“I’ll sleep when I’m dead.” That cliché was my mantra for years. My residency in emergency medicine, with its rotating day and night shifts, did not help. Nor did the days of 36 to 40 consecutive hours of work and wakefulness during those three years.
This evolved into years of entrepreneurial and school-induced sleep deprivation. Looking back, I was chronically sleep-deprived for probably more than 25 years.
While living through it, I really had no idea that four to five hours of sleep per night had such a harmful and insidious effect. And I didn’t believe I was sleep deprived.
In fact, I would argue vehemently against it.
The Game Changer
A couple of years ago, I decided to undergo a sleep study because I was constantly tired throughout the day and I snored at night, much to my wife’s detriment. After the study, I was diagnosed with obstructive (need to check) sleep apnea. (Link to sleep apnea blog)
People with sleep apnea will temporarily stop breathing throughout the night while they are sleeping. There are multiple types of sleep apnea, but obstructive sleep apnea is the most common. About 80-90 percent of diagnosed sleep apnea cases are obstructive sleep apnea. Obstructive sleep apnea is when the muscles of the throat become too relaxed during sleep, causing the airway to become restricted and eventually closed off. Recognizing that it’s not receiving oxygen, the body will then be jostled awake so that normal breathing can resume. What’s worse is that this pattern continues throughout the night, often without the person realizing it’s occurring.
After my diagnosis, I got a CPAP machine, which stands for continuous positive airway pressure, and I use it every night. A CPAP machine applies constant air pressure through the mask, which is worn over the nose and mouth. The machine is meant to keep someone’s airways open while they sleep. It has helped me sleep through the night and, more importantly, maintain a level of oxygen in my blood that is safe.
In an effort to better understand sleep, I read the book “Why We Sleep” by Matthew Walker and it was a game changer. Walker is the founder and director of UC Berkley’s Center for Human Sleep Science. His book explores sleep and how people can change their lives for the better by sleeping more.
As I read and researched the benefits of sleep, what became overtly clear to me is that the maxim “I’ll sleep when I am dead,” actually ensures you achieve the cliché. Now I can say I no longer live by that mantra.
Why Sleep is Important
Sleep plays an important role in every aspect of a person’s life. It is vital for good health and well-being—it can affect your mental and physical health, quality of life, safety and lifespan. While you sleep, your brain is preparing for the next day. And getting enough sleep will help you function throughout your day. A good night’s rest improves learning and helps with attention, decision making and creativity.
If you have not gotten enough sleep you are not at your physical and mental best. This took me a long time to realize. I didn’t notice how much lack of sleep was affecting my daily life—from my ability to work out to my mental clarity throughout the day. Everything was diminished.
Sleep helps your body heal and repair heart and blood vessels and maintain a healthy balance of the hormones that make you feel hungry or full.
There are five stages of sleep. The third and fourth stages are when deep sleep occurs and the fifth stage is REM sleep. During deep sleep, the body repairs muscles and tissues, stimulates growth and development, boosts immune function and builds energy for the next day. During REM sleep, your brain is consolidating and processing information from the day before and storing that in long-term memory.
Chronic sleep deprivation leads to some of the following health risks:
- Increased risk of mental illness.
- Exaggerated mood swings.
- Reduced grey matter in the brain.
- Increased heart and blood vessel disease.
- Increased risk of weight gain and obesity.
- Reduced testosterone levels.
- Have trouble fighting common infections.
- Increased risk of heart disease, kidney disease, high blood pressure, diabetes and stroke
- Linked to depressions, suicide and risk-taking behavior.
- Trouble making decisions, solving problems and controlling your emotions and behavior.
- In addition, sleep deprivation is a leading cause of car accidents.
Ultimately, not sleeping enough will shorten your lifespan. Keep in mind that, in most cases, you will experience multiple risks on this list. Sleep deficiency can lead to microsleep, which is when you fall asleep for brief moments through your waking day. One risk with microsleep is when you are driving, even if you close your eyes for a second it can be fatal. Because of this sleep deprivation is a leading cause of car accidents.
How to Correct Your Sleep Habits
If you are reading this and realizing that you might have a sleep problem, then it is time to make a change. Take steps to improve your sleep habits and take care of your body.
First, make sure you have enough time to sleep. Use time management to schedule your day so that you have time to sleep over eight hours. Even if that means eating earlier or skipping that late-night movie with friends. Make your sleep a priority. Figure out what time you want to wake up in the morning and work backward from there. Schedule your day this way. Working backward is a great way to ensure that you get everything done and still have enough time to get in those eight hours.
So if you are a morning person like me and want to get up at 5 a.m., then you should be ready and in bed before 9 p.m. This might mean that you have to go to bed earlier than you are used to. Start by getting accustomed to the change and go to bed 15 minutes earlier every night, continue this until you get to a reasonable hour. It will be difficult at first, but if you are getting up early and listening to your body’s cues you will be tired and ready for bed.
Establish a morning and evening routine. At night, implement a bedtime technology ban, so no phone, laptop or TV about an hour before bed. The blue light from technology disrupts your sleep. Find ways to relax and start winding down before bed. Take a warm bath, drink some chamomile tea, read a paper book or meditate. And go to bed at the same time every night. Stick to that schedule and it will be easier to fall asleep.
A morning routine will keep you on track and get you excited for the day. Wake up at the same time every day. Even on the weekends. It will help keep your body in a routine. If you are constantly changing your wakeup time depending on the day of the week, you will never fully train your body to wake up and start the day. Find something that gets you motivated or that helps get moving. Journal, drink a glass of water, meditate, stretch, cuddle your dog, make coffee. Whatever it is, do it every day. And get some movement in. Go for a long walk, do some yoga, go for a run, take an intense exercise class. Moving will wake you up and energize you for the rest of the day.
Getting diagnosed with sleep apnea was a blessing. The CPAP machine helped me sleep better and from there I changed my routine so I could sleep longer. I stick to a sleep schedule and go to bed around the same time every night and wake up around the same time every morning.
My schedule used to be all over the place, and it still can be depending on my shifts in the ED. However, I try to stick to a routine as much as possible. I usually go to bed around 9 p.m. and wake you up at 4:45 a.m. This gets me just under eight hours of sleep, which is a huge shift from my previous four to five hours. While it is not the full recommended eight hours, it works for me. Find what works for you.
Positive Habits to Get Better Sleep
After you start implementing a daily routine and working toward an eight hour sleep schedule, take a look at some of your other habits. There are things you may or may not be doing that could affect your quality of sleep. For me, it was my caffeine intake.
Over the years, I drank Diet Coke, then Diet Mountain Dew and then a variety of coffee drinks.
Caffeine has a half-life of 8 hours—meaning that if I had a cold brew at 8 am, just under half the caffeine was still floating around in my system when I was headed to bed. Realizing that one drink could affect my sleep, I decided to quit caffeine right away. I had a mild headache for a day or so and that was it. I have not touched caffeine since. After quitting I slept better and did not feel like I “had to have a cup of caffeine” to start my day.
When it comes to cutting out caffeine, everyone is different. I was lucky that my headache went away pretty fast. If completely cutting out all caffeinated beverages at the same time is not for you, then slowly taper off.
Do what feels right for you and your body.
Over the years I’ve counseled many patients attempting to cut caffeine from their diets. Some are able to quit with little work, others take months to completely kick the habit. The important thing is to keep trying.
Another part of getting a good night’s rest and helping wake up is exercise. Exercise gets the endorphins going and will help energize you. I exercise early in the morning. I wake up early, go for a run and lift weights. Exercise and moving help get me energized for the day.
If we aren’t a morning person, that workout later in the day. No matter what, exercise is great for letting off steam and reducing stress, which is helpful when you are trying to fall asleep. Figure out what kind of exercise and what time of day works best for you. There is not right thing or way, just start moving.
Now that I sleep between seven and eight hours a night, I am amazed at how much more energy I have, how alert I am and how my physical and mental performance has improved. My performance, mood and affect are literally night and day different.
Take it from somebody who was sleep deprived for decades, sleep is incredibly important. Anything you can do to improve the quality and duration of your sleep will add years to your life.