Fearless MD

Restorative Sleep: Often Overlooked and Underappreciated

Healthy Food Choices Help

How many hours of sleep do you get on average? If it’s under 7 hours, you may be at increased
risk for heart attack, dementia, diabetes, and other diseases. According to sleep expert Dr.
Matthew Walker, if you get seven to nine hours of good quality sleep, don’t worry. Dr. Walker is
the Director of UC Berkeley’s Center for Human Sleep. As an academic, Walker has focused on
the impact of sleep on human health. He recently published the book, “Why We Sleep.” I
extracted the following information from his book, and some of his interviews online.
Sleep deprivation is a growing concern in America and many nations worldwide that continue to
struggle with Covid-19 and socioeconomic and geopolitical issues. The stress and anxiety from
losing loved ones, Long-Covid, job loss, job pressures, inadequate income, crime, and
dysfunctional relationships are immeasurable.
Many of us desire to get more sleep but either struggle with falling asleep or awaken too soon
and can’t get back to sleep. Sleep disruption is worse when we miss those last few hours in the
morning, waking up prematurely. That’s when we often miss out on rapid eye movement sleep
(REM- sleep), a time when we tend to have dreams. Dream sleep is essential for helping to
smooth out emotional problems and enhancing our creativity and ingenuity.
Lack of qualitative sleep is associated with impaired memory, decreased productivity, mood
alterations, and increased stress levels. If you’re getting the sense that adequate sleep is vital for
good health, Bingo!
Many of us manage to upgrade our health by making better food choices and scheduling daily
exercise, but restorative sleep remains our Achilles heel. Why is it so difficult? I’ve often asked
myself that question and still don’t have all the answers. It helps to understand why it’s so
essential to have a night of restorative sleep.
So much can go wrong when the quality or quantity of sleep is inadequate. We can experience
impaired ability to focus, alertness, and decreased memory. Many mental health disorders are
associated with poor sleep quality. Anxiety and depression commonly partner with sleep
deprivation. Practically all mental health disorders involve some level of dysfunctional sleep.
The impact of cumulative sleep deprivation can cause or aggravate many acute and chronic
medical disorders, including hypertension, other cardiovascular diseases, diabetes, dementia, and
some cancers. Lack of good sleep reduces learning capacity, work productivity, relationship
building, and creativity. It can reduce fertility for men and women and reduce the ability to think,
judge, and discern. Sleep deprivation is associated with more auto accidents, depression, anxiety,
and suicidal behavior.
Our quality of sleep influences almost every aspect of life. You can take food or exercise away
for two days straight and survive, though quite hungry if the former. If forced to stay awake for
48 hours, you would look, feel and be sicker. Please don’t test that out.

Dr. Walker stated that when daylight savings causes us to lose an hour in the spring, there is an
increase in heart attacks by more than 20% the next day. When that hour returns to us in the fall,
there is a decrease in cardiac deaths, the next day, by more than 20%.
Sleep studies have identified 7-9 hours of sleep as optimal based on several health markers.
These include laboratory markers of immunity, inflammation, brain function, cardiac function,
metabolism, memory, and mental health.
How would you grade your sleep?
If you’re like me, and could use some help in improving your sleep efficiency, follow these ten

  1. Establish a regular time to go to bed and try your best to stick to that time seven days a
  2. Adjust your bedroom temperature to cool (65-70’F) for sleep time. You fall asleep faster
    and better maintain the sleep state in a cooler environment. Taking a warm bath or
    shower before bed may help achieve a better start to sleep.
  3. Dim the lights about an hour before retiring to, in effect, prepare your mind for sleep.
    Darken your bedroom by having appropriate shades or blinds. Remove sources of bright
    lights, for example, television and desk or laptop computer screens.
  4. Follow a daily wind-down routine that allows your mind to relax. For example, shortly
    before going to bed, meditate or listen to some calming music.
  5. If you awaken before it’s time to get up, give no more than twenty-five minutes to fall
    back asleep. After the twenty-five minutes, go to another room with dim lights and read a
    book. Do not watch a movie, check emails or get on social media. Also, avoid checking
    news channels or focusing on the day’s to-do list. You want to avoid stimulating the brain
    when close to sleep time.
  6. If you have a terrible night of sleep, don’t try to compensate for it by sleeping later, going
    to bed earlier, or napping the next day. Your circadian rhythm will adjust on its own.
    Changing your routine may further disrupt returning to your usual sleep cycle. A nap for
    more than 30 minutes may make it difficult for you to fall asleep that night. So, if you
    have an off night, try to stay the course the next night.
  7. Remove electronic noise-making and blue light-emitting devices, tablets, phones,
    electronic readers, etc.
  8. Don’t eat too close to bedtime, especially avoid sugary snacks after dinner. It’s crucial to
    avoid eating within hours of sleep if you have GERD.
  9. Time your coffee and alcohol appropriately. Avoid caffeine after the noon hour. Don’t
    use wine or other alcoholic beverages as a sleep aid.
  10. If you choose to take naps, get them in before 2 pm and keep them under 30 minutes.
    If these tips fail to help improve sleep, ask your doctor about cognitive therapy for insomnia or
    referral to a sleep specialist. Obstructive sleep apnea, asthma, sinus problems, gastric reflux, and
    anxiety can disrupt sleep and should be addressed if present.

Remember, a good night’s sleep is the foundation for all the other determinants of good health.
Spending time identifying why you have poor sleep can initiate a pathway to improve your
quality of life and extend life for several more years.

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