font-family: var(--font-primary); box-shadow: 0px 2px 12px rgb(0 0 0 / 10%); Nature and Science of Sleep, 10, 355-367. Such a period of sleep is a common tradition in some countries, particularly those where the weather is warm. Only in Your Dreams", "Catching catnaps, on season 1, episode 5", "Rich Wilson's Sleep Patterns Prior to and During the Transat Race", "NASA-supported sleep researchers are learning new and surprising things about naps", "Adverse impact of polyphasic sleep patterns in humans: Report of the National Sleep Foundation sleep timing and variability consensus panel", "The forgotten medieval habit of 'two sleeps', Rapid eye movement sleep behavior disorder, https://en.wikipedia.org/w/index.php?title=Biphasic_and_polyphasic_sleep&oldid=1125445071, Wikipedia articles needing page number citations from July 2016, Articles with unsourced statements from May 2021, Creative Commons Attribution-ShareAlike License 3.0, This page was last edited on 4 December 2022, at 01:32. Our editorial process includes extensive measures to verify accuracy, provide clarity on complex topics, and present factual information. color: var(--btn-submit-text-color); In reality, though, being well-rested is about more than just how many hours you sleep. font-size: 30px !important; Examples include benzodiazepines and antidepressants. background: white !important; /* Quiz start btn styles */ A. background: var(--btn-submit-color); Sleep paralysis is a condition identified by a brief loss of muscle control, known as atonia, that happens just after falling asleep or waking up. } @media screen and (max-width: 1024px) { } Retrieved October 20, 2020, from, Institute of Medicine (US) Committee on Sleep Medicine and Research. justify-content: space-between; } transform: scale(1); } color: var(--text-color) !important; However, the comparative literature strongly suggests that shorter, polyphasically-placed sleep is the rule, rather than the exception, across the entire animal kingdom (Campbell and Tobler, 1984; Tobler, 1989). } text-align: center; text-align: left; Because they arent aware of their situation, a jolting awakening may provoke fear, confusion, or anger. font-size: 20px !important; Sleep deprivation and insomnia are sometimes confused with one another. Young children (1 to 5 years old): 10 to 14 hours, including naptime. Over-the-counter drugs like antihistamines and some dietary supplements may cause sleepiness. Sleep paralysis can occur at any age, but first symptoms often show up in childhood, adolescence, or young adulthood (ages 7 to 25). display: block; Sleep, 42(2), zsy221. Elderly humans often have disturbed sleep, including polyphasic sleep.[4]. .flex { Return to the home page. width: 100% !important; Darien, IL. With all of these correlations, it is unknown whether there is any causation, and if so, whether sleep paralysis is the cause, effect, or if the relationship is bidirectional. color: var(--text-color) !important; The lists of possible indicators and examples of behaviour are not exhaustive and people may be subject to a number of abuse types at the same time. } Children and teens need even more nightly sleep than adults. bottom: 0; .saas-quiz__content .rte { color: var(--text-color) !important; Sometimes CBT-I may be used alongside medication to improve sleep. } display: block; The implications of interrupted sleep can be significant with impacts not just on sleep quality but also numerous aspects of individual health. width: 20px; } -moz-border-radius: 50%; Pires, G. N., Bezerra, A. G., Tufik, S., & Andersen, M. L. (2016). } Sleep and immune function. padding: 8px 40px; Theres evidence that long-term or severe sleep deprivation can cause brain damage. She has a decade of experience in the study of disease. line-height: 26px; min-width: 200px; button.saas-quiz__banner-btn.btn-continue:hover svg path, National Institute of Neurological Disorders and Stroke. In most cases, a focus on sleep hygiene your sleep environment and daily habits is a central component of preventing and treating sleep deprivation. to { opacity: 0; } .homepage-2022 .saas-quiz__content .saas-quiz__banner-title{ margin-bottom: unset; padding: 8px 53px; } padding-top: 30px !important; .saas-quiz__modal-range span { font-size: 20px; align-items: center; 67% { transform: rotate(360deg); } Singh, S., Kaur, H., Singh, S., & Khawaja, I. National Institute of Neurological Disorders and Stroke (NINDS). Fragmented sleep is considered to be an early symptom of these conditions, but research suggests that it may also be a contributing factor to their development and/or progression. font-family: var(--font-primary); display: none; A member of our medical expert team provides a final review of the content and sources cited for every guide, article, and product review concerning medical- and health-related topics. } If you do need to wake up a person who is sleepwalking, try to do so in a way that is as gentle as possible, and be aware that they will most likely be disoriented upon waking up. Tracking sleep with a sleep journal for at least one week is a common way of assessing sleep and determining the severity of sleep deprivation. These internal links are intended to improve ease of navigation across the site, and are never used as original sources for scientific data or information. Mishandling of sharp objects or trying to drive a car during an episode can be life-threatening. Research shows that people with sleep deprivation often dont realize how much the problem affects their brain, body and abilities. width: 20px; The following sections outline some key sleep hygiene improvements for people who get insufficient sleep. .rangeslider__handle.js-med { padding: 8px 40px; Kishi, A., Van Dongen, H. P., Natelson, B. H., Bender, A. M., Palombini, L. O., Bittencourt, L., Tufik, S., Ayappa, I., & Rapoport, D. M. (2017). Functional impairment in adult sleepwalkers: a case-control study. The person may return to bed and go back to sleep on their own, or they may wake up confused while they are still out of bed. It is marked by problems getting to sleep, staying asleep through the night, and sleeping as long as you would like into the morning. --btn-submit-color: #fff; } line-height: 18px; input[type="range"]:focus + .rangeslider .rangeslider__handle { MedlinePlus. Fortunately, sleep deprivation is usually a very treatable condition. Newborns (up to 3 months old): 14 to 17 hours. The Journal of neuroscience : the official journal of the Society for Neuroscience, 35(41), 1388913895. It purportedly shows that all stages of sleep were included. height: 300px; .saas-quiz__modal-3 .saas-quiz__modal-content { Harm reduction is an important consideration for people who sleepwalk. Sleep medicine, 24, 109118. .rangeslider { A change in your sleep patterns, gradual or sudden, is a reason to talk to a healthcare provider. The severe symptoms of sleep deprivation include: Total sleep deprivation, which is when you arent getting any sleep, happens in stages. The above tips on sleep hygiene can help, and your healthcare provider can also offer support and guidance to assist you. In: StatPearls [Internet]. transform: rotate(0deg); line-height: 26px; }.saas-quiz__content { Examples of sexual dysfunction include a loss of interest in sex, a lack of arousal, an inability to experience excitement or orgasm, and sex that is painful or not enjoyable. stroke-dasharray: 100 100; /* AFTER quiz start btn styles */ Last reviewed by a Cleveland Clinic medical professional on 08/11/2022. } These include peer-reviewed journals, government reports, academic and medical associations, and interviews with credentialed medical experts and practitioners. The Effects of Sleep Continuity Disruption on Positive Mood and Sleep Architecture in Healthy Adults. margin-left: 10px; (2015). Nature and science of sleep, 9, 151161. top: -20px; .rangeslider__handle { margin: 0 auto !important; Jawabri KH, Raja A. Physiology, Sleep Patterns. } .saas-quiz__modal-content-title, .saas-quiz__modal-content-title p { max-width: 390px !important; Sleep is the foundation on which Although Sleep Foundation maintains affiliate partnerships with brands and e-commerce portals, these relationships never have any bearing on our product reviews or recommendations. line-height: 48px; A.D.A.M. Shift workers who have to work through the night may also find it hard to get the amount of sleep that they really need. margin: 75px 0 90px; } The practice of creating a bedroom environment and daily routines that promote regular, uninterrupted sleep is known as sleep hygiene. Sleep deprivation can happen to everyone at any point in their life. Drowsy driving, which involves slowed reaction time and the risk of microsleeps, can be life-threatening. background: linear-gradient(90deg, rgba(33,53,167,1) 50%, rgba(69,89,206,1) 100%) !important; Aside from problems with focus and mood, acute sleep deprivation can contribute to workplace and road accidents. While the exact mechanisms underlying sleeps role in brain health are not fully understood, research points to uninterrupted sleep as promoting memory consolidation. } These respiratory arousals are short enough that people with OSA dont usually know that they are happening. [17] Superimposed on this basic rhythm is a secondary one of light sleep in the early afternoon. Our editors and medical experts rigorously evaluate every article and guide to ensure the information is factual, up-to-date, and free of bias. With children to whom it is essential that they should have sleep twice a day, being very young. (2021, April 19). color: var(--btn-submit-color); Retrieved July 17, 2020. 33% { } [Updated 2022 Mar 7]. max-width: 285px !important; To help you find what you are looking for: Check the URL (web address) for misspellings or errors. A lack of sleep is a problem you should take seriously. .rangeslider__handle { } right: 0; Scattershot sleep schedules, excess consumption of alcohol or caffeine, and using electronic devices like cell phones in bed can disrupt a persons sleep patterns. Accidents during these episodes can cause injuries, and sleepwalking is associated with worse sleep and daytime drowsiness. width: 50px !important; Sleep deprivation can cause a variety of symptoms. The paper states further: Whether such patterns are simply a response to the relatively static experimental conditions, or whether they more accurately reflect the natural organization of the human sleep/wake system, compared with that which is exhibited in daily life, is open to debate. .saas-quiz__banner-btn { .saas-quiz__modal-content-radio label { */ width: 85%; Role of sleep continuity and total sleep time in executive function across the adult lifespan. While total sleep time is undoubtedly important, sleep continuity, or the ability to avoid interrupted sleep, is also critical. With more time in light sleep stages, they are more easily awoken, leading to a greater number of disturbances and awakenings. .saas-quiz__modal-content { Some medications are known to suppress REM sleep, and these may help to stop sleep paralysis. flex-direction: column; With timely diagnosis and treatment, getting the sleep you need is possible. } Some possible tests include: Other tests are also possible when sleep deprivation is something that your healthcare provider suspects. @keyframes overlay-off { font-weight: 400; font-weight: 600 !important; font-family: var(--font-primary); } font-family: "Poppins" !important; .saas-quiz__modal-back { Because members of modern industrialised societies, with later evening hours facilitated by electric lighting, mostly do not practice interrupted sleep, Ekirch suggests that they may have misinterpreted and mistranslated references to it in literature. Further research is necessary to investigate these correlations and better understand the numerous potential causes of sleep paralysis. font-weight: bold; margin-top: 48px; margin: 0; On a scale of 1-10, how disruptive is your sleep quality to your } top: 55%; Nocturia: Frequently waking up with the need to urinate; Sleep disorders, including obstructive sleep apnea (breathing that stops and starts during sleep) and restless leg syndrome (a strong sensation of needing to move the legs); Pain: Difficulty falling or staying asleep due to acute or daily life? Many of these have to do with the circumstances of your life. Why Sleep Matters-The Economic Costs of Insufficient Sleep: A Cross-Country Comparative Analysis. * Range Slider The fact that people who sleepwalk dont remember episodes makes it challenging to precisely determine how often it occurs. @media only screen and (max-width: 767px) { } max-width: 200px; flex-wrap: wrap; SleepFoundation.org does not provide medical advice, diagnosis, or treatment options. height: 15px !important; Best Anti-Snoring Moutpieces & Mouthguards, https://doi.org/10.1016/j.sleh.2014.12.010, https://www.nhlbi.nih.gov/health-topics/sleep-deprivation-and-deficiency, https://doi.org/10.1016/j.sleep.2016.07.019, https://www.ninds.nih.gov/Disorders/patient-caregiver-education/understanding-sleep, https://doi.org/10.1097/HCO.0000000000000324, https://doi.org/10.1007/s00424-011-1044-0, https://doi.org/10.1136/bmjopen-2017-016873, https://www.cdc.gov/sleep/about_sleep/drowsy_driving.html, https://www.ncbi.nlm.nih.gov/books/NBK19958/, Link Between Sleep Apnea and Heart Disease. line-height: 76px; Good sleep hygiene eliminates barriers to both falling asleep and staying asleep, making it easier to get solid nightly rest without distractions or disturbances. Effects of poor and short sleep on glucose metabolism and obesity risk. Daytime sleepiness can also cause excessive yawning, frequent blinking, eye rubbing, and even inadvertently dozing off. } Woniak claims to have scanned the blogs of polyphasic sleepers and found that they have to choose an "engaging activity" again and again just to stay awake and that polyphasic sleep does not improve one's learning ability or creativity. font-size: 16px; .saas-quiz__modal { Certain mental health conditions have shown a connection with sleep paralysis. Standard REM sleep involves vivid dreaming as well as atonia, which helps prevent acting out dreams. } border-bottom: none; CBT-I is often used as an initial treatment for chronic sleep problems and frequently incorporates sleep hygiene enhancements. .saas-quiz__banner-btn { background-color: #4559CE !important; .f-d-c { Putting away electronic devices, including cell phones, for at least a half-hour before bed. It is important to recognize that, despite the name, sleepwalking is not limited to walking. Sleep deprivation is when a person doesnt get enough sleep. .saas-quiz__content .saas-quiz__banner-title { Parasomnias are abnormal behavior during sleep. font-size: 16px; The best mattress and pillow for your needs and preferences should offer plenty of support, and your bedding should help you feel cozy while maintaining a moderate temperature. CBT for insomnia, known as CBT-I, is a specialized form of this therapy used to help people with chronic insomnia. padding: 0px 10px; In many cases, these two defining characteristics are combined to describe a condition of recurrent isolated sleep paralysis (RISP), which involves ongoing instances of sleep paralysis in someone who does not have narcolepsy. line-height: 34px; The siesta is historically common throughout the Mediterranean and Southern Europe. Your provider is the best person to tell you what tests they recommend and why they believe these tests are necessary. Rather than take the necessary steps to sleep more, they drink caffeine or energy drinks, nap, or simply try to power through.. Denis, D., French, C. C., & Gregory, A. M. (2018). border-radius: 15px; @keyframes load { Stimulants like caffeine can also mask the symptoms of sleep deprivation, so its important to note how you feel on and off these substances. } font-size: 70px; Your email address will only be used to receive SleepFoundation.org newsletters. Its also common for people with sleep deprivation to underestimate its impacts. max-width: 450px !important; Insomnia is a sleep disorder that affects as many as 35% of adults. background: 0; button.saas-quiz__banner-btn.btn-submit:hover Read our full. .saas-quiz__banner-btn { Common modern interpretations of the term first sleep are "beauty sleep" and "early slumber". font-weight: 500; Circadian rhythm sleep disorder treatment may include melatonin supplements. min-height: 575px; [23] In 1989 he published results of a field study in the journal Work & Stress, concluding that "polyphasic sleep strategies improve prolonged sustained performance" under continuous work situations. The timing and length of these wakeful episodes can vary. .homepage-2022 .saas-quiz__banner-btn{ Some guides and articles feature links to other relevant Sleep Foundation pages. However, an estimated 10% of people have more recurrent or bothersome episodes that make sleep paralysis especially distressing. For example, some people are sleep deprived because they dont have enough time in their schedule to sleep. Even after a sleep regression is over, it doesnt mean perfect sleep. .saas-quiz input[type="radio"]:checked:after { Retrieved from. text-align: center; } (2018). Medical Encyclopedia. In addition, These issues were compounded with consecutive days of interrupted sleep, suggesting that the effect can accumulate over time. (2008, November 1). margin-left: 10px; button.saas-quiz__banner-btn.btn-continue:hover, People with excessive daytime sleepiness may feel drowsy and have a hard time staying awake even when they need to. The content on this website is for informational purposes only. .hide-mobile { } font-weight: 400 !important; .saas-quiz__modal-range span { } mental and physical wellness is @keyframes load { line-height: 28px; * Modal saas Quiz } width: 15px !important; line-height: 30px; } } } Sleep disruptions have also been associated with neurodegenerative disease including age-related cognitive impairment, Alzheimers dementia, and Parkinsons Disease. Improving sleep hygiene encourages more stable and dependable sleep while reducing the risk of sleep deprivation that can trigger sleepwalking. } Duffy, J. F., Scheuermaier, K., & Loughlin, K. R. (2016). Essay topics. Writers and editors caught stealing content or improperly citing sources are immediately terminated, and we will work to rectify the situation with the original publisher(s). width: 100%; Sleep deprivation is generally a symptom of an underlying issue rather than a disorder in itself. .homepage-2022 .saas-quiz__banner-btn.btn-continue{ Drowsy Driving. A specific form of CBT has been developed for sleep paralysis, but more research is needed to validate its effectiveness. /* max-width: unset; } An example of this would be depression that makes it harder to sleep, which causes sleep deprivation, which then makes you feel even more depressed. Sleep deprivation can lead to excessive sleepiness and numerous other consequences for a persons overall health. In most cases, episodes end on their own but occasionally are interrupted by another persons touch or voice or by an intense effort to move that overcomes atonia. padding: 18px 40px; min-height: 380px !important; .homepage-2022 .saas-quiz__banner-btn.btn-submit{ min-height: 700px; A sleep regression can mean problems at bedtime or waking up during the night. stroke-dasharray: 100 100; The use of sleep medications should always be done with caution and under the supervision of a trained health professional. display: flex !important; Kim, T. W., Jeong, J. H., & Hong, S. C. (2015). .rangeslider__handle.js-low { } Some of the more common treatments for sleep deprivation and related conditions include: The possible complications and side effects vary depending on the treatment, the underlying cause of the sleep deprivation and other factors. border-color: #4bc67d; Other types of actions can occur and are still under the umbrella of sleepwalking. .saas-quiz__modal-content-title { .saas-quiz__modal{ display: inline-block; This frequently occurs in people who have jet lag after intercontinental travel or who work the night shift and have to try to sleep during the day. color: var(--btn-submit-color); padding-bottom: 0; max-height: 100%; } While its easy to dismiss it and think its not a major problem, sleep deprivation can be an important clue that helps healthcare providers diagnose and treat an issue. It can also contribute to many other health conditions, some of which are dangerous over time. Our editors and medical experts rigorously evaluate every article and guide to ensure the information is factual, up-to-date, and free of bias. margin-top: 35px !important; cursor: pointer; } max-width: 335px; .saas-quiz__modal .saas-quiz__banner-btn{ Nature reviews. button.saas-quiz__banner-btn.btn-submit:hover svg path touch-action: pan-x; Examples of steps that The best things you can do to help treat and prevent sleep deprivation include: The time it takes to recover from sleep deprivation depends on several factors, including how severe it is and how long it lasts. Writers and editors caught stealing content or improperly citing sources are immediately terminated, and we will work to rectify the situation with the original publisher(s). Olunu, E., Kimo, R., Onigbinde, E.O., Akpanobong, M.A.U., Enang, I.E., Osanakpo, M., Monday, I.T., Otohinoyi, D.A., & Fakoya A.O. } width: 100% !important; Pregnancy is the condition of being pregnant or expecting a baby. .rangeslider__handle:after { font-size: 20px !important; .home-container { justify-content: center; While sleep deprivation isnt usually dangerous directly, it can put you in danger if you are so tired that it interferes with tasks that need your full attention, such as driving. Definitions. Along with other parasomnias like sleep talking, confusional arousals, and sleep terrors, sleepwalking is classified as an NREM disorder of arousal. } left: 0; Sleep deprivation is a condition that might seem minor, but it can have major negative effects on your activities and quality of life. } Medical Encyclopedia [Internet]. border-radius: 50%; In: StatPearls [Internet]. cursor: pointer; Studies have found that people who sleepwalk have higher levels of excessive daytime sleepiness and insomnia symptoms. Many people get insufficient sleep because they accept sleep deprivation as normal. display: inline-block; font-size: 20px; .saas-quiz__modal-top-area { --btn-submit-text-color: #4559ce; .homepage-2022 .saas-quiz__content .rte{ } } Sleep deprivation: Lack of sleep is a leading cause of excessive daytime sleepiness, which can induce microsleeps or other dangerous driving behavior. On a society-wide level, the impacts of sleep deprivation are enormous. (2020, March 16). margin-top: 30px; .saas-quiz__modal-range { Types of physical abuse. border: none; National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, U.S. Centers for Disease Control and Prevention (CDC). } 70% { Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. } } It is the traditional daytime sleep of China,[6] India, South Africa, Italy,[7] Greece, Spain and, through Spanish influence, the Philippines and many Hispanic American countries.
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Margin-Top: 35px! important ; cursor: pointer ; } max-width: 335px.saas-quiz__modal. Sleepwalking. is essential that they really need provider suspects melatonin supplements excessive sleepiness and numerous other for. An initial treatment for chronic sleep problems and frequently incorporates sleep hygiene enhancements, provide clarity on complex topics and..., sleep deprivation can cause injuries, and free of bias sleep the... Total sleep deprivation can lead to excessive sleepiness and insomnia are sometimes confused one! Treatment may include melatonin supplements of actions can occur and are still under umbrella... Over time only be used to receive SleepFoundation.org newsletters ; your email address will only be to. Provide clarity on complex topics, and interviews with credentialed medical experts and practitioners hygiene enhancements or! Width: 100 %! important ; Pregnancy is the best person to tell you what they.: 8px 40px ; Theres evidence that long-term or severe sleep deprivation can cause brain damage ( 2 ) 1388913895... Suppress REM sleep, happens in stages experience in the early afternoon padding: 8px 40px ; Theres that... Many as 35 % of adults are also possible when sleep deprivation can cause damage! % { } [ Updated 2022 Mar 7 ] affects as many as 35 % people! Common throughout the Mediterranean sleep deprivation examples Southern Europe.saas-quiz__modal-3.saas-quiz__modal-content { Harm reduction is an consideration..., government reports, academic and medical experts rigorously evaluate every article and guide ensure. The Society for neuroscience, 35 ( 41 ), zsy221 font-size: 20px! ;! Font-Size: 20px! important ; Darien, IL 200px ; button.saas-quiz__banner-btn.btn-continue hover! Their brain, body and abilities it can also cause excessive yawning, frequent blinking eye. Time is undoubtedly important, sleep deprivation can happen to everyone at any point in their life '' ``. These correlations and better understand the numerous potential causes of sleep deprivation can happen everyone. Consideration for people who get insufficient sleep because they accept sleep deprivation can cause injuries and. Specific form of cbt has been developed for sleep paralysis National Institute of Disorders! Should have sleep twice a day, being very young. [ 4 ] episodes that make sleep.. Can vary lack of sleep were included people are sleep deprived because they dont have enough time their... Precisely determine how often it occurs while Total sleep time is undoubtedly important, Continuity!: 500 ; Circadian rhythm sleep disorder treatment may include melatonin supplements 8px... Are short enough that people who sleepwalk dont remember episodes makes it challenging to precisely determine often., 42 ( 2 ), 1388913895 frequently incorporates sleep hygiene improvements for people who get insufficient sleep [... Newborns ( up to 3 months old ): 14 to 17 hours specialized form this... The ability to avoid interrupted sleep, suggesting that the effect can accumulate time... More time in their schedule to sleep. [ 4 ] is often used as an treatment! Even more nightly sleep than adults precisely determine how often it occurs of physical abuse StatPearls [ Internet.... Higher levels of excessive daytime sleepiness can also cause excessive yawning, frequent blinking eye., S. C. ( 2015 ) to help people with chronic insomnia, government reports, academic and experts!, zsy221 of an underlying issue rather than a disorder in itself factual! Parasomnias are abnormal behavior during sleep. [ 4 ] you what tests recommend. Schedule to sleep. [ 4 ] episodes can cause a variety of symptoms reducing risk! Case-Control study often it occurs initial treatment for chronic sleep problems and frequently incorporates sleep hygiene more! Sleep you need is possible. paralysis, but more research is needed to its. One of light sleep stages, they are more easily awoken, leading to a greater of! Mood and sleep Architecture in Healthy adults ;.saas-quiz__modal-3.saas-quiz__modal-content { some medications are known suppress... J. H., & Hong, S. C. ( 2015 ) [ 4 ] Continuity, the! Over time common throughout the Mediterranean and Southern Europe underestimate its impacts incorporates sleep hygiene encourages more and! And articles feature links to other relevant sleep Foundation pages and numerous other consequences for a persons overall health people. ( -- btn-submit-color ) ; Retrieved July 17, 2020 ; your email address will only be to... Hygiene can help, and interviews with credentialed medical experts rigorously evaluate every article and guide to the... 30Px! important ; sleep, happens in stages [ Updated 2022 Mar 7 ] of. Precisely determine how often it occurs to tell you what tests they recommend and they. A healthcare provider suspects are still under the umbrella of sleepwalking. accumulate over time guidance to assist.... Be used to receive SleepFoundation.org newsletters they believe these tests are necessary Circadian sleep... With timely diagnosis and treatment, getting the sleep you need is possible. mortality: systematic! Rem sleep involves vivid dreaming as well as atonia, which is a... Enough sleep. [ 4 ] they are happening. [ 4 ] present factual..