Episode 8: Sleep is the Answer!

If I said to you that you could sleep and dream to be successful in many areas of life then you’d probably laugh at me. And yet, that is precisely what I learnt from the 20 years of rigorous scientific research on the science of sleep and dreams! Listen to this episode to know why a regular 8 hours of sleep is more important than we think and a lack of it is more harmful than we know.  

In this episode, I have shared personal experiences and key findings from several ground-breaking research studies on why we sleep and how it affects our entire biology. Since sleep is not a well understood process, many of us have a casual apathy towards it, but Dr Walker and other scientists warn that we simply cannot afford to do that. There is no part of our body, mind, and society that is spared by the harmful effects of sleep deprivation. 

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Transcript

SLEEP IS THE ANSWER! 

Hello, my name is Dr Archana Mishra, and welcome back to wellbeing central! 

Sleeping regularly for 8 hours, waking up refreshed without an alarm, and not needing caffeine to remain alert during the day is a challenge for many of us. Well, this news may not be surprising to you, but knowing what happens to us when we don’t get enough sleep could really be alarming! I first learnt about the virtues of good sleeping habits from my health conscious parents. Luckily, I have been able to continue that habit till now. My husband and I wake up at 4 am, have dinner at 5pm, and go to bed around 8pm.  This routine keeps us happy and energetic but there are some trade-offs. For example, we don’t participate in many late night gatherings and we find ourselves ever explaining to friends that since we wake up really early, it’s difficult for us to be up very late. We normally go to daytime or early evening events and often decline invitations to night-time socials. Sometimes people understand that and sometimes they make fun of us asking us why we are so inflexible, and doesn’t take make our life boring? 

Since moving to Qatar, where people generally have a late night schedule, our sleep timing is often a subject of conversation. After frequent comments from others, I started wondering if we were indeed limiting ourselves by prioritizing our sleep. My curiosity grew and I wanted to know whether it’s worth it……. Luckily, I came across a book which details twenty years of rigorous scientific research on what is sleep and what are its benefits. After reading this book, I learnt that sleep is THE most important aspect of a healthy life because it affects our entire biology.  In his amazing book, “Why we sleep”, Dr Matthew Walker, who is a neuroscientist and sleep expert -- has detailed the science of sleep and dreams. Even as a fan of sleep, his findings are an eye opener to me! 

In this episode, I’ll share some of the key points from the two decades of research , and I encourage you to read this book for more detail. 

Coming across Dr Walker’s book was a great coincidence as my PhD research was motivated by the following question, “why, despite making progress in several areas of life, we are witnessing an increase in cardiovascular, metabolic, and autoimmune diseases as well as rising mental health issues particularly among the young people”.  My research found that we are challenged by the complexity of wellbeing that has at least eight dynamic components. And now, from this book, I learnt that sleep alone affects many of those eight components of wellbeing. 

Adults need 8 hours of quality sleep for optimum health and if we regularly cut our sleep to less than 6 or 7 hours then we run the risk of developing cancer, Alzheimer’s disease, diabetes, cardiovascular problems, infertility, obesity, and all major psychiatric conditions such as anxiety, depression, and suicidality. In fact, one night of bad sleep causes more physical and mental harm than a similar neglect in food or exercise.  Given  the risk associated with lack of sleep, The Guinness Book of world records has stopped recognizing attempts to break the sleep deprivation world record. This is because the  scientific world has now gathered enough evidence to claim that the shorter your sleep, the shorter are your life  and health span! ----- not sleeping well is simply--- too risky! 

There are two main factors that regulate our sleep and wakefulness. First, an internal body clock deep inside our brain that creates a day-night circadian rhythm --- because of which we feel awake during the day and sleepy during the night. This 24 hrs cycle of our circadian rhythm  begins its activity a few hours before we wake up--- and for most of us, it peaks by early afternoon. The second factor is a chemical called adenosine that creates the sleep pressure--- it starts building up from the time we wake up, continues to build our desire to sleep throughout the day ---- and finally peaks at night. It is the balance between the circadian rhythm and the sleep pressure that decides how alert we feel during the day,---- when we are ready to sleep,---- and how well we sleep. During the day, our circadian rhythm keeps us awake and alert and when we sleep, our brain removes the build-up of our day’s adenosine. This cleansing takes around 8 hours to complete, and after that a new cycle of circadian activity returns in the morning. That is why when we regularly get 8 hours of good sleep, we are ready to tackle 16 hours of wakefulness with great physical energy and  strong mental focus. 

 It is important to know that we all have different circadian timings and it’s genetically determined. That is why some of us feel good waking up early and some of us don’t. We are either the morning larks or the night owls for no fault of ours but because of our genes. It makes sense from the evolutionary perspective as mother nature made sure that we slept at different times and took turns to protect our community from external dangers. Sadly, our modern society, and workplaces in particular, are not designed for the night owls ---- so they have to wake up early to go to work even though their body is not ready for it and then after coming home, they struggle to sleep early.  As a result, they suffer due to perpetual lack of sleep, and develop several health risks. We all need 8 hours of sleep to lead a healthy life no matter what our circadian timings are. Also, children need to sleep more than 8 hours and their circadian timing is earlier  than adults so they need to go to bed earlier than us.  while teenagers and adolescents have a later cycle. That is one reason why our teenagers are particularly disadvantaged by early school hours. Many of them are perpetually sleep deprived and that cannot be good for them as well as for our society as a whole. Many of us think that our teenagers are  being lazy when they find it difficult to get out of the bed for school. Let’s remember that it’s not their choice but their biology. Should we not have a more flexible and sympathetic approach towards those whose body clock is naturally set for sleeping and waking up later or at different times?

Then as we become older, our sleep starts getting disrupted due to many reasons. Some people believe that older people do not need to sleep for 8 hours but that is not true, they also need a full 8 hours of sleep but due to the changing metabolism, bladder weaking and other factors, they are not able to have a full night sleep. This aggravates many health problems for them and creates a vicious cycle. 

After learning about sleep, I am quite alarmed by how much harm we are inflicting on ourselves by not taking it seriously and by thinking that we can actually manipulate it without any consequences.

Remember the chemical adenosine that develops sleep pressure - many of us manipulate it through caffeine which is found in coffee, tea, dark chocolate, energy drinks etc. Caffeine makes us alert and awake by blocking the adenosine receptors in the brain so even if we haven’t slept well, our brain wouldn’t know that until the effect of caffeine wears off. However, even if the brain doesn’t know----, while we are awake----, the brain doesn’t get a chance to remove the adenosine and thus the sleep pressure continues to build.  So, when the caffeine is removed from our system, we experience “caffeine crash” and our energy level drops rapidly. Now, because the sleep pressure has been building up in our brain all this time, unless we consume even more caffeine, we will find it very difficult to remain awake and energetic. This is how we create a caffeine dependency cycle. Like an accumulating debt, if we get less sleep than we need, the adenosine induced sleep pressure keeps building and rolls on to the next night. This is why, if we stay up late one night, it takes us several days to recover from it. Many of us are also trying to manipulate our sleep by taking pills but they do more harm than good. While sleeping pills make us drowsy and we do acquire sleep like state they  actually disrupt the quality of sleep needed to gain the necessary benefits. 

 So what happens when we sleep and how does it affect our entire biology?  We go through the sleep cycles of non-rapid eye movement or Non REM and rapid eye movement or REM state which is also called the dream state.------and it keeps replaying every 90 minutes after we sleep. In the first half of the night, a vast majority of the 90 minutes cycle is consumed by Non REM sleep and very little REM sleep. Then in the second half of the night this changes to REM sleep dominating the cycle and we dream during this time. In wake state we receive information from the world around us through our senses. The Non REM sleep stores and strengthens the new information, and skills. and, REM sleep or dreaming ----connects them with each other and help us get a more accurate picture of how the world works as well as offers us innovative insights and problem solving skills. Hence, our emotional IQ and creativity depends on getting enough dream filled REM sleep night after night. For example, after trying and failing many times in his wakeful state, Dimitri Mendeleev  finally cracked the code of arranging the periodic table in his dream! 

Sleep has not been a  well understood biological process so many of us have a general apathy towards it, so much so that we easily sacrifice it for other things like screen time, and social outings, etc. I’m guilty of doing that as well. For example, I used to have quite a casual approach to our children pulling all-nighters every now and then, meaning they’d get together to watch TV or simply have fun with friends without sleeping all night.  They’d feel tired and drowsy late at night but they hold off sleeping and then they experience a sudden burst of energy as the morning approaches. This is because their circadian rhythm becomes active at that time while the debt of sleep pressure continues to accumulate. Hence, it becomes very hard for them to make up for the loss and the harm it causes to their mental and physical health is simply not worth it. Now, I advise my children to try to follow their normal bedtime and perhaps invite their friends earlier in the evening, and ask them to leave later in the day so they can,  in effect, spend the same amount of waking time together. I know it sounds quite weird to be so regimented but I do that in the hope that even if my children half listen to me, they are still somewhat protected from the harm caused by not sleeping at all that night.

As a student, I used to sleep early the night before an exam and observed that I always did well when I had a full 8 hrs sleep, and performed poorly when I stretched the exam preparation till late night. That is because a good night sleep before we learn anything allows us to better grasp the concepts and sleeping well the night after allows us to retain them. A full night sleep also helps us get rid of what we don’t need -- from our brain and makes room for new information processing. A short day time nap is also good for us. So, no matter which way we look at it, we can truly be successful by sleeping and dreaming well on a regular basis! 

A regular full night sleep is required for us to be fully functioning as we need both Non REM and REM sleep cycles to perform their respective roles all night. We simply cannot sleep later or wake up earlier than needed, and expect to have a long and healthy life. Isn’t it sad that of all living beings, only humans deliberately cut short their sleep and willingly invite serious  health risks?

So, let’s stop looking at what sleep takes away from us but what it adds to our life. A regular good night sleep routine is an all-natural and free treatment for keeping us healthy, sharp, and creative. It allows us to manage optimum weight, protects us from cancer and dementia, increases immunity and fertility, reduces the risk of heart diseases and diabetes. It even makes us happier, less depressed, and less anxious. It also keeps us away from the risks of drowsy driving that is killing many people every day. In fact, more people are dying under the influence of short sleep than alcohol.  Sleep deprivation also has adverse financial impact on our society as sleepy employees cannot perform at their best. In fact, no part of our body, mind, or society is spared by the harmful effects of loss of sleep. 

Sleep is a free pharmacy at our disposal so let’s use it well. It's never too late to improve our sleep habits. At personal level, we can simply start by having a regular sleep schedule, keeping our bedrooms cool, dark, and gadget free, not consuming caffeine or alcohol closer to bed time, finding sleeping pill alternatives, taking hot shower, etc. At societal level, we should  work on having flexible workhours to cater to people with different circadian timings, and to advocate for later start of school for teenagers. Science very convincingly shows that a lot is at stake and we can’t afford to continue our apathy towards sleep. 

Knowing what I know now, I’m very thankful to my parents for giving me good sleep habits. They didn’t know the exact science behind it but they definitely understood that it’s not worth losing our sleep for anything. 

So, how do you know if you’re getting enough sleep?  After waking up in the morning, could you fall back asleep at 10 or 11 am? If yes, then you are likely not getting enough sleep. Also, can you function well without caffeine before noon? If no, then you are most likely self-medicating your state of chronic sleep deprivation and making yourself vulnerable to many physical and mental diseases. For many of our questions, sleep is the answer! So, if you have neglected your sleep until now, I hope that this episode is your wakeup call! 

If you have any questions, comments or need more detail, please contact me through my website: Wellbeingcentral.org. I have also offered some resources and details there if you need them. 

Thank you so much for listening to this episode. Stay tuned for the next one, and until then let’s get one stop closer to wellbeing central!