World Sleep Week

It’s World Sleep Week….grab your pillow and take a snooze to celebrate! As I write this, I am reminded how often I tell my 3-year-old “you won’t always fight to take a nap.” But seriously, why is sleep so important, and why is a there a week dedicated to making us aware of how important a good night’s sleep truly is?

For starters, we spend a third of our lives asleep. Just as food and water are important to our health, restful restorative sleep is vital to our physical and mental health. And like much in life, quality is more important than quantity. There are three essentials to good, quality sleep:

1. Duration – Total length of time while asleep, where the sleeper feels alert/rested the following day

2. Continuity – No fragmentation in sleep, the more fragmentation throughout the night, the less rested you will be

3. Depth – REM cycles and are you in deep, restorative sleep

How does sleep help?

The body uses sleep as a rebuilding time. Your body produces more protein while sleeping and repairs damage caused by stress and ultraviolet radiation. Studies have shown that reduced or impaired sleeping can increase your stress hormone or cortisol levels. Per the NIH, sleep supports good brain function and learning. During sleep, the body is forming more neural pathways to help with learning and problem-solving skills. Sleep can help with better decision making as well as creativity. Proper sleep also helps to decrease inflammation, which has far reaching effects on many of your body’s systems. 1

However, when we think of sleep, or lack thereof, we generally are looking at the effects of sleep deprivation. So… what’s so bad about not getting enough sleep, and how is it defined? According to the NIH, “Sleep deprivation is a condition that occurs if you don’t get enough sleep. Sleep deficiency is a broader concept.” It occurs if you have one or more of the following:

• You don’t get enough sleep (sleep deprivation)
• You sleep at the wrong time of day (that is, you’re out of sync with your body’s natural clock, i.e., circadian rhythm is disordered)
• You don’t sleep well or get all of the different types of sleep that your body needs
• You have a sleep disorder that prevents you from getting enough sleep or causes poor quality sleep 1

The CDC reports that 7-19% of Americans are not getting enough sleep, and about 70 million Americans suffer from chronic sleep problems.2 The consequences of sleep problems are linked to:

• Increased risk of heart disease, high blood pressure
• Increased risk of developing diabetes mellitus
• Increased risk of cancer (breast in women, prostate in men)
• Decreased memory and attention span
• Increased depression and anxiety
• Impaired driving and automobile collisions

Sleepiness can impair driving performance as much or more so than alcohol.3,4 Children are not immune to the consequences of sleep deficiency. For instance, researchers have found that there is a link between poor sleep duration and childhood obesity. These findings are more apparent in girls.5,6

What can you do to get a good night’s sleep?

For most people, you need to work on good sleep hygiene. In medical school, my study partner introduced me to this concept (in an effort to help us with test anxiety and concentration)!

1. Limit daytime naps to 30 minutes

2. Avoid stimulants like caffeine and nicotine before bedtime, and reduce alcohol intake

3. Get at least 10 minutes of exercise a day (however, avoid strenuous exercise right before bed)

4. Avoid foods that can cause heartburn (fried/fatty or spicy meals, tomato-based foods, citrus fruits/juices, and carbonated drinks)

5. Establish a bedtime routine (just like a kid has their bath time then bed, so should you! Take a bath, read a book, practice relaxation techniques)

6. Optimize your sleep environment (black out curtains, turn off the lights, turn off the TV, adjust blue light on cell phone)7

However, if you are unsure if you have a more significant issue with your sleep, you may need a proper workup from your doctor. You can begin by keeping a sleep diary. For instance, if you suffer from excessive snoring, then you may have a condition known as obstructive sleep apnea. For a proper diagnosis, a physician will order a sleep study. Most of these can now be performed in the comfort of your home with a small nasal appliance. If you are found to have obstructive sleep apnea, then you may be prescribed a mouth appliance or CPAP machine. Proper use of a CPAP has been shown to improve glucose utilization for patients with diabetes. Additionally, if patients have issues with restless legs, there are medications that have been found to help.

There are a variety of reasons why you may have difficulty sleeping. What is important is to recognize the issue and seek treatment. For additional information on sleep and sleep disorders, go to:

NIH’s guide to healthy sleep

https://www.nhlbi.nih.gov/health-topics/all-publications-and-resources/your-guide-healthy-sleep

References
1. https://www.nhlbi.nih.gov/health-topics/sleep-deprivation-and-deficiency
2. https://www.cdc.gov/sleep/about_us.html
3. Dawson, D. and K. Reid, 1997. Fatigue, alcohol and performance impairment. Nature, 338:235.
4. Powell, N.B., Schechtman, K.B., Riley, R.W>, et al, 2001. The road to danger: the comparative risks of driving while sleepy, The Laryngoscope, 111:887-893.
5. Yu Y, Lu BS, Wang B, Wang H, Yang J, Li Z, Wang L, Liu X, Tang G, Xing H, Xu X, Zee PC, Wang X. Short sleep duration and adiposity in Chinese adolescents. 2007 Dec 1;30(12):1688-97
6. Gozal D. et al, 2011 Pediatrics. In press
7. https://www.sleepfoundation.org/articles/sleep-hygiene