Sleep

The Value of Sleep

Everyone sleeps. Sleep is both natural and essential, and it contributes significantly to your mental well-being and your physical health. Yet more than a third of adults have sleep problems.^[1]

Adults typically spend (or should spend) one-third of their lives sleeping. Those hours of slumber are not wasted; sleep-time is when essential maintenance of your body takes place. If you don’t enjoy seven to nine hours of sleep in each 24-hour period, you won’t perform at your best when you’re awake. Sleeplessness leads to increased exhaustion and a reduced ability to cope with the events of the day. Furthermore, lack of sleep, whether it’s caused by stress, overwork, a frenetic a social life or other factors can directly lead to medical conditions that include obesity, heart disease and diabetes.^[2]

There really is no substitute for sleep, so taking steps that ensure a peaceful nighttime rest is another healthy living choice you need to make.

Why Do We Sleep?

Think of sleep as a session of intensive offline maintenance for the body. These are some of the internal tasks that take place while you’re fast asleep:

Your brain is creating new cells to replace dead cells, and building new neural connections. This is one of the ways that information you’ve acquired is stored. Sleep plays an essential part in learning, skill acquisition, and the building and embedding of cognitive skills such as problem solving and pattern recognition.

The flow of cerebral fluid in your brain increases during sleep^[3], in order to clear out dead tissue and toxins.

During sleep, your body is busy repairing damage to your circulatory system, building new blood vessels and fighting inflammation in your cardiovascular system, your brain and other organs.^[4]

Your immune system never stops functioning, but during sleep it gets a chance to catch up. There is evidence that sleep plays a role in building your immunological memory and countering low-grade inflammation.^[5]

During deep sleep the body releases growth hormones that foster the building and repair of muscles and other tissues. The same mechanism ensures normal development in children and young adults.

Sleep influences the way your body reacts to insulin, the hormone that controls your blood glucose level, and thus helps to determine yourrisk for diabetes and stroke.

How Much Sleep Is Enough?

Most adults need between seven and nine hours of sleep each day. Some people claim to be able to get by on just three or four hours sleep. If their claims are correct, they probably are heading for some kind of mental disturbance. It’s more likely that their three or four hours in bed are supplemented by naps and snoozes during the day, and slumbering in front of a TV for a few hours in the evening.

You can tell if you’re not getting enough quality sleep if you frequently:

Fall asleep, doze or have to fight against sleep when you’re stuck in traffic, watching TV, reading a book or sitting at a desk trying to get some work done.
Have persistent difficulty getting to sleep when you go to bed.
Wake in the middle of the night and are unable to go back to sleep.
Have difficulty getting out of bed, and routinely feel tired and grumpy during the day.
Overreact emotionally to small difficulties.

If you are concerned about the amount and quality of sleep you are getting, you might be interested in learning a bit more by completing the questionnaire provided by the World Sleep Survey^[6], which covers a number of different perspectives. (Please note that this online questionnaire is not intended to replace professional diagnosis or consultation; it may provide some insights and an indication of possible problems, but not much more. If you are seriously concerned, obtain professional advice.)

Sleep Deficiency

Lack of sleep or disturbed sleep patterns can lead to:

An increased risk of heart disease^[7], kidney disease, obesity, high blood pressure, diabetesand stroke
A higher chance of neurological illnesses, as a result of insufficient clearance of dead tissues and toxins
Low-grade inflammationthroughout the body
Immunodeficiency^[8]
Less resistance to common infections, such as colds, coughs and flu, and to allergens

If that isn’t enough, lack of sleep also manifests itself during daytime in ways that decrease our performance and increases risk:

Lack of sleep reduces alertness and increases nervous systemresponse times, which results in higher risk of driving accidents, household accidents, injuries caused by machinery and sports injuries. The risk of injury is increased not just for the fatigued person but for others in the vicinity.
Tiredness affects your mood. People who are tired are more likely to be depressed, less likely to be enthusiastic, and may lack the ability to focus and concentrate.
Tiredness leads to mood swings and emotional responses, which can negatively impact the way we interact with people.
Tiredness affects judgment, so tired people are more likely to take unnecessary risks.

There is a definite pattern of dysfunction related to tiredness, and it’s not surprising that people who do not get enough sleep suffer from additional stress as a result. We also know that a person experiencing stress and anxiety finds it more difficult to sleep. So people can enter a sleep-stress-sleep cycle,^[9]in which lack of sleep causes more stress, which results in restless (or no) sleep, and so on.

Breaking an ongoing cycle like this requires, first and foremost, stress reduction.^[10]You can’t wave a magic wand and eliminate stressful events, but the various recommendations for stress reduction that appear later in this chapter will go some way toward reducing stress. We need to replace the downward sleep-stress-sleep cycle with an upward self-reinforcing trajectory that results in more sleep and less stress.

How to Sleep Longer and Better

Around one-third of adults in the U.S. don’t get enough sleep^[11], so if you feel you have a sleep problem, you’re not alone. In addition to working on mindfulness and stress reduction, it might improve things by just changing the way you approach sleeping. Here are some examples.

Exercise More

My No. 1 tip for sleeping longer and better is to get more exercise. If you don’t exert yourself, you will not sleep well. No matter what else is going on that might be disrupting your sleep, the first step is to increase your physical activity. Body movements demand more oxygen, and that oxygen reaches all parts of your body, including your brain. Your body uses more energy, and that causes genuine sleepiness. Exercise also reduces stress and anxiety, which in turn encourages beneficial sleep. I suggest avoiding vigorous exercise within an hour of bedtime to allow your heart rate to settle—and to allow your body to ease into its bedtime routine.

A Calming Bedtime Routine

If you work and exercise right up until bedtime, your mind and body will be fully engaged, and thus it may take longer to fall asleep. Similarly, if you become absorbed in stressful activities just before bed, you’ll still be thinking about them while your eyes are closed. Watching TV or browsing the internet just before bed (or even in bed) can fool your brain into believing it’s not time to sleep: The blue tinted light in these devices is not helpful, so if you have problems sleeping, that could be one of the reasons.

Start winding down at least an hour before you go to bed. Stop working, shut down the computer, switch off the TV. Connect your smartphone to its charger (outside the bedroom) and leave it there. If you are feeling stressed, a warm bath and a warm drink (herbal tea) can be relaxing. Also, anxiety levels can be reduced with a short meditation session before sleeping.

Sleeping Environment

Consider your sleeping environment. It should be quiet, welcoming, comfortable and dark, with curtains or shades that block outside light. Many bedrooms are busy with unnecessarily bright LED indicator lights on various devices: You can put some sticky tape on them to block or dim the light. If you have an LED clock, turn it away from you, or replace it with an old-fashioned clock.

Some people sleep better when pulling the sheets back from a properly made bed, so making your bed in the morning should be a daily habit.

How old is your mattress? Mattresses don’t last forever. If yours is more than 10 years old, it’s probably time to get a new one. But it’s not just about age. A well-designed and well-made mattress will last longer than a less expensive one. If it’s been well maintained (regularly turned and vacuumed according to instructions) it also will last longer. If it’s been damaged by spills or been used like a trampoline, it will wear out. Lumps and sags and squeaks mean that you need to buy a new one.

Time Disruptions

Disruptions to your daily patterns of behavior can affect your sleep for several days. Examples of time disruptions include changes to your working hours at either end of the day; traveling across multiple time zones; twice-a-year changes to local time (daylight savings); partying until way past your normal bedtime. All of these can cause sleep disruptions for more than one night. Interruptions to normal schedules can have an impact on your sleep quality, even though you may not be conscious of it. Many people handle time changes with ease, but others who already have erratic sleep patterns can find that a small change has a disproportionate impact. Many of these disruptions are unavoidable if you’re leading a busy life, but you can still do something to reduce the impact. A good approach, if possible, is to plan ahead. Get plenty of sleep before the change happens, and gently adjust your sleeping hours in small chunks as you approach the date of the change.

Cigarettes and Alcohol

If you smoke cigarettes, you are more likely to have unsatisfactory sleep patterns. The remedy is to quit smoking, although it’s understood that words alone won’t change this habit. As for drinking alcohol immediately before bed, it generally reduces the quality of your sleep. Sometimes alcohol can bring on drowsiness, but it doesn’t encourage good sleep. If you keep within the “moderate” levels of alcohol consumption described earlier, and avoid alcohol within a couple of hours of going to bed, you may improve things. But the best course of action, if you have sleep problems, is not to drink alcohol in the evening (or at all) until your sleep patterns improve.

Caffeine

When someone needs to fight drowsiness, they tend to drink a caffeinated drink. Coffee, tea, and caffeinated sodas all work to keep people awake, so it’s hardly surprising that caffeinated drinks, before bedtime, are disruptive to sleep. Try and drink caffeinated drinks in small quantities, and only in the morning and early afternoon. It helps to allow at least eight hours between your last cup of coffee and going to bed; that gives the caffeine time to work through your system.

An Overactive Brain

Too much thinking can be a problem. Even without high levels of stress, some people lie awake thinking through problems, or just trying to do work. You should try to avoid working in bed. One approach is to use meditation or relaxation techniques to remove focus from these thoughts and encourage sleep. Another approach is to get out of bed and work when this happens—and then come back to bed when you actually feel sleepy.

Productive thinking in bed is not so good, but too much useless thinking is an even worse problem. Trying to solve things that you can’t do anything about is a waste of your sleep hours. For example, if you’re anxious about a forthcoming event (a speech, an interview, an appearance on a talk show), don’t ruminate endlessly over your anxiety. If you can do something (like write notes about the next day’s activities) then do it immediately to defuse the anxiety. If you can’t do something, then do some mindfulness meditation, or find a brain challenge that allows you to displace your anxiety-forming thoughts.

Naps, Siestas, Awakenings

Having more than one session of sleep during the span of a day is nothing to worry about. It’s quite natural for some people, and there’s no rule that your eight hours of sleep must be in one continuous stretch.^[12]If you nap during the day for, say, half an hour, that might even be good for you.^[13]Siestas are part of the culture in many countries, allowing people go to bed later and still get up early without suffering a sleep deficit. Some people routinely wake up in the night, do something for a couple of hours and then go back to bed and sleep. If you feel that works for you, then don’t become anxious about it.

^[1]. Sleep statistics: https://www.sleepassociation.org/about-sleep/sleep-statistics/

^[2]. Why lack of sleep is bad for your health: http://www.nhs.uk/Livewell/tiredness-and-fatigue/Pages/lack-of-sleep-health-risks.aspx

^[3]. While you call it quits for the day, your mind does some serious work: https://sleep.org/articles/brain-during-sleep/

^[4]. How sleep deprivation affects your heart: https://sleepfoundation.org/sleep-news/how-sleep-deprivation-affects-your-heart

^[5]. Sleep and immune function: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256323/

^[6]. World Sleep Survey: https://www.worldsleepsurvey.com/sleep-score

^[7]. The Physiology of Sleep – The Cardiovascular System: http://sleepdisorders.sleepfoundation.org/chapter-1-normal-sleep/the-physiology-of-sleep-the-cardiovascular-system/

^[8]. Sleep and immune function: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256323/

^[9]. Sleep-stress cycle: http://www.apa.org/news/press/releases/stress/2013/sleep.aspx

^[10]. How to break the stress-sleep cycle: http://www.ahchealthenews.com/2016/11/28/break-vicious-stress-sleep-cycle-2/

^[11]. Sleep deprived: http://www.medicaldaily.com/nearly-third-americans-are-sleep-deprived-240273,

^[12]. The myth of the eight hour sleep: http://www.bbc.com/news/magazine-16964783