question: Why is it that when I'm super tired, sometimes like yesterday, I don't even really remember hitting the pillow. Other times, like today, I have to sit there for a hour or so before I even fall asleep? I feel like I was just as tired today as I was yesterday
comment: Your level of tiredness is not the only thing that controls your ability to fall asleep. It is a factor, but not the most important. When you begin to fall asleep you enter a period of quiet wakefulness, where you attempt to "let go" of your conscious state and enter sleep. This is best achieved with a certain lack of focus. If you are too focused on the idea of getting to sleep, you are engaging your conscious brain and preventing it from resting. The reason? When you are thinking about sleep, you are externalizing the thought process, it is an "event" that you are wanting to do, rather than an action you let happen. By changing your thought process you can help facilitate sleep faster. Focusing more on self-reflection, on how you feel rather than what you feel you should do. Instead of thinking "I need to get to sleep" think instead "I feel sleepy". This self-referential thought process is a better transitional state from which to enter sleep than active thought external to yourself. Practice inward thinking.
passages: Section::::History.:2006.
   Section::::History.:2006.:Fall 2006.
   Section::::History.:Currently.
   Section::::Treatments/countermeasures.:Caffeine.
  
  Caffeine is a xanthine derivative that can cross the blood-brain barrier. The caffeine present in coffee or tea exerts its stimulating action by blocking adenosine receptors in the brain. By antagonizing the adenosine receptors caffeine limits the effects of adenosine buildup in the brain and increases alertness and attentiveness. Previous research has shown that coupled with a short nap, consuming caffeine prior to the nap can alleviate the effects of sleep inertia. Nonetheless, individual degree of consumption and tolerance to caffeine may be responsible for variation in its efficacy to reduce sleep inertia symptoms.
  
  Section::::Treatments/countermeasures.:Light.
   Section::::Severity.
  
  A number of diagnostic tests, including the Epworth Sleepiness Scale, are available to help ascertain the seriousness and likely causes of abnormal somnolence.
  
  Section::::Treatment.
  
  Somnolence is a symptom, so the treatment will depend on its cause. If the cause is the behavior and life choices of the patient (like working long hours, smoking, mental state), it may help to get plenty of rest and get rid of distractions. It’s also important to investigate what’s causing the problem, such as stress or anxiety, and take steps to reduce the feeling.
  
  Section::::See also.
  
  BULLET::::- Chronic fatigue syndrome
  
  BULLET::::- Decision fatigue
   "Makura-gaeshi", or pillow shifter, is another "yōkai" relate to sleep. Sleep was a particularly vulnerable state of being because it was believed that the spirit and physical body seemed to separated while dreaming. The pillow was a threshold, a sort of magical device, that allowed one to travel to another world. Because of this, pillows were treated with respect. It would have been disturbing to wake up and discover that your pillow had been shifted. If the makura-gaeshi moved your pillow while you were asleep, it was possible that your spirit would not be able to return to the body. This threat turns a seemingly innocuous prank into a deadly one and is all the more frightening because of the vulnerable unconscious state of dreaming.
   Finally, on the opposite end of the spectrum, other patients may report feeling that they have slept much longer than is observed. It has been proposed that this experience be subclassified under sleep state misperception as "positive sleep state misperception", "reverse sleep state misperception", and "negative sleep state misperception".
  
  Section::::Symptoms and diagnosis.:Diagnostic criteria.
   A sleep diary, also called sleep log or sleep journal, kept by a patient at home for at least two weeks, while subjective, may help determine the extent and nature of sleep disturbance and the level of alertness in the normal environment. A parallel journal kept by a parent or bed partner, if any, can also be helpful. Sleep logs can also be used for self-monitoring and in connection with behavioral and other treatment. The image at the top of this page, with nighttime in the middle and the weekend in the middle, shows a layout that can aid in noticing trends
   This drama paints the married life of four wedded couples: a pair of newly-weds enjoying nuptial bliss; a couple married for seven years struggling for survival in the midst of establishing their careers and raising children, and whose marriage is showing cracks yet they are clueless about managing the strained relationship; a middle-aged couple married for decades who try but fail to change each other's ways, and who long to end their marriage to gain freedom but eventually realising that they are inseparable; an old loving couple who bicker to spice up their lives, and having understood the essence of marriage, manage their monotonous married life with wisdom.
   Because disrupted sleep is a significant contributor to fatigue, a diagnostic evaluation considers the quality of sleep, the emotional state of the person, sleep pattern, and stress level. The amount of sleep, the hours that are set aside for sleep, and the number of times that a person awakens during the night are important. A sleep study may be ordered to rule out a sleep disorder.
  
  Depression and other psychological conditions can produce fatigue, so people who report fatigue are routinely screened for these conditions, along with drug abuse, poor diet, and lack of physical exercise, which paradoxically increases fatigue.
   BULLET::::- Sleep disturbances: Patients who do not sleep well are more tired than others. Cancer patients commonly experience insomnia or hypersomnia. Sleep disturbances may be caused by sleeping too much during the day, by restless leg syndrome, by pain, by anxiety, or by other medical conditions, like obstructive sleep apnea or menopause. Practicing good sleep hygiene may reduce fatigue by improving sleep quality.
   Section::::The Heian Period.
   Pillow fights are known to occur during children's sleepovers. Since pillows are usually soft, injuries rarely occur. The heft of a pillow can still knock a young person off balance, especially on a soft surface such as a bed, which is a common venue. In earlier eras, pillows would often break, shedding feathers throughout a room. Modern pillows tend to be stronger and are often filled with a solid block of artificial filling, so breakage occurs far less frequently.
  
  Section::::Culture.:Activities.:Pillow talk.
   Many times pillow fights occur during children's sleepovers. Since pillows are usually soft, injuries rarely occur. The heft of a pillow can still knock a young person off balance, especially on a soft surface such as a bed, which is a common venue. In earlier eras, pillows would often break, shedding feathers throughout a room. Modern pillows tend to be stronger and are often filled with a solid block of artificial filling, so breakage occurs far less frequently.
  
  Section::::Organized pillow fights.
   Section::::History.:Ancient China.
   "There were a lot of nerves that third night, a lot of nerves. I didn’t sleep well. John came and got me. We went to A & W. He said I was a real basket case. He was almost worried about me before the fourth day. I was so nervous the third night I called home and talked to friends for hours, but I guess once I got up and got started then things eased up. Once I started shooting and got into the rhythm of things, I knew I was ok."
   Thus, in many people, there is a dip when the drive for sleep has been building for hours and the drive for wakefulness has not yet started. This is, again quoting Czeisler, "a great time for a nap". The drive for wakefulness intensifies through the evening, making it difficult to get to sleep 2–3 hours before one's usual bedtime when the "wake maintenance zone" ends.
  
  Section::::Sleep cultures.
   Therefore, sleep in aging is another equally important area of research. A common observation is that many older adults spend time awake in bed after sleep onset in an inability to fall asleep and experience marked decrease in sleep efficiency. There may also be some changes in circadian rhythms. Studies are ongoing about what causes these changes and how they may be reduced to ensure comfortable sleep of old adults.
  
  Section::::Brain activity during sleep.
   Sleep disorders are more frequently reported when patients suffer from mild TBI (mTBI). Reasons for that could be the increased awareness of postinjury changes in mild TBI patients because they may be more determined to return to their preinjury life situation. All age groups can be affected from sleep disorders after TBI, including children and adolescents.
  
  There are several risk factors that are associated with occurring sleep disorders, such as lower years of education, severity of head injury and occurrence of residuals symptoms, for example headache or dizziness.
   Nearly every day, the person may sleep excessively, known as hypersomnia, or not enough, known as insomnia. Insomnia is the most common type of sleep disturbance for people who are clinically depressed. Symptoms of insomnia include trouble falling asleep, trouble staying asleep, or waking up too early in the morning. Hypersomnia is a less common type of sleep disturbance. It may include sleeping for prolonged periods at night or increased sleeping during the daytime. The sleep may not be restful, and the person may feel sluggish despite many hours of sleep, which may amplify their depressive symptoms and interfere with other aspects of their lives. Hypersomnia is often associated with an atypical depression, as well as seasonal affective disorder.
   "The severity of daytime sleepiness needs to be quantified by subjective scales (at least the Epworth Sleepiness Scale) and objective tests such as the multiple sleep latency test (MSLT)." The Stanford sleepiness scale (SSS) is another frequently-used subjective measurement of sleepiness. After it is determined that excessive daytime sleepiness is present, a complete medical examination and full evaluation of potential disorders in the differential diagnosis (which can be tedious, expensive and time-consuming) should be undertaken.
  
  Section::::Diagnosis.:Differential diagnosis.
   Electronic media and sleep
  
  The use of computers (including devices such as smartphones, tablet computers and laptops) by children and adolescents before bed has been associated with a reduction in the hours of sleep experienced by frequent users, along with a decreased quality of sleep, in most cases. The results of computer use at night have been linked with tiredness.
   Starting with the old adage "Once there was a little girl..." you come across a little girl and her parents, all wearing crowns. The little girl is wide awake claiming she is not tired. Her parents take this almost as a regular occurrence and require that she at least put on her pajamas, wash her face, brush her teeth. The little girl keeps repeating that she is not tired but climbs into bed and under the sheets since that is where she is the most comfortable. She then proceeds to ask her parents if everything thing goes to sleep. The parents then proceed to go through a list of animals and their habits of sleeping. They discuss the family dog, the cat, bats, snails, bears, and whales. The little girl proclaims that she knows an animal that sleeps a lot. We then finally come across the tiger in the jungle, where the little girl tells her parents that he sleeps to stay strong. The parents agree that sleep is good to stay strong then say goodnight even though the little girl claims she is still not sleepy. Her parents know what will happen and agree that she can stay awake all night long. After the long discussion, the little girl goes through all the processes that the animals go through and ends up fast asleep.
   Looking back on the episode, Hilarie Burton said, "when we were doing the episode for "One Tree Hill" about the school shooting, none of the actors were into it, none of us wanted to do it. We got the script, we were very upset about it. Um, we were like 'This hasn't happened in so long. Why would we bring this up? We don't want to encourage or give attention to that kind of behavior.' Then literally while we're having this conversation with our creator and our bosses, two incidents happened. It was heartbreaking to know that stuff was still going on, it just wasn't receiving media attention that it used to."
   Section::::Lifespan, Maintenance and Waste management.
  
presuppositions: Being tired should make me fall asleep instantly. A person's level of tiredness solely controls one's ability to fall asleep.
corrections: Being tired isn't the only factor in making you fall asleep.  A person's level of tiredness is just one factor among many that controls one's ability to fall asleep.
raw_presuppositions: Being tired should make me fall asleep instantly. A person's level of tiredness solely controls one's ability to fall asleep.
raw_corrections: Being tired isn't the only factor in making you fall asleep.  A person's level of tiredness is just one factor among many that controls one's ability to fall asleep.