SLEEP

The two complaints I hear most commonly in my practice is that “I can’t sleep” and “I can’t lose weight!”  As it turns out, the two are intimately related (see Weight Loss section for more information).   Sleep is critical for weight loss, but also critical for almost everything else.

Sleep has been very well studied over the decades, but rarely taught.  I had finished grades 1-12, college, graduate school, and medical school before I was taught anything about sleep, and that was only because I did an elective rotation through on of the first “sleep labs” in the US.  But then we mostly focused on the stages of sleep and how to diagnose sleep apnea.   Why so limited?  Follow the dollar.  You can make lots of money from sleep apnea, but not from normal sleep.

There is very solid scientific data supporting the importance of sleep.  Everything I say in this article has impeccable scientific backing. 

Many people claim that they don’t need much sleep.  You probably know some of them.  You may even be one.  There is a well-documented genetic mutation that allows a few people to get by on less sleep.  But even with this mutation, at least six hours of sleep is needed.  This incidence of this mutation?  1 in 12,500, the same odds as being struck by lightening in your lifetime!  So basically, everybody needs 7-8 hours every night.

Sleep is important for memory, brain health, weight loss, good judgment, attentiveness, hormone optimization, prevention of cancer, diabetes, heart disease, and for longevity.  Pretty important stuff. Driving with sleep deprivation is more dangerous by far than driving while intoxicated.  If you’re sleep deprived, your brain cannot resist brief 1-2 second periods of sleep.  How far can a vehicle travelling 60+ miles per hour travel in one second?  Enough to become a 2 ton missile of death!

So why do doctors, lawyers, judges, politicians, soldiers and CEOs insist on chronic sleep deprivation?  Why do surgeons brag about operating all night and then working the next day?  Why to students often study all night before a big exam?  Why do important leaders insist on staying awake until an important discovery or decision is made?  Could sleep deprivation be a reason that the world is in so much trouble? 

Every animal studied sleeps (as far as we can tell), as well as many plants.  Fish, which have to be awake to swim, sleep with one half of their brain at a time.  Birds that flock together also sleep, but a few sentinel birds stay on the outside of the flock for protection.  Even these birds sleep with half of their brain at a time.  In the middle of the night, they turn around and sleep with the other side of their brain, the awake side always pointing away from the flock.

So, the inquisitive mind might ask why every animal devotes 1/3 of their life to sleep.  After all, animals are much more vulnerable while asleep.  Must be a hugely important process, don’t you think?  In fact, with no sleep, people die, and pretty quickly.  The cause is total body failure!  Failure of the gut, the immune system, the skin, the brain and all organs.

Now that we’ve agreed that sleep might be somewhat critical, let’s examine why it’s so hard to get enough:  Stress, ambient light, especially blue light from digital devises, gut dysbiosis, stimulants, pharmaceuticals and temperature control all interfere with sleep.  

During the hundreds of millions of years of evolution, diurnal animals went to sleep when the sun went down and woke up when it arose.  The temperature dropped 10-15 degrees F at night.  There were no artificial lights, little noise and not a lot of stress (if you don’t count predators, etc.)  So the trick is to mimic the conditions of old, so that our natural diurnal regulatory factors will make us sleep. 

Make sure your hormones and diet are optimal.  Make sure you are not taking medications that may interfere with natural sleep.  Avoid exercise or food two hours prior to sleep.  Avoid digital light two hours before bed, including TV, computer and cell phone.  Cool the room by several degrees before bed.  Use the bedroom for sleep only. Turn off the lights and lie quietly.  Think of calming thoughts.  If sleep doesn’t come, get up.  Do calming activities for a short time before returning to bed.  Natural sleeping aids such as melatonin, GABA, etc. may be helpful.  Go to bed early enough to allow 7 to 8 hours of sleep.  If you need an alarm to wake up, you probably aren’t getting enough quality sleep.

Easy, huh?  Well not at first, but quality sleep is as natural as breathing.  Once we eliminate the factors that interfere, sleep will become very natural.

A word about sleeping pills.  DON’T.  Pharmaceutical sleep aids do not produce normal sleep, they may produce unconsciousness.  Sleep is a very active process, and each phase of sleep is important.  Further, many sleeping pills are addictive or increase the risk of dementia.  Especially medications that rely on cholinergic actions to produce sleep, including anti-depressants and antihistamines that are in most OTC sleeping aids.

 

Related:  restless leg syndrome, insominia, apnea, anxiety.

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