You may or may not be able to have a support person in the room, especially because of the pandemic.

Okay, now that we have that out of the way, let’s go over all of these in a lot more detail.

How long does it take to give birth after being induced?

An induction of labor can take anywhere from 12 to 24 hours until your baby is born. If you include cervical ripening, the entire process can take 48 hours or more.

Unfortunately, it is impossible to predict how long it will take for you, but we do have standard averages.

It also largely depends on the type of induction you are having.

The different types of induction Methods

There are many different ways we can induce your labor.

The most important factor to determine which induction agent to use is your Bishop Score.

The Bishop Score takes into account:

How many centimeters dilated you are,
How effaced your cervix is, (or how thin your cervix is; it’s normally thick)
The position of your cervix (is it way back posterior, more mid-position, or anterior)
The consistency of your cervix, (is it firm, medium, or soft), and
The station. (how low is the fetal head relative to your pelvic bone).

Based on these 5 factors, your physician will determine a numerical value from 0 – 13.

Score	Dilation	Effacement	Consistency	Position	Station
0	Closed	0-30%	Firm	Posterior	-3
1	1-2	40-50%	Medium	Mid	-2
2	3-4	60-70%	Soft	Anterior	-1,0
3	5-6	80%	–	–	+1

A value greater than 6 indicates a “favorable cervix” meaning you are more likely to have a successful induction.

A value less than 6 indicates a “less favorable bishop score” signifying that your chance of successful vaginal birth is decreased.

If your bishop score is less than 6, we will need to first ripen your cervix. In other words, we try to soften and prepare your cervix for dilation.

Let’s talk about how we do that.

Prostaglandin Medications

Prostaglandins are the most commonly used medications for ripening or preparing your cervix for labor induction.

There are two types of prostaglandin medications:

Misoprostol, also known as Cytotec, and
Dinoprostone, also known as Cervidil

Cytotec

Cytotec is a prostaglandin E1 analogue that helps to soften the cervix and it often causes uterine contractions.

This medication comes in pill form and could be placed in the vagina or under the tongue.

It could be given every 3-4 hours for a maximum of 6 doses.

I do want to say, this medication is contraindicated if you are attempting a trial of labor after cesarean (TOLAC).

Cervidil

Cervidil is a prostaglandin E2 analogue that is meant to soften the cervix. It may cause dilation and contractions as well.

This medication looks like a small skinny tampon with a long string, and it is placed deep into the vagina to start the ripening process.

The cervidil will be removed:

if you begin dilating,
if you begin contracting excessively,
or if 12 hours have passed (whichever comes first).

Aside from medications, we also have another way to dilate or ripen the cervix.

Mechanical Dilation

Mechanical dilation uses pressure to dilate your cervix, rather than medications.

This can be done using a:

Cook balloon, or
Foley catheter balloon

One of these balloons will be inserted into your cervix and the balloon will be filled with sterile water.

You may feel a lot of pressure as the balloon is filling. So if you eventually want an epidural, feel free to get one prior to balloon placement.

The balloon will stay inserted in the cervix until your cervix is about 4 centimeters dilated or after 12 hours (whichever comes first).

A mechanical dilation is a great option for:

women who are about 0.5-1 centimeter dilated, and/or
for women who cannot receive additional prostaglandin medication.

It is also a great option if you are considering a trial of labor after cesarean (TOLAC).

Okay, so that’s how to ripen the cervix and get a couple of centimeters of dilation.

Now let’s get to the full-blown induction.

Uterotonic Medications

The most commonly used uterotonic mediation is oxytocin also known as Pitocin.

Oxytocin is a hormone that is normally released by the posterior pituitary gland when the onset of labor occurs and also during breastfeeding.

We give it through the IV to either initiate uterine contractions or augment your labor.

Pitocin mostly works at the uterine receptors to increase the frequency, duration, and amplitude of your contractions.

Once you are on oxytocin, most hospitals will not allow you to eat in case of an emergency (i. e needing an urgent cesarean section).

And last but not least we have another intervention up our sleeve…

Amniotomy

Amniotomy is a process in which we “break your water.” This is known as AROM, or artificial rupture of membranes.

This is a bedside procedure that occurs using a small hook to pierce the amniotic sac which causes the amniotic fluid to leak out.

Don’t worry this will not hurt!

After an amniotomy, you will continue to leak- this is completely normal.

Sometimes, an amniotomy alone can get your contractions going. But we often use this in conjunction with pitocin to achieve a regular contraction pattern.

So those are all the ways in which we can induce your labor starting from a closed cervix.

Now let’s talk about timing.

How Long Does An Induction Take (Step By Step)

As I mentioned before, an induction of labor can take upwards of 48 hours in first-time moms and up to 24 hours in women who have given birth before.

Let’s discuss the three stages of labor and how long each one takes.

Inducing The First Stage of Labor

The first stage of labor corresponds to when you are 0 cm dilated, to 10 cm dilated.

It is broken up into 2 parts, the Latent Phase & The Active Phase

The Latent Phase

The latent phase is the time it takes to get from 0 – 6 centimeters.

This can take up to 20 hours in primiparous women aka, first-time moms and
Up to 14 hours in multiparous women aka women who have had a prior delivery.

Yes, I know what you are thinking, it is a long time.

But you have to understand that your cervix and body weren’t yet ready for labor.

You really must be patient during this stage of labor and stay positive.

The Active Phase

Active labor occurs from the time you reach 6 centimeters to the time you are fully dilated or 10 centimeters.

This stage can last anywhere from 0 – 6 hours on average depending on your parity.

For multiparous women, this stage can be very short!

There have been so many instances where I have seen women go from 6 centimeters to fully dilated in less than an hour.

Studies have shown that after 6 centimeters dilation, labor accelerated faster in multiparous women compared to nulliparous women.

On the other hand, nulliparous women with and without epidural had an active phase of approximately 3.6 and 2.8 hours, respectively.

The Second Stage of Labor

The second stage of labor occurs from full dilatation to delivery of the fetus.

This stage could last anywhere from 1- 4 hours depending on if you are nulliparous or multiparous, the type of pelvis you have, the position of the baby, and whether or not you have an epidural.

Some providers will have you start pushing as soon as you reach full dilatation whereas others will allow you to “labor down.”

Laboring down is a process in which you allow the fetal head to descend further down into the pelvis before you start pushing.

The thought process is that laboring down will help prevent you from pushing for hours, which can tire you out.

Believe it or not, the average time it takes to push a baby out is 90 minutes! It’s not instantaneous like you see in the movies.

To learn more about pushing, how to push effectively, and exercises you could do to prepare you for labor, click here.

The Third Stage of Labor

The third stage of labor occurs from delivery of the fetus to delivery of the placenta.

This should take no longer than 30 minutes.

If after 30 minutes the placenta does not deliver the placenta has to be removed manually.

Your provider will either manually deliver the placenta at the bedside, or take you to the operating room to surgically remove the placenta to reduce your risk of postpartum hemorrhage and infection.

Here is a table of how long a normal induction of labor can take.

Stage of Labor	Nulliparous Woman	Multiparous Woman
Cervical Ripening	Up to 12 hours	Usually not needed
Latent Phase of Labor (0-5 cm dilated)	Up to 20 hours	Up to 14 hours
Active Phase of Labor (6-10 cm dilated)	~ 6 hours	0-6 hours
The Second Stage (Delivery of the baby)	1-4 hours	0-3 hours
The Third Stage (Delivery of placenta)	Up to 30 min	Up to 30 min

The Immediate Postpartum

The fourth stage of labor has been described by some to be the immediate postpartum period.

During this time your provider will:

assess the tone of your uterus to ensure it has started to contract down.
assess and repair any lacerations.
assess your vital signs including blood pressure and heart rate.
assess the amount of uterine/vaginal bleeding you are experiencing.

This is one of the most important phases of labor as hemorrhage is one of the leading causes of maternal morbidity and mortality in developed and developing nations.

Is induced Labor more painful Than Natural Labor?

Induced labor can be more painful than natural labor.

Pitocin often causes stronger, longer, and more frequent uterine contractions than natural contractions.

Oftentimes, women will get an epidural due to the intensity of the pain.

With that said, I have seen plenty of women get induced without pain medication.

It is possible!

However, I always tell my patients, if you are in pain and you cannot tolerate the pain it is OKAY to have pain relief.

YOU DON’T HAVE TO BE A HERO OR PROVE ANYTHING TO ANYONE.

Getting a break from the pain of the contractions could help you relax and get some rest before needing to push.

Can I Get An Epidural Before The Induction?

You can get an epidural at any point in your induction!

There is no minimum number of centimeters dilated you need to be.

I do want to say however, you must be able to sit still for epidural placement.

So please don’t wait until the pain is so severe that you are unable to sit still.

Also, once you get the epidural, you will be confined to the bed. So no more walking around.

Is being induced harmful to the baby?

The actual induction of labor is not harmful to the baby, however, your baby may not tolerate the frequent contractions.

This is why you will be connected to an electronic fetal heart rate monitor when we start your induction.

The baby communicates with us through its heart rate.

If the baby is in distress, we will know.

Unfortunately, all medications used for induction of labor have side effects and because of that, we need to keep a close eye on your baby’s heart rate tracing.

Do you stay in the hospital after being induced?

Yes, you will be admitted to the hospital for an induction of labor and will stay in the hospital for at least 1-2 days postpartum or 2-4 days post-c-section.

We must monitor you in the early postpartum period to check your bleeding, your blood pressure, and incision if you had a cesarean delivery.

What Are The Disadvantages and Risks of Induced Labor?

I do want to mention that inductions of labor can be associated with some risks and disadvantages.

Those risks include:

Infection
Tachysystole (Frequent contractions)
Failed induction

1. Infection

When you are admitted to the labor floor, typically you will have a cervical exam every 4-6 hours depending on the institution, to assess for change.

If you are being induced for 24-48 hours that can be a lot of examinations!

Although we are using sterile gloves, the vagina has A LOT of bacteria including group b streptococcus (GBS) that is present in some women. Thus, each time we examine you there is a risk of introducing bacteria into the uterus.

The risk of infection is further increased if your amniotic membranes have been ruptured for several hours.

To decrease the risk of infection, most physicians will limit the number of examinations you receive while in labor and/or give you antibiotics if you are found to be GBS positive.

2. Tachysystole

Tachysystole is defined as having too many uterine contractions, too close together.

The actual definition is the presence of more than 5 uterine contractions in a ten-minute period averaged over 30 minutes.

Tachysystole is considered a risk of induction because it can cause your baby to become distressed.

Think about it- as the uterus contracts the baby, placenta, and umbilical cord are getting squeezed.

During tachysystole, the baby only has about one minute of relaxation to “catch its breath.”

Some babies do fine and can tolerate it, whereas other babies cannot.

If your baby is in distress, we can give medication to relax the uterus to allow your baby more time to recover.

3. Possible need for cesarean section

Once we start an induction – the clock has started.

Depending on how many centimeters dilated you are, you have to show signs of progress. If you are not, you will need a c-section.

With that said, the need for a cesarean section can occur even if you don’t have an induction.

Studies show that there is no increased risk of cesarean section during an induction of labor.

Final Words on Labor Induction

So there you have everything you need to know about labor induction.

Do you feel ready?

Now I want to hear from you.

Did you have your labor induced, or are you scheduled for an induction?

What was your experience like or what are you most worried about?

Comment below and let me know!

How long can a baby be awake at a given age?

Wake time (WT) is all the time the child is awake between waking up and falling asleep the next nap. These are not only games, but also preparation for sleep: feeding, changing clothes, the ritual of laying down and the process of falling asleep. Of course, young children have much shorter wake times than adults. nine0003

Sleep intervals increase as the child grows and develops. We always remember that children are different (temperament, characteristics of the nervous system, sensitivity). Some may stay awake longer than their peers, others tire more quickly, and some need more sleep to fully recuperate.

Age norms for wakefulness are based on statistical data and numerous studies of healthy children, which confirm the effect of bedtime on sleep quality. But remember that the table is only a guideline, and the main criterion is the child's behavior! nine0003

If you have a cheerful baby who easily falls asleep and wakes up without tears, sleeps well at night, is actively awake with a good mood, the duration of his daytime sleep is an hour or more - he gets enough sleep, even if the total number of hours of sleep per day does not fit into sleep age chart.

It is very important for parents to listen to the child's signals and adjust the time of wakefulness. How to understand in which direction to change it - to increase or reduce? To get started, familiarize yourself with the age norms of wakefulness in children, i.e. the time that babies can usually stay awake during the day without overworking and crying. nine0003

Closely observe the child's behavior shortly before the end of the waking hours. Your task is to notice the first signs of fatigue and immediately proceed to the ritual of laying down. Laying down for signs of fatigue is more important than meeting the time indicated in the table. The kid should not fit into the average frame. It is important that he falls asleep calmly and without protests.

This chart will be your guide.

Important!

Wake times in the chart are for children who are getting good sleep. If the child had too little sleep or there is a lack of sleep accumulated over several days, the time of wakefulness will be less. When the child sleeps off, compensates for lack of sleep, his wakefulness time will approach the table. nine0003

If the baby had a lot of emotions, bright events, pleasant or unpleasant (noisy guests, a trip to the clinic, a lesson in the pool, etc.), rest will also be required earlier.

Focus on the values from the table if:

the child wakes up in tears
sleeps for 20–40 minutes and wakes up crying
begins to act up and cry a lot before going to bed
arranges festivities at night.

In such cases, the child needs the help of parents: prolonging or reducing the time of wakefulness.

If your baby is awake longer (or less) than indicated in the table, but you can see that he has enough sleep, there is no reason to worry. This is not so rare, especially with the next leap in development, changes in family life, moving, illness, teething, etc.

Child's day regimen

Some parents of newborn children begin to ask themselves the question "when will the child live according to the regimen?" But before 10 months, it's too early to talk about a clear regimen. Intervals of sleep and wakefulness rhythmically replace each other several times during the day, but the picture of dreams often changes. nine0003

In the first 3-4 months of a baby's life, very important processes take place: the formation of a sleep structure, like in an adult, the beginning of the body's production of melatonin, the "hormone of the night", the consolidation of sleep around the night. It’s good if parents manage to put the baby to bed on time: at the moment when he is already tired and ready to fall asleep, but has not yet overtired and has not begun to cry in a state of fatigue. In the first months, the initial form of the regime is gradually formed - a more or less stable rhythm of sleep and wakefulness. nine0003

If you do not monitor the duration of wakefulness and delay in bedtime, the child cries and becomes more and more naughty from overwork, it is more difficult for him to calm down and fall asleep. Even 5-10 extra minutes of wakefulness can be critical, so up to 10 months it is important to focus more not on the clock, but on signs of fatigue.

After 10 months of life, the rhythm of sleep and wakefulness of the baby becomes more and more stable. Walking within 15-30 minutes no longer affects the quality of sleep so much. nine0003

Try to show your baby the difference between day and night as clearly as possible. This helps the process of consolidating sleep around the night. The night is just a time for sleep. Do not turn on the light, speak quietly, do not start the game and communication.

What to do with a child while awake?

It depends on age, but there is a general rule. It is important to divide the child's wakefulness into two parts - active and calm. The active part includes fun games, practicing new skills, and physical activity. Read recommendations on games for each age in our service "Games with a child month by month". Closer to sleep, you need to organize calm activities without emotional and physical stress: cleaning toys, reading, drawing, bathing (if it relaxes the baby), light relaxing massage, feeding, etc. nine0003

Note to mom!

Waking time includes not only games, feeding and getting ready for sleep, but also the ritual of bedtime and the process of falling asleep. If the duration of wakefulness by the age of the child is 1.5 hours, calculate how long it takes to change clothes, prepare the room, ritual, fall asleep. Finish the games in advance, so that without haste and discomfort, everything is in time before the baby “overtakes”. You may find that you need to start getting ready for bed as early as an hour after getting up. Easily excitable and highly sensitive children usually need more time and help to calm down before bed. nine0003

If you are unable to find a suitable sleep rhythm for your baby, please contact the BabySleep Center for a personalized consultation with an escort. A baby sleep consultant will help you get better sleep and give you advice for the future.

# norms # wb

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How much sleep to get enough sleep? And 21 more questions to the somnologist

Sleep is the most important factor influencing our health. Not "one of", but the most. That's why we started our series of articles with him. nine0003

The article was written jointly with Euromed Clinic sleep doctor Alexander Aleksandrovich Kazachenko

How many people can go without sleep?
Is it possible to train yourself to sleep less?
What happens if you sleep too little or too much?
Should I sleep during the day and how to do it?
Is it harmful to go to bed very late, for example, at 3-5 am? nine0055
Who are "larks" and "owls"?
How are sleep and light connected?
Why does insomnia occur?
I can't sleep, what should I do?
I wake up at night and do not sleep for 3-4 hours, and in the morning I am broken. What to do?
What is the easiest way to survive the change of time zones?
Sleeping pills: how to treat them?
How do alcohol and caffeine affect sleep?
Do I need special rituals before going to bed?
What should be the sleep hygiene?
Why do people sleep less with age? nine0055
What is therapeutic sleep deprivation and why is it needed?
What are dreams?
What is sleepwalking?
What is sleep apnea?
How do sleep apps help?

IMPORTANT! Information from the article cannot be used for self-diagnosis and self-treatment! Only a doctor can prescribe the necessary examinations, establish a diagnosis and draw up a treatment plan for a consultation!

1.

How much sleep do you need? nine0027

The vast majority of adults need 7-9 hours of sleep each night. The average “norm of sleep” is considered to be 7 hours and 40 minutes. Seven-forty is easy to remember, isn't it?

There are a number of "quick sleepers" or "short sleepers" who need 4-5 hours of sleep, and "long sleepers" who need more than 10 hours of sleep. If this is their individual feature, then as a rule it does not affect their health. But more often, such a sleep pattern is associated with hidden or obvious problems, the elimination of which can be fundamentally important. nine0003

So there are studies according to which regular sleep of more than 10 and less than 5 hours has a negative impact on health and life expectancy.

2. How many people can go without sleep?

There were unique people who, after injuries or from birth, did not need sleep at all, they only fell into a nap for a short time. Such phenomena are associated with special, extremely rare disorders in the brain.

Many volunteers tried to find the limit of human capabilities by going without sleep for a long time. Record set at 1963 year old American youth Randy Gardner, who at that time was 17 years old. He did not sleep for 11 days (264 and a half hours), and at the same time he was mentally healthy and did not die. He is still alive, he did not try to break his record, others did not beat him either. After several days of being awake, Gardner had great difficulty concentrating, could mistake a street sign for a person, but spoke quite articulately and even played pinball quite well.

It should be noted that with some mental illnesses a person may also stay awake (or rather, cannot or does not want to sleep) for weeks or falls into only brief episodes of drowsiness, but such cases are not taken into account when setting records. So, a sharply reduced need for sleep is one of the characteristic signs of the manic phase of bipolar disorder, along with hyperactivity, high mood and accelerated thinking. At the peak of the phase, a person can sleep 1-2 hours a day or not sleep at all, and at the same time not experience drowsiness. However, in another phase - depressive - one has to pay for the illusion of superpowers. nine0051

3. Can you train yourself to sleep less?

Theoretically, this is possible. But, as a rule, most people do it wrong, which can have serious health consequences. Therefore, we do not recommend actively interfering with your individual sleep duration. If it seems to you that without this in any way, then first consult a somnologist. Otherwise, you will get something from the series “I taught the crocodile to do without food, but then he himself disappeared somewhere ...”.

4. What happens if you sleep too little or too much?

If you sleep too little, you won't produce enough cortisol. This hormone is necessary for the proper functioning of the immune system, the regulation of the body's energy reserves (including the accumulation and burning of fats . ..). It also controls the production of the sex hormones estrogen and testosterone and thyroid hormones.

Consequences of lack of sleep are diverse - to list them all, a separate large article is needed, but the main ones are: decreased performance (primarily its effectiveness), depression, anxiety. nine0003

Sleeping too long can be associated with serious illnesses, most notably obstructive sleep apnea, which we'll talk about next.

In any case, long sleep, if it is not an individual feature of the body, is harmful: it can worsen the functioning of the cardiovascular system, increase the risk of heart attack and stroke, and cause many other diseases.

5. Should I sleep during the day and how to do it?

"Don't sleep during the day," Pasternak warned us. He was partly right. nine0051 Indeed, if an adult falls asleep in the middle of the day for a long time (for 1-2 hours), this can lead to a failure of biorhythms. As a result, he will feel overwhelmed and lethargic, he may have a sharp increase in anxiety, disturbed night sleep, which is undesirable, especially if a person already suffers from insomnia. Daytime sleep is contraindicated in patients with depression.

However, if you take a nap for 20-30 minutes between 13:00 and 15:00, then everything is quite the opposite! A short nap in the middle of the day (literally - lay down, relaxed, overslept one phase of sleep and woke up) refreshes, improves the functioning of many body systems. nine0003

University of California studies have shown that those who sleep 20-30 minutes during the day have a 50% increase in concentration and a 30% improvement in memory compared to non-sleepers, and in addition, regular short naps reduce the risk of heart attack.

For daytime sleep, it is especially important to relax well, eliminate light sources, take a comfortable position, unbutton clothes that are too tight. It is better not to go to bed, but to take a nap reclining, for example, in an armchair, on the car seat. nine0003

If you have difficulty waking up after a short daytime sleep, you need to evaluate how well you sleep at night, and you most likely need to reconsider your attitude to the duration of a night's sleep.

In any case, with all the benefits of daytime sleep, you must remember that if it makes it difficult for you to fall asleep in the evening, then even a short daytime sleep is undesirable for you.

6. Is it harmful to go to bed very late, for example, at 3-5 am?

First, you need to understand what is "late"? When building daily rhythms, the body reacts to the level of illumination. If there is no daylight for a long time, and you are still awake, then it is already “too late”. The body does not begin to synthesize melatonin in time, which can lead to a wide variety of disorders (regulation of fat metabolism, suppression of tumors, regulation of sexual function, mood balancing ...) Artificial lighting solves the problem to some extent, and if you want to live in a different time zone Protect yourself from natural light during the day and lots and lots of fluorescent lights at night. Although this minimizes the harm only partially. It is believed that the body synthesizes melatonin precisely at the conditional "night" of your time zone, from about 22 to 5 hours. The exact time can float, but the fact is that it is better to go to bed before midnight. nine0003

Secondly, for most people, going to bed after 12 at night is late and harmful, if only for the reason that workers and students need to get up early. If a person goes to bed after midnight, then the duration of his sleep may be less than his individual norm, and he will simply not get enough sleep.

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7. Who are "larks" and "owls"?

These are two chronotypes that differ in the nature of activity during the day. "Larks" independently and easily wake up early in the morning (at 6-7 o'clock), want to eat in the morning, are more active in the first half of the day, go to bed early (at 21-22 o'clock). Owls wake up at 9-10 am, more active in the evening, go to bed at 0-2 am. Studies have proven that "larks" and "owls" really exist: in the urban population, 40-45% are "owls", 25% are "larks", the rest are "pigeons". Of the "owls" and "larks", not all represent a pure type - most still have a lot of "pigeon" features. Children, as a rule, are "larks", they begin to "advice" by the age of 13-14.

So is it possible to adapt to a “not your own” regime?

It is possible, and even useful. Some researchers believe that owls who have had to get up early all their lives do not change their chronotype, but maintain better health and are more psychologically stable than "larks". nine0003

From this it follows, among other things, that the desire to go to bed at 5 am and get up at noon is no longer just “sovism”, but a violation of the regime, which should be avoided in any case.

8. How are sleep and light related?

Illumination is one of the key parameters of circadian rhythms. The brighter the lighting, the more serotonin, and accordingly, we are more cheerful. The darker it is, the more melatonin is produced, and the more we want to sleep. If you live in areas where the nights are white in summer and there is too little light in winter, this parameter should be adjusted. Here are some simple tips:

Make sure your "home" is well lit when you are awake at night. Combine warm light with fluorescent lights. They are not harmful, but, on the contrary, improve light perception.
An hour before bedtime, turn off the lights in the entire apartment, leaving only small sources of it. Try not to use your computer or gadgets 2 hours before bed.
On white nights, close the windows tightly and create twilight. To fall asleep easily and sleep well, you need melatonin, which is practically not synthesized in good light conditions. nine0055

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LIGHT CLICE LIGHT CLICK. Why does insomnia occur?
Is it difficult to sleep? Little sleep? Waking up multiple times in the middle of the night? Sleep of poor quality, ragged? I seem to be sleeping enough, but not getting enough sleep? As a rule, insomnia is the result of another problem or several problems:

Poor sleep conditions: light, noise, stuffiness, uncomfortable bed

The habit of going to bed at different times, including sleeping on weekends

normal night

Overeating and drinking alcohol, cigarettes, coffee during the evening

Stress, anxiety, depression

Chronic or acute diseases (including gastroenterological, urological, heart, lung, joint and muscle diseases) accompanied by physical discomfort

Obstructive sleep apnea syndrome (see below)

Restless legs syndrome

Disturbance of circadian rhythms - shift work, constant flights and jet lag

Neurological and mental diseases that disrupt circadian rhythms and sleep quality

Separately, we can distinguish "insomnia", accompanied by the fear of "not falling asleep" or "not getting enough sleep. " As a rule, the initial problem has already passed, but the fear remains. With this option, a person of "good intentions" begins to violate all possible rules of sleep hygiene and further exacerbates the problem.
Most often, insomnia is caused by a combination of several problems, and in order to fully understand the causes of sleep disorders, it is necessary to consult a specialist and, if necessary, conduct a specialized sleep examination. nine0051

10. I can't sleep, what should I do?

There are several tricks that work that can help you fall asleep faster.

Focus on your breath. It should be even, neither too frequent nor too deep, the inhalation being at least half as long as the exhalation. You imitate the breathing of a sleeping person and gradually fall asleep.

Close your eyes, move the pupils under the eyelids up and to the sides. You will immediately feel that you want to sleep more. nine0055
Check muscle clamps. It is especially important to relax your shoulders and neck.

Find a comfortable sleeping position. Some people find it helpful to lie on their stomach a little before falling asleep to relax their muscles and reduce the amount of oxygen entering the blood (when you lie on your stomach, you breathe less deeply and often). If you have stomach or liver problems, it is easier to fall asleep on your left side, if you have a heart problem, on your right side. Sometimes your doctor may recommend that you sleep reclining.

A common psychological cause of difficulty falling asleep is thoughts that a person endlessly turns in his head. In this case, try to find another, more soothing "mental chewing gum" , preventing yourself from slipping into the burning problems of the day or old grievances.

11. I wake up at night and do not sleep for 3-4 hours, and in the morning I am broken. What to do?

There is historical evidence that in many countries, especially northern ones, people often divided the night into two sleeps. Sleeping from 8-9in the evening until midnight, they got up, engaged in simple work or entertainment, even went to visit. Then at 3-4 o'clock they went to bed again and slept until 7-8 in the morning. In our time, the situation when a person goes to bed at 23-24 hours, then wakes up at 3 am and tosses and turns until 5-6 am, and falls asleep again in the morning - unfortunately, it is not uncommon, and can no longer be perceived as a variant of the norm.

You need to look for the cause, perhaps yours is mentioned in paragraph ten. If the situation with nocturnal awakenings bothers you every night and for a long time, you need to contact a somnologist. nine0003
If the situation rarely arises, then you can reduce the time of night vigils if you do not toss and turn in bed, but get up, turn on the light (where no one sleeps), stay fully awake for an hour and a half, doing routine things or reading a book that is not very interesting , and then turn off the lights again and go to bed for the second time that night.

12. What is the easiest way to survive the change of time zones?

If the trip is short, try not to completely switch to the new regime, but to stick to at least the average between it and the regime in which you are used to living. If the trip was long, start to gradually shift the sleep time towards the regime of the country of return 7-10 days before the flight. Try to get a good night's sleep the night before. Try not to sleep on the plane. nine0003
If you arrived during the day, stay up until evening, even if you really want to. If you arrived at night, you should at least get some sleep, even if you don’t feel like it. In the first few days, do not drink coffee and alcohol, but drink more water. Spend some time outdoors - this will help the body to quickly rebuild biorhythms. Melatonin preparations also help to quickly rebuild to a new rhythm.

13. Sleeping pills: how to treat them?

Doctors are unanimous: the constant use of sleeping pills is very harmful. Sleeping pills should not be taken for more than two weeks in a row. Even episodic use of sleeping pills shortens life by 10-15%. nine0003

Sleeping pills are addictive - sleep "breaks" and without them you won't fall asleep at all.

Sleeping pills cause adaptation - an increase in dose is required, which can be very dangerous, since high doses of sleeping pills can lead to a slowdown in heart activity during sleep.

In short, sleeping pills, even over-the-counter ones, are an emergency measure for emergencies. It should be taken only in the minimum dose and in a short course. In case of dependence on sleeping pills, it is worth undergoing treatment and still set up a normal sleep. nine0003

What remedies will help you sleep safely?

Some are helped by herbal remedies: hawthorn, valerian, motherwort, as well as preparations based on them.

Melaxen has recently become very popular. This is a drug that increases melatonin if not enough is produced. Melatonin is not a sleeping pill, but a regulator of circadian rhythms. It won't work as an emergency "sleep pill," but it will help normalize rhythms if you go to bed at the same time. nine0055
In some cases, sleep disorders are associated with magnesium deficiency. The sleep normalization program often includes taking vitamins with magnesium.

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In short, they influence badly. The degree of influence depends on the dose, the exact time of consumption in relation to sleep, body weight and concomitant diseases.

Evening coffee impairs sleep in everyone except people who have already acquired a tolerance to caffeine. If you are one of those people, the evening drink will only satisfy your caffeine need, but will not affect your sleep in any way. nine0003
Some say that coffee makes them sleepy. Indeed, there are people who are not susceptible to caffeine, they are about 3% in the population. Evening coffee will not harm their sleep either.

As for alcohol, it harms sleep in many ways: it makes it shallow and intermittent, increases thirst, increases urination, causes intoxication of the body - the next morning a person wakes up sleepy and broken.

If you are unhappy with the quality of your sleep, cut out caffeine 10 hours before going to bed, alcohol 3-4 hours before bed , counting 2-3 doses, that is, half a liter of beer, two glasses of wine or a glass of vodka. If you're going to drink 4-5 doses, your sleep will inevitably be affected, so don't do this more than a few times a year. When drinking alcohol, drink water as well - this will help to quickly remove it from the body.

15. Do I need special rituals before going to bed?

For some, these rituals can help set the mood for the transition from day to night. From this point of view, it doesn’t matter what you do: “warm milk and a hot bath” by themselves do not help you fall asleep unless it is part of a daily habitual ritual that sets you up for sleep. And they will certainly not be of any use if you continue to look at the brightly lit screen at the same time. Instead, you can just read for a quarter of an hour. nine0051

16. What should be the sleep hygiene?

Nothing special: comfortable, fairly spacious bed, anatomical pillow, not too soft and not too hard mattress (hardness depends on habits and the health of your back). Stuffiness and heat interfere with sleep, so it is better if the bedroom is ventilated, cooling down to 18-22 degrees. Cuddling is uncomfortable for most people, so if you're sleeping with a partner and/or child, buying separate blankets will improve the quality of your sleep. nine0051

17. Why do people sleep less with age?

Indeed, many people over 60 say that 6 hours is enough for them. Or not quite enough, but they cannot sleep longer. There is no definitive answer as to why this is happening. Apparently, this is due to the death of some neurons in one of the sleep centers in the brain. In addition, after 60, almost everyone already has problems from among those described in paragraph 10 of our article (go back to paragraph 10), so there are enough reasons for insomnia. On the other hand, with age, the level of activity also decreases sharply, which means both readiness and the need for sleep decrease. Unfortunately, doctors cannot unequivocally state that reducing the amount of sleep does not harm older people and does not affect the quality and length of their lives. nine0051

18. What is therapeutic sleep deprivation and why is it needed?

Sleep deprivation (depriving a person of sleep for 36-38 hours) is used as a treatment for severe depression. Since, with this disease, a person’s circadian rhythms are knocked down, and all the processes occurring in the body are mismatched, sleep deprivation creates, as it were, the effect of “zeroing circadian rhythms to factory settings”. The treatment is carried out twice a week, with the improvement of the condition - once a week. The method is used only under the supervision of a doctor and strictly for medical reasons. nine0051

19. What are dreams?

Dreams (dreams) are visual, auditory and other images that arise in the brain of a sleeping person. Dreams are seen by all people, but many do not remember them. We dream every night in "REM" sleep phases and sometimes in slow sleep (but such dreams are less short and vivid). Colored, vivid and detailed dreams are seen by children, people with developed emotions. Often we see such dreams during illness or important events in life. Some people can have lucid dreams in which they realize they are dreaming and can control the events of the dream. nine0003

The meaning of sleep lies in the subconscious processing and modeling of reality with the help of images. Such modeling becomes much more fruitful in a dream, as the consciousness releases control and the imagination is released.

A person in a dream can experience feelings that are hidden from him in reality. So, a recurring nightmare is a sign of a problem that our brain is persistently trying to work through.

20. What is sleepwalking?

Sleepwalking (somnambulism, sleepwalking) is a disorder in which people, while asleep, get up and perform any activity, from simple cleaning to driving a car or violent attacks on loved ones. The “lunatic” then does not remember about his actions. An attack of sleepwalking can last from 30 seconds to several hours. Most often, sleepwalking occurs in children and is a sign of an immature nervous system. The cause of sleepwalking in adults is unknown, and there is no cure or treatment. nine0051

21. What is sleep apnea?

This is the cessation of breathing during sleep for more than 10 seconds, which develops due to the collapse of the soft tissues at the level of the oropharynx. From the outside, it may look like this: against the background of snoring or sniffing, silence sets in, the person first freezes and stops breathing, then after a while he starts moving his arms and legs (trying to find the reason that prevents him from breathing), takes a noisy and deep breath and either wakes up or starts snoring again. nine0003
Often, sleep apnea lasts from 20-30 seconds to 2-3 minutes and is so frequent that it takes up more than half of a night's sleep, which can lead to a marked decrease in blood oxygen levels. In addition, each cessation of breathing ends with micro-awakening, and in severe apnea, when a person has more than 30 of them per hour, during the night, in order not to suffocate, he essentially wakes up at least 1 time in 2 minutes! Is it possible to sleep well in such a situation? Of course not. Therefore, during the day after such nights, a person feels overwhelmed, not getting enough sleep, tired and ready to fall asleep in any situation. nine0003

An interesting fact: according to statistics, the probability of getting into an accident is higher for those drivers who want to sleep, and not for those who have drunk alcohol!

Another problem with sleep apnea is the high risk of cancer, cardiovascular disease, including heart attacks and strokes. Chronic lack of sleep and hypoxia can cause problems with potency in men. Sleep apnea is more common in men, but in women it manifests itself in menopause.

Obesity, short neck, some ENT diseases can be considered risk factors. Snoring and pauses in breathing during sleep are the main manifestations of this condition, but if a person sleeps alone or his snoring is not loud, then no one will indicate these signs to him. nine0003
Therefore, it is worth paying attention to other manifestations of apnea: constant awakenings, nightmares and daytime sleepiness.

Treatment of sleep apnea depends on the severity of the condition and its underlying causes. The main method for moderate forms is CPAP therapy (Constant Positive Airway Pressure, CPAP). The essence is simple: the device supplies air at a constant low (comfortable for the patient) pressure, due to which an “air frame” is created that prevents the airways from falling and prevents the development of apnea.
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