We all have to do it, and without it we wouldn't survive.
You may be under the false impression that your body and mind just “turn
off†at night, but that couldn't be further from the truth. It has actually
taken quite a lot of scientific research to understand what's going on when we
sleep, with new discoveries being made all the time. We are only now learning
more about the ways that sleep affects our physical and mental health and our
ability to function while awake.
You probably know that there are several “stages†of
sleep, during which we experience different critical biological processes. Every
night, we travel through each of these important periods, and we must spend
adequate time in every stage in order to maintain wellness and feel rested in
the morning.
Let's look at the journey of sleep we take every night and
how the four stages fit into a healthy regenerative cycle. We have three stages
of non-rapid eye movement (NREM) sleep, followed by one stage of rapid eye
movement (REM) sleep. It takes about an hour and a half to go through all four
stages, and a good night's sleep consists of moving through this complete cycle
several times.
Here's what happens in one of these cycles:
NREM1: Slipping into sleep.
Your brain waves begin to slow as you ease into the first relaxing stage of
sleep. You are entering a very light sleep from which you can be easily
awakened. Your eyes move slowly, muscles relax, and your heart rate and
breathing slow down.
NREM2: Light sleep. There is
a notable drop in your body temperature, heart rate, and blood pressure. Your
eye movements cease and your brain waves slow way down,
with occasional bursts of rapid waves.
NREM3: Deeper sleep. Your
brain waves slow down even further. Now that you are in deep sleep, it's more
difficult to rouse you. In this stage, much healing and regeneration occurs,
including the repair of tissue, new cell growth, and the buildup of your immune
system, among other things. If you don't spend adequate time in this stage, you
will not feel well rested in the morning.
REM: Rapid eye movement
sleep. About ninety minutes after falling asleep, you reach REM sleep. In
this stage, you dream. Your eyes move rapidly beneath closed eyelids and your
heart rate and blood pressure may rise, yet your muscles are temporarily
paralyzed to protect you from acting out your dreams. This stage is important in
learning, processing, and sorting information.
Research indicates that we get the greatest health benefits
in NREM3 and REM sleep. If we don't get enough sleep during the course of the
night, we miss out on the regenerative and protective processes of these stages,
thus setting ourselves up for dysregulation and disease.
Dangers of Disordered Sleep
Whether you have worked night shifts for years, struggle
with occasional sleepless nights, or just decide to stay up another hour to
finish a few things you want to do, losing sleep leads to profound
health-related complications. If you avoid going to sleep because you think it's
wasted time, you couldn't be more mistaken. Whatever work you do in the extra
hours you stay awake will be slower and less productive, and it will come at the
cost of your overall health. The cognitive loss you experience in sleep deficit
is similar to having a blood alcohol concentration over the legal limit for
driving.
Despite the very real dangers of not getting
enough sleep, however, our contemporary culture seems to encourage it. We are
conditioned to be proud of not “needing†more than a few hours of sleep;
we're told that this makes us hard workers, dedicated to our professions, or
admirably unwilling to miss a single moment of our lives. We may repeat phrases
like, “I'll sleep when I'm dead,†or “Sleep is for the weak.†An entire
energy drink industry exists in intimate relationship to these false ideas about
sleep and profits from keeping people up when they should be resting. The fact
is that sleep is a fundamental human necessity, not a weakness, and sleep
deprivation is not a sign of our dedication—it's a sign that we are
overworked, overstressed, and damaging our health. I want us to stop celebrating
people who sacrifice sleep, as sleep deprivation puts everyone at risk.
Insomnia is the most common sleep disorder reported by
Americans and characterized by chronic difficulty falling asleep and/or staying
asleep. Many factors may contribute to this, including stress, physical pain,
depression, drugs, alcohol, and even some medications. Of course, we all on
occasion experience trouble sleeping—that's normal. We call it insomnia when
this issue goes on for three months or more. This condition can be treated and
must be brought to the attention of a physician. Please do not delay seeking
care from a health-care professional if you are experiencing ongoing sleep
deprivation. The overview of sleep in this chapter will help you have a
meaningful conversation with your doctor to get the best possible treatment
plan.
In addition to insomnia, the other most common sleep issue
I see in clinical practice is obstructive sleep apnea (OSA). Sleep apnea is a
category of conditions related to irregular breathing during sleep. OSA is often
related to obesity, as increased fat deposits around the tongue and throat
restrict airflow, resulting in lack of oxygen and awakening from sleep. Many
patients may not be aware that anything is wrong, and often the first clue comes
from their sleep partner, who reports loud snoring with periodic frightening
episodes when the individual appears to stop breathing. OSA may be present in
almost half of those with a BMI greater than 30. This
is sobering, since the most recent obesity rate reported by the CDC is 42.4
percent.
This equates to many millions of Americans
suffering from OSA. This condition is treatable and manageable, but the
diagnosis needs to be made to prevent complications like heart disease and
increased risk of motor vehicle accidents. If you snore and/or experience
daytime drowsiness, please bring this to the attention of your doctor for an
appropriate evaluation.
Beyond these leading sleep disorders, I encounter patients
dealing with restless legs syndrome, narcolepsy, sleepwalking, bed-wetting,
nightmares, and more—all of which can complicate effective sleep hygiene.
Whenever a patient is having trouble sleeping, it is important to take a
detailed history and complete a thorough physical exam to fully understand what
is contributing to this disruption.
In a recent case, a patient presented to me with what he
described as inexplicable alertness and nervousness over six months, which was
interfering with his sleep. In working with him further, I made a diagnosis of
hyperthyroidism. Once we treated his overactive thyroid, his sleep cycle
normalized. In another case, a patient was sleeping nine to ten hours, which is
more than normal. Her blood work revealed she was suffering from iron deficiency
anemia from uterine fibroids. Once her fibroids were managed by her gynecologist
and iron stores were replenished, she reverted to a healthy regenerative sleep
cycle. I share these examples to dissuade you from ignoring any sleeping
problems you may be experiencing, as so many people do for years, and tell your
doctor about them instead.
For all of us, it's not just the quantity of sleep that is
important, but the quality of sleep too. That is, you might stay in bed for
seven or eight hours a night without ever fully going through all four sleep
stages. Inadequate or poor-quality sleep has been linked to several chronic
diseases including heart disease, type 2 diabetes, stroke, obesity, and
depression.
There is even evidence that poor sleep habits like those
practiced by irregular shift workers could contribute to cancer risk. In a study
published in 2013, investigators concluded that female night shift workers were at a 30 percent increased risk of breast cancer. This might
be due to the disruption of normal circadian rhythm (another name for our
internal biological clock). Being in a light-filled environment at night
suppresses the release of the chemical melatonin. Melatonin helps us feel sleepy
and fall asleep naturally. When this cycle gets disrupted long term, it can be
hard to get a good night's sleep. That's why turning off all the lights in your bedroom may be one of the
simplest and most important things you can do to improve the quality of your
sleep.
Sleep disorders are indeed a global challenge, with
Americans experiencing more trouble sleeping than other cultures. An
international survey conducted more than a decade ago showed that 56 percent of
people surveyed in the United States reported sleep problems, compared to 31
percent in western Europe and 23 percent in Japan. Over half of Americans aren't
sleeping well, and even if they know the health and safety dangers, very few
folks ask for help from their doctors. When they do, physicians most commonly
treat the sleep complaint with a prescription. Sound familiar? By now you know
that there is often a better way than the prescription pad to address the root
causes of chronic conditions through simple, profound lifestyle practices that
elevate virtually every measure of health and well-being.
Tags:
self improvement