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Let's Talk About SLEEP, Baby. Let's Talk About YOU and Z's!


“Human beings are the only species that will deliberately deprive themselves of sleep without legitimate gain.” 

- Matthew Walker, PhD (Author of "Why We Sleep")
                                             
Sleep is a big issue for many people. Some have difficulty sleeping because they are in pain. Others have difficulty quieting their mind at night. Regardless of the cause, a lack of sleep can have some pretty damaging effects. I think we all sort of have a sense that sleep matters, but perhaps not how much or why, so let's go over what some of the research says about sleep.

First of all, the average adult human needs 7-9 hours of sleep each night. This does not mean you should go for 5 days with only 5 hours of sleep and then try to "catch up" on the weekend by sleeping half the day so that your average sleep is 49 hours for the week. While this may work occasionally to mitigate negative effects of limited sleep, this is not a good long term solution. Same thing goes for naps. While naps may occasionally help you get a boost and can be very beneficial if you are otherwise getting sufficient nighttime sleep, you should not rely on them regularly as a way to make up for a significant lack of long-duration sleep.

Young children and teens need even more sleep! Here are the recommended sleep durations by age from the National Sleep Foundation:




Some of the things associated with lack of sleep or poor sleep quality include increased pain and a lower pain threshold. Studies have shown that people who report insomnia or poor sleep quality are more likely to develop persistent or chronic pain. This often leads to the use of opioids to reduce pain; not only do these medications have a lot of dangerous side effects, but research has shown that opioids further reduce sleep quality. Among patients with chronic pain, those taking opioids report greater sleep impairment as well as increased sleep apnea.

Lack of sleep also affects your blood sugar regulation and metabolism. This can contribute to obesity, insulin resistance, and diabetes. Studies have found that young, healthy subjects whose sleep was restricted to about 4 hours per night for 4-6 consecutive nights developed blood profiles similar to older adults with diabetes or impaired blood sugar tolerance. While many people are aware of the influence of diet and exercise on risks of obesity and diabetes, most don't think of sleep as a contributing factor.

Limited sleep has also been shown to impair your immune system. This increases your risk of infection and delays healing. Those who regularly sleep 5 hours or less are 4.5 times more likely to catch a cold. Studies suggest that this immune system suppression may also increase cancer risk.

Your risk of injury is higher if you are skimping on sleep. Workers who reported less sleep were more likely to sustain a work-related injury. Healthy, young, and well-trained athletes have also demonstrated poorer performance and increased risk of injury with limited sleep.

Finally, lack of sleep worsens depression, anxiety, and any task that requires effort and attention. This could affect problem-solving, learning new things, driving, patience, and sticking to a nutrition or exercise plan.

Perhaps the biggest problem with lack of sleep is that our brains are amazing at acclimatizing. With long-term sleep restriction, we will adjust to the feelings of fatigue, the impaired performance, the reduced energy levels and this slowly becomes our new normal. So we will continue to get too little sleep on a regular basis. We will tell people that we just “don’t need” that much sleep. I hear people brag ALL THE TIME how they "only need 5 hours or so”. No, you don’t. You need much more. You are not a sleep super-hero.

Those who DO recognize sleep is important may begin to take sleep medications in an attempt to get those Z's. This can be dangerous. Not only are there many risky side effects associated with sleeping pills, but it is actually natural sleep that your body needs to be able to repair, improve immune function, metabolism, and mental function. Sleeping pills are like fixing a hole in the wall by covering it with a poster, rather than repairing the wall itself.

We all have stress, work, sick kids, and many other things competing for our time. The to-do list seems never ending. I admit that I struggle with this myself. Something I am guilty of is staying up too late because everyone else is in bed, the house is finally quiet, and there is no one who needs anything from me. ALONE AT LAST! Even though I know I should go to bed, I stay up too long reading, watching Netflix, or catching up on work. Many times with a glass of wine (which further reduces sleep quality, by the way).

I get it. It is HARD. Creating a new habit and charting a new path takes time. Realizing that it is an issue in the first place is a great start.

Think of times in your life where you went for long periods getting little sleep. Maybe with young children, or a stressful time at work, or recovering from an injury, illness, or surgery. There will be those times, for sure. What we need to do is set ourselves up to be able to handle those brief insults by having a good sleep base to begin with. If we are already in a sleep debt when we get to one of those times, we are going to be so much worse off.


For more information, here is a great book on how a little more sleep might just change your life: Why We Sleep



REFERENCES

1. Hirshkowitz M, Whiton K, Albert SM, et al. National Sleep Foundation’s sleep time duration recommendations: Methodology and results summary. Sleep Health. 2015;1(1): 40-43. https://doi.org/10.1016/j.sleh.2014.12.010

2. Watson NF, Badr MS, Belenky G, et al. Recommended amount of sleep for a healthy adult: A joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep. 2015;38(6):843–844. https://doi.org/10.5665/sleep.4716

3. Lentz MJ, Landis CA, Rothermel J, Shaver JL. Effects of selective slow wave sleep disruption on musculoskeletal pain and fatigue in middle aged women. J Rheumatol. 1999;26(7):1586–1592. http://www.jrheum.org

4. Keiko Y, Yasuhiko K, Yuji, S, Masahiko, S, Nobuo, M. Association of sleep sufficiency and duration with chronic pain prevalence: A population-based cross-sectional study. J Psychosom Res. 2019;120:74-80. https://doi.org/10.1016/j.jpsychores.2019.03.005

5. Morasco BJ, O’Hearn D, Turk DC, Dobscha SK. Associations between prescription opioid use and sleep impairment among veterans with chronic pain. Pain Med. 2014;15(11):1902-11. https://doi.org.10.1111/pme.12472

6. Broussard JL, Chapotot F, Abraham V, et al. Sleep restriction increases free fatty acids in healthy men. Diabetologia. 2015;58(4):791-8. https://doi.org/10.1007/s00125-015-3500-4

7. Jun, JC & Polotsky VY. Are we waking up to the effects of NEFA? Diabetologia. 2015;58(4):651-53. https://doi.org/10.1007/s00125-014-3489-0

8. Briançon-Marjollet A, Weiszenstein M, Henri M, et al. The impact of sleep disorders on glucose metabolism: Endocrine and molecular mechanisms. Diabetol Metab Syndr. 2015;7:25. https://doi.org/10.1186/s13098-015-0018-3

9. Knutson KL. Impact of sleep and sleep loss on glucose homeostasis and appetite regulation. Sleep Med Clin. 2007;2(2):187–197. https://doi.org/10.1016/j.jsmc.2007.03.00

10. Prather AA, Janicki-Deverts D, Hall MH, et al. Behaviorally assessed sleep and susceptibility to the common cold. JSDR. 2015;38(9):1353-1359. http://doi.org/10.5665/sleep.4968

11. Besedovsky L & Born J. Sleep, don’t sneeze: Longer sleep reduces the risk of catching a cold. JSDR. 2015;38(9):1341-1342. http://doi.org/10.5665/sleep.4958

12. Blask DE. Melatonin, sleep disturbance and cancer risk. Sleep Med Rev. 2009;13(4):257-264. https://doi.org/10.1016/j.smrv.2008.07.007

13. Knutson KL. Impact of sleep and sleep loss on glucose homeostasis and appetite regulation. Sleep Med Clin. 2007;2(2):187–197. https://doi.org/10.1016/j.jsmc.2007.03.00

14. Milewski MD, Skaggs, DL, Bishop GA, et al. Chronic lack of sleep is associated with increased sports injuries in adolescent athletes. J Pediatr Orthop. 2014;34(2):129-33. https://doi.org/10.1097/BPO.0000000000000151

15. Johnston R, Catalan R, Bonnett L, et al. General health complaints and sleep associated with new injury within an endurance sporting population: A prospective study [published online November 01, 2019]. J Sci Med Sport. 2019. https://doi.org/10.1016/j.jsams.2019.10.013

16. Lombardi DA, Folkard S, Willetts JL, Smith GS. Daily sleep, weekly working hours, and risk of work-related injury: US National Health Interview Survey (2004-2008). Chronobiol Int. 2010;27(5):1013-1030. https://doi.org/10.3109/0742058.2010.489466





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