Tuesday, May 15, 2018

The dangers and consequences of lack of sleep

Sleep is one of those funny things that most of us love, but we can never seem to get enough. On the one hand, anyone who is tired will tell you how much they desperately want more sleep. They might have to take naps, or just crave a decent full-night of sleep.

On the other hand, a lot of us also need down-time after work and into the evening. Maybe you have kids and you don't get time for yourself or alone time with your partner until after the kids are in bed. Maybe you take work home with you and work late, and therefore just don't get to bed early enough. Either way, we're pushing our bedtimes later, and our wake-up times aren't necessarily changing.

This balance of sleep, work, and time for yourself to decompress, can be really tough to achieve. Part of it is due to how we, as a North American society, view our daily expectations. Workplaces expect a 8-hour workday minimum, with more and more jobs requiring additional hours adding up to 60-80 hours per week. How on earth is that healthy for anyone?

Most of the research I have done in this area is eye-opening. Humans in general need a minimum of 7 hours per night. Anything less than 6.5 hours per night increases the risk of developing Alzheimer's disease, cardiovascular disease, and certain cancers such as breast cancer. (full article with references here: http://thenatpath.com/mind/sleep-deprivation-chronic-health-outcomes/)

I was reminded of these while listening to a fascinating podcast with Matthew Walker, professor of neuroscience and founder/director of the Centre for Human Sleep Science on the JRE:

I've posted a short clip below, but the full video is also found on YouTube: https://www.youtube.com/watch?v=pwaWilO_Pig

Key messages were that in addition to the number of hours of sleep needed, the quality of sleep is crucially important. That evening glass of wine might help you relax, but the alcohol is keeping your system up.

As well, sleep isn't just for rest! This isn't just about letting the body go to sleep, but allowing your brain to solidify all the connections you were trying to make from your day. This is where the saying "sleep on it" comes from. Even for students who are studying - it is more beneficial for their learning and memory to sleep, rather than to pull an all-nighter. You might think you're giving your brain extra study hours, but the connections will not be made or stay the same way if you instead got a good night of sleep.

Studies have also looked at the mental and cognitive function of school-aged children, finding that children are better able to learn when school start times are pushed back from 7/8am to 9 am or later.

And what about our doctors? The ones who pull double or triple shifts at hospitals, or who have a ridiculous number of working hours during their residency? Aren't we supposed to be superhuman and push through it? Nope! The initial regimen of pushing medical residents started with one MD: a man who was able to follow these long working hours. But it wasn't because of his "mental strength" - it was because he was accidentally addicted to cocaine! And now we use this as our standard for medical students and hospital doctors.

This type of sleep deprivation can cause major issues of impairment both on the job and while driving, being equated to the impairment of drunk driving. Falling asleep at the wheel is no joke, and it's not uncommon. That's what makes this so dangerous.

These developments in sleep science should be unnerving for a lot of us. Sleep isn't something to take for granted. These aren't extra hours to allocate to whatever activities you deem important. This is about your chronic health, and the safety of those around you. Today you might feel okay with 4-5 hours, but 10 years from now your health could be facing the consequences.

Interestingly, Walker actually addresses the "4-5 hour sleeper". He says that the percentage of human beings that can actually get away with that amount of sleep per night with no repercussions is a fraction of 1% but even that number is rounded up!

There are multiple ways to help improve sleep. Walker goes into a few of them, though what's most important is keeping a routine and removing obstacles that can keep you from good sleep:

  • Have a set bedtime, set an alarm if you need to remind yourself. 
  • Avoid screen time, like smartphones and computers before bed. Put a blue-light filter on your devices if you must use them. 
  • Avoid eating 2 hours before bed, and alcohol about 4 hours before bed (or just avoid alcohol altogether). 
  • Refrain from caffeine after noon
  • Keep the bedroom dark and do not allow light in from outside. Cover up electronics that have lights on them while you sleep
  • Keep your bedroom cooler at night. Use fans, A/C or lighter pyjamas if necessary. 
  • Work on stress management to regulate cortisol levels. This is crucial for those who find they're waking between 2-4am.