with Choice Nutrition's Dr. Evan McCarvill, ND
My goal in this article is not just to dispel this stigma, but to even flip it on its head. After you learn of the essential functions carried out by our daily sleep phase, and after you learn of the long-term health consequences of not getting enough sleep on a regular basis, my hope is that you will no longer be willing to compromise on your daily eight hours.
We've all heard the basic rule of thumb that we should aim for eight hours of sleep per day and after you've been awake for sixteen hours or so, certain biological sensations compel you to seek rest. So it is not like this is news to us.
Our culture tends to view sleep as little more than an inconvenience.
To give one's body an abundance of opportunity to rest and rejuvenate is considered “lazy”. It is considered a “badge of honour” when someone works long hours, and gets by on merely six hours of sleep, or even less.
According to Matthew Walker, a sleep scientist at the University of California, Berkely, “No aspect of our biology is left unscathed by sleep deprivation,” and that our culture is in the midst of a sleep loss epidemic. The urgency and extent of the issue, he says, should not merely even be left to the individual, but rather there needs to be substantive change to our workplace attitudes and institutions, perhaps backed up by government intervention.
Back in the early 20th century, less than a tenth of people were trying to survive on less than six hours of sleep per night. But now, almost one in every two people are getting by with so little sleep. And two thirds of adults in developed nations are failing to get the recommended eight hours. So many of us just compensate with coffee, in order to get ourselves moving in the morning.
So what happened? Well in general, there are more electric lights keeping us stimulated late into the night, than there were in the 1940s. We are a lonelier and more depressed society, so anxiety is a major factor for many people. And then there is our work attitude. We work long hours, but then also want our time with family and entertainment. The thing we end up compromising is the time we take for sleep, because we apparently consider it a lower priority.
What happens when we sleep:
We generally think of sleep as this period during which we are simply in this coma-like state where not much happens. The “real” action happens when you're awake, and so that is what to prioritize. But think again.
As Doctor Matthew Walker explains, “During NREM sleep, your brain goes into this incredible synchronized pattern of rhythmic chanting. There’s a remarkable unity across the surface of the brain, like a deep, slow mantra.” Imagine hundreds of thousands of neurons in your brain singing together in synchronized waves of activity and inactivity. This is the brain undergoing vast amounts of memory processing. On the other hand, REM (rapid eye movement) sleep is associated with brain activity more akin to one who is awake. The heart and nervous system go through spurts of activity. It's not entirely clear why, but this is typically considered the dreaming state.
All of this activity while asleep helps your brain work properly. The brain is consolidating memories of the previous day, and preparing for the next day. Each NREM and REM alternating cycle takes approximately 90 minutes, and you want four or five such cycles each night in order for your brain to complete its process. This is where we get the 7.5 to 8 hours of recommended sleep each night. Power naps can sometimes take the edge off of drowsiness, but they are not enough to gain the benefit of a proper night's sleep.
Certain brain activities have been shown to be altered in sleep-deprived individuals. With insufficient sleep, there may be trouble with solving problems, making decisions, and regulating your impulses and emotions. Depression, suicide, addictions, and risk-taking behaviour have also been linked with sleep deprivation. In psychiatry, it is widely believed that various mental disorders cause sleep disruption, but it may well be that the line of causality is the other way around. Ensuring good quality regular sleep can improve the health of, say, someone suffering from anxiety or bipolar disorder.
Many people are not aware of the drawbacks of sleep deficiency, and may not be aware of the signs of sleep deprivation. Drowsy drivers may well feel like they can drive perfectly well, but studies have shown that sleep loss can compromise one's driving ability at least as much as being drunk. Sleepiness is a factor in 100,000 car accidents each year, accounting for some 1,500 deaths, according to some estimates. If you drive a car when you have had less than five hours’ sleep, you are 4.3 times more likely to be involved in a crash. If you drive having had four hours, you are 11.5 times more likely to be involved in an accident. All lines of work can be affected this way, including students, lawyers, healthcare workers, pilots, and mechanics.
When we have the flu, our first instinct is to go to bed, because our body is trying to “sleep” itself healthy again. Sleep has a potent effect on the activity of the immune system. Your resilience to infection is dramatically reduced from even one night of lost sleep. If you are tired, you are more likely to catch a cold, but if you are well-rested, you are not only less likely to catch a cold, but also more likely to respond to the flu vaccine.
Natural killer cells are a kind of white blood cell that is very important for the detection and destruction of the cancer cells that pop up in your body every day. These life-protecting natural killer cells drop in number by about 70% after just one night of only four or five hours of sleep. Lack of sleep has been linked to the incidence of various kinds of cancer, including bowel, endometrium, prostate, and breast. The World Health Organization has even classified night-shift work as a probable carcinogen.
There are more than twenty epidemiological studies that have come to the same conclusion about sleep; the shorter your sleep, the shorter you are likely to live. Adults aged 45 or older are 200% more likely to experience a heart attack or stroke in their lifetime if they try to survive on less than six hours of sleep per night.
A big part of this trend has to to with blood pressure. Heart rate and blood pressure are distinctively higher in individuals who are sleep-deprived. An adult sleeping only 6.75 hours a night would be predicted to live only to their early 60s without medical intervention.
Additionally, sleep is involved in the healing and repair of micro-tears that can form in your heart and blood vessels. Chronic inflammation, lack of healing, and thus accumulation of such micro-tears in the blood vessel walls, leads to atherosclerosis, high blood pressure, and increased risk of heart disease and stroke.
In 2011, there was a study of male Japanese factory workers which showed that there was a five-fold increase in risk of heart attack over a 14 year period in those individuals who slept less than six hours per night, compared with those who got seven to eight hours per night.
The development of Alzheimer’s disease is associated with the accumulation in the brain of toxic protein bundles or “plaques”, called amyloid deposits, which tend to kill the surrounding brain cells. These amyloid deposits are effectively cleared from the brain during deep sleep.
From this, it is clear to see how getting too little sleep over your adult life span can increase your risk of developing alzheimer’s disease. With chronic sleep deprivation, these plaques build up, especially in the regions of the brain normally active during deep sleep, attacking and degrading them. With these brain regions thus degraded, deep sleep becomes more difficult to accomplish, and without it, even more plaques accumulate. And so it becomes a vicious circle. It is noteworthy, anecdotally at least, that both Ronald Reagan and Margaret Thatcher would go on to develop the disease, while in previous years were vocal about how little they “needed” to sleep. Sleep aides our capacity for learning, and our ability to make new memories.
The cells of sleep-deprived individuals have been shown to be less responsive to insulin, and thus can predispose to a pre-diabetic state of hyperglycaemia. Insufficient sleep also decreases levels of leptin, a hormone important for signalling satiety, and increases ghrelin, which is the hormone that signals hunger. It is therefore easy to see how sleep deprivation can predispose to excessive snacking, and to weight gain.
If you are trying to lose weight through diet and exercise, but you are only sleeping five or six hours per night, 75% of your weight loss will be lean body mass, and only 25% of your weight loss will be actual fat. However, if you are getting enough sleep, fat accounts for 50% of weight loss. Many sleep deprived people report difficulty with losing weight, or they report an experience of slow weight gain.
MY PROFESSIONAL TWO CENTS
FIRST, people should avoid pulling “all-nighters”,
at their desks or on the dance floor. After being awake for 19 hours, you’re as cognitively impaired as someone who is drunk, and so the “extra” time you are putting in as not of the same quality anyway.
SECOND, they should change their attitude toward the value of sleep, and think of it as another form of work; like going to the gym for the sake of your brain and memory. If you use an alarm to wake you in the morning, then consider using an alarm to signal a non-negotiable bedtime. Start thinking of midnight more in terms of its original meaning; as the MIDDLE of the night!!!
AND I WILL GO EVEN FURTHER!
Schools should consider later starts for students, as these correlate with higher IQ scores. Companies should think about rewarding sleep, as on balance, productivity will actually rise. Sleep can be measured using tracking devices, and some far-sighted companies in the US already give employees time off if they clock enough of it.
CHECKLIST FOR THOSE WITH SLEEP PROBLEMS:
- Take a good look at your sleep hygiene. Organize your environment and lower your activity level to promote sleep as bedtime approaches.
- Dim lights as bedtime approaches. Turn off ceiling lights and switch to floor and table lamps to create a dimmer and more relaxing ambience in the final hour before bedtime.
- Avoid stimulating your eyes with television, computer screen, tablets, or smartphones for an hour before bedtime.
- Skip caffeine after noon; not only coffee, but also soda, chocolate, and certain herbal teas also contain caffeine!!
- Avoid alcohol and heavy meals within three hours of bedtime.
- Regular exercise is great for promoting sleep at the appropriate time of day. Though try to complete your strenuous exercise prior to five or six hours before bedtime. It is probably best to restrict exercise to the morning, before your day begins.
- A hot bath or shower a half hour before bedtime can also promote sleep.
- People with less severe sleep apnea may be able to get their symptoms under control by just adopting strategies that prevent them from sleeping on their back, for example sewing a tennis ball into the front pocket of a T-shirt and wearing it backwards. There are even shirts that you can buy with built in padding to prevent back sleeping.
Hopefully, with this information in hand, you can find NEW motivation and NEW strategies to promote abundant sleep for yourself in our currently sleep-deprived world.
Have a good night!
Yours in health,
Dr. Evan McCarvill, ND
P.S. Sometimes sleep problems are caused by underlying health issues or if you have concerns you would like to discuss with our doctors - please give us a call today. Our mission is to investigate root causes of disease and we are proud of the results we have been achieving for our clients - since 1993!
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