Sleep Soundly Every Night, Feel Fantastic Every Day (7 page)

 

 

Silence is the sleep that nourishes wisdom.

—SIR FRANCIS BACON

The recent decade of sleep research has shown that sleep is one cornerstone of your health. Like water, nutrition, and exercise, sleep is vital to your quality of life, your ability to focus and think, and even your ability to empathetically relate to people. People need seven to nine hours of sleep
each
night to allow biological systems the time they need to regenerate energy, balance stress, and consolidate memory and learning. Sleeping deeply enables your body to balance and renew tired or stressed systems. You awaken from this type of sleep feeling refreshed, focused, and ready for your day. Yet, according to a National Sleep Foundation poll conducted in 2012, Americans average less than seven hours of sleep on weeknights. For the majority of people who do not sleep deeply, the brain and body experience alarming, debilitating symptoms.

The two dimensions of sleep most important for you to know are
duration,
how long you can and need to sleep, and
depth,
your ability to reach and sustain uninterrupted deep sleep. You need to sleep long enough and deeply enough to give your body the time it needs to recharge, stabilize, and balance the internal functions. Think of what is required to recharge a dead car battery. First, you need a strong, uninterrupted charge that sparks the battery to regenerate power. The charge has to endure long enough to ensure that the battery is stable.

What we know of sleep comes from studying our brainwaves (with an electroencephalograh, or EEG), and our behavior, as we sleep. Normal sleep includes the sleeper moving from wakefulness through stages of lighter sleep to deeper sleep stages associated with delta frequencies, also referred to as slow wave sleep. The cycle repeats throughout the night.

1.
 
Stage 1, or non-REM 1 (non-rapid eye movement 1), is shallow and we are half-awake and half-asleep. Non-REM 1 is only supposed to comprise 2% to 5% of our sleep. An increase in this stage is a sign of sleep disturbance.

2.
 
Our sleep gradually deepens into Stages 2, 3, and 4 non-REM phases. These cycles are 80% of a night's sleep.

3.
 
Then we transition to REM (rapid eye movement) sleep.

After the short REM phase, we cycle back into non-REM stages, and the whole process happens again, with each cycle lasting between 90 and 120 minutes. Most people experience from three to seven such cycles per night. When sleep experts like me advise that you get enough sleep, we want you to pass through all three sleep stages, four to five times each night. A good eight-hour sleep allows you to move through five cycles.

REM sleep is characterized by rapid eye movements, paralysis of most muscles other than the diaphragm, and the presence of dreaming. REM sleep makes up about 20% of our sleep and tends to increase during the second half of the night. The first REM stage is short, maybe 10 minutes, and it becomes longer through each cycle, possibly up to 60 minutes. Dreams generally occur in the REM stage of sleep.

The standard unit of measure for any type and frequency of waves is hertz (Hz), which refers here to the brain wave cycles per second.

Understanding the sleep stages and cycles can help you plan when to go to sleep and when to awaken for maximum benefit. For example, if you tend to go bed at 11:00 p.m., read a book, and drift off to sleep about 11:30 p.m., your ideal waking time might be after four sleep cycles, which would bring you to 7:30 a.m. If you felt you needed more sleep, you would go to bed at 10:00 p.m. to allow completion of five sleep cycles. Four cycles of undisturbed sleep may render you fresher and feeling better in the morning than your friend's sleep of five cycles in which her cat disturbed her sleep on and off. Experiment to find out what works best for you.

For the majority of people who get inadequate sleep, the human brain and body experience alarming symptoms. The research is conclusive:

1.
 
The National Sleep Foundation estimates that over 30% of the population sleep less than six hours at night. What is the big deal, you ask? Sleep is a critical cornerstone of good health. Sleep is the opportunity for the body to restore balance. When that doesn't happen, internal systems break down over time.

2.
 
There is a direct relationship between the lack of sleep and the obesity epidemic. Insufficient sleep causes an increase in the release of
ghrelin,
an appetite-enhancing hormone secreted by the stomach that makes you want to eat. At the same time, it causes a decrease in the secretion of
leptin,
an appetite-suppressing hormone produced by fat cells. This, in addition to the fatigue caused by insufficient sleep, leads to weight gain. Unfortunately, this is a major problem in children as well, and is a contributing factor to childhood obesity.

3.
 
Insufficient sleep also causes insulin resistance, which can contribute to a diagnosis of type 2 diabetes. The American Diabetes Association is now publicizing the fact that adequate sleep is an important part of treating diabetes.

4.
 
Inadequate sleep also results in cognitive dysfunction and sleepiness. If you have insufficient sleep, you tend to underperform at work. You have difficulty concentrating, focusing, remembering, and you tend to become easily irritated.

5.
 
Breaking new research has found that lack of sleep and poor quality sleep can compromise your immune system and inhibit your immunological reaction to infection. In one study, people deprived of sleep for a few days following an influenza vaccine had a much lower immune response as measured by antibody production when tested two weeks after vaccination.

Abnormalities in your immune system's responses to fighting infections or diseases sometimes create inflammatory conditions such as allergies, asthma, heartburn, or ulcers. Chronic inflammation moves beyond the local organ or tissue, where it starts as a healing agent, and moves into the blood vessels and organs. When this happens, the changing characteristics of inflammation are now “systemic inflammation.”

In one sleep study, researchers tested and examined the participants' specific levels of three inflammatory markers. These three markers are associated with a higher risk of atherosclerosis, predisposing one to heart attacks and strokes:

1.
 
Fibrinogen (blood-clotting protein)

2.
 
Interleukin-6 (proinflammatory and anti-inflammatory cytokine)

3.
 
C-reactive protein (CRP levels in blood rise in response to inflammation)

Participants with poor quality sleep had higher levels in all three inflammatory markers while those who slept six to nine hours had lower levels. The conclusion of the study indicated:

1.
 
Poor sleep quality and short sleep durations are associated with higher levels of inflammation.

2.
 
Normalizing sleep quality and duration reduces the risk of inflammation in cardiovascular disease.

3.
 
There is a direct link between lack of sleep and hypertension and cardiovascular disease. If you are chronically sleep deprived, your body produces excessive amounts of the stress hormones adrenaline and noradrenalin. The result is progressive blood pressure elevations. Additionally, when you sleep, your average blood pressure drops by 10 to 15 points. Sleeping less deprives you of several hours of this important decrease in blood pressure that you should be experiencing every night. According to Professor Francesco Cappuccio of the University of Warwick Medical School: “If you sleep less than six hours per night and have disturbed sleep, you stand a 48% greater chance of developing or dying from heart disease and a 15% greater chance of developing or dying of a stroke.”

4.
 
Lack of sleep can exacerbate multiple sclerosis. A recent study revealed that cells that produce myelin, the nerve-insulating material that is destroyed in multiple sclerosis, double in production during REM sleep and are destroyed in sleep-deprived mice. (Because mice and humans share the brain's ancient circuitry, these findings are important to note.)

5.
 
There is a potential connection to Alzheimer's disease. Another recent study of mice showed that during sleep the process through which cerebrospinal fluid cleanses
the brain of harmful wastes such as beta amyloid, the protein affecting memory loss in Alzheimer's disease, increases tenfold. Lack of sleep compromises this process.

I cannot emphasize enough how an uninterrupted night of solid eight-hour sleep can help maintain good health and improve both emotional stability and mental functions.

Sandy appeared more than just tired during our consultation. The word
exhausted
came to mind, as I quickly scanned the dark circles under her puffy eyes. Her shoulders sagged as if she were holding the weight of the world. I welcomed her and asked, “How can I help you today? Are you not sleeping?” My bit of humor in asking if she had come to a sleep clinic because she wasn't sleeping well flew right over her head.

Rather, Sandy focused mentally on her story, and with scrunched brows, she began: “I am not sure I've slept well now for the past year—about the time my husband of 30 years needed emergency heart surgery. We got through that, and he gained back the weight he lost before the heart surgery. His snoring also returned because he now sleeps on his back. I seem to spend the night waking him up to ask that he turn on his side, and then I can't sleep at all.”

“Sandy, were you sleeping better before his heart surgery? Were your patterns of sleep different?”

“Hmm, well, thinking back, every time he gained a lot of weight, he snored more. So I woke up several times a night, and I tossed and turned a lot. I could tell when I was tired because I'd take a nap, pass out, and just be dead to the world … maybe about once a week. Now and then he tried to wake me up to make sure I wasn't dead.”

I laughed at her humor, but she did not. She was dead serious. My mind started clicking through my mental file of symptoms, checking for types of insomnia, possible patterns of sleep deprivation, and reviewing her sleep hygiene. I asked, “Sandy, did your husband come with you today?”

“No.”

“Any particular reason why?”

“I didn't want him to come. I want to find a way for me to sleep first, and then I can help him with any sleep issues. I read your sleep column in the paper on sleep apnea, and I think he might have that. But …”

I waited. She seemed to forget what she was saying. “Sandy, you were saying you wanted to see me first. Why is that?”

“Yeah. I did, and forgetting like that in the middle of conversation is one reason. I am forgetful. My brain is mush most of the day, although I seem to do okay at work. Sometimes I run home on my lunch break and just take a short nap. A power nap, I think it was called in a magazine. Even 10 minutes helps.”