PART TWO – “Sleep When You’re Alive” – Health

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by Adam Soyars

Sleep is a biological necessity. My goal is to convince you that sleep is worth prioritizing and to hold it sacred. Improving your sleep quality will improve your life now and into your future. Let’s learn a little about sleep. Last issue we learned about Circadian Rhythm and Sleep Drive. Here are several other factors that contribute to your sleep health.

Caffeine
Caffeine works by binding to the Adenosine-receptors in the brain without activating them. It is an antagonist of Adenosine. Adenosine continues to build, but our brain cannot receive its signal.
While caffeine will make us feel more aroused, alert, and vigilant, it cannot replicate or support higher-order brain functions. Simply put, caffeine tricks our brain, but it does not substitute for sleep.

Sleep Debt
Not obtaining adequate sleep will cause you to accrue sleep debt. For example, a person needing 8-hours of sleep per night but only getting 6 hours of sleep will accumulate 2-hours of sleep debt each night. After 5 days, that is 10-hours of sleep debt.
What is the toll of sleep debt?
If we are unable to clear all of the Adenosine from our brain (because we don’t sleep enough), we will carry that sleepiness into the following day. It is the equivalent of starting your day with built-up sleep inertia.
Unfortunately, sleep is not a financial institution that we can simply “pay back on the weekend” with extra sleep. If you miss sleep, specifically critical stages of sleep, your body is not capable of regaining what was lost. Performance suffers, circadian rhythm is disrupted, and the downstream health consequences are significant.

Health Impact
Sleep deficiency is associated with many chronic health problems. From high blood pressure, heart disease, kidney disease, and stroke to obesity, diabetes, and depression [1].
In the short-term, poor sleep will lead to more cravings, disruption of brain signals for hunger and satiation, impaired glucose tolerance, increased anxiety [2]. The data is overwhelming and consistent: poor sleep = poor health outcomes.

Weight Loss
Poor sleep impairs your ability to lose weight, specifically fat loss. One study compared two groups of people, both groups on the same calorie restricted diet. One group was allowed to sleep 8.5 hours in a bed and the other was only allowed to sleep 5.5 hours in a bed. After 14-days, the group who slept more showed 55% increase of weight lost as fat.

The FIX
Sometimes we have to “see it to believe it.” We have assembled some general guidelines to start your journey.
First, personalization is key. Work with your Healthcare Provider to dial in a sleep protocol that is personalized to you, your chronotype, and your lifestyle. You are unique. Your health protocols should be as well.
Second, track your sleep. There are tons of wearables on the market (Oura, Whoop, Apple, Garmin, Eight Sleep, etc). They all have pros and cons, but having objective data (even imperfect data) can provide valuable feedback for optimizing your routines.
Below, we’ve put together some general guidelines that are supported by research. Give them a try and be consistent. One night is not long enough to assess the efficacy of a particular intervention.


Sleep Timing
Have consistent sleep-wake timing. Regularity is the most impactful and beneficial tactic. Most of our DEEP (restorative) sleep happens in the first half of the night; REM (memory, mood, learning) sleep stages lengthen in the second half of the night.
Late nights and early mornings create a sort of Social Jet Lag. Consistently to bed late? You’re probably sacrificing DEEP sleep. Are you an early riser? You may be sacrificing REM sleep. Make your sleep window consistent.

SLEEP HYGIENE
Develop an evening wind-down ritual. Bath, shower, light stretching, meditation, breathing exercises, journal, prayer, reading, etc. If you spend time ruminating, consider using a 5-minute “worry journal” practice: spill your thoughts onto your page (studies show this decreases sleep latency).

Dark: pitch-darkness
No nightlights. Switch your evening lamps to incandescent bulbs (instead of LED). Eliminate blue light (or wear blockers) for the last hour before bed. Use blackout curtains. Consider a sleeping mask, if needed.

Devices
Remove clock faces from your room. Keep your phone away from your bed. No television and phone scrolling in your bedroom.

Cool
60-67 degrees is the magic number (infants should be warmer) [5].

View Morning Sunlight
This resets your circadian rhythm and will assist with proper sleep timing for the coming night. Get 20-minutes of sunlight exposure every morning.

Food
No food/calories within 2-3 hours of bed. Late meals decrease sleep quality and interfere with hormones and metabolism. Digestion requires energy and increases core body temperature (your body needs to be cool for sleep).

Caffeine
The half-life of caffeine is 5-6 hours. Translation: If you have one cup of coffee (100mg caffeine) at 2pm, you will still have 25mg of caffeine circulating your brain at midnight. Aside from sleep pressure, caffeine also reduces the amount of DEEP (restorative) sleep one is able to achieve. Avoid caffeine after lunch.

Alcohol
Alcohol fragments sleep and suppresses REM sleep. >2 drinks reduces sleep quality by 39% [4]. Ideally, alcohol consumption would be 3-4 hours prior to bed.

Sleep Agents
Please work with your healthcare provider regarding any supplements, over-the-counter products or pharmaceuticals. Human physiology is complex. Proper medical supervision is important.

The literature is clear, if you want to optimize your life, your health, and your well-being, prioritize sleep. There are no shortcuts. Get it right. Hold it sacred.
You can do it! Use the steps above. Start tracking! If you want to dig deeper and are in search of more nuanced protocols, reach out to your Healthcare Provider!