By Laurie Gribschaw, DPT, ATC, PRC
The latest overwhelming recommendation in our modern medical system is: getting 8 hours of sleep (go figure that what’s old is trendy again)!
Researchers and healthcare providers across nearly all disciplines universally agree that sleep is of critical importance for our health. We are recognizing sleep as the cornerstone of our cardiovascular, neurologic, and mental health, as well as a critical piece for our dental health, weight loss, and performance optimization. As physical therapists, we see first-hand how injury recovery is expedited, or slowed, by variables such as stress levels, nutrition, and sleep. A good night’s sleep stimulates your body’s natural healing and immune mechanism, reducing inflammation and solidifying the new items learned during the previous day. While the general trend over the past 30 years has been a significant reduction in sleep duration and quality, it is imperative for our overall health, performance, recovery, and cognitive function to immediately take steps to reverse this trend (1,2,3,4).
First, the ugly and sometimes scary truths that illuminate how important sleep is for healthy living:
- Driving while drowsy causes the majority of car accidents (more than drugs & alcohol combined!). Drunk driving is about equal to drowsy driving when monitoring driver error rates. When one combines alcohol with sleep deprivation (4 hours of sleep + legally drunk) the results were 30x more likely to drive off the road in a driving simulator (1).
- Functional MRIs show that we are 60% more emotionally reactive when sleep-deprived, whether from an all-nighter, or 5 nights of 5 hours of sleep or less (snap at your loved ones much?). There is a strong link between sleep-disruption and suicidal thoughts, violence, and addictive substance use (1).
- Too little sleep across an adult life-span significantly increases the risk of Alzheimer’s disease as it interrupts the ‘cleansing process’ of our brains that happens in deep sleep (1,2).
- Adults 45 y/o or older with less than 6 hrs of sleep/night are 200 % more likely to have a heart attack or stroke during their lifetime (compared to sleeping 7-8 hrs/night) (1).
- Chronic sleep deprivation increases your risk of Type 2 diabetes by increasing your insulin resistance (1,2,4).
- Sleep deprivation contributes to weight gain due to alterations in the hunger control hormones, causing us to not only consume more calories but also to choose high caloric items>> stay away from those buffets when sleepy! (1,2,4).
- Sleeping 6 hours or less/night is associated with a 40% risk increase of developing cancer compared to those sleeping 7 hours or greater. (1,2)
Wooof. If that wasn’t enough to encourage us all to reflect on our sleep needs, one of the larger concerns associated with chronic sleep deprivation (<6 hours/night) is that our own perception of our sleepiness, and our subsequent lowered performance, levels off after a few days (1,2). As critical thinking plummets, we are left completely unaware of this lowered performance and are at greater risk for making poor decisions.
We need to perform some self-analysis throughout the day to determine if we’re getting adequate rest (hello buzzword of mindfullness!):
- Is it difficult to get going in the morning without coffee or other stimulants?
- Do you have difficulty remaining focused and productive when sitting/standing for a while?
- Do you have a negative mood or poor memory?
Devices like the FitBit and Oura ring can give you some data on your rest, but recognizing and decoding your body’s own feedback system is a life skill to practice daily.
Given that at least 1/3 of Americans are now sleep deprived, we need to initiate small steps in the right direction to try to create change in the areas we have control over. The goal of achieving 8 hours consistently in our modern era is quite difficult with how plugged in we are, our increasing commute times, light pollution affecting our natural circadian rhythm, and other behavioral/lifestyle choices.
Our goal is to create a sleep regimen to help our body maintain its natural sleep/wake cycles by giving it the environmental cues and transition time it needs to wind down after a hyper-stimulated day. Start small and choose one thing at a time; aim to perform it consistently. The human body loves routine and thrives on maintaining a 24 hour rhythm, so consistency is key even if your adjustment is a small one (1,2,3,4).
- Try to have a reliable wake and sleep time; keep a regular schedule. Above everything else, research supports consistency in bed and wake times.
- Unplug all electronics at least 30 min before bed. If not possible due to your occupation, install and use blue light filters to reduce the harsh light (like f.lux) or use orange tinted, blue light blocker glasses available on Amazon.
- Avoid caffeine and alcohol in the afternoons/late evenings. Caffeine impairs your ability to fall asleep, and alcohol reduces your REM sleep (sedation is not equal to quality sleep cycles).
- Try to take a hot bath/shower before bed; a drop in temperature after the shower helps prepare your body for rest.
- Expose yourself to natural light at least 30 minutes/day. Start off the day with bright lights or sunlight exposure, and dim the lights before bedtime.
- Try to incorporate some relaxation before bedtime with whatever works for you. Gentle yoga, foam rolling, reading, or your breathing exercises might be a good place to start.
- Cultivate an optimal environment for sleep in your room: keep the ambient temperature low (65-70 degs), keep it dark, and keep it technology free.
And what if these strategies (performed consistently over 2-3 months) don’t yield the restful nights of sleep that you deserve? It’s possibly time to look a little further and get some help. Sleep deprivation can sometimes take a village for a well-rounded plan: a physical therapist can assist you with lifestyle/behavioral habits while evaluating your breathing and airway mechanics. From there, it may be a coordinated effort between a sleep study, MD/ND for supplementation to assist in restful sleep, and possibly a dentist for airway management, but every situation is unique with sleep disturbance (3). This becomes extremely important for children as their brains are developing at rapid rates each night and require both light and deep sleep in normal quantities (1,3).
Think of how many less car accidents, workplace inefficiencies, and emotional/behavioral outbursts we could reduce if we slowly returned to our 7-9 hours of sleep consistently! Our family, community, and world would be a healthier place with widespread financial gains. So start with any small step in the right direction to creating that sleep regimen towards a healthy body weight, decreased mortality risk, improved mood, and performance gains across the mental/physical spectrum.
- Walker, M Why We Sleep: Unlocking the Power of Sleep and Dreams. 2017
- White Paper: How Much Sleep do Adults Need? National Sleep Foundation. 2019
- Gelb M. Hindin H. GASP: Airway Health. 2016.
- Berardi, Andrews, St. Pierre, Scott-Dixon, Kollias, DePutter. The Essentials of Sport and Exercise Nutrition. Precision Nutrition. www.precisionnutrition.com/blog 2018-current.