Tag: Sleep

Morning People May Be at Lower Risk of Depression Than Night Owls

Going to bed early and waking up early may help to provide some protection against depression, a new study suggests.

If you are a morning person, you may be at reduced risk for major depression, a new study suggests.

Several studies of the body’s circadian sleep-wake cycle have shown that being an early bird is associated with a lower risk for depression. But those studies were observational so could not prove cause and effect.

For example, people who are early birds may have other health or lifestyle behaviors that reduce their risk for depression — they may have a healthier diet, for example, exercise more, or have fewer health conditions, such as chronic pain, that are associated with depression. All these factors, and many others, could explain the decreased risk for depression, and not the fact of being an early bird. Moreover, depression itself causes sleep disturbances, so it could be that depression is a cause of being a night owl, rather than the other way around.

The new study, however, offers more compelling evidence that going to bed early and waking early may, in itself, provide protection against depression, independent of other factors. The study, published in JAMA Psychiatry, uses a research method called Mendelian randomization that helps pinpoint the cause of what may be a cause-and-effect relationship.

With Mendelian randomization, researchers can compare large groups of people based on genetic variants that are independent of other health or behavioral characteristics — in this case, the tendency to being a night owl or a morning person, inherited traits that are randomly allocated during our development in the womb. More than 340 genetic variants associated with circadian sleep rhythm have been identified, and the researchers can compare large groups of people with the genetic variants for being a morning person with groups that lack them. Nature has, in essence, set up the randomized experiment for them.

For the study, the scientists used two genetic databases of more than 800,000 adults to do a Mendelian randomization study of circadian rhythm and the risk for depression. They not only had genetic data, but also data on diagnoses of major depression and information on when people went to bed and woke up, collected with both self-reports and sleep laboratory records, which the researchers used to track the midpoint of sleep, a helpful scientific measure of someone’s sleep tendencies. A morning person who tended to go to bed at 10 and wake up at 6, for example, would have a sleep midpoint of 2 a.m.

They found that in people with the genetic variants for being an early bird, for every hour earlier the sleep midpoint, there was a 23 percent lower risk of major depression.

Dr. Till Roenneberg, an expert in chronobiology who was not involved in the research, said a shortcoming of the study was that the scientists had no data on when these people had to rise for work or other obligations. Even with Mendelian randomization, he said, they can’t account for the fact that late types often need to go to work too early, which in itself may contribute to depression.

“They’ve drawn the right conclusions from their data,” he said, “but life is more complicated than that.”

If you are a night owl, will changing your habits alleviate depression or decrease the risk for developing it? Not necessarily, said the lead author, Dr. Iyas Daghlas, a resident physician at the University of California, San Francisco. The study, he said, looks at large groups of people, not individuals.

“This data tells us that certain trends in society” — such as using smartphones and other blue light devices at night, which make us go to sleep later — “may be having an effect on the level of depression in the population,” he said. “These results do not say that if you go to sleep earlier, you’ll get rid of depression. Discovering which intervention in which populations will be effective — that has to be left to clinical trials.”

Still, he said, “While our data doesn’t tell us where the sweet spot is, I would say that if you’re an evening person, especially one who has to wake up early, advancing your bedtime about an hour or so is a safe intervention that might be helpful for your mental health.”

The Health Benefits of Coffee

Drinking coffee has been linked to a reduced risk of all kinds of ailments, including Parkinson’s disease, melanoma, prostate cancer, even suicide.

Americans sure love their coffee. Even last spring when the pandemic shut down New York, nearly every neighborhood shop that sold takeout coffee managed to stay open, and I was amazed at how many people ventured forth to start their stay-at-home days with a favorite store-made brew.

One elderly friend who prepandemic had traveled from Brooklyn to Manhattan by subway to buy her preferred blend of ground coffee arranged to have it delivered. “Well worth the added cost,” she told me. I use machine-brewed coffee from pods, and last summer when it seemed reasonably safe for me to shop I stocked up on a year’s supply of the blends I like. (Happily, the pods are now recyclable.)

All of us should be happy to know that whatever it took to secure that favorite cup of Joe may actually have helped to keep us healthy. The latest assessments of the health effects of coffee and caffeine, its main active ingredient, are reassuring indeed. Their consumption has been linked to a reduced risk of all kinds of ailments, including Parkinson’s disease, heart disease, Type 2 diabetes, gallstones, depression, suicide, cirrhosis, liver cancer, melanoma and prostate cancer.

In fact, in numerous studies conducted throughout the world, consuming four or five eight-ounce cups of coffee (or about 400 milligrams of caffeine) a day has been associated with reduced death rates. In a study of more than 200,000 participants followed for up to 30 years, those who drank three to five cups of coffee a day, with or without caffeine, were 15 percent less likely to die early from all causes than were people who shunned coffee. Perhaps most dramatic was a 50 percent reduction in the risk of suicide among both men and women who were moderate coffee drinkers, perhaps by boosting production of brain chemicals that have antidepressant effects.

As a report published last summer by a research team at the Harvard School of Public Health concluded, although current evidence may not warrant recommending coffee or caffeine to prevent disease, for most people drinking coffee in moderation “can be part of a healthy lifestyle.”

It wasn’t always thus. I’ve lived through decades of sporadic warnings that coffee could be a health hazard. Over the years, coffee’s been deemed a cause of conditions such as heart disease, stroke, Type 2 diabetes, pancreatic cancer, anxiety disorder, nutrient deficiencies, gastric reflux disease, migraine, insomnia, and premature death. As recently as 1991, the World Health Organization listed coffee as a possible carcinogen. In some of the now-discredited studies, smoking, not coffee drinking (the two often went hand-in-hand) was responsible for the purported hazard.

“These periodic scares have given the public a very distorted view,” said Dr. Walter C. Willett, professor of nutrition and epidemiology at the Harvard T.H. Chan School of Public Health. “Overall, despite various concerns that have cropped up over the years, coffee is remarkably safe and has a number of important potential benefits.”

That’s not to say coffee warrants a totally clean bill of health. Caffeine crosses the placenta into the fetus, and coffee drinking during pregnancy can increase the risk of miscarriage, low birth weight and premature birth. Pregnancy alters how the body metabolizes caffeine, and women who are pregnant or nursing are advised to abstain entirely, stick to decaf or at the very least limit their caffeine intake to less than 200 milligrams a day, the amount in about two standard cups of American coffee.

The most common ill effect associated with caffeinated coffee is sleep disturbance. Caffeine locks into the same receptor in the brain as the neurotransmitter adenosine, a natural sedative. Dr. Willett, a co-author of the Harvard report, told me, “I really do love coffee, but I have it only occasionally because otherwise I don’t sleep very well. Lots of people with sleep problems don’t recognize the connection to coffee.”

In discussing his audiobook on caffeine with Terry Gross on NPR last winter, Michael Pollan called caffeine “the enemy of good sleep” because it interferes with deep sleep. He confessed that after the challenging task of weaning himself from coffee, he “was sleeping like a teenager again.”

Dr. Willett, now 75, said, “You don’t have to get to zero consumption to minimize the impact on sleep,” but he acknowledged that a person’s sensitivity to caffeine “probably increases with age.” People also vary widely in how rapidly they metabolize caffeine, enabling some to sleep soundly after drinking caffeinated coffee at dinner while others have trouble sleeping if they have coffee at lunch. But even if you can fall asleep readily after an evening coffee, it may disrupt your ability to get adequate deep sleep, Mr. Pollan states in his forthcoming book, “This Is Your Mind on Plants.”

Dr. Willett said it’s possible to develop a degree of tolerance to caffeine’s effect on sleep. My 75-year-old brother, an inveterate imbiber of caffeinated coffee, claims it has no effect on him. However, acquiring a tolerance to caffeine could blunt its benefit if, say, you wanted it to help you stay alert and focused while driving or taking a test.

Caffeine is one of more than a thousand chemicals in coffee, not all of which are beneficial. Among others with positive effects are polyphenols and antioxidants. Polyphenols can inhibit the growth of cancer cells and lower the risk of Type 2 diabetes; antioxidants, which have anti-inflammatory effects, can counter both heart disease and cancer, the nation’s leading killers.

None of this means coffee is beneficial regardless of how it’s prepared. When brewed without a paper filter, as in French press, Norwegian boiled coffee, espresso or Turkish coffee, oily chemicals called diterpenes come through that can raise artery-damaging LDL cholesterol. However, these chemicals are virtually absent in both filtered and instant coffee. Knowing I have a cholesterol problem, I dissected a coffee pod and found a paper filter lining the plastic cup. Whew!

Also countering the potential health benefits of coffee are popular additions some people use, like cream and sweet syrups, that can convert this calorie-free beverage into a calorie-rich dessert. “All the things people put into coffee can result in a junk food with as many as 500 to 600 calories,” Dr. Willett said. A 16-ounce Starbucks Mocha Frappuccino, for example, has 51 grams of sugar, 15 grams of fat (10 of them saturated) and 370 calories.

With iced coffee season approaching, more people are likely to turn to cold-brew coffee. Now rising in popularity, cold brew counters coffee’s natural acidity and the bitterness that results when boiling water is poured over the grounds. Cold brew is made by steeping the grounds in cold water for several hours, then straining the liquid through a paper filter to remove the grounds and harmful diterpenes and keep the flavor and caffeine for you to enjoy. Cold brew can also be made with decaffeinated coffee.

Decaf is not totally without health benefits. As with caffeinated coffee, the polyphenols it contains have anti-inflammatory properties that may lower the risk of Type 2 diabetes and cancer.

¿Tienes insomnio? Tenemos consejos para dormir mejor

¿Tu sueño no es lo que solía ser? ¿Tu mente se acelera cuando tu cabeza toca la almohada? ¿Te despiertas a las 4:00 a. m. y te cuesta volverte a dormir? ¿Sientes somnolencia y falta de sueño sin importar cuántas horas pases en la cama?

Para muchas personas, dormir mal era la norma antes de la pandemia. Después, el estrés, la ansiedad y las interrupciones empeoraron nuestro sueño nocturno, dando lugar a términos como “coronainsomnio” para describir el aumento de las alteraciones del sueño el año pasado. Pero recientemente, los expertos del sueño han observado algo que les ha sorprendido: tras más de un año de pandemia, nuestro sueño colectivo no ha hecho más que empeorar.

En una encuesta realizada a miles de adultos el verano pasado, la Academia Estadounidense de Medicina del Sueño descubrió que el 20 por ciento de los estadounidenses decían tener problemas para dormir debido a la pandemia. Pero cuando la academia repitió su encuesta diez meses después, en marzo, esas cifras aumentaron drásticamente. Aproximadamente el 60 por ciento de las personas dijo que tenía problemas de insomnio relacionados con la pandemia, y casi la mitad informó que la calidad de su sueño había disminuido, a pesar de que las tasas de infección se han reducido y el país se está abriendo de nuevo.

“Mucha gente pensó que nuestro sueño debería mejorar porque podemos ver la luz al final del túnel, pero ahora es peor que el año pasado”, dijo Fariha Abbasi-Feinberg, especialista en medicina del sueño y portavoz de la Academia Estadounidense de Medicina del Sueño. “La gente sigue experimentando grandes dificultades”.

Dormir mal de forma crónica es algo más que una molestia. Debilita el sistema inmunitario, reduce la memoria y la capacidad de atención y aumenta la probabilidad de padecer afecciones crónicas como la depresión, la diabetes de tipo 2 y las enfermedades cardíacas. Los estudios sugieren que cuanto menos se duerme, menos se vive. Y para las personas mayores de 50 años, dormir menos de seis horas por noche incluso puede aumentar el riesgo de demencia.

“En el último año hemos tenido la tormenta perfecta de todas las cosas malas posibles para el sueño”, afirma Sabra Abbott, profesora adjunta de neurología en medicina del sueño de la Facultad de Medicina Feinberg de la Universidad Northwestern de Chicago.

Los estudios demuestran que, durante la pandemia, la gente tendía a mantener horarios de sueño irregulares, acostándose mucho más tarde y durmiendo más de lo habitual, lo que puede alterar nuestros ritmos circadianos. Redujimos nuestros niveles de actividad física y pasamos más tiempo en casa; ganamos peso y bebimos más alcohol; y borramos las líneas que separan el trabajo y la escuela de nuestras casas y dormitorios, todo lo cual es perjudicial para el sueño.

Lo más sorprendente de todo es que nuestros niveles de estrés y ansiedad se dispararon, que son dos de las causas fundamentales del insomnio. En un informe publicado en mayo, la Asociación Estadounidense de Psiquiatría descubrió que la mayoría de las personas del país seguían preocupadas por su salud, sus finanzas y la posibilidad de que un ser querido sufriera COVID-19. Más de la mitad de los padres dijeron que estaban preocupados por el estado mental de sus hijos, y el 41 por ciento de los adultos dijeron que tenían más ansiedad hoy que durante los primeros meses de la pandemia.

No todo el mundo, por supuesto, sufre trastornos del sueño. Un equipo de investigadores internacionales que estudió a tres millones de personas en Nueva York, Londres, Los Ángeles, Seúl y Estocolmo descubrió que, en promedio, la gente ganó 25 minutos más de sueño cada noche durante la pandemia en comparación con el año previo. Los que más se beneficiaron fueron las personas que naturalmente tienden a acostarse tarde, pero que ya no tenían que poner una alarma temprana para ir al trabajo o preparar a sus hijos para la escuela, dijo Matthew Walker, profesor de neurociencia y psicología de la Universidad de California, Berkeley, y autor del exitoso libro Por qué dormimos.

“Si hay una historia de éxito, es la venganza de los noctámbulos en lo que respecta a la covid y el sueño”, dijo Walker. “Por fin, los noctámbulos están empezando a dormir un poco más en sincronía con su biología”.

Pero para otros millones de personas que padecen insomnio, el tiempo extra en la cama puede, paradójicamente, empeorar las cosas. Cuando las personas tienen dificultades para conciliar o mantener el sueño, sus cerebros asocian sus camas con experiencias estresantes. “El cerebro aprende que la cama es el lugar donde no se duerme”, explica Abbott. “Cuanto más tiempo pasas en la cama, más refuerzas esa idea”. Uno de los tratamientos estándar para el insomnio es una estrategia llamada restricción del sueño, que hace que las personas duerman mejor y más eficientemente al enseñarles a pasar menos tiempo en la cama, no más.

Entonces, ¿qué más podemos hacer para recuperar nuestro sueño interrumpido? Sigue leyendo. Y visita nuestras 20 preguntas más frecuentes de los lectores sobre cómo dormir mejor [en inglés].

Cómo vencer al insomnio

Es normal tener problemas para dormir durante los grandes cambios en la vida. Pero cuando las interrupciones del sueño duran más de tres meses puede calificarse de insomnio crónico, que puede tener consecuencias para la salud a largo plazo. Uno de los tratamientos más eficaces es la terapia cognitivo-conductual, o TCC. Este enfoque te ayuda a abordar los pensamientos, sentimientos y comportamientos subyacentes que están arruinando tu sueño. He aquí algunas formas de combatir el insomnio inspiradas en la TCC.

Sigue la regla de los 25 minutos

Si te metes a la cama y no puedes dormirte después de 25 minutos, o te despiertas por la noche y no puedes conciliar el sueño después de 25 minutos, no te quedes en la cama. Levántate y haz una actividad tranquila que calme tu mente y te haga sentir somnoliento. “Simplemente levántate, no te preocupes”, dice Walker. “Si te quedas en la cama despierto durante mucho tiempo, tu cerebro piensa: ‘Cada vez que me meto en la cama, este es el lugar donde debo estar despierto’. Y tienes que romper esa asociación”.

Haz cualquier actividad que te relaje. Levántate y estírate. Siéntate en el sofá y medita o lee una revista. Lee un libro con luz tenue. Haz ejercicios de respiración profunda. Escucha un pódcast relajante. Si quieres, puedes sentarte en una silla y dibujar o tejer. A continuación, cuando empieces a sentirte de nuevo somnoliento, vuelve a meterte en la cama e intenta dormirte. Eso sí, no te metas en la cama si no estás cansado. “Nunca te sentarías en la mesa para cenar esperando a tener hambre”, dice Walker. “Así que, ¿por qué ibas a estar en la cama esperando a tener sueño?”.

Deshazte de tus preocupaciones

Siéntate con un papel en blanco una o dos horas antes de acostarte cada noche. Luego escribe todos tus pensamientos, especialmente cualquier cosa que te moleste. Puede ser lo que vas a hacer mañana en el trabajo, las llamadas telefónicas que tienes que hacer o las facturas que tienes que pagar. “Si la mayor parte de lo que has anotado son cosas que te preocupan, arruga el papel y tíralo a la basura: a eso se le llama descargar tus pensamientos”, dice Ilene Rosen, médica especialista en medicina del sueño y profesora asociada de medicina clínica en la Escuela de Medicina Perelman de la Universidad de Pensilvania. El acto de volcar tus pensamientos en un papel y tirarlo a la basura es un gesto simbólico que te da poder y calma tu mente, dijo Rosen. “Tenías esos pensamientos y ahora se han ido”, dijo.

Pantallas en el dormitorio, reglas de juego

Una de las razones por las que el sueño ha sufrido este último año es que la gente lo sacrifica para ver todas las cosas divertidas que se perdieron durante el día, como mirar Instagram y videos de YouTube. Este fenómeno, conocido como procrastinación por venganza a la hora de acostarse, se ve agravado por nuestro apego a los teléfonos y a las pantallas, que a menudo nos siguen hasta la cama. (¿Cuántas veces has estado pegado a tu teléfono mucho después de tu hora de dormir?)

Todos sabemos que no debemos mirar pantallas brillantes a altas horas de la noche porque la luz azul que emiten indica al cerebro que es hora de estar despierto. Pero muchos lo hacemos de todos modos. Así que sigue esta pauta: si vas a usar tu teléfono o dispositivo después de la hora de acostarte, hazlo solo de pie. Cuando quieras sentarte o acostarte, tienes que guardar el dispositivo. “Descubrirás que después de unos diez minutos de estar de pie a tu hora normal de acostarte, dirás: ‘Necesito acostarme’, y eso es lo que tu cuerpo te dice que tienes que guardar el teléfono y dormir”, dijo Walker.

Hábitos diarios para dormir mejor

Dormir bien empieza mucho antes de acostarse. Muchas de las cosas que hagas durante el día afectarán a la calidad de tu sueño. Así que prueba estos hábitos que favorecen el sueño.

Levántate a la misma hora cada mañana

Nuestro cuerpo sigue un ritmo circadiano diario, y despertarse a horas diferentes lo desajusta. Lo mejor es mantener la misma hora de despertarse. No te quedes dormido, ni siquiera los fines de semana. “Cuando suene el despertador, sal de la cama y empieza el día sin importar cuánto hayas dormido”, dice Rosen. “Puede que no te sientas bien durante unos días, pero estás reforzando que cuando estás en la cama, duermes”. Lo mismo ocurre con la hora de acostarse: mantén la constancia. Cuanto menos te desvíes de tus horarios normales para acostarte y levantarte, mejor dormirás.

Toma la luz del sol cada mañana

Si no sales de casa para ir al trabajo, puede ser fácil pasarte todas las mañanas bajo techo. Pero la exposición a la luz del sol tiene un propósito importante: desactiva la liberación de melatonina, una hormona que promueve el sueño. “La mayor parte de la niebla cerebral por la mañana está causada por la producción continuada de melatonina”, dice Michael Breus, psicólogo clínico y autor de The Power of When. “Cuando la luz del sol golpea tu ojo, envía una señal a tu cerebro para decirle al grifo de la melatonina que se cierre”. Intenta recibir al menos 15 minutos de luz solar a primera hora de la mañana.

Haz de tu cama un santuario

Trabajar desde casa —a veces desde nuestra cama— ha borrado muchos de los límites entre el trabajo y el sueño. Pero convertir tu colchón en una oficina puede condicionar a tu cerebro a ver tu cama como un lugar que te estresa y te pone alerta, lo que puede provocar insomnio. Por eso los expertos en sueño dicen que hay que reservar la cama solo para dos actividades. “La cama es para dormir o para el sexo”, dice Rosen. “Si no estás haciendo ninguna de esas dos cosas, sal de la cama. Si puedes permitirte el lujo de ir a otra habitación, mejor aún. Hay que romper la asociación de estar despierto en la cama”.

Haz ejercicio para dormir mejor

La pandemia hizo que la gente redujera su actividad física. Pero el ejercicio es la forma más fácil de mejorar el sueño, dijo Breus. “El sueño es recuperación”, añadió. “Si no tienes nada de lo que recuperarte, tu sueño no va a ser tan bueno”. Al menos 29 estudios han descubierto que el ejercicio diario, independientemente del tipo o la intensidad, ayuda a conciliar el sueño más rápidamente y a mantenerlo durante más tiempo, especialmente entre las personas de mediana edad o mayores. Según la Fundación del Sueño, las personas con insomnio crónico pueden dormirse unos 13 minutos más rápido y ganar hasta 20 minutos extra de sueño por noche si comienzan una rutina de ejercicios. Una advertencia: termina el ejercicio por lo menos cuatro horas antes de acostarte, de lo contrario podría interferir con tu sueño al aumentar la temperatura central del cuerpo, dijo Breus.

Deja la cafeína a las 2:00 p. m.

La cafeína tiene una vida media de seis a ocho horas y una vida media de unas 12 horas. Eso significa que si tomas café a las 4:00 p. m., “todavía tendrás una cuarta parte de la cafeína flotando en tu cerebro a las 4:00 a. m.”, dijo Breus. Evitar la cafeína por la noche es una obviedad. Pero lo ideal es que te mantengas alejado de la cafeína después de las 2:00 p. m. para que tu cuerpo tenga tiempo suficiente para metabolizarla y eliminarla de tu organismo.

Sigue la regla de los dos tragos.

Si bebes alcohol, limítate a dos tragos por la noche y deja de hacerlo al menos tres horas antes de acostarte. Alterna cada bebida con un vaso de agua. Como el alcohol es un sedante, algunas personas beben una copa para dormirse más rápido. Pero el alcohol suprime el sueño REM y provoca interrupciones del sueño, lo que empeorará la calidad general del mismo. “Cuanto más cerca de la hora de acostarte bebas, peor será tu sueño”, afirma Breus.

Cuándo buscar ayuda

Los ataques ocasionales de insomnio no son motivo de preocupación. Pero si se introducen cambios en la rutina de sueño y nada parece ayudar, puede que sea el momento de consultar a un médico. Un especialista del sueño puede determinar si necesita una terapia cognitivo-conductual, medicación u otro tratamiento. O puede ser que tengas un trastorno del sueño subyacente, como el síndrome de las piernas inquietas o la apnea del sueño. Un médico te evaluará para averiguarlo.

Si vives en Estados Unidos y necesitas ayuda, entra en el sitio web de la Academia Estadounidense de Medicina del Sueño, sleepeducation.org, e introduce tu código postal para encontrar un médico o proveedor del sueño local. “No sufras en silencio”, dice Abbasi-Feinberg. “Pide ayuda si la necesitas. Hay médicos del sueño en todas partes, y para eso estamos”.

Anahad O’Connor cubre temas de salud, ciencia, nutrición y otros. También es el autor de exitosos libros de salud como Never Shower in a Thunderstorm y The 10 Things You Need to Eat.


Your ‘How to Sleep Questions’ Answered

First off, you’re not alone. While cramps, bloating and mood swings are some of the most common signs that your period is coming, many women also experience insomnia, nightmares and frequent awakenings. Women with premenstrual syndrome are twice as likely as other women to have insomnia. And about seven in 10 women who have a more severe form of PMS called premenstrual dysphoric disorder, or PMDD, routinely struggle to get a good night’s sleep in the days before their period.

So what gives? Cramps, muscle pain and headaches can wreak havoc on a woman’s sleep. Plus it is normal for core body temperature to rise during menstruation, which makes it harder to doze off. On top of that, the abrupt rise and fall of progesterone, estrogen and other hormones during a woman’s period can influence her circadian rhythm and alter the different stages of her sleep, worsening her sleep quality. Women with severe premenstrual syndrome have also been shown to secrete lower levels of melatonin, the hormone that ushers us to sleep at night.

So what can you do? For starters, if you use birth control pills, consider whether they’re impacting your sleep. Some research indicates that women who use hormonal contraceptives experience more insomnia and daytime sleepiness than women who are not on the pill. On the other hand, some experts speculate that certain contraceptives, particularly those that contain progestin only, might actually help with insomnia. Unfortunately, there is not a lot of data on how contraceptives may impact sleep, but it may be worth discussing their potential impact on sleep with your doctor.

Second, there are things you can try besides sleep medications. Cognitive behavioral therapy, which can help ease stress and anxiety, is one of the best ways to combat insomnia. Another treatment for sleep problems called bright light therapy has been shown to help women with severe PMS. Scientists are not exactly sure why light treatment works. But it involves using a light box to get regular exposure to artificial light, which affects melatonin as well as the hypothalamus, a region in the brain that regulates mood and sleep. You can learn about the best light therapy lamps in this article from Wirecutter.

Lastly, focus on your sleep hygiene in the days before you get your period. Avoid alcohol, which can affect hormone levels and stir you awake at night. Keep a strict sleep schedule, going to bed and waking up at the same time every day. Don’t overdo it on caffeine, and be sure to exercise daily, which can help promote a smoother night of slumber.

¿Apnea del sueño? La máquina de CPAP podría no ser la respuesta

Una operación o un dispositivo bucal pueden ser mejores alternativas frente al costo y la incomodidad de las máquinas de presión positiva, según un nuevo estudio

Muchas personas utilizan una máquina de presión positiva continua en la vía aérea (CPAP, por su sigla en inglés) por las noches para controlar la respiración cortada producida por la apnea obstructiva del sueño, padecimiento que se calcula que sufren 22 millones de estadounidenses. El problema con el tratamiento CPAP es que las máquinas son ruidosas, estorbosas e incómodas, por lo que muchas personas dejan de utilizarlas, con consecuencias nefastas a largo plazo.

Según un nuevo artículo, un dispositivo bucal puede resultar una alternativa más cómoda y fácil de utilizar para muchas personas que padecen apnea obstructiva del sueño. El estudio, publicado en la revista científica Laryngoscope, consistió en observar la respuesta de 347 personas diagnosticadas con apnea del sueño después de que un otorrinolaringólogo les colocó un dispositivo bucal. Dos terceras partes de los pacientes dijeron sentirse cómodos con el aparato, que al parecer fue efectivo, pues les ayudó a aliviar la respiración interrumpida que provoca la apnea obstructiva del sueño.

El principal autor del estudio, Guillaume Buiret, director de Otorrinolaringología en el hospital Valence en Valence, Francia, dijo que si tuviera apnea del sueño, probaría primero un dispositivo bucal.

“Es fácil de tolerar, es efectivo y cuesta mucho menos que la CPAP”, dijo. “Entre el 30 y el 40 por ciento de nuestros pacientes no pueden utilizar la máquina de CPAP, así que a este grupo casi siempre el aparato dental les parece útil. En lo personal, lo recomendaría como tratamiento en primera instancia”.

Los ronquidos fuertes quizá sean la consecuencia más obvia de la apnea del sueño, pero si no se sigue algún tratamiento para esta afección, puede provocar un amplio rango de complicaciones como hipertensión, cardiopatías, disfunción hepática y diabetes tipo 2.

Este trastorno se presenta cuando el tejido blando que se encuentra en la parte posterior de la garganta se relaja durante el sueño y causa que se cierren las vías aéreas. Este bloqueo impide la respiración por periodos breves, por lo que la persona puede jadear debido a la falta de aire, tener dificultad para mantenerse dormida y sufrir todos los problemas que conlleva la somnolencia durante el día, desde mal desempeño laboral hasta accidentes fatales. Los animales también pueden sufrir esta enfermedad: los perros bulldog, por ejemplo, tienen vías respiratorias muy estrechas y un paladar blando que las bloquea con gran facilidad. Su apnea del sueño es casi idéntica a la de los seres humanos.

La gravedad de este padecimiento varía mucho, desde un ligero problema que quizá no amerite tratamiento hasta una enfermedad grave que incluso puede poner en riesgo la vida. Sara Benjamin, neuróloga y especialista del sueño en Johns Hopkins, explica que pernoctar en un laboratorio del sueño donde un técnico pueda monitorear los movimientos del paciente es la mejor manera de diagnosticar la apnea. Un estudio de laboratorio ofrece el análisis más completo y permite detectar muchos otros problemas del sueño además de la apnea, pero también hay pruebas que puedes realizar en casa con facilidad y sin necesidad de una gran inversión. Estas pruebas miden el esfuerzo necesario para respirar y los niveles de oxígeno, pero no analizan las ondas cerebrales, el tono muscular ni los movimientos de piernas que registra la prueba realizada en el laboratorio.

¿Qué señales te pueden indicar que necesitas una evaluación del sueño? “No necesitas sufrir síntomas graves para considerar una evaluación, ya sea una prueba en casa o en el laboratorio”, aseveró Benjamin. “Basta que una persona sienta que sus problemas de sueño afectan sus actividades diarias para hacerse una evaluación. Si la causa es un problema de respiración, no es prudente ignorarlo”.

Una máquina para CPAP por lo regular es la primera opción de tratamiento para la apnea del sueño. Uno de los componentes es un motor que emite aire presurizado a través de un tubo unido a una máscara que cubre la nariz, o la nariz y la boca. Este equipo mantiene desbloqueadas las vías aéreas. Algunas máquinas pueden hacer ajustes automáticos en la presión para compensar cambios en la posición durante el sueño; otras solo tienen ajuste manual. La sección que se coloca en el rostro varía, pero todas las versiones tienen cintas ajustables para lograr el empalme adecuado. Los modelos más recientes tienen la opción de producir aire caliente o húmedo, según la preferencia del paciente, y además hay modelos pequeños para los viajes.

Pero muchos pacientes dicen que dormir con un protector bucal es menos incómodo o desagradable que usar una máquina CPAP. El término técnico para estos aparatos es dispositivos de avance mandibular, llamados así porque empujan la mandíbula inferior hacia adelante, lo que en la mayoría de las personas ayuda a mantener abiertas las vías respiratorias. Hay muchas variaciones de estos dispositivos disponibles en las farmacias, pero un dentista puede diseñar un dispositivo personalizado más eficaz y modificarlo o ajustarlo cuando sea necesario. Todos los pacientes del estudio volvieron a ser examinados después de la primera adaptación y la mayoría necesitó ajustes durante un período de dos a cuatro semanas.

“Recomendamos un dispositivo personalizado que sea fabricado por un dentista”, dijo Benjamin. “Y debería volver a hacerse la prueba para ver qué tan bien está funcionando. Hay una mejora subjetiva y objetiva de la que se debe realizar un seguimiento”.

Sin embargo, a algunas personas no les funcionan ni la CPAP ni los aparatos dentales, ya sea porque no pueden utilizarlos con constancia o de manera correcta, o bien porque estos dispositivos no resuelven el problema aunque los utilicen como es debido. Este tipo de pacientes pueden optar por toda una variedad de procedimientos quirúrgicos efectivos.

El más común es la cirugía de tejido blando, que consiste en modificar o extraer tejido del fondo de la boca. Dependiendo de la estructura y distribución de los músculos bucales, el cirujano puede retirar el velo del paladar y la úvula, extraer las amígdalas, cortar exceso de tejido con un instrumento caliente, enderezar el septo nasal si está desviado o cambiar la posición de los músculos de la lengua, en todos los casos con el propósito de mejorar el flujo en las vías respiratorias.

También existen cirugías de tejido óseo cuyo objetivo es mover la mandíbula hacia el frente y, al elongarla, abrir más espacio para la respiración. Este tipo de procedimiento requiere un periodo de recuperación prolongado.

En 2014, la Administración de Alimentos y Medicamentos de Estados Unidos autorizó el uso de un dispositivo de servoventilación adaptativa. Se trata de un aparato pequeño que se implanta bajo la piel como un marcapasos cardiaco. Gracias a dos cables eléctricos, percibe el patrón de respiración y estimula el nervio encargado de controlar la lengua para que la mueva y permita el paso del aire sin obstrucciones. El procedimiento ambulatorio para colocar el implante se realiza en un par de horas.

“No involucra cambios anatómicos y el paciente se recupera con más facilidad que en otras cirugías”, comentó Maria Suurna, profesora asociada de Otorrinolaringología en Weill Cornell Medicine y especialista en cirugías para la apnea del sueño. “Es efectiva. Tiene la menor tasa de complicaciones de todas las cirugías.

“Eso sí, no es para todos. Solo está autorizada para adultos mayores de 18 años que no tienen sobrepeso y cuya apnea es de moderada a grave”. Algunas personas quizá no puedan someterse a ese procedimiento debido a su estructura anatómica.

“La cirugía es complicada”, reconoció Suurna. “Pero lo cierto es que no existe un tratamiento ideal para la apnea. Todos tienen sus pros y sus contras, beneficios y riesgos”.

For Sleep Apnea, a Mouth Guard May be a Good Alternative to CPAP

People with sleep apnea who can’t tolerate the noise and discomfort of a CPAP machine might benefit from a mouth guard or surgery.

Many people wear a CPAP machine at night to treat the interrupted breathing of obstructive sleep apnea, a condition that affects an estimated 22 million Americans. But CPAP machines can be noisy, cumbersome and uncomfortable, and many people stop using the devices altogether, which can have dire long-term consequences.

Mouth guards may be a more comfortable and easy-to-use alternative for many people with obstructive sleep apnea, according to a new report. The study, published in Laryngoscope, looked at 347 people with sleep apnea who were fitted with a mouth guard by an otolaryngologist. Two-thirds of patients reported they were comfortable wearing the devices, and the devices appeared to be effective in helping to relieve the disordered breathing of obstructive sleep apnea.

The lead author of the study, Dr. Guillaume Buiret, head of otolaryngology at Valence Hospital in Valence, France, said that if he had sleep apnea, he would choose an oral appliance first.

“It’s easy to tolerate, effective and it costs a lot less than CPAP,” he said. “Thirty to 40 percent of our patients can’t use CPAP, and these patients almost always find the dental appliance helpful. I would recommend it as a first-line treatment”

Loud snoring may be the most obvious consequence of sleep apnea, but the condition, if left untreated, can lead to a broad range of complications, including high blood pressure, heart disease, liver dysfunction and Type 2 diabetes.

The problem develops when the soft tissue at the back of the throat collapses during sleep, blocking the airway. This leads to breathing cessation for brief periods, gasping for air, difficulty staying asleep, and all the problems of daytime sleepiness, from poor job performance to fatal accidents. Animals can have it too — bulldogs, for example, have a narrow airway and a soft palate that can easily block it. Their sleep apnea is almost identical to the human version.

The severity of the condition varies widely from a very mild problem that may need no treatment at all to severe or even life-threatening disease. Dr. Sara E. Benjamin, a neurologist and sleep specialist at Johns Hopkins, said that spending a night in a sleep laboratory monitored by a technician is the best way to diagnose apnea. A lab study offers the most thorough analysis, and can detect many other sleep problems besides apnea, but there are home test kits that are easy to use and cost-effective. They test breathing effort and oxygen levels, but not the brain waves, muscle tone and leg movements that a lab test records.

How can you know that you need a sleep assessment? “It’s a low standard to get evaluated, either by home testing or in a sleep lab,” Dr. Benjamin said. “If a person feels sleep problems are impacting daily activities, that’s enough to go and get evaluated. If the cause is a breathing problem, you don’t want to ignore it.”

A CPAP — continuous positive airway pressure — machine is usually the first option for treating sleep apnea. The device has a motor that delivers pressurized air through a tube attached to a mask that covers the nose, or both the nose and the mouth. This keeps the airway open. Some machines can automatically change the pressure to compensate for changes in sleep position; others require manual adjustment. Headgear varies, but all have adjustable straps to get the right fit. There are newer models that can deliver heated or humidified air, depending on the patient’s preferences, and there are small travel models as well.

But many patients find sleeping with a mouth guard less awkward or unpleasant than using a CPAP machine. The technical term for these appliances is mandibular advancement devices, so named because they work by pushing the lower jaw forward, which in most people helps keep the airway open. There are many variations of these gadgets available in drugstores, but a dentist can design a more effective personalized appliance, and modify or adjust it when necessary. The patients in the Laryngoscope study were all re-examined after the first fitting, and most needed adjustments over a two- to four-week period.

“We recommend a custom device made by a dentist,” Dr. Benjamin said. “And you should be retested to see how well it’s working. There’s subjective and objective improvement that should be tracked.”

But there are people for whom neither CPAP nor dental appliances work, either because they cannot use them consistently or correctly, or because the devices themselves do not solve the problem even when used properly. For these patients, there are various effective surgical procedures.

The most common is soft tissue surgery, which involves modifying or excising tissue at the back of the mouth. Depending on the structures and musculature of the mouth, the surgeon can trim the soft palate and the uvula, remove the tonsils, shrink tissues with a heated instrument, straighten a deviated septum, or alter the position of the tongue muscles, all with the aim of improving air flow.

There are also bone surgeries that move the jaw forward to make the entire breathing space larger, a procedure that can involve a protracted recovery period.

In 2014, the Food and Drug Administration approved a device called Inspire Upper Airway Stimulation. This is a small appliance implanted under the skin like a heart pacemaker. Using two electrical leads, it senses the breathing pattern and stimulates the nerve that controls the tongue to move it out of the way and allow air to pass freely. Implanting it is a day surgery procedure that takes about two hours.

“It doesn’t change the anatomy, and recovery is easier than with other surgeries,” said Dr. Maria V. Suurna, an associate professor of otolaryngology at Weill Cornell Medicine who specializes in surgery for sleep apnea. “It’s effective. It has the lowest complication rate of all the surgeries.

“But it’s not for everyone. It’s approved only for adults 18 and older who are not overweight and who have moderate to severe apnea.” Some people may be ineligible because of the structure of their anatomy.

“Surgery is tricky,” Dr. Suurna said. “But there’s no ideal treatment for apnea. Each has pros and cons, benefits and risks.”

What Questions Do You Have About Sleep?

Plagued by insomnia? Waking up in the night? Dubious about supplements? The Well desk wants to help.

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For many people, sleep has become an elusive dream during the pandemic. Terms like “coronasomnia” or “Covid-somnia” have sprung up to describe any sleep disruption caused by the stress of living through a global health crisis. Maybe anxiety is getting in the way of you falling asleep. Or you’re having nightmares about being trapped in a crowd without masks. Sacrificing precious hours of sleep just to get some time to yourself for fun? (That one’s become known as “revenge bedtime procrastination.”) Or are the conditions you need for a good night’s sleep, like not doing your day job from bed, simply out of whack.

No matter what your sleep affliction is, it’s important to solve it. Making sure that you regularly get good sleep can boost your mental health, protect you from chronic diseases and according to a study published just this week, may even ward off dementia in middle age.

So, the Well desk wants to help. We want to know what’s keeping you from great, consistent, restful sleep. And what you most want to hear from sleep experts about how to get more and better rest? Are you looking for advice on how to fall back to sleep after waking? Wondering about medications or supplements? Or just need to know what to do when your partner snores so loudly that you can’t sleep in the same room?

For an upcoming story about sleep, submit your questions below along with a few details about yourself. Because of the large number of submissions, we can answer only select questions. Some questions may be edited before posting. If we select your question, a reporter may be in touch.

Ask Well Your Sleep Questions

Sleeping Too Little in Middle-Age May Raise Dementia Risk, Study Finds

The research, tracking thousands of people from age 50 on, suggests those who sleep six hours or less a night are more likely to develop dementia in their late 70s.

Could getting too little sleep increase your chances of developing dementia?

For years, researchers have pondered this and other questions about how sleep relates to cognitive decline. Answers have been elusive because it is hard to know if insufficient sleep is a symptom of the brain changes that underlie dementia — or if it can actually help cause those changes.

Now, a large new study reports some of the most persuasive findings yet to suggest that people who don’t get enough sleep in their 50s and 60s may be more likely to develop dementia when they are older.

The research, published Tuesday in the journal Nature Communications, has limitations but also several strengths. It followed nearly 8,000 people in Britain for about 25 years, beginning when they were 50-years-old. It found that those who consistently reported sleeping six hours or less on an average weeknight were about 30 percent more likely than people who regularly got seven hours sleep (defined as “normal” sleep in the study) to be diagnosed with dementia nearly three decades later.

“It would be really unlikely that almost three decades earlier, this sleep was a symptom of dementia, so it’s a great study in providing strong evidence that sleep is really a risk factor,” said Dr. Kristine Yaffe, a professor of neurology and psychiatry at the University of California, San Francisco, who was not involved in the study.

Pre-dementia brain changes like accumulations of proteins associated with Alzheimer’s are known to begin about 15 to 20 years before people exhibit memory and thinking problems, so sleep patterns within that time frame could be considered an emerging effect of the disease. That has posed a “chicken or egg question of which comes first, the sleep problem or the pathology,” said Dr. Erik Musiek, a neurologist and co-director of the Center on Biological Rhythms and Sleep at Washington University in St. Louis, who was not involved in the new research.

“I don’t know that this study necessarily seals the deal, but it gets closer because it has a lot of people who were relatively young,” he said. “There’s a decent chance that they are capturing people in middle age before they have Alzheimer’s disease pathology or plaques and tangles in their brain.”

Drawing on medical records and other data from a prominent study of British civil servants called Whitehall II, which began in the mid-1980s, the researchers tracked how many hours 7,959 participants said they slept in reports filed six times between 1985 and 2016. By the end of the study, 521 people had been diagnosed with dementia at an average age of 77.

The team was able to factor out several behaviors and characteristics that might influence people’s sleep patterns or dementia risk, said an author of the study, Séverine Sabia, an epidemiologist at Inserm, the French public-health research center. Those included smoking, alcohol consumption, how physically active people were, body mass index, fruit and vegetable consumption, education level, marital status and conditions like hypertension, diabetes and cardiovascular disease.

To clarify the sleep-dementia relationship further, researchers separated out people who had mental illnesses before age 65. Depression is considered a risk factor for dementia and “mental health disorders are quite strongly linked with sleep disturbances,” Dr. Sabia said. The study’s analysis of participants without mental illnesses found a similar association between short-sleepers and increased risk of dementia.

The correlation also held whether or not people were taking sleep medication and whether or not they had a mutation called ApoE4 that makes people more likely to develop Alzheimer’s, Dr. Sabia said.

“The study found a modest, but I would say somewhat important association of short sleep and dementia risk,” said Pamela Lutsey, an associate professor of epidemiology and community health at the University of Minnesota, who was not involved in the research. “Short sleep is very common and because of that, even if it’s modestly associated with dementia risk, it can be important at a societal level. Short sleep is something that we have control over, something that you can change.”

Still, as with other research in this area, the study had limitations that prevent it from proving that inadequate sleep can help cause dementia. Most of the sleep data was self-reported, a subjective measure that isn’t always accurate, experts said.

At one point, nearly 4,000 participants did have sleep duration measured by accelerometers and that data was consistent with their self-reported sleep times, the researchers said. Still, that quantitative measure came late in the study, when participants were about 69, making it less useful than if it had been obtained at younger ages.

In addition, most participants were white and better educated and healthier than the overall British population. And in relying on electronic medical records for dementia diagnoses, researchers might have missed some cases. They also could not identify exact types of dementia.

“It’s always difficult to know what to conclude from these kinds of studies,” wrote Robert Howard, a professor of old age psychiatry at University College London, one of several experts who submitted comments about the study to Nature Communications. “Insomniacs — who probably don’t need something else to ruminate about in bed,” he added, “shouldn’t worry that they are heading for dementia unless they get off to sleep immediately.”

There are compelling scientific theories about why too little sleep might exacerbate the risk of dementia, especially Alzheimer’s. Studies have found that cerebrospinal fluid levels of amyloid, a protein that clumps into plaques in Alzheimer’s, “go up if you sleep-deprive people,” Dr. Musiek said. Other studies of amyloid and another Alzheimer’s protein, tau, suggest that “sleep is important for clearing proteins from the brain or limiting the production,” he said.

One theory is that the more people are awake, the longer their neurons are active and the more amyloid is produced, Dr. Musiek said. Another theory is that during sleep, fluid flowing in the brain helps clear out excess proteins, so inadequate sleep means more protein buildup, he said. Some scientists also think getting sufficient time in certain sleep phases may be important for clearing proteins.

Dr. Lutsey said too little sleep might also function indirectly, fueling conditions that are known dementia risk factors. “Think of someone who is staying up too late and having snacks, or because they get very little sleep, they have low motivation for physical activity,” she said. “That could predispose them to obesity and then things like diabetes and hypertension that have been pretty robustly linked to dementia risk.”

Another theory is “a shared genetic link,” said Dr. Yaffe, “genetic pathways or profiles that go along with both shorter sleep and increased risk of Alzheimer’s.” She and others said it’s also possible that the sleep-dementia relationship is “bidirectional,” with poor sleep fueling dementia, which further reduces sleep, which worsens dementia.

Experts seem to agree that researching the sleep-and-dementia connection is challenging and that previous studies have sometimes yielded confusing findings. In some studies, for example, people who sleep too long (usually measured as nine hours or more) appear to have greater dementia risk, but several of those studies were smaller or had older participants, experts said. In the new study, results hinted at increased risk for long sleepers (defined as eight hours or more because there weren’t enough nine-hour sleepers, Dr. Sabia said), but the association was not statistically significant.

Experts said they couldn’t think of scientific explanations for why long sleep would increase dementia risk and that it might reflect another underlying health condition.

The new study also examined whether people’s sleep changed over time. There appeared to be slightly increased dementia risk in people who shifted from short to normal sleep, Dr. Sabia said, a pattern she believes may reflect that they slept too little at age 50 and needed more sleep later because of developing dementia.

So, if short sleep is a culprit, how can people get more Zzz’s?

“In general, sleeping pills and a lot of other things don’t give you as deep of a sleep,” Dr. Yaffe said. And “we really want the deep sleep because that seems to be the time when things get cleared out and it’s more restorative.”

She said naps are OK to catch up on missed sleep, but getting a good night’s sleep should make naps unnecessary. People with sleep disorders or apnea should consult sleep specialists, she said.

For others, Dr. Lutsey said, having a regular sleep schedule, avoiding caffeine and alcohol before bedtime and removing phones and computers from the bedroom are among the Centers for Disease Control and Prevention’s “sleep hygiene” guidelines.

But much about sleep remains puzzling. The new study “provides a pretty strong piece of evidence that sleep is important in middle age,” Dr. Musiek said. “But we still have a lot to learn about that and how the relationship actually occurs in people and what to do about it.”

So You Want to Have a Lucid Dream?

The internet is home to all kinds of advice about how to experience consciousness while dreaming. What works?

Questions about the phenomenon of lucid dreaming — that is, experiencing consciousness while in a dream state — have been tossed around for thousands of years. Aristotle wrote about lucid dreams in 350 B.C.E., and Buddhists have practiced “dream yoga” for centuries.

Such dreams have underpinned literary and cinematic plots (“Alice’s Adventures in Wonderland,” “Inception”), as well as scientific studies on sleep; a review of such studies, published in 2019, found that brain activity during lucid dreaming is distinct.

More recently, lucid dreaming has become a kind of sport — fodder for countless life-hack-style posts on Reddit, YouTube and TikTok, where people expound on their moments of mid-sleep awareness and trade tips about how to increase the frequency of lucid dreams.

In theory, anyone can have a lucid dream; after combing through 50 years of research on sleep and dreaming, a group of scientists concluded that about half the global population has experienced one.

“From everything we know, if people really try to start engaging with the topic and maybe do some training and so on, most people at some point will have a lucid dream,” said Martin Dresler, a cognitive neuroscientist at Radboud University’s Donders Institute for Brain, Cognition and Behavior in the Netherlands.

Daniel Love, a lucid dream educator in Truro, England, said that he’s observed a wide range of experiences with lucid dreaming. “Over years of teaching, I found a huge variety in the abilities for people and some people who just can’t get past certain blockages,” he said. Skilled lucid dreamers may only have one every few weeks.

There are two commonly recommended techniques for developing that skill, both of which take time and practice, and don’t always bear fruit. The first is to record your dreams in a journal and look for patterns within them. I noticed, for example, that many of my dreams take place in my parents’ attic and my elementary school gymnasium. Now when a dream takes place in either of those spaces, it should be easier for me to recognize it for what it is.

The second technique often touted for promoting lucidity is “reality checking”: questioning one’s consciousness during waking hours through simple tests like counting fingers. Once those checks become habitual, Mr. Love said, they may occur during a dream state, where logical outcomes could have dreamlike distortions — the wrong number of fingers, for instance.

The internet is saturated with other tips, of course, spilling out of YouTube videos, Reddit posts and blogs, not to mention the endless virtual classes, books, coaching, devices and even supplements, like melatonin and vitamin B6, that claim to help people achieve lucid dreaming. (In one small study of 35 people over eight nights, a drug designed originally for treating Alzheimer’s symptoms induced lucid dreams. Dr. Ralph Carlson, an educational psychologist at the University of Texas Rio Grande Valley and an author of the study, asserted that no one should take any drug without first consulting a physician.)

Still, even those who sell such products and services said they are not necessary. “You really don’t need to throw money at this subject,” Mr. Love said. He offers coaching and sells books, but said that they’re “there for people who are struggling, who just want that extra push, but they don’t need it.”

It’s a sentiment shared by Nate Turner, a 19-year-old bartender in Michigan whose TikTok videos about lucid dreaming have earned him a following on the app. His advice to beginners sifting through online tips? “If it sounds too good to be true, it’s probably not true.”

Mr. Love echoed that point. “Lucid dreaming essentially is hacking the world’s most complicated computer: the human brain,” he said. “So anyone who’s promising to give you lucid dreams in five days, one day, 30 days? That’s impossible.”

Jay Mutzafi, a moderator of r/LucidDreaming on Reddit, spends a lot of time removing posts that might mislead prospective lucid dreamers. He believes that the community element can be helpful for those starting out, to ask questions and trade notes. But at the same time, he warns, it can be detrimental to compare yourself too much to others: “It’s all subjective, personal experience. Different brains work differently.”

People pursue lucid dreaming for all kinds of reasons: as a mental challenge, for therapeutic purposes or as an amusing hobby. Mr. Turner described his experiences as “a video game world inside my head.”

My own practice has evolved out of a grim immediate reality, set against a pandemic now in its second year. I felt stuck in my life, and desperate for control. My grandfather is terminally ill, and I spend several nights a week sleeping on his couch to be available to take care of him. While there, I keep a dream journal and practice reality checks.

Sleeping in a foreign environment often promotes more vivid dreams and the disruption of sleep can promote lucidity, according to Dr. Dresler. But even on these difficult nights, even on this miserable couch from the ’70s, I only achieve lucidity once, briefly. I dream that my grandfather and I are seated at his favorite booth at his favorite lunch spot, unmasked and healthy. He smiles, and though I know I am dreaming, that this perfect moment must be impossible, I smile back.