“New research shows that sleeping better is one of the simplest and most effective things we can do to vastly enhance and extend our lives.”


So says Dr. James B. Maas, a leading authority on sleep and performance, acclaimed author, and CEO of Sleep for Success.  I had the immense pleasure of hearing Dr. Maas give a lecture on the importance of sleep at a medical conference many years ago and, despite the fact that the audience was filled with sleep-deprived doctors, all eyes and ears were wide-open as we listened to him eloquently present “scare-the-pants-off-you” data on the crucial role sleep plays in health.  It is now almost a decade since I heard Dr. Maas’ lecture and the evidence that enough shut-eye is imperative for good health continues to mount. It seems everywhere I look I see another article or book about how critical sleep is for our health. In August this year, the cover story in National Geographic was entitled “The Science of Sleep”. Google search “the importance of sleep” and 750,000,000 results come up (in just 0.44 seconds…amazing! But I digress). There is no longer any debate – getting the right quantity and quality of sleep is simply essential for optimal physical health, cognitive performance, athletic performance and emotional well-being.  So why, according to the CDC, are 80 million Americans adults chronically sleep-deprived?  The answer is complicated but ultimately it seems we humans are trying to deny the immutable fact that we live on a planet that spins around its axis, creating a 24-hour cycle of light and dark.  Our bodies evolved in sync with this 24-hour cycle and many critical physiologic processes depend on the body obeying its circadian rhythm in order to function properly.  


(Are you sleepy yet?  If 2 minutes of reading finds your eyelids heavy, it may be a sign that you are sleep deprived! Or I’m just a boring writer.  Either way, try to keep reading…)


Why is lack of sleep so unhealthy?

This is where the science starts to get interesting.  Summarizing all we now know about the links between chronic sleep deprivation and ill-health would take pages (and I’d be up too late).  So let me just say this…deprive yourself of sleep over and over and you put yourself at risk for obesity, diabetes, high blood pressure, heart disease, stroke, poor immune system function, some forms of cancer, and dementia (see this well-written summary on sleep and disease from Harvard for more detailed information).  Moreover, fatigue plays a major role in motor vehicle crashes (experts estimate that there could be as many as 1.2 million crashes, 8,000 lives lost, and 500,000 injuries in the US due to drowsy driving each year!) and work place accidents (see this Huffington Post article about the suspected contribution of fatigue to Chernobyl, Three Mile Island, Challenger, the Exxon Valdez oil spill, and the American Airlines flight 1420 crash).  While nuclear meltdowns and space shuttle crashes may not seem immediately applicable to your life, I don’t know anyone who is immune to car crashes and the threat of chronic illness.  Foregoing sleep is just not safe.  


But why do our bodies need to sleep?


Until fairly recently, the function of sleep in humans and other mammals largely remained a mystery.  That is beginning to change – and, again, the science here is really cool. One particularly intriguing recent discovery is that of a brain waste removal system (think “Rumpke” for your brain) that clears potentially neurotoxic substances from the central nervous system.  Called the glymphatic system, this clearance pathway functions mainly during sleep, with some brain cells shrinking by 60% during sleep to allow more room for the fluid that carries away this metabolic waste.  Forgo enough sleep and your brain may start to look like the streets of New York City when the trash collectors go on strike! Have you ever experienced that?  It’s ugly!


Sleep researchers also know that the production and release of several important hormones are dependent on circadian rhythm.  Melatonin is probably the best known “sleep hormone” but the control and release of growth hormone, insulin, serotonin, cortisol and other key substances are also intimately tied to sleep cycles.       


How do I know if I’m sleep deprived?

It seems like a straightforward enough question, with a straightforward answer, right?  Well, turns out a large number of people under estimate the amount of sleep they need and are walking around in a perpetual state of chronic sleep deprivation.  For the vast majority of us, regularly sleeping less than 7 hours a night puts us at risk for the profound and widespread detrimental effects of chronic sleep deprivation.  Many sleep-deprived people rely on caffeine and/or nicotine to keep them awake and may try to make up for not enough sleep most days of the week by sleeping extra on the weekends.  Turns out all of those things only act to impair quality of sleep over the long run.


There are a few well-validated tools to assess your level of sleepiness.  The Maas Robbins Alertness Questionnaire and the Epworth Sleepiness Scale are quick, reliable ways to see if you might be living your life in a suboptimal state of chronic sleep debt.


How do I get better sleep?

#1: MAKE SLEEP A PRIORITY!  It is no secret that our culture does not place a high value on sleep.  In fact, in many circles (including, somewhat ironically, medicine), prioritizing sleep is seen as weak and lazy, an indulgence.  Nothing could be further from the truth. But we live in a world that can make getting a good night’s sleep very difficult. Demands from jobs and family that find you working late into the night, caffeine (read “Venti Mocha Latte” #2 of the day), and those blasted screens (perhaps one of the biggest hindrances to sleep in this day and age) all interfere with the ability to achieve your best night’s sleep.  But don’t despair! There are many simple things you can start doing right now (read…tonight!) to start getting better sleep. Keep in mind, however, the most important, and probably the most difficult, of these keys to good sleep is to MAKE SLEEP A PRIORITY.

#2.  If you, or your partner, suspect you have sleep apnea, speak to your doctor.  Signs may include loud snoring, gasping for air during sleep, waking with a headache, waking with a sore, dry throat, and/or excessive daytime sleepiness despite what should be enough time in bed.  You may need a sleep study to rule out this very common condition that not only leads to poor sleep quality and excessive fatigue but also puts you at risk for a host of serious medical conditions, including high blood pressure, cardiovascular disease and diabetes.  (This link from The Mayo Clinic provides a good overview of sleep apnea.)

#3.  Create the right environment for sleep. Keep your bedroom cool (about 60-68°F) and VERY dark when you are sleeping.  Even a small amount of light can disrupt melatonin secretion.

#4.  Know that the highest bang for your buck in sleep hours is found between the hours of 10pm-2am.  Sorry, night owls – some of the key processes I mentioned above happen between those 4 precious hours of slumber.

#5.  Get outside!  Exposing yourself to enough sunlight during the day helps enormously to keep your body aligned with its natural circadian rhythm.  Get at least 30 minutes of daylight every day you can fit it in.

#6.  Stop drinking caffeine by 2pm (switch to decaf if you must drink coffee or tea later in the day but realize that even decaffeinated varieties have up to 30% the caffeine content of regular coffee and tea – so if you’re very caffeine sensitive, stick with no caffeine after 2pm.  Better yet, cut way down on caffeine throughout the whole day. “Impossible” you say…follow the other strategies for good sleep and you may be surprised to find yourself in a natural state of alertness without the need for an artificial boost).

#7.  Stop eating at least 3 hours before bedtime.  A late-night snack may make you groggy but does not set you up for the quality sleep you need.  

#8.  Keep your weekend sleep schedule very close (within 1 hour) to your during-the-week sleep times.  Staying up extra late and/or sleeping in extra long on the weekends, although seemingly so appealing (especially the latter for all of you strung out, over-worked, over-soccer-mommed/dadded-out parents), sets you up for failure when Monday roles around and you try to adhere to a consistent, healthy sleep routine.

#9.  Quiet relentless mind-chatter.  Does a stream of endless thoughts keep you lying awake at night, tossing and turning, trying to fall to sleep.  It doesn’t seem like falling asleep is something we should have to TRY to do. However, the big and little stresses of everyday life often become an obstacle to restful sleep.  The answer here is not quite as straightforward as turning down the thermostat or avoiding caffeine. Quieting your mind requires a proactive approach to managing the stress in your life.  The most effective strategies are very personal. For some, a few minutes of meditation before bedtime helps. Acupuncture, massage, and gentle yoga are very effective for others (we happen to have great resources for these disciplines right here in Bexley – try Kit Yoon at Bexley Acupuncture, Juli Burris or Gabe Vydra for massage and look for the Urban Zen and Yin Yoga classes at Bexley Yoga and Wellness).  Reading for a few minutes before bedtime (from an ancient relic known as a “book” rather than a tablet), as long as it is not upsetting or stressful (i.e. do NOT read your P&L reports) can be a nice transition from day to night.  Experiment and see what works for you. When you discover an effective technique for relaxation, sleep will be just one of many areas in your life that will benefit immensely.

#10.  I saved this one for last because, after #1 above, this one is probably the next most difficult.  But it is also probably the most critical. SAY NO TO SCREENS AT NIGHT! Any and all kinds of screens, especially within 90 minutes of bedtime.  The blue light emitted by electronic devices wreaks havoc with your body’s ability to regulate its sleep-wake cycles. Researchers have learned that exposure to screens before bed increases the time to maximum melatonin release, lowers the peak levels of melatonin, and disrupts REM sleep.  In one study, participants who read from an electronic device (as opposed to printed material) before going to sleep reported being more tired the next day, even if they got the same amount of sleep as the print readers.  Staring into a screen before bedtime, especially if it is done while you are in your bed, is entirely counterproductive to getting a good night’s sleep.

(These 10 strategies, and more, can be found in a fabulous book called Sleep Smarter by Shawn Stevenson.  I strongly recommend you read this book if you find getting enough good quality sleep really difficult, or if you want to read more about the fascinating discoveries that are informing these healthy sleep habits.  The author does an excellent job of sharing the latest scientific discoveries in a very readable way, all while infusing a good bit of humor.)


One last thing in closing…I know as well as anyone how demanding life can be.  We are all looking for more hours in the day. Stealing those hours from sleep seems like a very reasonable way to manage a hectic life.  But the fact is, there is no way to overstate the detrimental impact that chronic sleep deprivation has on living your best life.  And if it’s pure number of awake hours you’re arguing for, think of it this way…any of the chronic illnesses mentioned above could easily take a decade off your life.  There are over 87,000 hours in 10 years – assuming 2/3 of that time is spent awake, dying a decade early cuts close to 60,000 waking hours off your life!  According to Malcolm Gladwell, you could become a master in SIX different disciplines in those 60,000 hours (read “Outliers” to learn more about that…but not at night from a tablet!)  


We need to wake up, and go to sleep.