Sleep
Why it matters and how to improve it
We ask every patient about their sleep. How many hours they sleep, how do they feel about the quality of their sleep? It is surprising how many report NOT sleeping well and some describe their sleep as “terrible” or “awful” and admit that it has been like that for many years.
Sleep is when we humans (and probably animals too since all animals sleep, it’s non-negotiable) process thoughts, memories and emotions from our waking hours. This has been likened to a cleaning up and filing system for our brain and nervous system.
How much Sleep should we get?
As with many questions the answer is ‘it depends’, but a good generalisation is between 7-8 hours per night. However, if you are especially fatigued from mental or physical effort you will benefit from more.
A study done on a team of basketball players in the USA determined that with up to 10 hours sleep (in every 24hrs) including naps, their sprint times and shooting accuracy improved by an average 9% over a number of weeks.
You may not want to “shoot hoops” but I bet you wouldn’t say no to a little more physical performance, energy and mental acuity like these basketball players clearly enjoyed.
The benefits of getting enough sleep and what happens if we don’t!
The obvious benefits are waking feeling refreshed and full of energy. The consequences of not achieving good quality sleep in sufficient quantity can be serious and health limiting.
Poor quantity and quality of sleep is linked to an increased risk of
Physical injury (less than 6 hours per night = 2.5 times increased risk of injury according to some studies when compared to getting 8 hrs sleep per night)
Elevated insulin levels + decreased capacity to dispose of Glucose (increased Type 2 diabetes risk)
High cortisol levels (stress hormones) causing increased Blood pressure and further glucose management issues increasing diabetes risk.
Appetite problems - Reduced Leptin (hormone to tell you to stop eating when you’re full) and increased Grhelin (hormone that tells you when you are hungry) so, tired people are often hungry people.
Increased risk of Heart Disease - Less than 6 hrs per night - 6-26% increased risk of cardiovascular disease.
Increased risk of Alzhiemer’s Disease.
Better memory and Emotional processing
Sleep comes in phases, light, deep, REM and Non-REM. Different things happen in your brain and body during these different phases.
Deep sleep is when the brain clears out it’s short term memories and selects the ones it wants to store in long term memory centres helping us reinforce and retain the important things from our previous day. Emotionally charged events are processed too. A particularly important feature of this process being the separation of the emotion from the memory of the positive or negative experience that triggered the emotion.
This is why going to sleep on a problem sometimes makes it seem less important or emotionally charged the next day. We still have the memory but not so much of the pain associated with it. Without this ability we risk living in a state of constant anxiety and may explain some of the reporting of anxiety and other mental health disorders in some people without good sleep.
Deep sleep is also when our brain makes new connections between nerve cells helping us to problem solve as well as learn and develop new skills. It’s also when the brain gets flushed through with it’s own circulatory fluid (Cerebro-Spinal Fluid) helping to sweep away the waste products that build up every day. A bit like a road sweeper clearing detritus from city streets.
How to get better sleep
Creating the right conditions for sleep will improve your chances of achieving better sleep quality and quantity which will positively affect how you feel in the short term and your health in the long term. The following are suggestions from the book Outlive by Peter Attia. I recommend it not only for it’s chapter on sleep but for Dr Attia’s insights into all areas of health and wellbeing, it’s a worthwhile read.
Some of these suggestions may require a significant overhaul to your lifestyle others less so, you can decide what good sleep is worth to you.
Don’t drink Alcohol. It impairs sleep quality more than any other factor within our control. Don’t confuse the drowsiness it induces with quality sleep.
Don’t eat anything less than 3 hours before bedtime.
Abstain from stimulating electronics 2 hours before bedtime especially interactive screen use like video gaming or social media interaction. These get your brain humming and ruminating, not what you want for restful, high quality sleep.
If you have access to a sauna or hot bath/shower before bed spend time here before bed. Once you get in to a cool bed your reducing body temperature will tell your brain it’s time for sleep.
Cool your bedroom (ideally mid 60’s F/ 18C)
Give yourself time to sleep. Go to bed at least 8 hours before you need to get up giving yourself enough time to get your optimal amount of sleep.
Fix your wake up time and don’t deviate from it even on weekends.
Don’t obsess over your sleep with a visible alarm clock (turn it to the wall) and give yourself a break from any sleep tracking device if you find yourself continually worrying over what it tells you. You don’t need any added stress!
Caffeine - this has an average 6 hour half life in our body. This means if you had a double espresso at 12 noon you would only be experiencing the effects of a single shot at 6pm and the effects will have dissipated by midnight. There is some variation in each person’s ability to process caffeine and if you are on the more speedy end of the spectrum by all means enjoy a coffee with your dinner, but for most of us coffee after mid afternoon can leave us buzzing long into the evening.
Exercise - is helpful as long as it is not too close to bedtime. A good Zone 2 (moderate endurance) workout 2-3 hours before bed can be an aid to good sleep.
Darkness, making the room as dark as possible or using a sleep mask will help, it’s amazing how even a tiny bit of light can disrupt high quality sleep. See my sleep mask review below.