Wednesday, 9 October 2013

Sleeping Yourself Healthy

Research shows that as demands on our time increase we cut back on our sleep. Not our work hours. Not our TV and screen time. Our sleep. 
Most of us understand that sleep is good for us. We probably don't know why sleep is good for us. We could list two, maybe three, benefits of sleep if we were playing a tie-breaker game of Trivial Pursuit and this was a pie question.

In fact the benefits of sleep are numerous. Catching the right amount of Zzzz's can improve memory, help with weight loss and reduce inflammation. It can even enhance creativity. had me at weight loss.

Why then, are we so bad at getting shut eye? North Americans have alarming rates of sleep deprivation.  According to Harvard Medical School, research shows that as demands on our time increase we cut back on our sleep. Not our work hours. Not our TV and screen time. Our sleep. A poll conducted for CBC News in 2010 reported that 60% of Canadians get less than the recommended 8 hours of sleep per night and 18% get less than five hours per night. Time and stress were the reasons sited for this lack of sleep (CBC).

Not only do we skimp on our night time sleep hours but we also shun naps. 85% of mammals take naps. Kids and seniors take naps. Entire countries outside of North America take naps. But your average North American middle-aged adult won't stop for an afternoon siesta. And yet naps can be so helpful. A study of NASA pilots and astronauts showed that after just 40 minutes of napping time they had a 34% improvement in performance and a 100% increase in alertness (National Sleep Foundation). 

But how much does it really matter if we get 6 hours a night instead of 8? What if we are short on sleep during the week but catch up on Sundays? Doesn't sleep only matter for kids? Hey....I can sleep when I'm dead right? Well that may come sooner than you think if you aren't logging the right hours.

According to the National Sleep Foundation 60% of drivers admit to having driven a car when drowsy and 30% admit that they have fallen asleep at the wheel. It's estimated that 20% of all motor vehicle accidents involve a drowsy driver which in the USA is 1 million accidents with 500,000 injuries and 8,000 deaths per year. Fatigue causes more car accidents each year than alcohol (Harvard Med & WebMD). Just think about that for a minute.

A Harvard study showed that medical errors could be decreased by 36% if we limited doctors shifts to 16 hours and didn't ask them to work more than 80 hours per week (Harvard Med). What I really want to know about this statistic is who the heck thought that working 16 hours a day or 80 hours a week was a good idea in the first place?! But I digress.

Investigative reports confirm that sleep deprivation played a critical role in the Three Mile Island and Chernobyl nuclear accidents, the Exxon Valdez oil tanker spill, and the Challenger explosion (Harvard Medical School).  You may not be in charge of a nuclear reactor but chances are that at some point in your day you operate a vehicle, heavy equipment, or provide care for other people. Maybe your biggest risk is using the LARGE cutting knife when you're making dinner. But fall asleep at the blade...and you know....the outcomes could be disastrous.

So apart from avoiding amputations why is sleep so good for us?

Benefits of sleep
  • Improved Memory: we acquire information throughout our day but it is during sleep that this info is "consolidated". That's were information becomes stable and our brain sorts and organizes all of the data it has collected so that when we want to retrieve information we are able to access it ("recall" or "remember").
  • Enhanced Learning: What you learn when you are awake is consolidated (see above) when you sleep. Without sleep you don't retain what you have learned. Every day is ground hog day.
  • Improved Safety: As sleep time decreases so does productivity and concentration. Errors and accidents go up. 
  • Better Immunity:  People who sleep 8 hours or more a night are 3 times less likely to get a cold than people who sleep seven hours a night or less (Mayo Clinic).  Natural immune modulators circulate and increase as we sleep to fight off illness. 
  • Reduced Chronic Conditions: Sleep allows your body to produce all of the regulatory hormones that we need to regulate blood pressure and control blood sugar. As soon as we are sleep deprived our bodies don't metabolize glucose properly and we begin to show impaired glucose tolerance - or pre-diabetes (WebMD & NIH)).
  • Decreased Inflammation: those who sleep less than 6 hours per night have higher serum levels of inflammatory proteins (C-Reactive Protein). Inflammation plays a huge role in heart disease, stroke, diabetes, arthritis, cancers, dementia, and even aging. Want to live longer and look good doing it? Hit the hay. 
  • Better Creativity: Sleep consolidates the details of memories but also the emotional component of memories which allows people to be more creative (Harvard)
  • Better Athletic Performance: sleep decreases fatigue and increases stamina. Blood supply to muscles goes up so we recover faster from physical and emotional stress. You want to beat your best friends half-marathon PR? Sleep on it. 
  • Efficient Weight Loss: Sleep regulates levels of ghrelin (the hormone that makes you feel hungry) and leptin (the hormone that makes you feel full). As sleep time shortens these hormones get out of balance and we feel hungry. Sleep longer and these hormones are more balanced and we eat less (CBC & Mayo). We also know that less sleep makes you crave more carbohydrates such as sugar, candy, cookies and cake (CBC)
  • Reduced Stress & Depression: People with impaired sleep are twice as likely to develop depression (CBC). Sleeping won't change the stressors in your life but it will improve your capacity for managing stressful situation. 

Tips for a good long sleep
  • Get regular: Stockpiling doesn't work. You need sleep every night. Establish a routine and go to bed approximately the same time each night and wake up at the same time each morning. 
  • Chill out: A cooler room enhances sleep.
  • Get unplugged: Bedrooms need to be as dark as possible. Kill the lights and banish all electronic devices. Even if electronics aren't switched on research shows that we sleep poorly with them in the room (lighter sleep just in case someone sends a text). Your brain needs to associate your bedroom with sleep. Not work. Not Facebook posts. 
  • Clear out pollution: Noise pollution that is. Remove things from our room that make noise.  That includes the snoring partner (yep sometimes separate rooms is the healthier choice). If there is environmental noise outside of your house that you cannot control consider having white noise in your bedroom to mask it - a fan for example. 
  • Exercise: Exercise (earlier in the day not right before bed) and you will sleep better. Simple. 
  • Avoid stimulants: Caffeine and nicotine are the biggies. One 8 oz cup of coffee circulates caffeine in your body for 12 hours. Nicotine is legal speed. Don't book an appointment with the Nurse Practitioner because you can't sleep and then tell her you drink 6 cups of coffee, 10 Coke's, and smoke a pack a day. There will be stern words spoken.
  • Dry out: Alcohol impairs sleep. Doesn't feel like it but it's true. You may fall asleep after a glass or two but you won't stay asleep and you won't get into sustained deep sleep. 
  • Manage pain: Try to ensure that chronic pain is managed well before you hit the sheets. Skimping on analgesia is not good if it means that you aren't getting the rest that you need. 
  • Get in a rut: Have a pre-bed routine that you do every night. That could be a bath or shower, reading, or taking a few minutes to breath and reflect. If we perform the same rituals every night our brain learns to associate these with sleeping. Just like infants when you read that bed time story, sing the familiar song, or rock in the chair. At the first sign of the ritual the brain begins to enter sleep mode. Similarly some people find scent therapy helpful. Use a scent that you only use for sleep time and when your brain gets the first whiff it starts to gear down. 

Thanks for reading Getting Healthy With NP Sam. Comments welcome - please click the pencil icon below. 

References, Resources & Links:
Sleep, Learning, & Memory (Harvard Med School)
Sleep, Performance, & Public Safety (Harvard Med School)
Benefits of Slumber (NIH)
How Many Hours of Sleep are Enough (Mayo clinic)
Sleep & Weight Gain (Mayo clinic)
Napping (National Sleep Foundation)
Benefits of a Good Nights Sleep (WebMD)
Health Benefits of Sleep (CBC)

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