Waking Up The Importance Of Sleep

By Heidi Dvorak

Not getting adequate sleep won’t just leave you craving a Starbucks fix, it can have a serious negative impact on your health—and may prevent you from losing weight.

Cathryn, a 38-year-old mother of preteen twins, works full-time at an insurance office, eats healthfully and does Pilates twice a week. But when bedtime comes, she tosses and turns, then frequently awakens at 4 a.m., overwhelmed by worries and unable to get back to sleep.

Her boss had warned her she was in danger of losing her job due to careless errors, but it wasn’t until she had a near-miss car accident after she nodded off at the wheel that she realized she had a major problem.

“Even though I was dead-tired all the time, it never occurred to me that missing a few hours of sleep was a big deal,” she says. “I figured I could make up the lost hours on the weekend.”

Underestimating the importance of sleep is a common miscalculation. More than 70 million Americans suffer from insufficient sleep, the Centers for Disease Control reports. National Sleep Foundation statistics reveal that only two-thirds of women get a good night’s rest only a few nights per week and that 29 percent regularly take sleeping aids.
“Lack of adequate sleep is a major problem, with an average night’s sleep decreasing from nine hours a night 130 years ago to six and three-quarters hours a night,” says sleep expert Jacob Teitelbaum, MD, medical director of the Fibromyalgia and Fatigue Centers, a nationwide group of clinics.

“Many people don’t prioritize sleep in their lives,” says David Kuhlmann, MD, medical director of Sleep Medicine at Bothwell Regional Health Center in Sedalia, MO. “You have to give yourself enough time to get an adequate amount. People think that the goal of sleep is to sleep. It is not. The goal is to wake up feeling refreshed.”

You can temporarily disguise the effects of sleep loss with concealer or by drinking gallons of coffee to rev you up. But in time, it can have serious medical consequences such as weight gain, diminished heart health, diabetes, certain cancers, diminished memory and depression. Here, some of the ways your lack of pillow time may be affecting your health:

IT CAN CAUSE YOU TO GAIN WEIGHT.

“Insufficient sleep is associated with a 30 percent increased risk of obesity,” says Dr. Teitelbaum.

“Sleep affects metabolism,” explains William Kohler, MD, medical director of the Florida Sleep Institute in Springhill. “When you lose sleep, chemicals in the brain are altered and there are elevated changes in the key appetite hormones, leptin and ghrelin. So lack of sleep can potentially make you eat more, because you won’t have that feeling of being satiated.”

“Sleep loss will trigger fatigue, which causes sugar cravings,” adds Dr. Teitelbaum.
The Nurses Health Study at Case Western Reserve University in Cleveland tracked the sleeping patterns of 68,183 women for 16 years. Those logging in five hours or less gained about 2 1⁄2 pounds more than did those sleeping seven hours.

Even if you’re dieting, evidence suggests that you’ll lose fewer pounds if you’re not getting enough rest. A National Institutes of Health study showed that after two weeks of calorie restriction, the group that got 8 1⁄2 hours of sleep lost about 3 pounds, while the group that got 5 1⁄2 hours lost only about 1 1⁄2 pounds.

“Also, over time, sleep loss can cause a significant weight gain resulting from decreased energy levels, thus decreased exercise,” Dr. Kohler adds. “You might have the same calorie intake but you’re not as active.”

SLEEP DEPRIVATION IS LINKED TO CARDIOVASCULAR DISEASE.

Although many physicians believe that lack of sleep may adversely affect your ticker, most are unwilling to go on the record until clinical studies are 100 percent conclusive. Until then, experts like Dr. Teitelbaum couch it this way: “Poor sleep is associated with an increased risk of metabolic syndrome,” which is the name given to a group of factors that increase the risk for heart disease, stroke, certain cancers and type-2 diabetes among other conditions. “Metabolic syndrome is a major risk factor for heart disease in the U.S.,” Dr. Teitelbaum says. “Because of this, insomnia is a predictor of cardiac mortality.”

Studies back up the link. A large 2007 study at the University of Warwick Medical School found that when participants reduced their sleeping hours from seven to five hours or fewer per night, they doubled their risk of death from cardiovascular problems. Seven hours of shut-eye nightly was perceived as an optimal goal.

IT CAN INCREASE INFLAMMATION AND DEPRESS YOUR IMMUNE SYSTEM.

When your body gets injured, irritated or infected, inflammation is how it responds. Inflammation has been shown to trigger cardiovascular disease, certain cancers, type-2 diabetes and other conditions. A 2010 Emory University study found that people who did not get enough sleep (i.e. got less than six hours a night)—or got poor-quality slumber, had higher levels of three inflammatory markers. One in particular, called C-reactive protein (CRP), increased by 25 percent. Chronic elevations of CRP are present in those with heart disease, certain cancers and diabetes.

“Sleep deprivation is a good way to immune-suppress an animal—including people,” says Dr. Teitelbaum. “An optimized immune system is associated with less cancer and infections.

LACK OF SLEEP CAN AFFECT YOUR MEMORY.

“Sleep loss results in a decrease in short-term memory,” says Donna Arand, PhD, clinical director of the Kettering Sleep Disorders Center in Dayton, OH. “The greater the loss, the greater the impact on memory. The brain area for memory is smaller in patients who sleep less. My research demonstrates that sleep deprivation impacts memory, fine-motor coordination, mood and cognitive processes.”

Not being well rested also affects the ability to learn new things, process new information and access it after it’s stored. Processing information (called consolidation) takes place during sleep when neural connections are strengthened and memories are formed.

CHRONIC INSOMNIA CAN INCREASE YOUR RISK OF DEPRESSION.

Though short-term sleep deprivation “has a remarkably positive effect on depression,” according to Jerome Siegel, PhD, chief of neurobiology research at the VA Greater Los Angeles Healthcare System and a professor of psychiatry at UCLA, “chronic sleep deprivation may precipitate depression.”

Dr. Kohler views the relationship between poor sleep and depression as complex. “The chemicals in the brain that are involved in sleep are also involved in the emotional state. There’s an overlap in transmitters. Most of us feel down the next day with a lack of sleep. Poor sleep can cause difficulty with interpersonal relationships and a decrease of ambition.”

Dr. Teitelbaum sees insomnia and depression as one another’s enablers. “Eighty percent of those with depression have insomnia, and it is suspected that insomnia may increase the risk of depression. In addition, those with insomnia have disrupted patterns with more dreaming and less deep sleep.”

The Do’s and Dont’s of Good Sleep

Here, some tips for improving your sleep.

Do Get Enough Sleep For Your Body

Although most experts concur that getting around seven hours of sleep a night is optimal, Dr. Kuhlmann offers this advice: “However long your body requires to awaken feeling rested is how much sleep that you need.”

Don’t Drink Caffeine After Lunch

Even if your bedtime is hours later, the effects of caffeine may take 8 to 14 hours to completely wear off, so that 2 p.m. espresso may keep you up.

Do Exercise

Dr. Kohler recommends exercise, but says that timing is key. “Exercise performed four to five hours before bedtime will increase the ability to fall asleep and stay asleep. If you exercise too close to bedtime, epinephrine increases and can keep you awake.”

Pilates can help improve sleep quality. A study at Appalachian State University in North Carolina revealed that after participants took a Pilates class for a semester, sleep quality and mood improved.

Don’t Take Naps or Try to Catch Up On Sleep On The Weekend

“There are a number of restorative physiological processes that take place during consolidated sleep,” Dr. Kuhlmann says. “Those body functions may not operate at peak efficiency when sleep occurs in multiple blocks.”

Dr. Teitelbaum agrees: “The body needs periods of extended sleep to go into the deep stages and through the repeats of the sleep cycle.”

Do Go To Bed At The Same Time Every Night

“The brain likes consistency,” says Dr. Kohler. “Get up and go to bed at the same time.”

Do Turn Out The Lights

A 2010 University of Haifa study of 1,679 women showed that light at night in the surrounding environment is associated with a risk of breast cancer. “The comparison was done between women sleeping in a completely dark room and those sleeping in an illuminated room,” says study head Abraham Haim, PhD. “In the latter, there was a 40 percent increase of cancer incidence. He suggests either sleeping with all lights off, or, for safety’s sake, using a low-intensity, low-wave light.

Do Turn Off The Computer And TVs

“Too much bright light in the evening is going to inhibit sleep, even a bright TV or computer monitor,” says Dr. Kohler. “If you look at it late in the evening, potentially that could interfere with your sleep that night. Eyeshades are important, especially if your partner is reading at night or watching TV. You might want earplugs too.”

Do Establish A Relaxing Bedtime Routine

When Cathryn told Elizabeth Larkam, a Balanced Body master instructor in San Francisco, about her insomnia, Larkam prescribed a before-bedtime routine of slow, deep breathing through her nose. Larkam also suggested that just before bed, Cathryn turn off the lights and lie on her back on her mat hugging her knees to her chest while practicing her breathing and rocking slowly from side to side for two to five minutes. After that, she advised Cathryn to get into bed and continue her breathing for another two minutes on her back and then move into her normal sleeping position.

“The sleep regulatory centers in the brain stem process information from joints, organs, muscle receptors and other areas of the brain,” says Larkam. “Lower levels of stimulation induce sleep and rocking may facilitate the brain to transition to balance, harmony and synchrony. A calm mind and relaxed body are prerequisites for restorative sleep.”

The rocking and breathing helped calm Cathryn’s mind, which typically raced incessantly as soon as she turned off the lights. She now looks forward to preparing for bed since the mat rocking relaxes her and makes it easier to fall asleep.

Do You Have Sleep Apnea?

Symptoms of sleep apnea include snoring or waking up gasping for air (or if a partner has commented that you struggle to breathe while sleeping). Sleep apnea can cause you to stop breathing for a few seconds to a minute or two up to 30 times per hour. “In sleep apnea the muscles that normally help to keep the upper airway open collapse together, which may temporarily stop breathing,” Dr. Kuhlmann explains. “The two parts of your body most sensitive to oxygen deprivation are your heart and your brain, which is why sleep apnea has such a strong association with heart problems and strokes.” If you suspect you have this common condition, see your doctor.