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In Post #59, I talked about the lifestyle choices that are important to maximizing health and lifespan:
1. Benchmarking Health
2. Nutrition
3. Exercise
4. Maintaining Musco-skelatal Integrity
5. Maintaining Mind-body Connection
6. Enhancing and Maintaining Brain
7. Stress Management
8. Adequate Sleep
9. Social Engagement
10. Purposeful Living
11. Making full-use of all modalities of medical care
12. Make use of Genetics Science
These were of course not in any particular order. For example, Adequate Sleep would rate much higher in priority, probably towards the top. After all, most of us cannot even function if deprived of sleep over even a few days.
I recently read the book, Why We Sleep by Mathew Walker, Ph.D. He is a professor at University of California Berkeley and has dedicated his career to research in sleep. This is a pretty definitive book on sleep and covers the topic from almost all angles.
I have been generally aware that 7 to 9 hours of sleep is considered a must for optimal health. And, since I learned that I do make the effort to catch that much sleep and when I don’t I would make effort to catch up on that sleep during the weekends.
However, reading this book has been seriously eye opener for me. As a result, I am taking sleep as a lifestyle choice for living for optimal health now much more seriously than I used to.
Sleep Myths – Busted
Here are some myths about sleep that the research cited in the book has busted for me.
1. I can live quite well with 6 to 6.5 hours of sleep. Dr. Mathews is very definitive on research that the range of sleep for optimal health for healthy adults is between 7 to 9 hours. Of course, children have different needs for sleep and so do sick people to allow their body to recover.
He also makes distinction between “opportunity to sleep”, e.g., how long I kept my head on the pillow, and actual sleep. So, if I was “in bed” for 7 hours, it took me half an hour to fall sleep, I got up twice to go to the bathroom and each time it took me half hour to fall back to sleep, then I slept for 5.5 hour. There is some research that more than 9 hour sleep is not optimal, but that research is still controversial.
One test for adequate sleep is that if during the day you close your eyes and see yourself falling asleep, then you are not getting enough sleep.
2. Early morning sleep is more important that the late-night sleep. There are two broad categories of sleep: Rapid Eye Movement or REM happens when we are in deep dream state. In early sleep cycles, which generally happen before and shortly after mid night, most of the sleep is not REM or NREM. In early morning hours, sleep is mostly REM. Each REM and NREM have their very distinct function for brain and our physiology and we need both. The following figure from scielo.br illustrates how amount of REM sleep increases as the sleep progresses and NREM shown here as Stages 1 through 4 decreases.
In NREM sleep, for example, our brain takes information stored in short-term memory and shuffles it over to the long-term memory regions of the brain. In REM sleep then our brain builds interconnection with pre-existing long-term elements. If we miss NREM sleep, short-term memory buffers get over-written. If we miss REM sleep, we don’t get a chance to develop ways to access and use the information on the long term.
3. If I don’t sleep enough during the week day, I can always catch up during the weekend. From the REM and NREM sleep discussion above, you can probably quickly extrapolate that if we short change sleep, certain functions are not optimal on a daily basis. Information once lost, probably is lost forever – unless of course you relearn it.
Sleep is driven by two cycles: Circadian clock and a hormone Adenosine, see the picture below (from hackyourgut.com). Circadian clock drives our urge to awake while adenosine drives our urge to sleep. Adenosine only goes up after we wake up until we clear it again during sleep. More adenosine in our body the more is our urge to fall asleep. Our body’s energy level changes with change in circadian rhythm. When energy is increasing, we have the urge to wake up.
When we skip sleep, it feels that we have energy to keep going based on our circadian clock. But we may still have the urge to sleep because adenosine is still high. So, when we sleep extra during the weekend, we are clearing up any residual adenosine which clears the urge to sleep. So, we feel like we have caught up on sleep. But remember, we did not really catch up on the mental benefits of sleep for memory capture and reorganization. And, that is the missed opportunity, when we try to catch up on sleep during the weekends.
4. Alcohol and sleeping pills can make you sleep better. Alcohol makes you sleepy, so clearly it must make you sleep better. Right. Wrong. Both alcohol and sleeping pills have similar effect on the brain. They are sedatives and make you drowsy by shutting down you neo-cortex, i.e., thinking brain, activities. When monitored, your brain does not have the same physiology as if you were sleeping in either REM or NREM sleep. Hence, you find that people who take sleeping pills or night caps as sleep aids, are often groggy, lacking motor skills, lethargic, and forgetful during the next day.
5. If I am short of sleep, I will know so I can correct it. And, that is the same thing someone who is drunk would say, ”I am not drunk. I don’t feel drunk.” We just discussed above the effect of alcohol on the thinking brain, which is also the decision-making brain. Lack of sleep has exactly the same effect as being drunk. And, that is one of the reason, lack of sleep leads to car accidents.
In fact, did you know, lack of sleep causes more accidents than drunk driving. If you have slept only 4 hours or less the previous 24 hours, your chance of car crash increase by a factor of 10.
And, if you are short of sleep, it is the micro sleeps that make driving fatal. if you are sleep deprived, brain just shuts down for a second or two. And, a second or two while going at 60 miles an hour is sufficient to cause serious crashes.
6. Coffee, slapping myself, or loud music can keep me going: Turns out that research shows none of these are effective at preventing micro sleeps. The only thing that is found effective is, you pull over, stop and take a nap.
7. Caffeine is not a problem, if don’t ingest caffeinated drinks at dinner time. Half-life of caffeine is 8 hours. So, it can take up to 16 hours to purge effect of just a cup of coffee from the body. So, any caffeinated drink after lunch can probably disrupt the sleep and should be avoided to obtain highest quality of sleep.
8. Melatonin will help me sleep better. Actually this is yes and no depends upon the nuance. Melatonin does not improve the quality of sleep. It does, however, tell your brain and body when it is time to go to sleep and to start to get ready. Generally, it is released as the darkness sets in.
In our modern worlds, where darkness hardly sets in or if our body clock is messed up due to jetlag from travel, it may be helpful to have melatonin supplement to tell the body that it is time for bed. Dimming lights and shutting down screens (TV, smart phones iPads, laptops) as the bed time appraoches is an excellent way of getting your body to start producing its own melatonin.
If you do take mealtonin supplements, just be warned that melatonin pills available over the counter have great variability in the melatonin content when you compare actual vs. printed on the label. In one test, FDA found -89% to +473% variability. I recently learned that a great source of melatonin is raw pistachio. Just a few kernels of pistachio release enough melatonin that is in most pills. Check out this link from NutritionFacts.Org.
Sleep Hygiene – Best Method to Improve Quality of Sleep
Instead of taking any sleeping pills, Dr. Walker recommends the same sleep protocol that NIH recommend, see NIH published Your Guide to Healthy Sleep,
1. Stick to a sleep schedule.
2. Exercise is great, but not too late in the day.
3. Avoid caffeine and nicotine.
4. Avoid alcoholic drinks before bed.
5. Avoid large meals and beverages late at night.
6. If possible, avoid medicines that delay or disrupt your sleep.
7. Don’t take naps after 3 p.m
8. Relax before bed.
9. Take a hot bath before bed.
10. Have a good sleeping environment.
11. Have the right sunlight exposure.
12. Don’t lie in bed awake.
13. See a doctor if you continue to have trouble sleeping
Summary
Sleep is way at the top of lifestyle choices for optimal health. Statistics show again and again that most of us do not get enough sleep.
Dr. Mathew Walker’s book Why We Sleep is a great book if you want to learn about latest on every aspect of sleep. NIH published Your Guide to Healthy Sleep is also a great resource that summarizes healthful practices.
In this post, I covered several myths on sleep
1. I can live quite well with 6 to 6.5 hours of sleep
2. Early morning sleep is more important that the late-night sleep
3. If I don’t sleep enough during the week day, I can always catch up on the weekend
4. Alcohol and sleeping pills can make you sleep better
5. If I am short of sleep, I will know so I can correct it
6. Coffee, slapping myself, or loud music can keep me going
7. Caffeine is not a problem, if don’t ingest caffeinated drinks at dinner time
8. Melatonin will help me sleep better
If you want to improve the quality of your sleep, check out the 13 step Sleep Hygiene protocols that I summarized above. Dr. Walker and NIH recommend this method of improving your sleep quality and is proven to work better than sleeping pills.
NIH published Your Guide to Healthy Sleep and Dr. Walker’s book have more details on this method of improving sleep quality.
What do you think?
Have you learnt something about sleep, that you can share?
I would love to hear from you and learn from you.
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