The act of sleeping. Something so routine and overlooked may be the key to one’s health and well-being. Sleeping issues have plagued humans for centuries but today’s technological advancements are feeding an every growing monster. Lack of sleep can contribute to small things such as fatigue but can also facilitate more sinister of problems. On the other hand, advanced sleeping regimens can offer an performance advantage in the office as well as on the field.
A Sleep Sick Society
Sleep awareness was a second rate concept for many years and was nearly nonexistent in the medical community. Thanks to pioneers, such as Dr. William C. Dement, we have come to understand the importance that adequate sleep plays in the function of the well-oiled machine we call the human body. However, in order to appreciate the benefits of sleep, we must recognize the current issues and trends in society today. Dr. Dement, who is considered by many as the pioneer in sleep medicine speculates that half of us mismanage our sleep to the point where it negatively affects our health and safety and that, on average, each of us sleeps one and half fewer hours each night than our great-grandparents did a century ago. In his book, The Promise of Sleep, he states:
"Study after study has revealed that people who are chronically sleep deprived can be completely unaware of the root cause of their overwhelming fatigue. Many people conclude that being run down, apathetic, and glum, must be the normal human condition, or can be attributed to boredom, warm rooms, or heavy meals."
- 50-70 million US adults have a sleep disorder
- 37.9% reported unintentionally falling asleep during the day at least once in the preceding month
- 4.7% reported nodding off or falling asleep while driving at least once in the preceding month. Drowsy driving is responsible for 1,550 fatalities and 40,000 nonfatal injuries annually in the United States.
- 48.0% of adults report snoring
- 25 million US adults have obstructive sleep apnea
- 100,000 deaths occur each year in the US hospitals due to medical errors and sleep deprivation have been shown to make a significant contributing.
The evidence that we are malnourished sleep wise is concrete. The exact mechanisms for why, however, is not. Before we can lay blame to our habits and rituals, it helps to understand what happens while we sleep.
Stages of Sleep
During sleep, the body cycles between 4 non-REM (rapid eye movement) stages and one REM stage totaling 5 stages. Throughout the night, the body will go through these 5 stages 4-6 times, spending an average of 90 minutes in each stage. Stage 1 and 2 (non-REM) are considered light sleep while 3, 4, and REM are labeled as deep sleep. Each stage serves a unique restorative function which means it is crucial to properly cycle through each stage. The following is a brief description of each stage:
- Stage 1 – Often called the transitional phase. In this stage, we may be partially awake as our mind begins to drift into light sleep. This is also the stage of sleep where we experience hypnic myoclonia, which is when your muscles involuntarily jerk. Many embarrassing moments have gone down in history as a result of this reflex!
- Stage 2 – Our heart rate begins to slow, our core body temperature decreases, eye movement stops, and our brain waves slow down. We spend about 50% of the night in stage 2.
- Stages 3 and 4 – Called slow wave sleep and is our deepest sleep that is often very hard to wake up from. Our blood pressure drops and our breathing becomes deeper, slower, and more rhythmic. Our body is immobile at this point but our muscles can still function such as when we sleepwalk. During these stages, hormones are released to aid in growth and appetite control thus making it an important stage for rejuvenating the body.
REM – The dreaming stage. Eye movement dramatically increases and our brain is bursting with activity. Adults spend about 20% of the night in REM sleep. REM sleep is crucial for revitalizing the brain and allowing for sharper focus for the day.
Sleep Debt - Myth or Real?
Most people have probably said at one point in their life that they need to “catch up on their sleep” but is this accurate? Based on several scientific studies, not only is the possibility of sleep debt real, its effects can be detrimental. Dr. Dement describes sleep debt as “nature’s loan shark”. Generally, people need to sleep one hour for every two hours awake which translates to roughly 8 hours a night. Of course, some people need more and some need less, and a few people require a great deal more or less. The premise is that if an individual only gets 6 hours of sleep a night they will end up with 14 hours of sleep debt by the end of the week. Sleeping in over the weekend can help reduce the debt but is not enough to overcome the total burden.
Essentially, all wakefulness is sleep deprivation. Like hunger and food, when the former increases to a considerable level the latter is all that the individual will desire. It is easy to understand sleep debt in great scales, such as pulling an all-nighter to study. However, studies are revealing the effects of minor sleep debt which can range from subtle problems like sleepiness to more significant issues like insomnia, stress, and anxiety.
How can I get good sleep at night?
Well for starters, make sleep a priority like you would diet and exercise. In fact, quality sleep may be the missing link to achieving your fitness and performance goals. My biggest recommendation is to establish a night time routine that consists of winding down and relaxing. These routines should also consist of avoiding stimulatory mediums like cell phones and TV’s. The following are some Do’s and Don’ts for assuring a quality night sleep:
DO'S for a Good Night's Sleep
- Have a set "bed time" that consists of a winding down process with a goal to be in bed by a certain time. The can consist of drinking night time tea, reading a book, planning for the next day, light stretching, etc.
- Investing in a good mattress. You spend roughly a third of your life in bed so get something that works for you. This does not mean it has to cost a fortune. I purchased a king sized mattress from Tuft and Needling for under a $1,000. They allow a 100 day trial period (at that time at least) and even ship the mattress to your door! I always recommend that people sleep on a newly bought mattress for a few weeks at least to make sure it works for them.
- Use supplements and other tricks (Check with your doctor before starting any supplements). Melatonin can help with the process especially if you work night shifts or have jet lag. Essential oil products can help with some relaxation. Try lavender and peace and calming.
- Have a bedroom temperature set between 60-67 degrees. Decreasing your body temperature can help with falling asleep.
- Read a book. The act of reading in a quiet setting sets the mood for a restful night.
DON'TS for a Good Night's Sleep
- Avoid alcohol before bed. Although alcohol can help you feel sleepy, the metabolism that occurs can disrupt your sleep cycles, interrupt circadian rhythm, block REM sleep and aggravate breathing problems. In addition, it results in increased bathroom trips.
- Limit caffeine intake to 300 mg to 400 mg and avoid intake at least 6 hours before bed.
- Eating large portions of crappy food before bed. Small snacks consisting of protein and complex carbs may help you sleep better.
- Avoid stimulatory activities and mediums. Avoid planning for the next day if this is generally a stressful process. I tend to read a fictional book before bed because it helps me take my mind somewhere other than clinic and business.
- Avoid blue light during the winding down process. Objects that contain blue light are cell phones, tablets, computers, and TV’s. Blue light suppresses melatonin production and interferes with your normal circadian rhythm.
The biggest violator to good sleep in our society is the increased blue light and stimulatory activities before bed which often results in an increased time to fall asleep. Also, the workaholic mentality that is a hallmark of our country is silently destroying us. Pushing our work into the late hours of the night all but virtually guarantees starting the next day with a struggle.
You Owe Yourself a Good Night's Sleep!
So put down your phones and make an attempt to get around 8 hours a sleep a night. Plan ahead and coordinate an effective routine to get you on track in the evenings. If there are potential medical problems preventing quality of sleep, then seek help from a medical provider. If you are unsure of whether or not you are sleeping well, a well-executed sleep study may uncover more than you think. You owe it to yourself and your family to operate on a full tank. And, you just might find that your low back pain and headaches improve quite a bit.
Originally posted 03/05/2018
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