Sleep is often the first thing executives sacrifice to pack more hours into the day. Long days run into even more grueling evenings, and sack time is often “stolen.” This kind of self-denial can be sustainable for surprisingly long intervals but, sooner or later, the piper has to be paid.
Most experts believe sleep is the time we require to recharge our mind and body. It’s practically a given that high-level wellness cannot truly be attained without adequate restful sleep. However, many professions and lifestyles practically demand chronic sleep deprivation.
How can you tell if you’re sleep deprived? Just answer the following questions: Do you often feel like you need a nap during the day? Do you fall asleep while watching TV? Have you ever fallen asleep while waiting at a red light in your car, or felt so overwhelmingly sleepy that you had to pull off the road? Do you have trouble comprehending or remembering newspaper articles or feel taxed while doing basic math? If you answered “yes” to any of these questions, you may not be getting enough sleep.
Forms of sleep deprivation
The vast majority of us need between seven and nine hours of uninterrupted sleep per night. And it’s not always lack of sleep alone that creates deprivation. Other factors that reduce the quality of sleep can have nearly the same detrimental effect. Sleeping all night in an uncomfortable place or waking up several times during the night will have the same kind of adverse impact.
Sleep disorders affect as much as 20 percent of the population and can take several forms. Insomnia means difficulty falling and/or staying asleep. It can be transient, short-term or chronic. Causes include stress; psychological or emotional problems; use of drugs, caffeine, alcohol, stimulants, and/or nicotine; erratic hours, like shift work; a sedentary lifestyle; a noisy environment including traffic, TV, raucous music, a snoring spouse, and/or attention-seeking pets; and physical illness such as breathing problems, pain, injury or restless and crampy legs. Learned insomnia is caused by worrying about not being able to sleep.
Sleep apnea means you stop breathing for variable intervals. It’s caused by various obstructions to your air passages while asleep. Blocked breathing causes low blood-oxygen levels, which directly cause loss of mental acuity. Some of the more dire consequences of sleep apnea include dangerous hypertension and sudden death. Signs that you may be affected by sleep apnea include loud snoring, waking up feeling unrefreshed, trouble staying awake during the day, waking with severe tension-type headaches, waking with the sensation of choking, repeated dreams in which you are struggling against something or waking up sweating profusely for no obvious reason.
The physical toll
Although research has largely debunked the notion, studies do continue to pop up claiming people are better off with less, rather than more, sleep. And admittedly, there’s a small minority who are gifted (burdened?) with a lesser physiological need for sleep—as low as three to five hours per night. But the bulk of well-designed sleep and rest studies have built a substantial body of evidence that indicates sleep loss and poor rest quality lead to a host of negative side effects. These include sleepiness, repeated yawning, unexplainable anxiety, impaired concentration, poor memory and general irritability. Other studies have documented a link between exhaustion and stress hormones, which promote tissue breakdown (catabolism) and lead to an impaired immune system.
The psychological toll
Chronic sleep loss also carries a psychological toll. Research has shown that accuracy, memory and judgment can be critically impaired after remaining sleepless for more than 18 to 24 hours. Sleep-deprived people are more prone to depression, have a reduced attention span, are less likely to maintain successful intimate relationships, suffer reduced patience levels and have a greater incidence of dysfunctional family life. They also have a greater overall incidence of mental breaks, psychosis and suicide.
Paying the sleep debt
Studies have demonstrated that when we forego sleep, an internal body monitoring system registers how much has been lost. Generally, a sleep debt must be repaid hour-for-hour. Unfortunately, it seems you can’t grab “extra sleep” in anticipation of doing without it at a later date. Following any loss of sleep, the best physiological policy is to “catch up” as soon as possible to restore the balance of rest and energy.
An overlooked penalty
Hardly ever mentioned in popular articles about sleep deprivation is how it can hurt your spine. You may ask, “What on earth does the spinal column have to do with sleep?” The fact is, people who get less than seven or eight hours of recumbency each night have a higher rate of degenerative spinal disk disease and herniated disks than do people who stay down as long as they should. The disks that support and cushion the block-like vertebrae of the spine have no blood vessels. These disks get all their oxygen, moisture and energy from a daylong “breathing” cycle. In the morning, you’re actually taller than at the end of the day. While you’re standing or sitting, gravity causes your disks to very slowly compress by expelling small quantities of fluid and waste products.
At night while lying flat, normal healthy disks slowly re-expand, restoring fluids and nutrients to normal levels. If you’re recumbent less time than the disks need to finish their “breath,” they won’t fully re-expand or replenish. The end result, when this becomes a regular pattern in your life, is that your disks age prematurely. They become thinner, get brittle, are less able to stand up to stresses and strains and are more likely to rupture (herniate or protrude) and cause back pain and/or sciatica.
Optimizing restorative sleep
The best way to get the rest you need is:
• Sleep when your body is tired.
• Get regular, moderate exercise at least three to four hours before bedtime.
• Take a warm bath or hot shower before bed.
• Avoid alcohol and REM-sleep suppressing drugs, like Valium and its cousins.
• Avoid large meals within four hours of bedtime.
• Sleep in a dark room or use eye shields.
• Avoid late night TV viewing, e-mailing and Web surfing.
• Avoid carbonated and caffeinated beverages and anything containing guarana, pseudoephedrine, ephedrine or stimulants.
• Don’t smoke.
• Don’t take daytime naps unless you’ve found they don’t interfere with falling asleep at bedtime.
• Reserve your bedroom for sleep and intimacy.
• Use relaxation techniques such as meditation, yoga and biofeedback.
• If you’re a bedroom worrier, dedicate another time (say 30 minutes after dinner) to writing down problems and solutions.
• If you can’t sleep, get up, go to another room and do a quiet activity until you feel sleepy.
• Forget the clock.
• If your bladder wakes you up at night, avoid drinking fluids for three to four hours before bedtime.
• Ensure adequate treatment of pain.
• Try aromatherapy, electronic light-sound brain synchronizing devices, massage or a glass of warm milk or tea before bed.
• Exile pets from the bedroom.
By getting all the sleep you need and regaining the benefits of a fully rested mind and body, you’ll add energy to your days and nights, improve the quality of your life and handle stress and minor irritations more effectively. This will optimize your effectiveness at work and put you back on the path toward wellness.
Allen Gruber, M.D., is an anesthesiologist and pain management specialist. He’s been living along the Russian River and practicing medicine in Sonoma County for 15+ years. You can reach him at agruber@northbaybiz.com.
