The Science of Sleep

By on November 4, 2014

Making the most of pillow time is critical to health

Jackson Hole, Wyoming – I’ve never had trouble sleeping. Planes, trains, Greyhounds, church pews, laundromats, easy chairs, hardwood floors, even an MRI tube have all provided adequate opportunity for 40 winks. Yet sleep study professionals would probably say I have a problem. Nodding off during the day is as worrisome as the wide-eyed midnight insomniac cursing that waiter for mixing up the decaf order at dinner.

We all spend a third of our lives doing it. Shouldn’t we be good at it by now? But the struggle to fall asleep or the 0-dark-thirty volley with the snooze button has afflicted everyone at one time or another. Experts say, in part, that we’re doing it all wrong — making blockheaded mistakes and messing with a fine-tuned design called circadian rhythm.

“Obviously, you want to limit your caffeine toward the end of the day. Chocolate, too,” said Roger Olin. He’s the sleep technologist at St. John’s Sleep Disorder Center. “A big meal before bedtime is definitely not recommended, either.”

Retired sleep technologist Joe Burke, who ran the center for 18 years, pointed out some other common mistakes we make. “The hard and fast rule in the sleep medicine business is the bedroom is for three things: sleep, changing clothes and having sex,” he said. “If you are not doing one of those things, get out of the bedroom.”

“Sleep, those little slices of death; how I loathe them.”  oft-mis-attributed to Edgar Allen Poe

Patients at St. John’s Sleep Disorder Center, such as Molly Hufford (above), are monitored for signs they are transitioning smoothly from one stage of sleep to the next. No, technicians can’t tell what you’re dreaming about, but they can diagnose and remedy most sleep maladies like apnea, restless leg syndrome or upper airway resistance. Photo credit: KELLI WINDSOR

Patients at St. John’s Sleep Disorder Center are monitored for signs they are transitioning smoothly from one stage of sleep to the next. No, technicians can’t tell what you’re dreaming about, but they can diagnose and remedy most sleep maladies like apnea, restless leg syndrome or upper airway resistance. Photo credit: KELLI WINDSOR

Ready for the numbers? At least 40 million Americans each year suffer from chronic, long-term sleeping maladies ranging across a spectrum of 70-plus identified disorders. Another 20 million experience occasional problems. An estimated $16 billion is billed in related medical costs, annually.

And you don’t have to be a slumbersome train conductor or a dozy night watchman to experience the dark side of drowsy. Sleepy motorists cause 100,000 traffic accidents a year. Lost productivity is immeasurable. The snooze button was invented for our sleep-deprived, caffeine-driven society. Is it any wonder the Centers for Disease Control and Prevention called insufficient sleep a public health epidemic earlier this year?

“There are a lot of people in the medical field that never had any training regarding sleeping curriculum — and sleep is a third of our life — that are now recognizing all these comorbidities with people not getting enough sleep. Sleep as it relates to other diseases — high blood pressure, Type II diabetes, obesity — you name it,” Burke said.

Olin added, “If you are sleep-deprived, expect to see things like irritability, anxiety, headaches, weight gain, fatigue, obviously, and depression might be a factor. If it takes you a while to get up in the morning and you need four or five cups, you are probably exhibiting some signs you are not getting enough sleep.”

“The only time I have problems is when I sleep.”  Tupac Shakur

From legendary high-achievers like da Vinci, Einstein and Tesla to modern-day notables like Yahoo CEO Marissa Mayer, TV personality Kelly Ripa and President Barack Obama, short-sleepers claim they need only four to six hours of sleep a night. Some, much less than that. Really? How much sleep do we really need?

“Most of these [short-sleepers] are loading up at the Starbucks counter,” Burke said with skepticism. “The average adult needs about 7-and-a-half to about 8 hours of sleep. There are always some outliers but their numbers are relatively small.”

One out of every 200 people are bona fide short-sleepers according to research conducted by the University of Utah School of Medicine published in the journal SLEEP last August. They defy conventional wisdom and may hold insight into fighting obesity, ADD and bipolar disorder. And don’t try training yourself to be one. You either are or you aren’t. It’s in the genes.

Olin said young children need more like 10 to 12 hours. Adolescents do better on about 9 hours of sack time. “The body needs six to eight hours of sleep to repair, restore and rejuvenate itself. There could be a rare individual that can get by on less but eventually down the road it will catch up with them,” he said.

And what about catching up? Scores of adults and teenagers alike look forward to sleeping in late on Saturday and Sunday to compensate for a week’s worth of missed curfews. It’s called sleep debt and science lab wisdom is you can never recover those lost hours of sleep. You’ll just make yourself more tired trying, according to Olin.

“When I used to go to the schools and talk to the kids about sleep, I’d ask them a loaded question I knew the answer to: ‘How much do you sleep during the week?’ ” Burke recalled. “Now, these kids do have a little bit of a biological later lights out, probably closer to 11 o’clock. It’s amazing, but a lot of them are up until 12 o’clock, sometimes 1 or 2 o’clock. With texting and all these other technology gadgets they’ve got in their room that can keep them up, sometimes they’ve only gotten 4 to maybe 6 hours of sleep when they need about 9-and-a-half at that adolescent age.

“Then the second part of that loaded question would be, ‘So how much do you sleep on weekends?’ They would say, ‘Oh man, I sleep until the afternoon sometimes.’ Then they would start asking me questions. ‘Can you sleep too much?’ they’d ask. They would sleep for 12 or 14 or 16 hours and say they didn’t feel too good when they got up. Well, I told them, I want you to think about something. If you are down for 16 hours, your blood sugar is going to drop and you are going to be dehydrated. You’ve shocked your body in another sort of a way. You pay the piper sooner or later. There is a major flaw with the notion you can catch up on that sleep debt if you are, say, 16 hours short by the weekend and you think you can sleep that off. That’s not the way that works.”

Studies of exhausted patients looking to catch up on lost sleep have shown that so-called rebound sleep can be very compressed. Restorative slow-wave sleep time is nearly doubled in patients who are running on fumes. “They will not get the total debt payment but the sleep they get is really compressed,” Burke said. “They get a lot of juice for the squeeze.”

“I slept like a baby. I woke up every two  hours crying.”  Bob Dole

Most are familiar with the Rapid Eye Movement stage of sleep called REM. It’s the final stage of a sleep cycle that encompasses four total stages. Every slumberer progresses through the first cycle in about 90 minutes, with each additional cycle lasting a bit longer than the previous one. Most sleepers will get through four cycles in a good eight-hour session. Aware of it or not, you will awake after each cycle ends, though maybe only enough to turn over.

It’s called sleep architecture, Olin explained.

Stage I is a gateway to sleep. You’ll catch yourself, maybe, nodding off in this stage. Stage II is the beginning of slow-wave sleep, when the body begins making necessary repairs to cells.

“There is very little vigilance in Stage III sleep. It’s hard to arouse somebody out of that,” Burke said. “If you think of little kids who fall asleep in the car and you bring them into the house and accidentally bang their head on the doorjamb; they hardly wake up. They are in a drunken stupor in an attempt to wake up.”

Ending that hour-and-a-half cycle of sleep is the REM stage.

“Some people think that is a very deep sleep but it’s not. It’s right on the edge of wakefulness,” Burke said. “This is when our hard drive full of memory gets defragged. We are filing away the day’s new information. It’s like Random Access Memory filing. You are shifting stuff around, opening up some windows and moving things from short-term storage to long-term. Old information is discarded.”

Olin added, “REM is considered a dream sleep, however, a person can dream in other stages of sleep. On the EEG during REM, signals from leads on the chin will drop to their lowest point. When a person goes into REM there is a loss of muscle tone so the chin will drop. Your muscles are actually functionally paralyzed when you go into REM. Rapid eye movement is detected. A fine sawtooth pattern develops on the EEG.”

Think about your dog that thrashes about, believing he’s running or chasing something while he dreams. The muscle twitches are reminiscent of REM stage sleep.

“I think so many people have the perception of sleep as putting the car in the garage and turning it off. The car is then inactive,” Burke said. “But sleep is a very active process.”

Body temperature plummets during the night, sometimes by two degrees or more. Keeping the bedroom on the cool side is recommended. Warm rooms will cause sleepers to wake up sweating. Get up to go the bathroom and turn on a bright light — you’ve just stimulated your optic nerve into wakefulness. Your melatonin levels dive and you’re wide awake at three in the morning.

“Sleep is the best meditation.” Dalai Lama

Stress is a huge problem for people who have trouble falling asleep. It hits every age group. Here’s a common scenario: You’re dog-tired all day. The 2:30 p.m. blood sugar crash has you almost head down at your desk. You vow to get to bed early. Before you know it, it’s 10:30 p.m. and you’re staring at the ceiling.

“Some people, myself included, have a hard time shutting their brain off,” Olin said. “You may be extremely tired but once you lay down, boing, you’re wide awake.”

Burke agreed. “The biggest thing with people who have sleep onset problems is they cannot shut off their mind. They are trying to reconcile the day when they should be putting all that aside. They are thinking about tomorrow before that day has arrived.”

The experts agree: Spend 15 minutes or more counting sheep and you might as well get up.

“You need to just get up and leave the room when that happens. Stop trying to focus on falling asleep,” Olin said. “Do something that’s going to make you tired like reading. Sit up, don’t lie down. Stop watching the clock. Try to avoid direct light, say, from a computer. To stay lying there and keep trying to fall asleep is defeating the purpose.”

Another no-no in the practice of good sleep hygiene is use of a TV to help you conk out. It’s a rookie mistake.

“Some people say they can’t sleep without the TV on. They use that to ‘debrainify’ — to keep their mind off of everything,” Olin said. “It’s fine if you need some background noise, but use a radio or something because the TV has flashing light that is stimulating a person to wake up.”

“I’ll sleep when I’m dead.” Warren Zevon

The term “power nap” was coined by Cornell University social psychologist James Maas. Some swear by the practice of catnapping for 20 minutes. They wake feeling refreshed and revitalized. But are naps useful?

“Technically, you are probably not going to sleep,” Burke said. Twenty minutes simply isn’t enough time for the body to enter into any form of slow wave, restorative sleep. “These people who talk about sleeping for 10 or 15 minutes shouldn’t be refreshed from that kind of sleep. That just doesn’t happen. My theory is that you are enjoying the benefits of a type of transcendental meditation. You just totally relax and it’s like hitting a reset button in your brain. You purge all these stressors. It’s a soft boot where sleeping is a hard boot. It seems to work for some people.”

Olin said, “[Naps] are actually very valuable. From all the research I’ve been reading, and in my own experience, they are helpful for a lot of people and can be restorative.”

Adjustments to our biological clocks are difficult but not impossible. We are triggered mainly by light to maintain a circadian rhythm that’s actually a bit longer than 24 hours. Shift workers and coast-to-coast flyers get a taste of what happens when that rhythm is jimmied with. Burke and Olin both have a few tricks they employ to get back on schedule when they work the late shift or experience jet lag. It’s all about preparing yourself ahead of time and altering your routine.

With the return to Standard Time last weekend, many Americans welcomed the extra hour of snooze time like finding change in the couch cushions. The dreaded lost hour entering Daylight Saving Time is tougher. Much tougher.

New research using Michigan’s BMC2 database shows that heart attacks — which historically occur more often on Monday mornings than any other day of the week — jump by 25 percent on the Monday following “spring forward” compared to other Mondays of the year. In Russia, President Vladimir Putin signed into law this past summer a bill that abandons the highly unpopular Daylight Saving Time, keeping all 11 time zones in the country on standard “Winter Time.”

Closer to home, Utah is making noise about bucking the system and joining Hawaii and Arizona as states uninterested in keeping DST. Nationwide polls consistently show Americans prefer one time or another but not both.


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