Sleep Well to Live Well!

We spend about a third of our life in sleep. Why? No one knows exactly, but experts agree that sleep along with nutrition and exercises are necessary for a healthy living. As a culture we value hard work, productivity and efficiency. Americans work long hours, take less vacation, and sleep less in compared to people in many developed nations. Surveys have shown that around one third of the US population may be suffering from one or more sleep problems like difficulty initiating or maintaining sleep, waking up too early, and poor quality of sleep. A recent study found that US workers lose 11.3 days of work due to sleep problems totaling an average of $2,280 per person per year.  In total, untreated sleep problems may cost the US economy $63 billion dollars annually.

So How Much Sleep Do You Need?

The National Sleep Foundation, USA convened multiple experts from various health organizations and came up with the following recommendations:

Life Stage Age Sleep-Needs
Newborns 0-3 months 14 to 17 hours
Infants 4 to 11 months 12 to 15 hours
Toddlers 1 to 2 years 11 to 14 hours
Preschoolers 3 to 5 years 10 to 13 hours
School Children 6 to 13 years 9 to 11 hours
Teenagers 14 to 17 years 8 to 10 hours
Young Adults 18 to 25 years 7 to 9 hours
Adults 26 to 64 years 7 to 9 hours
Older adults 65 years and over 7 to 8 hour

Poor sleep quality or quantity can cause acute and chronic health problems, afflicting the mind and the body.

Mental Problems with Sleep Deprivation:

The brain uses neurotransmitters (NT) to think, remember, analyze and experience emotions. The NT‘s begin to deplete as the day goes and are regenerated during sleep. People with chronic sleep deprivation may have depleted NT which may trigger psychiatric problems. A person not sleeping for days may experience a psychotic or manic episode. Poor sleep is associated with depression, anxiety, and ADHD symptoms. It may diminish cognition, memory, alertness, creativity and problem-solving abilities. Many are familiar with the feelings of irritability, distractibility, fatigue, forgetfulness, and inattention during the day following night-shift work.  Sleep loss not only endangers the individual, but also the community. One without sleep for 24 hours is as impaired as one who is drunk with high blood alcohol level (BAL>0.8). It can lead to slower reaction time, reduced vigilance and deficits in information processing which increases the risk for motor vehicle accidents. The National Highway Traffic safety Administration attributes around 100,000 police reported crashes as the direct result of driver fatigue each year.

Physical Problems with Sleep Deprivation:

Sleep may appear as a quiet time but it’s highly active time for body’s maintenance. Sleep is the time for body’s rest and restoration. Many hormonal changes take place. The pituitary secretes the Growth hormone which is essential for growth and development. In addition there is release of melatonin which is a powerful anti-oxidant and a scavenger of free radicals. Melatonin is anti-inflammatory and plays a crucial role is tissue repair and healing. The stress hormone cortisol drops down at bedtime and helps us to relax and un-wind. The immune system is highly active during sleep: killing the germs, fighting tumor cells, and removing the toxins. The hormones controlling hunger and satiety namely Leptin and Ghrelin are also regulated by sleep. Lack of sleep impairs the body’s glucose metabolism and increases the craving for high calorie food. The above physiological findings are supported by clinical research which has linked sleep deprivation to obesity, hypertension, diabetes and heart attack.  Poor sleep has been shown to reduce immunity along with increased incidence of cancer and infections. Even a single night of lost sleep increases one’s chance of catching the common-cold.  Sleep loos seems to accelerate the ageing process making the body vulnerable to all kinds of maladies.

There are many simple life-style changes which can promote sleep.

 

Ten Tips for Good Sleep:

  1. Schedule Sleep: Maintain a consistent bed-time routine. Go to bed at the same time every night, no later than 12 pm. Try to keep it the same on weekends to keep body’s clock tuned.
  2. Regular Exercise: Try to get some exercise during the day; as little as 20 minutes can help.
  3. Avoid any alcohol, nicotine, and caffeine before bedtime.  Alcohol helps to sleep in short term, but robs the brain of deep restorative sleep in long term. Caffeine present in tea, coffee, soda; nicotine present in cigarettes are both brain stimulants- which makes one more alert and awake, but makes it difficult to fall asleep.
  4. Relaxation: Do some relaxing activity like taking a warm bath, reading, listening to music before bed time. Mindfulness and breathing exercises may also help.
  5. Light: Try to get exposure to sunlight or any full spectrum bright light in the morning. Exposure to light during the day and darkness before bed, will entrain your circadian rhythm to the daily light-dark cycle. This will help you to stay alert and active during day, and tired and sleepy at night.
  6. Try to avoid food few hours before going to bed. Heavy meal before bedtime may impair sleep.
  7. Don’t check emails or work on your laptop just before bed. The mind needs to relax and any activation will impair sleep. Avoid TV, Computer, or bright light before sleep as they inhibit the sleep inducing hormone –melatonin.
  8. Keep your bedroom quiet, cold and, dark. Adjust your thermostat to a lower temperature around 60 to 67 degrees. Use thick curtains to block any light and use white noise to block out any sound.
  9. Use bed only for sleep and sex, and may be some light reading preferably fiction.  Avoid any other activates on the bed or in the bed-room if you can; your body will associate bed with sleep.
  10. Keep a journal or diary at bedside- and write down your thoughts, plans of stress on the paper. This will stop the recurring sleep-disturbing thoughts.

Sleep is vital to life. Seek professional help if you struggle with sleep chronically and experience day-time fatigue. Many of the sleep problems can be resolved with the help of medications and therapy like Cognitive behavioral therapy for Insomnia (CBT-I). To that end – don’t neglect any sleep problems, and make every effort to get good sleep for your health and well being.

Dr. Panchajanya Paul, MD is a staff psychiatrist at DeKalb CSB. He is board certified Child, Adolescent and Adult psychiatrist. He also practices integrative and holistic medicine, and is a diplomat of the American Board of Integrative and Holistic Medicine.

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