Poor sleep affects all areas of wellness, not just feeling tired — it can lead to serious health issues
Improve sleep habits by following the body’s sleep cycles
Sleep deprivation is more than just feeling tired during the day. The rest your body gets at night is meant to rejuvenate you — you wake up alert, energetic, optimistic and focused. But missing out on those crucial sleep hours — whether it’s from sleep apnea or insomnia (obstructed breathing or the inability to fall or stay asleep, respectively), or other causes such as illness (including cancer) or advanced age — can have a huge impact on your health.
In fact, sleep is the most important thing for overall health, says Richard D. Simon, MD, the medical director of the Kathryn Severyns Dement Sleep Disorders Center in Walla Walla, Washington. “Sleep is the most fascinating thing in the world, and the most underappreciated, in my opinion.”
Dr. Simon discusses the science of good sleep, what happens when you don’t get it and how you can change your sleep habits for the better.
Q. How do circadian rhythms — the body’s sleep cycles — work?
A. “You have a group of cells in your brain that act like a clock, if you will. The cells turn on and progressively alert you for about 16 hours a day on average, and then they decrease alertness at night. All day long as you’re staying awake the brain is developing the need for sleep — we call that the homeostatic sleep drive. And then at night when the clock starts turning off, that sleep debt you’ve accumulated all day is what drives sleep.
“The thing most people don’t recognize is the timing of that sleep/wake schedule is rather difficult to change day to day; it pretty much stays the same. You don’t really have the option biologically to change your sleep/wake schedule by more than an hour or two a day. You can’t go to bed one night at 8 p.m. and wake up at 4 a.m. and then expect the next night to go until about midnight and wake up at 8 a.m.”
Q. How do you know if you’re not getting enough sleep?
A. “There are several signs that can indicate you are sleep deprived. If you lie down to take a nap and fall asleep quickly, you’re not getting enough sleep. If you’re well rested throughout the day, you’re getting enough sleep. Here’s the big test: Boredom does not cause sleepiness, it unmasks a sleep debt. Once you put yourself in a boring environment — you’re sitting on a couch doing nothing — if you can stay awake doing that, without any stimulants such as caffeine, you’re probably not sleepy. But if every time you get in front of a boring television show, you drift off, then you probably have a sleep deficit.
“Another way to tell is if you go to bed at night and can’t sleep for two hours but then you need five alarm clocks to wake up. What that’s telling you is you’re going to sleep when your brain is still trying to keep you alert, and you’re waking up in the morning when the brain is still off. The opposite is also true. If you can’t stay up until midnight, and then you wake up at 5 a.m. and can’t sleep until 8 a.m. — you’re going to bed after your brain has turned off and waking up after it’s already turned on. Those are called circadian rhythm disorders. The normal sleeper goes to bed at night, falls asleep within 15 minutes and wakes up in the morning feeling alert, without having to use an alarm clock.”
Q. So how does sleep deprivation affect your health?
A. “It affects everything. One of the first things that happens is your reaction time declines; your ability to respond to stimulus, whether visual, oral or otherwise, declines. If you drift into microsleep, it may go away completely — you may not hear or see a thing that is there. You may be watching television with your kids at night and they say, ‘Mom, you’re falling asleep,’ and you say, ‘No, I’m wide awake.’ They noticed you’re not paying attention, but you think you’re awake. That’s very dangerous when you are driving because you may think you’re awake but you are drifting off to sleep, and if something bad happens you may not see it.
“As you become more and more sleep deprived, your metabolic systems become less effective. So that’s diabetes, obesity regulation, appetite regulation. Studies from the University of Chicago have shown that if you deprive kids of just a little sleep at night they get glucose tolerance curves that resemble patients with diabetes, and their leptin and ghrelin levels, which control weight and appetite change, are such that one tends to gain weight. One wonders if the 10- to 15-pound weight gain that can occur in college freshmen could be from sleep deprivation alone. And sleep deprivation can dramatically affect teenagers, who are developing night owl brains that lead them to stay up late, but they still have to get up for school early in the morning. They need nine hours of sleep and if they don’t get that, they can end up feeling unhappy or depressed, unable to learn and have a harder time regulating themselves.
Also, blood pressure regulation becomes off. The inflammatory system gets activated. Cancer screening mechanisms in the body go awry. Mood gets bad, the ability to monitor yourself declines, and the ability to learn and remember things, both simple and complex, goes away when you’re sleep deprived. Everything becomes dysfunctional when you don’t sleep well. Every domain you look at, sleep deprivation makes it worse and sleep repletion makes it better.”
Q. What can you do to get more sleep?
A. “The absolute most important thing for good sleep is to anchor your sleep with the same wake time every day. Number two would be to get as much bright light as possible all day long because that tells your brain when daytime is. Number three is to go to bed at night only when you are sleepy. So you get up at the same time every day, but bedtime can be somewhat variable. That’s the way human beings are programmed. The others would be to minimize stimulants that are long lasting — one cup of coffee in the morning is fine, but having coffee all day probably isn’t a good idea.”
Do you have a problem with your sleep habits? Take our sleep quiz or contact a clinic near you:
Washington: Kathryn Severyns Dement Sleep Disorders Center
