Undersleeping Is An Epidemic: The Anatomy of Sleep
Undersleeping: everybody’s doing it. Pushing their limits, watching another episode before bed, waking up too early to cram more into the day. The CDC (Centers for Disease Control and Prevention) has labeled insufficient sleep a public health epidemic (the same initial warning they gave smoking cigarettes several decades ago). And it's got to stop if you want to regain vital health.
It’s as if all of our family members, friends, coworkers and acquaintences are jumping off of bridges and most of us are following suit. I’m guilty of it, and I’m pretty sure you’ve done it before and may still be doing it now - getting less than what your body needs to complete four to six complete sleep cycles (more on this later).
I’m calling you out on it.
About 99% of my initial patients complain about one of two things: not getting proper sleep (too few hours, too restless, trouble falling to sleep) or feeling tired during the day. And I hear the same stories over and over... "there’s too much to do during the day, the only way for me to get it all done is to cut back on the hours of sleep I get." It makes rational sense, to reduce sleep hours so we can jam more into our busy lives. But the truth is that you can’t afford not to sleep well every single night.
Even minimal sleep loss takes a toll on your mood, energy, ability to handle stress, hormonal health, productivity, creativity, physical vitality and even your weight. If you’re one of my chronic yes-ers, or someone who tries to sleep as little as possible, you need to read this.
Many of us think of sleep as a time for the brain and the body to shut off, like a computer. This isn’t really true, as while you’re sleeping your brain is busy overseeing a variety of biological maintenance that prepares your body for the next day. You can think of it as a ‘service’ appointment for the body. Skimp on your regular service, and you’re headed for a major mental and physical breakdown.
Think six hours of sleep is enough?
It’s not. Researchers at the Univeristy of California (San Francisco) have discovered that some people have a genetic makeup that enables them to function well on only 6 hours of sleep a night. This gene, however, is extremely rare – it occurs in less than 3% of the population. For the vast majority of us, 6 hours doesn’t cut it. And even if you think you’re doing great with only six hours, that doesn’t mean you wouldn’t feel a lot better and get more done if you had between 7.5 and 9 hours of sleep per night.
Sleep occurs in predictable stages, oscillating between deep/restorative sleep (‘deep sleep’) and more alert stages with dreaming ('REM sleep'). Together, the stages of REM and non-REM sleep form a complete sleep cycle that lasts typically 90 minutes. It also takes between 15-30 minutes at the beginning of sleep to transition from awake state to the first deep sleep stage. The average adult over 18 years of age needs between 7.5-9 hours of sleep, or enough time to complete between five and (ideally) six 90 minute sleep cycles.
Also, it’s not just the number of hours but the quality of the hours that you’re sleeping. If you’re getting the correct number of hours, but still waking feeling unrefreshed, you may not be spending adequate time in each of the stages of sleep. The most damaging effects of sleep deprivation come from inadequate deep sleep, the majority of which happens during the first half of a night’s sleep. The hours of sleep between 10pm-2am are crucial because during deep sleep the body is repairing itself and building for the day ahead. Deep sleep stimulates growth and development, repairs tissues, and boosts the immune system. You may miss out on adequate deep sleep if you go to bed after 10pm, sleep without complete darkness in your room, if you’re awoken by noise or other people, work night shifts or swing shifts, and smoke/drink in the evening.
REM sleep is important to renew the mind, as it plays a key role in learning and memory. During REM sleep, the brain consolidates information that you’ve learned during the day, forms neural connections that strengthen memory, and replenishes neurotransmitters (like feel-good serotonin and dopamine). REM sleep is often shortened if the body isn’t getting enough deep sleep, or if you wake up super early in the morning (you get more REM sleep stages in the latter half of sleep). So, improving your overall sleep quality and getting to bed earlier can enhance REM sleep.
Getting even one less hour of sleep per night will affect daytime functioning, cardiovascular health, energy balance and immune system function. You may feel ok to keep up during the day, but that’s only because your adrenal glands are pushed to respond to daily demands. Eventually, you’ll burnout. And that’s when you end up in my office.
Each time you miss an hour, you can add it to your ‘sleep debt’: the difference between the amount of sleep that you need and the hours you actually get. Each time you skimp on sleep, you add to your debt. Eventually, it’ll have to be repaid – whether voluntarily or not.. You must make up that extra hour somewhere down the line in order to bring your sleep ‘account’ back into balance. And sleeping in on the weekends doesn’t count – if you’re chronically sleep deprived, getting one or two solid nights of sleep on the weekend isn’t enough to pay back your debt. It may give you a temporary Monday morning boost, but your performance and energy will return to inadequate as the day wears on.
So what if you have a serious sleep debt and want to start reparing it? These tips can be helpful:
1. Aim for AT LEAST 7.5 hours of sleep per night: make sure you don’t add any further to your sleep debt.
2. Choose intervals of sleep that are 90 minutes long: if you go to bed at 10pm, setting your alarm at 5:30am may help you feel more refreshed than if you set it at 6:00am or 6:30am. This is because you’ll be waking yourself up while in REM or light sleep stages, as opposed to during deep sleep when you’ll often wake feeling groggy and unrefreshed.
3. Keep a sleep diary: track when you go to bed, when you wake up, your total hours of sleep and how you feel throughout the day. This can help guide your sleep and alarm decisions.
4. Take a sleep vacation to pay off a long-term sleep debt: if you’ve been skimping on sleep for longer than the past month, pick a two week period when you have a flexible schedule and be really strict about your sleep regime. Go to bed at the same time every night (ideally before 10pm), and allow yourself to wake up naturally, without an alarm!
5. Get an extra 90 minutes of sleep tonight: in order to repay a short-term sleep debt from as recent as the past 10 days.
6. Make sleep a priority: read here about the important benefits of sleep, and then make it one of your non-negotiables. Instead of cutting back on sleep in order to jam more into your day, put sleep at the top of your list and work around it.
If you have trouble falling to sleep, maintaining sleep all night long, wake feeling unrefreshed or find yourself yawning throughout the work day – you may need some natural intervention to support the sleep cycle and energy production systems in the body. The in-office testing I do at Acubalance is a great way to start, to see how the cortisol system may be imbalanced. Call the clinic for your free 15 minute consultation to discuss with me how natural medicine can help fix your sleep.
Dr. Kali MacIsaac HBSc, ND