What’s the craziest thing you’ve ever done in your sleep? If you’re like most people, it’s probably pretty tame, like saying something strange or sleepwalking. According to a new book by Dr. Guy Leschziner, a London-based sleep specialist and neurologist, though, some people do pretty bizarre things in their sleep.

Dr. Leschziner speaks of people who ride motorcycles, cook, eat, or have sex while sleeping. These things happen because different parts of the brain aren’t always in the same stage of sleep at the same time.  Some patients experienced a lifetime of choking at night, only to be diagnosed later with nocturnal epilepsy. There are even people who have cut their own throats while asleep. The condition that’s most puzzling to Leschziner, though, is Kleine-Levin syndrome. In this disorder, young adults experience days or weeks of deep sleepiness, confusion, and strange behavior for seemingly no reason, and then after a few years, the condition disappears. He notes that while some of these incidents and conditions may sound funny, they can be life-changing. They may result in major injury and in at least one case, something done in a person’s sleep led to a criminal conviction.

How do you protect yourself from this kind of nocturnal activity? There’s a genetic component at play, but sleep disruption also factors in. Leschziner recommends staying away from medications if you’re experiencing insomnia. Instead, try to address the underlying issue, perhaps with cognitive behavioral therapy. He also frowns on the use of smartwatches and other devices to self-diagnose sleep disorders. Using these devices to track exercise and diet is productive because these areas can be improved. Because sleep is a passive process, though, focusing on your poor-quality sleep may provoke anxiety, which leads to worse sleep.

Sleep is impacted by a variety of factors: biological, psychological, behavioral, and environmental. Physical and mental health, as well as how waking hours are spent, have an effect on sleep. It’s also important to have positive associations with your bed. Good sleepers tend to think of their beds as cozy, comfortable places to drift off to sleep and wake up refreshed, whereas insomniacs may dread going to bed to an extreme degree. Leschziner recommends reading before sleep, to reduce light exposure while keeping your mind a little bit active, to help you get into the right frame of mind to drift off.

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