• Dr. E Farrell

How's your sleep (and why am I asking?)



It's well known that stress, anxiety and depression can result in sleep problems, but not as well known that sleep loss can be the cause of mental and physical health issues and exacerbate those that you're already trying to cope with.

In order to stay healthy we need what is referred to as restorative sleep involving cell growth and repair, learning and memory consolidation, and emotional processing. Sleep occurs in stages in a cycle that takes around 110 minutes and then begins again, with REM or the last stage of sleep increasing in length as the time asleep continues. It's believed that this process needs to go on for at least 7-8 hours each night.

But what happens when this cycle is disrupted, and you don't get enough sleep?

You may get a second wind. You might feel sleepy and then surprisingly feel fine again. When you deprive yourself of sleep your brain triggers the release of stress hormones to keep you awake. You may be deceived into thinking that you can survive on less sleep but keep up this pattern for a while and your cognitive abilities will start to show signs of impairment.

You can become emotionally vulnerable, more irritable and more impulsive. Decisions are more likely to be based on immediate gratification rather than well thought out solutions. This is one reason why casinos stay open all night long. They're banking on keeping you awake to increase the chances you would be willing to part with your money! The longer you stay up, the more risk you are likely to take.

Sleep loss causes physical impairment. When we are sleep deprived, we are less alert. Our performance suffers. Drivers that are sleep deprived have a level of impairment similar to someone with a blood alcohol level of 0.05, or legally intoxicated. The sinister thing is that individuals at this point are not aware of the impairment and insist that they are fine!

Performance is affected. A study that examined the effect of sleep loss on cognitive ability involved letting some students study longer the night before a test, which limited their sleep to four hours and comparing them to students that studied less but got a full night's sleep. Not only did the students that studied more but slept less get worse grades on the tests, but they had incorrectly predicted they would outperform their peers who studied less but were more rested before the test.

This is a pervasive problem in our society. Many people believe that they can learn to adapt to less sleep in order to be more productive, but the results of studies on sleep loss tell another story.

Immunity is compromised. Additional research examining sleep loss showed that reducing sleep to four hours for only one night caused a drop in natural killer cell activity which did not return to normal even after the subjects were given a full night of recovery sleep the next day!

Other areas of your health are affected. Additional research has shown a link between sleep loss and inflammation, a decrease in hormones necessary for the control of appetite, obesity and overall disease mortality. (1,2)

We are now beginning to recognize the health benefits of sleep, but what can you do if you have sleep problems?


First, report this to your physician. Insomnia can be caused by illness and certain medications. If sleep loss is affecting your ability to function, you should be screened for sleep disorders, including sleep apnea, a disorder where the airway becomes so relaxed that it prevents airflow. Untreated, sleep apnea can result not only in excess fatigue, but can also lead to serious health problems including high blood pressure and heart disease.

If sleep problems are severe, your physician may prescribe a sleep aid, but medication comes with it's own risks, and is usually beneficial as an adjunct to therapy which can help with a long term solution.

Cognitive Behavioral Therapy is used to treat insomnia in order to help change unhelpful thinking patterns that can feed anxiety and depression, and result in excessive rumination, repetitive distressing thoughts that interfere with the ability to fall asleep.

What are some things you can do to improve sleep and overall sleep quality?

  1. Have a pattern. Try to go to bed at the same time

  2. Try to get regular exercise during the day, but not right before bedtime.

  3. Avoid caffeine several hours before bedtime such as chocolate, tea, soda & over the counter medications that include caffeine.

  4. If you're hungry, have a light snack but avoid heavy late night meals and rich or spicy food.

  5. Avoid nicotine right before bedtime.

  6. Avoid alcohol which has a paradoxical effect on the body, initially causing you to feel sleepy but once metabolized, can cause you to wake up and have trouble getting back to sleep.

  7. Avoid looking at your tablet, computer, or phone before bedtime. The blue light has been shown to interfere with melatonin production and keep you alert. (3)

  8. Control the environment. Block out light and noise.You can install black out shades if there is still light coming through the window or if you do shift work and sleep during the day.

  9. Use the bed for sleep and sex. Do not sit in bed to read, write, or use your computer.

  10. If you cannot get to sleep after 15 minutes, get up and do something else, such as reading, listening to soft music, or writing in a journal (studies show that making todo lists or writing down your thoughts can be helpful if you are ruminating.)

©Evelyn Farrell, 2013

References:

  1. “Why sleep is important for health: a psychoneuroimmunology perspective” vol. 66 (2014): 143-72.

  2. Besedovsky, Luciana et al. “Sleep and immune function” vol. 463,1 (2011): 121-37.

  3. Rahman, Shadab A et al. “Effects of filtering visual short wavelengths during nocturnal shiftwork on sleep and performance” vol. 30,8 (2013): 951-62.

#Sleep #insomnia

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