By MICHAEL SHAPIRO, PhD
I once heard sleep compared to a fickle girlfriend: when you want her and need her, she’s nowhere to be found. When you don’t want her around, there she is (before you ladies get indignant…this is just a metaphor. The same could certainly be said of a boyfriend!). Very few biological activities (other than sex, perhaps) have been sought after so rigorously or been the subject of so much attention. Sometimes we yearn for it deeply. Sometimes we resent it and fight it with all we’ve got. In the end, however, it always wins.
Most people spend about a third of their life asleep. That means that if you live to be, say, 75 years old and are lucky enough to sleep 8 hours per night, you will have been unconscious for about 25 of those years, or 9125 days.
Have you ever wondered why so much of our time on this earth has to be devoted to sleep? Doesn’t it strike you as a huge waste of time? The fact is, while you’re asleep, your body is very busy doing lots of restorative work. Sleep is sort of the custodian on the night shift at the museum, charged with repairing and maintaining the facility while no one is using it. This takes time: during deep sleep, your body works to repair cells in your muscles and organs. Chemicals that strengthen your immune system start to circulate in your blood. In addition, hormones that regulate appetite (ghrelin and leptin) are balanced. Consequently, when we’re sleep deprived, we feel the need to eat more, which leads to weight gain.
Not only does your body stay busy during sleep, but your brain is (as always) hard at work: sleep consolidates and strengthens memories that you’ve formed throughout the day, and newer memories are linked to older ones during sleep. Of course, your brain is also busy dreaming! No matter what you may have heard, and despite the many advances in the psychological and biological sciences that have occurred since Freud theorized that dreams are a manifestation of subconscious fears and desires, no one is absolutely sure why people dream. However, we do know that while you dream, your arm and leg muscles become temporarily paralyzed, thereby preventing you from acting out your dreams (thank goodness)!
So, while much about sleep remains a mystery, we do know that it’s critically important to life. Although we actually need less sleep as we age, the research suggests that adults should get no less than 7 hours of sleep per night to maintain optimal health. Unfortunately, the invention of the electric light bulb in 1879 forever changed the course of sleep history. Ever since then, humans have been able to cheat sleep by staying awake and staying active well past sunset, which is nature’s cue for the body to begin to settle down. Now, in the 21st century, this situation is made even worse by television, computers, smart phones, and other distractions that prolong the “day” and keep our brains busy, well past the time we should be resting.
In fact, research indicates that anywhere from 35% to 50% of adults get less than the recommended 7 hours of sleep per night. In addition to contributing to obesity, this “insomnia epidemic” increases the risk of many other health problems such as hypertension, stroke, and psychiatric disorders (like depression and dementia). One study has even suggested that sleeplessness results in the loss of certain brain cells in the part of your brain that regulates stress and panic! There is also an increased risk of death by accident: if you haven’t been getting enough sleep, your brain will go into “microsleep,” which is an uncontrollable, brief episode of sleep that can last anywhere from a fraction of a second to a full 10 seconds. Of course, the results can be fatal if a microsleep occurs while you’re behind the wheel or operating machinery!
Now that I’ve described the dangers of sleeplessness in gory detail, you’ll probably lie in bed tonight with eyes wide open, ruminating about why you’re not asleep…but don’t panic! Here are some hints for maintaining good “sleep hygiene,” which is the modern term for the habits and practices that are conducive to sleeping well on a regular basis:
- No screens! For my patients, I recommend turning off all screen devices at least 30 minutes before going to sleep, because light from those devices disrupts the body’s internal “clock.” You may have heard that only blue light is harmful to sleep, which is why some devices have a setting that allows you to filter or minimize light in the blue wavelength. However, don’t be fooled…all light stimulates the brain and disrupts circadian rhythm. Find something else to do besides looking at a screen! You may want to try one of those old-fashioned leafy things…um, what are they called? Oh yeah, books! Just use a soft white light to read by until you feel sleepy.
- No alcohol! Although a beer or a shot of your favorite spirit might help you fall asleep, alcohol disrupts normal sleep “architecture” (the phases of sleep) and blocks you from getting enough REM sleep (which is considered the most restorative phase of sleep).
- Create a good sleep environment. For optimal sleep, the temperature of your room should be between 60 and 67 degrees. Cold? Yes, but it has been shown that the cooler environment helps stimulate sleep (much like hibernation) and allows your body to cycle naturally through the various sleep stages. It is also good to use “blackout” window coverings that keep any ambient light from messing with your sleep.
- Adopt a schedule that is conducive to sleep. Make it a point to set your “go to bed” and “get up” times at least 7 hours apart. In other words, as far as I can tell, it takes at least 7 hours to get 7 hours-worth of sleep.
- If you can’t sleep, get out of bed! Much like Pavlov’s famous dogs learned to associate the sound of a bell with the coming of food, we tend to make associations (over time) between our experiences and the environment in which those experiences occur. So, if you lie awake in bed with your eyes wide open, feeling mounting anxiety and panic as you hear (or see) the clock counting down to “wake up time,” you will eventually begin to associate your bed (and bedroom) with sleeplessness, rather than sleep. Then, the prospect of going to bed each night will become terrifying, as if you’re being sentenced to time in a torture rack! If you’re not sleeping, don’t just lie there: get out of bed, go sit in a chair and read until you feel sleepy, and then try again (as you can tell, I’m a big fan of reading to promote sleep: it focuses your mind and gets you to stop thinking about anything else. Just make sure the book is fun and entertaining…no college texts or political treatises!).
Even when you begin to use good sleep hygiene, you may still find it hard to fall into a health sleep-wake pattern (old habits die hard). Also, there are a number of medical conditions that interfere with sleep, such as chronic pain, sleep apnea, or restless leg syndrome. You should consult with your family doc or primary care provider to rule out or deal with any of these conditions. For some people, a prescription sleep aid may be appropriate just to get the sleep-wake cycle back on track: for example, medications like Ambien and Lunesta have become especially popular in recent years. However, many prescription sleep medications carry a risk of dependence, so they should be used only temporarily, and only under the guidance of a physician. There are also “natural” sleep aids (such as melatonin, which is a hormone that’s made by the pineal gland in the brain)…but just remember this: just because a medication is “natural” doesn’t mean that it doesn’t have potential side-effects or doesn’t run the risk of interacting with some other medication that you might be taking.
Benjamin Franklin once said that “Fatigue is the best pillow.” Staying busy, exercising regularly, and maintaining good sleep hygiene should help you get along better with the “fickle friend.” Meanwhile, I wish you “sweet dreams!”