Healthy sleep is one of the main pillars of health, wellness and longevity,  yet most people don’t get nearly enough. In fact, two thirds of adults throughout all developed nations fail to obtain the recommended average eight hours of sleep every night.

I have been one of those sleep deprived adults, and I have made it a goal and priority to improve my sleep habits for 2018. I have been researching my own sleep issues for the past year and have learned so much about the importance of good sleep. For example, I realized I’ve been suffering from a combination of two common sleep disorders:

1. Sleep deprivation: giving oneself an inadequate opportunity to sleep (staying up too late, getting up too early, not allowing the 8+ hours window in bed)
2. Insomnia: Suffering from an inadequate ability to sleep even when allowing the 8 hours in bed (there is a difference between sleep *onset* insomnia – not able to fall asleep at the beginning of the night –  and sleep *maintenance* insomnia, the difficulty staying asleep. I have been dealing with the latter one.)

My sleep problems developed gradually over the last 15 years or so. I married a night owl (while I am a morning lark), and got into the habit of staying up too late to spend time with him and, when we became parents, to “work on stuff.” We had twin babies in 2003 and for the first year I barely got any sleep. It didn’t help that I was traveling with the babies quite a few times by myself (Germany, Pasadena, Texas, Portland – every time I sacrificed my own sleep – what was I thinking?). Given that 1.2 Million accidents are caused by sleepiness each year in the United States,  I will be forever grateful that I wasn’t one of them.

I taught early morning exercise classes at the YMCA despite going to bed late the night before. But I really hit rock bottom with several months of almost no sleep at all in the first half of 2016 when my marriage of then 16 years fell apart. I would lay awake at night, with a truck on my chest (obviously, we had more differences than just our opposite circadian rhythms). I tried to deal with the insomnia myself, to no avail, and finally saw my physician who put me on sleep medication (Lunesta) – I have since learned that prescription sleeping pills should not be the first choice to treat insomnia.  After that I started to do my own research and took my sleep problems into my own hands, making it a priority to get more sleep.

Arianna Huffingtons’s book “The Sleep Revolution” kicked off my sleep research last summer. I missed her talks in the Bay Area which I heard were very captivating. Two months ago I attended a lecture by Matthew Walker, author of “Why We Sleep”, at the Commonwealth Club in Palo Alto. This eye opening lecture was a fantastic introduction to the science of sleep. Walker’s book was just published and I found it extremely helpful and very insightful, especially in the context of learning for our children and in preventing major diseases like Alzheimer’s.

Walker is a professor of Neuroscience and Psychology at UC Berkeley and the Director of its Sleep and Neuroimaging Lab. He calls the ‘silent sleep loss epidemic the greatest public health challenge we face in the 21st century.’

Instead of writing a lengthy essay about the information I learned, I have summarized the most compelling facts and knowledge that I have compiled from my research, Walker’s book and my own methods to improve sleep practices.

Problems due to lack of sleep:

1. The shorter you sleep, the shorter your life.
2. Lack of sleep is linked to every major disease and suicide.
3. The elastic band of sleep deprivation only stretches so far before it snaps.
4. Insufficient sleep is a key lifestyle factor determining whether or not you will develop Alzheimer’s Disease. Margaret Thatcher and Ronald Reagan, both known for sleeping only 4-5 hours each night, went on to develop Alzheimer’s. Getting too little sleep across the adult life span will significantly raise your risk of developing Alzheimer’s disease.
5. The World Health Organization (WHO) has determined that sleep loss is an epidemic in industrialized nations.
6. The WHO considers night shift work to be carcinogenic.
7. 1.2 Million accidents are caused by sleepiness each year in the United States. Vehicle accidents caused by drowsy driving exceed those caused by alcohol and drugs combined. It’s like drunk driving, you think you are fine to drive, but you are not. Even more dangerous: drowsy truckers.
8. We tend to eat more and in unhealthier ways when we are sleep deprived.
9. Biggest misconception – the notion of somebody saying “I am the first one who can operate on 4 hours of sleep”.
10. It is a myth that older people need less sleep – they frequently don’t get enough sleep due to other health issues.
11. Daylight savings time: 1.5 billion people are forced to reduce their sleep by one hour for a single night each year. This sleep reduction comes with a frightening spike in heart attacks the following day. Interestingly, in the Northern hemisphere, when the clocks move back and we gain an hour of sleep opportunity time, rates of heart attacks plummet the day after. A similar rise-and-fall relationship can be seen with the number of traffic accidents.

Sleep benefits:

1. 7-9 hours is recommended, non negotiable: 8 hours average of sleep. You cannot catch up on lost sleep like with sleeping in on the weekend.
2. Sleep is the Swiss Army Knife of life/ health.
3. Sleep is blood pressure medication.
4. “Prescription sleep” – it is painless, enjoyable and free.
5. Sleep is mental and emotional First Aid.
6. Numerous functions of the brain are restored by, and depend upon, sleep. Sleep enriches a diversity of functions, including our ability to learn, memorize, make logical decisions and choices.
7. Sleep acts like a nighttime “power cleanse”, which helps “wash away” the buildup of beta-amyloid (a toxic form of protein) plaques in the brain, associated with Alzheimer’s Disease.
8. Sleep is the single most effective thing we can do to reset our brain and body health each day.

Sleep and school:

1. Sleep deprivation is seriously linked to the # 1 and # 2 causes of death in young adults in developed countries: car crashes and suicide.
2. Adolescents face two harmful challenges in their struggles to obtain sufficient sleep as their brains continue to develop: change in circadian rhythm and early school start. They are robbed of some critical amount of sleep which interferes not only with learning but also with the control of emotions and behavior.
3. A century ago, schools in the US started at 9am and as a result, 95% of all kids woke up without an alarm clock.
4. That critical stage in the final hours of sleep, REM sleep, often creates a difference between a stable and unstable mental state (mental illnesses often develop through adolescence).
5. Delayed school start times combat truancy and behavioral problems.
6. 10am school start time would be perfect.
7. Later school start: life expectancy in teens increases – fewer car crashes.
8. Sleep enhances the education and lifespan of our children.
9. Sleep is crucial the day before and the day after learning.
10. Sleep is critical for learning performance, sleep essential after learning for memory, like a “save” button.
11. Strong link between sleep deficiency and ADHD. Both show basically the same symptoms: irritability, unable to maintain focus and attention, moody, distractible, often mental health instability.
12. Sleep improves the motor skills and sport performances of all athletes –  fewer injuries.

Habits that interfere with sleep:

1. Alcohol is a sedative. Alcohol consumption causes sleep fragmentation which results in waking up several times throughout the night thus blocking healthy dream sleep.
2. Caffeine – we are self medicating our sleep deprivation.
3. Caffeine has an average half-life of 5-7 hours. “De”-caffeinated does not mean “un”-caffeinated. Seize caffeine intake after 1-2pm.
4. 10 million people in America have taken sleep medications within the last month.
5. The original Star Wars movies required more than 40 years to amass $3 billion in revenue. It took Ambien (one of the most popular sleep medications) only 24 months to amass $4 billion in sales profit, discounting the black market.
6. Sleeping pills pose higher risk of death and cancer.
7. Sleeping pills do not provide natural sleep, can damage health, and increase the risk of life-threatening diseases.
8. Sleeping pills are sedatives that target the same system in the brain that alcohol does.
9. Sleeping pills produce rebound insomnia, caused by dependency.
10. Instead: CBT-I (cognitive behavioral therapy for insomnia)  should always be first choice to treat sleep disorders, alternative to sleeping pills, work with therapist, no side effects.
11. Melatonin is not a powerful sleeping aid. There may be little, if any, quality melatonin in the pill. There is a significant sleep placebo effect of melatonin. Over-the-counter melatonin is not commonly regulated by FDA.

Sleep apps:

1. What gets measured, gets managed:  trackers seem to be helpful, monitor sleep and waking time behavior. You might get less sleep than you think.
2. The 10 Best Sleep Trackers in 2017
3. APPs: CALM, Headspace (meditation), sleep guidance

Practice good sleep hygiene:

1. No electronics, TV or cell phones in the bedroom.
2. Stick to a sleep schedule. Go to bed and wake up at the same time each day (both weekend and weekday). Make enough time for sleep.
3. Keep bedroom at cool temperatures like 67 degrees.
4. Keep the room dark. Turn the clock’s face out of view to avoid anxiety.
5. Avoid caffeine, nicotine and alcohol.
6. Avoid large meals and beverages late at night. Large meals can cause indigestion; drinking too many fluids can cause frequent awakenings to urinate.
7. Don’t take naps after 3pm.
8. Relax before bed. Establish a bedtime routine.
9. Don’t lie in bed awake. If you lie awake for more than 20 min, get up and do something relaxing like reading.
10. Avoid sleep medications. Seek cognitive behavioral therapy instead.

Things that I have changed to get better sleep:

1. I go to bed earlier, provide the time window for sleep – if you need 8 hours of sleep and have to get up at 6am, you just have to do the math. As a morning person, the best and most uninterrupted sleep I get when I go to bed around 9:15pm or 9:30pm.
2. For years, an annoying street light let in more light than I wanted through my white curtains in my bedroom. Finally, I got a big piece of blackout cloth from Jo-Ann Fabrics, attached two loops at the corners and two hooks in the wall and now cover up the window with this fabulous piece of cloth every night for a pitch dark room! It’s a day and night difference (pun intended).
3. When I got a Fitbit Charge 2 to track my sleep, I realized how little sleep I was getting. It tracks sleep pretty accurately through heart rate and movement. It shows I get an average of almost 7 hours of sleep a night now. Still to be improved!
4. No electronics in the bedroom or before sleep.
5. I have no more tea/ caffeine after 2pm. (I used to drink black tea well into the afternoon).
6. I enjoy my sleep routine of lavender drops on my pillow, ear plugs and a little reading. I also used a sleep mask before I got the blackout cloth in front of my window.
7. I completely gave up alcohol as I did not sleep well after even having one glass of champagne.
8. I open the window before bedtime to let cold air in.
9. I used to exercise a lot before my kids even got up but I made sleep a priority: Sleep comes before exercise. I only go to early morning workout classes now when I wake up by myself and feel rested.
10. The “Square breathing technique” helps me to fall back to sleep when I wake up in the middle of the night or early in the morning. This deep or “box” breathing technique often makes me sink into the mattress. There are links and videos online to learn more about it.

Lastly, I have a great gift idea for you if you have a loved one who suffers from insomnia: put the Matt Walker book into a nice package with lavender oil, a sleep mask and some ear plugs. If you are handy and they are not, help them install some blackout curtains or blinds if their bedroom is too bright. I wish I had done this years ago! I even found a list of gift ideas for insomniacs.

Helpful links:

“Why We Sleep” by Matthew Walker, PhD
“The Sleep Revolution” by Arianna Huffington
Recording of the Matthew Walker talk: Why We Sleep
National Sleep Foundation

Have a great start into the new year and I wish everyone a good night’s sleep!

In Health, Constance