Sleep Debt

In my last entry, I asked if you were getting enough sleep.  Our bodies require homeostatic regulation, which means that without the required amount of sleep you develop a sleep debt, which is cumulative. It is fairly simple to determine what your sleep debt is.  Take the amount of sleep your body needs (discussed in previous blog entries) and subtract the amount of sleep that you are getting.  If your body needs 9 hours of sleep a night and you are only getting 6 hours of sleep, then that is 3 hours of sleep debt that you have acquired in one night.  By the end of the week, 7 days times 3 hours, you have accumulated 21 hours of sleep debt.  Accumulated sleep debt results in uncontrollable falling asleep, regardless of the circumstances.  In a study done by the Centers for Disease Control (CDC), it was found that 40% of adults report falling asleep during the day at least once in the last month.  As discussed in the last blog, if this happens when behind the wheel, that can be incredibly dangerous and perhaps even deadly.  According to the CDC, 30% of adults get less than 6 hours per night and 70% of high school student report getting less than 8 hours per night.  In addition, many people who think that they are getting the sleep that they need may not be getting that sleep due to compromised quality of sleep, e.g. sleep disordered breathing, which affects 5- 25% of the population.  What is your sleep debt?

Are You Getting Enough Sleep?

Chances are you might not be getting enough sleep.  The Centers for Disease Control and Prevention (CDC) say that 25% of adults in the United States do not get enough sleep at least half of the time and 25% of teens are only getting 6.5 hours of sleep or less.  This has far reaching consequences even beyond the health issues that I have already addressed in previous posts.  That National Highway Traffic Safety Administration states that 100,000 crashes occur every year due to driver fatigue.  This leads to 1,550 deaths and 70,000 injuries annually.  It is important to get the amount of sleep that your body needs!

Let's consider some of the signs to look for to determine if you are getting enough sleep: 

Are you more emotional than usual?  As mentioned before, sleep has a huge impact on your emotions, and feeling overwhelmed by emotions and stress may be a sign that you are lacking the sleep needed to provide you with the resources to deal with situations that you could handle if you were fully rested. 

Are you having poor motor skills or visual problems?  An important part of sleep is restoring our body to be able to function, and when we don't get enough sleep even some of our most basic functions can suffer.

Are you having a hard time concentrating or making decisions?  In an earlier post, I addressed how sleep aids the brain's ability to process complex tasks or come up with creative solutions.  A lack of sleep can make it so that you are not able to do these things, thus making it difficult to concentrate or make decisions.   

Are you having a hard time remembering things?  As also previously discussed, sleep is necessary for consolidation of memory, and lack of sleep means that you are not able to give your brain the opportunity to do what it needs to do. 

Are you more hungry than usual or gaining weight?  I also have talked in a previous post about how the hunger hormone ghrelin is released when a person does not get enough sleep.  

And the final question to ask yourself is "when I get up in the morning do I feel rested?"  If the answer is "no," then you might not be getting enough sleep or you might have a sleep disorder such as sleep apnea.

If after reading this you came to the conclusion that you need more sleep, then see my previous posts for some ideas on how to get more sleep.  If you are concerned that you may have a sleep disorder such as sleep apnea, consult your physician.

 

Sleep and the Immune System

There have been some fascinating studies looking at our sleep cycles and how the genes that set the body's circadian clock are connected to our immune cells.  Researchers have found that the proteins produced by our "clock genes" attach to genes for a protein (NFIL3) that guides the development of immune cells and turns on the activity of other cells.  This activity varies by day/night cycles with less of this protein (NFIL3) being produced in the day than at night.  What this means is that we need a healthy pattern of sleep, i.e. patterns of light and dark.  This will help to keep the immune system in balance.  This is especially true for disorders of inflammation (heart disease, asthma, chronic pain, bursitis, dermatitis).  In developed countries, where people's circadian rhythms are chronically disrupted, there are more inflammatory conditions.  These chronic disruptions to our rhythms are related to things mentioned in past posts, such as staying up too late and looking at lit-up screens into all hours of the night.  Another great reason to turn down that light, turn off that screen, and wind down to go to sleep!!

New Sleep Recommendations

Hot off the press, The National Sleep Foundation has updated its nightly sleep recommendations for all ages in a report published February 2nd in Sleep Health: The Official Journal of the National Sleep Foundation.

Here's the breakdown of the recommendations:

Newborn (0-3 months): 14-17 hours (previously: 12-18 hours)
Infant (4-11 months): 12-15 hours (previously: 14-15 hours)
Toddler (1-2 years): 11-14 hours (previously: 12-14 hours)
Preschooler (3-5 years): 10-13 hours (previously: 11-13 hours)
School-Age Child (6-13 years): 9-11 hours (previously: 10-11 hours)
Teen (14-17 years): 8-10 hours (previously: 8½-9½ hours)
Young Adult (18-25 years): 7-9 hours (new category)
Adult (26-64 years): 7-9 hours (no change)
Older Adult (65+ years): 7-8 hours (new category)

Tips for the Teenage Night Owl

Most teenagers are hard wired by their circadian rhythms to be night owls.  It is one of the ways their body and brains are changing.  The big problem with this is that most schools start very early in the morning.  Some high schools start before the sun has even risen!  So what is a teenage night owl to do?  For starters, read my earlier posts on tips for getting a good night’s sleep because those will be important.  The hard part though is how to shift your internal clock to be able to go to bed and then get up early. 

First, try some experiments to see just how much sleep you actually need.  Most teenagers will need between 8- 9 hours a night.  On a Saturday night, make note of the time that you are going to bed, don’t set your alarm and let your body wake up naturally on Sunday.  This will give you an indication of how much sleep your body needs.  I suggest doing this on Saturday night to Sunday morning because most teens are so tired by the end of the week their bodies will need more sleep than usual on Friday night. 

Once you have an idea of how much sleep you need, then decide what is the latest that you can get up in the morning and not be late for school.  I suggest doing whatever can be done the night before when you are more awake and have the energy.  This means picking out your clothes, packing your bag, making your lunch, and even showering.  It is better to do these things at night when you are awake then trying to do them in the morning when your body just wants to sleep.  This will let you get more sleep in the morning.

Here is an example.  I know that my body needs 9 hours of sleep.  I have to be at school at 7:30 am.  It will take me 30 minutes to get ready and 15 minutes to drive there.  I need to be up then by 6:45 am.  If I need 9 hours of sleep, then I should be in bed by 9:45 pm. 

If you are used to going to bed late it can be hard to try to go to bed that early, so I suggest taking steps of moving your bed time back.  If you usually go to bed at midnight, then try 11:30 or 11 pm.  The next night try 10:45 or 10:30.  Keep doing this until you are at the time you need to be in bed.  It can be very tempting to then on the weekend stay up super late because you know you don’t have to be up early the next morning, but I would suggest avoiding this.  That will make it really hard then to go to bed on Sunday night and get up early on Monday morning.  It is okay to stay up a little later on Friday and Saturday night, but you don’t want to do it by several hours. 

Your body will still want to be up at night, so that is why it will be very important to follow the other tips that I have written about, e.g. limiting exposure to light etc. 

It may sound like a lot of work, but if you can get yourself getting to bed earlier you will feel better in the morning and it will be worth it! 

When You Just Can’t Sleep

We have all had those nights when we turn out the light and then we lay there, and we lay there, and we lay there.  We wait for sleep to come, and instead all that shows up is the anxiety and frustration about how we are not falling asleep.  The following are some tips for when this happens.  Of course not everything works for everyone, but try some of them out and see what will work for you.

Occupy Your Brain

There was some reasoning behind the old counting sheep adage.  The idea of it is to occupy your brain so that you aren’t ruminating, thinking over and over about something that is bothering you.  If you find that you are lost in anxiety and can’t sleep, the first question is to ask yourself if there is anything that you can do right now.  If the answer is no, then the best thing you can do for yourself is to get some rest.  In my last entry, I had suggested reading a book and focusing on the characters and story after you turn out the light.  If you have done this and still can’t sleep, try reading some more until you start to feel drowsy.  Another great way of occupying your brain is to listen to a body scan meditation while lying in bed.  You can find these online and they are a great way of focusing on something other than your worry thoughts.  Many people report that they end up falling asleep in the middle of the body scan, and in this case, that is okay!  Finally, you can try listening to some soothing music, or to talk radio like NPR.  Do this in the dark, with your head on your pillow and you may just drift off to sleep.  If you can set a timer so that the device turns off the music or radio automatically, even better.

Don’t Pay Attention to the Time

For many people, part of what keeps them up is the thought that they should be asleep, and they start counting down the hours until they have to get up.  The more you think about time, the less time you will get to spend sleeping.  I suggest not looking at the time at all.  If you have an alarm clock with a clearly visible time illuminating from it, turn it around.  If you use your phone as an alarm, don’t look at the time on it.  Morning will come whether you are counting down the hours or not. 

Don’t Use Your Bed for Anything Except Sleep

This is a tip that you need to have done before the sleepless night occurs.  Beds should only be for sleep (or for the reading that leads up to sleep).  Some people think that their beds are so comfortable that they are great places to do their homework, their studying, pay their bills, watch TV, etc.  The problem with this is that in doing so, we start to associate our beds with being awake and doing stuff.  What we want is our bed to only be associated with sleep.  There is a phenomenon called conditioning in which we make pairings and will have responses to things without even realizing it.  Just like how the kitchen can become paired with being hungry, we want the bed to be paired with being tired.  If you have a hard time sleeping at night, you may want to assess whether you are using your bed for things other than sleeping, and then consider finding another place to do your work or watch TV. 

Tips for Getting More Sleep

Food and Drink

This may seem like an obvious tip, but avoid caffeine later in the day.  Many people don’t realize that their afternoon mocha or coke with dinner can affect their sleep.  Caffeine can last in our bodies for 8 hours or longer.  If you love your coffee, try to keep it limited to the morning time.  Also, foods that seem like they are morning foods, like oatmeal, cereal, yogurt, and bananas actually can help you fall asleep.  Avoid any sort of big meal before bed because if the body is busy digesting a large meal, that can keep you awake.

Exercise

Not everyone loves going for a morning run, and that’s okay, you can exercise later in the day as long as it is not before bedtime.  Exercise is a great way to tire yourself and make yourself sleepy, just don’t do it in the hours before bed.  Exercising gets the heart rate up, and that is the exact opposite of what you want when you are trying to relax and fall asleep.

Light

Our bodies all have an internal biological clock called our circadian rhythm.  The circadian rhythm regulates when we are sleepy and when we are awake.  Our circadian rhythm responds to light and dark signals.  It’s a complex process, but to put it simply, light cues can alter our biological clock, causing us to feel awake when we should be feeling sleepy.  The best way to help ourselves get more sleep is to be aware that the light coming from our computer screens, phone screens, TV screens, etc. is affecting how sleepy we feel.  About an hour before you plan to go to bed, start turning the screens off, or lowering their brightness.  Then about a half-hour before you plan to go to bed, lower the overhead lights in your bedroom, or turn them off completely and just have on a low-lit table lamp.  This lowering of the lights helps to mimic a sunset and helps you to feel sleepy.  (There are alarm clocks that you can buy that will slowly dim the light as you approach your sleep time, and then slowly light up at the time you set the alarm to wake up.  This makes it easier to wake up, and is much less jarring than a loud alarm noise in the dark.  I highly recommend them, I have one and I love it!)

Room Temperature

It’s tempting to pile on the blankets and want our beds to feel super cozy, but we actually sleep better when the temperature is cool. This doesn’t mean that the room should be freezing, because being too cold will wake you up, but when things are on the cool side we tend to have less disrupted sleep.

Thoughts

One way to guarantee that you won’t fall asleep is to put your head on the pillow while thinking of everything you have to do the next day.  If you need to do this, do it before getting into bed.  For many people, it is helpful to read for a few minutes before turning out the light.  Read something for fun that is entertaining, but not so engrossing that you won’t want to put it down.  After you finish reading, lie down and close your eyes, continuing to think about the characters and the story that you just read.  Let your thoughts drift there, until you drift off to sleep. 

Next time I will share some tips on what to do if you have a hard time staying asleep.