Sleep

"Sleep is that golden chain that ties health and our bodies together" 
​Thomas Dekker

Sleep Principles:

1. Go to bed and get up at the same time, every day
2. Aim for 7 to 8 hours
3. Build your night-time routine

From the time that we were very young, people, starting with our mothers, have been telling us about the importance of sleep.

I am going to do the same...

Like all of the Wellness Garage core behaviors, failing at sleep will negatively impact all other behaviors and will independently and collectively worsen your health.
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The impact of lack of sleep is both obvious and insidious; obvious to the extent that our performance is clearly impaired; insidious in the way chronic sleep deprivation increases our risk for chronic disease.

• People who lack sleep report that their quality of life suffers as a result of lack of energy, drowsiness and unplanned naps.
• Accidents and workplace errors are more common among people with sleep disorders
• Sleep is considered a risk factor for obesity.  Research has shown that people who sleep less than 6 hours per night are more likely to be obese.  Possible mechanisms for this likely relate the role of sleep and the circadian rhythm on metabolism and appetite. Sleep has been shown to affect levels of key metabolic hormones insulin(regulates blood sugar), cortisol ("stress"), leptin ("satiety") and ghrelin ("hunger").
• Insufficient sleep is associated with diabetes and insulin resistance
• An association between poor sleep, cardiovascular disease and stroke may be related to the effect of sleep on blood pressure as well as metabolic effects
• An independent association between obstructive sleep apnea, hypertension and cardiovascular disease has been demonstrated.  People with sleep apnea awaken many times during the night following periods where their airway closes and they stop breathing (apnea). These episodes have profound physiological effects on blood pressure, cholesterol metabolism, inflammation and insulin resistance/diabetes.
• Lack of sleep affects the immune system, increasing inflammation while decreasing immune function.  Sleep deprivation increases susceptibility to colds, flus and common infections.
• Finally there is a suggestion that that sleeping < 6 hours per night is associated with increase all-cause mortality.  Interestingly many studies also show a U shaped curve where too much sleep >9 hours per night increases mortality as well.

So if we summarize, lack of sleep disturbs your metabolism, can cause you to gain weight, increases your risk for hypertension, high cholesterol, heart disease,stroke, diabetes, infections and it probably takes years off of your life.

So what to do...

Go to bed and get up at the same time, every day.  

• ​​​​​The sleep-wake cycle is the foundation of our intrinsic circadian time keeping system that modulates many of our core physiological systems and helps with optimal functioning of many organ systems.  Misaligning our intrinsic timing system with our sleep schedule will have profound effects.  The simplest way to avoid this is by sleeping on a consistent schedule.
• Of the two, getting up at the same time each day is more important. Your body will regulate when you go to sleep by generating sleep pressure and fatigue.
• If you are having sleep issues this is the place to start.

Aim for 7-8 hours per night.

• This may vary for some individuals but not that many.  If you are getting less that 6 hours per night and more than 9 hours per night your health may be compromised and you should really take a hard look at whether this is having an impact on your overall well-being.
• The goal of sleep is to sleep as long as necessary to feel rested - no more, no less.  It is important to realize that this should be determined before you go to bed.  If you are tired because you did not get enough sleep the night before, go to bed earlier.  If you are well rested you might be able to stay up a bit later.  In either case you need to get up at the same time each morning (see Principle #1).  One mistake that is common is to decide when the alarm goes off that you need more sleep.  This might be true, but altering your sleep patterns messes with your intrinsic circadian rhythms and is counter-productive.  Better to 'suck it up' and get up.  

Build your night-time routine

• as an extension of Principle #1 you should develop a routine or ritual around your bedtime
• There are things to avoid
  • avoid caffeine after 2 PM
  • avoid smoking (of course)
  • avoid exercise within 3-4 hours of bedtime
  • avoid screens before bed
• These are important but they should be part of a more positive routine that you build to progressively relax before falling asleep
• I will have more on these routines in future posts

As part of all Wellness Garage programs we will assess your sleep and help you build the right behaviors that optimize your health.

Beyond the basics for insomnia