After practicing medicine for 19 years, day in and day out, I find myself becoming a crusader of sleep. I have realized sleep gives immediate relief to fifty percent of the cases I see on a daily basis. My regular patients will often recall me exploring their sleep patterns very often. We have become a society that burns the candle from both ends. Our country is a place where people stay up late into the night watching television, study, work or to have fun.
Health by definition is a disease-free state. I am sure a lot of you would want to know about: heart issues, diabetes, asthma, metabolic syndrome, obesity, menopause, andropause, depression, anxiety and addiction. The list is endless; instead I decided to write on one of the most ignored aspect of daily health: YOUR SLEEP.
However, going without enough sleep has its consequences. Lack of sleep can have an immediate effect on judgment, mood, ability to learn, memory and may increase risk of accidents.
According to the National Highway Traffic Safety Administration * in the US,
Driver fatigue is responsible for an estimated 100,000 motor vehicle accidents and 1500 deaths each year.
In the long-term, lack of sleep may lead to health problems including obesity, diabetes, heart disease and even early death.
Sleep is typically classified into two stages: REM and NREM (Rapid eye movement and Non Rapid eye movement). Usually, sleepers pass through five stages: 1, 2, 3, 4 and REM (rapid eye movement) sleep. These stages progress cyclically from 1 through REM then again restart with stage 1. A complete sleep cycle takes an average of 90 to110 minutes. The primary sleep cycles have relatively short REM sleeps and long periods of deep sleep, but later in the night, REM periods lengthen and deep sleep time decreases. That is why the early part of your sleep is very important. It is the NREM 1-4 stages when the body rejuvenates; cellular repair and regeneration happens.
The amount of sleep needed depends on many factors, including age. An infant requires 16hours of sleep, teenagers need an average of 9hours and adults need seven to eight hours of sleep. As people get older they sleep lightly and for shorter spans of time. About half of the people over 65 years of age, have a higher risk of frequent sleep disorders. Studies have shown that people who sleep less then six hours are much more likely to have higher BMI compared to people who sleep eight hours. During sleep, our bodies secrete leptin (abhormone that helps control appetite). Insufficient sleep is associated with lower levels of Leptin, but higher levels of Gherlin (a biochemical that stimulates appetite). This explains why poor sleep may result in food cravings, having consumed adequate calories. Poor sleep leads to an increase in cortisol (stress hormone) and excessive insulin secretion. Higher insulin levels promotes fat accumulation, causes obesity and early diabetes.
Researches have found that inadequate sleep influences the way glucose is metabolized in our body. This may lead to type 2 diabetes. Epidemiological data has revealed, adults who sleep less than five hours per day have increased risk of developing diabetes. If people who have hypertension suffer lack of sleep for one night, they will have an elevated blood pressure throughout the entire day. Poor sleep from obstructive sleep apnea (condition in which episodes of complete cessation of breathing throughout the night) causes heart disease and diabetes. People with this disorder experience multiple awakenings during the night. This causes surges in blood pressure on awakening, which becomes permanent hypertension in future. Sleep apnea is very easily curable, with the right treatment, helps in reducing elevated blood pressure.
One very important aspect of lack of sleep is decreased immunity. When we suffer from an infection we feel extremely sleepy and fatigued. Research has shown that when the immune system fights an infection, it releases cytokines which also causes sleep. In animal research, it has shown that those animals who got a deep sleep during a microbial infection had better chances of survival. Mood disorders are conceivable from insufficient sleep. From increased irritability, depression, anxiety, diminished optimism to mental exhaustion, they are all related to chronic lack of sleep. These improve dramatically with adequate sleep.
Alcohol usage is very common in individuals with inadequate sleep. Initially alcohol acts as a mild sedative, but as the body starts metabolizing the alcohol, it begins to stimulate part of the brain that causes arousal, which leads to sleep problems later in the night.
A large percentage of our population suffers from sleep deprivation; very few mention this to their doctors. Yet I have noticed doctors remain non-inquisitive regarding their patient’s sleep patterns. I sincerely wish that after reading this article your awareness regarding sleep and its importance to yours and others health will be sharpened. Remember, the relationship between sleep and health is symbiotic: one cannot survive without the other.
I leave you with some tips for the restful night’s sleep:
- Have a schedule of same bedtime and wakeup time
- Have a relaxing bedtime ritual away from bright lights
- Avoid afternoon naps if you have trouble sleeping
- Exercise daily
- Soothing environment with cool temperature, free from lights, noises, distractions
- Make sure the mattress and pillows are comfortable & supportive.
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About The Author
Dr. Chhavi Goyal-Mehra – MBBS, MD – University of California Sanfrancisco, Diplomate American Board of Internal Medicine.