Want Better Health? Go to Sleep!

What indeed, Mr Milton, what indeed…

First, a quick background about my troubled relationship with sleep (which I’ve written about before here). I’ve always maintained that I’m one of those people who simply doesn’t need much sleep. My body actively fights sleep. My university roommates and family will certainly attest to that! In school, I was known for pulling all-nighter cram sessions, sometimes a few in a row (this horrifies me now). In hindsight, it isn’t that I didn’t NEED the sleep, I just didn’t know HOW to get it. Also, a part of me liked the weird out-of-sync perspective of being awake while the rest of the world sleeps. I’m particularly skilled at soldiering through, at looking ok even when I’m sleep deficient (thank you makeup). I drink coffee and pretend like everything is fine. I’m more irritable and forgetful when I’m sleep-deprived,  but I soldier my way through that as well.

Isn’t EVERYONE tired? Aren’t we all busy being busy, feeling deeply virtuous for working so hard, while neglecting one of our most basic needs, sleep? Aren’t we all rushing to show up for our overwhelming obligations but neglecting to tend to our necessities? I sometimes wonder if the ‘hustle’ generation would need to be so obsessed with ‘self-care’ (lord, how I hate that term) if they were getting enough sleep.

Two recent events have changed everything for me–

1- Last year for my birthday, my husband bought me a Fitbit, mostly for sleep tracking. At first I was mildly offended. Why make me more anxious about the sleep I know I’m not getting? That’s not helpful! Furthermore, on the days I don’t get 10,000 steps because I am busy writing to meet a deadline, a Fitbit only increases my irritation at my schedule. It effectively tracks and records my inadequacy; who needs that? I called the new Fitbit my Manacle of Shame. I saw that I was never getting seven hours of sleep a night, and most nights I wasn’t even getting six. However, I did notice that on the odd occasion I had over 7 hours, I felt more positive and I ate better the next day. Nothing drives me to bad decisions around food more than fatigue.

2-  As part of my ongoing research into my bizarre perimenopause symptoms, I ran across work from Matthew Walker, a neuroscientist who specialises in sleep. He has changed my life. I listened to his TED talk. I went to hear him speak in London a couple of weeks ago, and then devoured his book, Why We Sleep. Just as Susan Pierce Thompson enabled me to make sense of my sugar addiction, Matthew Walker made me understand the serious long-term damage my sleep deficiency was doing to me.

If you have a difficult relationship with sleep, I urge you (beg you!) to read his book. I’m evangelical about it. It is dense and scientific, but extremely entertaining and well-written. He writes just like he talks, so if you like the TED talk I linked to, you’ll love the book. After reading it, I have completely re-prioritised my life to accommodate sleep. Even if I don’t have a nice eight-hour night like normal people, I create an eight hour window of ‘sleep opportunity’ so at least I have that possibility. Here are some of the life-altering facts Matthew explained at the lecture I recently attended.

Shorter sleep = a shorter life. It really is as simple as that. Because I had a child later in life, it is a priority for me to be as healthy as I can for as long as I can. Cancer, heart attacks, and Alzheimers are the main risks caused (yes, it is causational, not just correlational) by too little sleep. A lack of sleep upregulates chronic inflammation in our body, promotes the growth of tumours, and wrecks our immune system.  Our risk of cancer is doubled if we get less than six or seven hours routinely. Adequate sleep is also critical for our cardiovascular system; it lowers blood pressure and keeps our heart muscles healthy. During sleep, our brains do many things, but among the most important of these is the glymphatic system’s processes. Our brain and central nervous system has its own ‘sewage system’ which gets cleaned out at night. If this isn’t done, beta amyloid builds up plaque in the brain, collects between neurons, disrupts brain cell function and causes cell death, which promotes and/or causes Alzheimers. It is critical we give our brains this time to clean and regenerate.

Sleep isn’t a bank with deposits and credits. You can’t make up for lost sleep or catch up on the weekends. Your body wants and needs regularity, so having regular sleep and wake times is important.

Sedation is not sleep. Sleeping pills or alcohol gives you fragmented and unrestorative sleep, and blocks REM sleep cycles which your brain and body need for repair. A nightcap is one of the worst things you can do for a restful night. Sleeping pills are a disaster for the brain.

Anxiety is the principal cause of insomnia. Anxiety is your body’s fight or flight mechanism at work. Your body needs this to SHUT OFF for sleep to occur, or else you just stay awake, like I do. Matthew often recommends a worry journal for his patients. For many people, keeping one halves the time it takes for them to fall asleep. Apparently, the act of writing down the things that cause you anxiety allows your brain to process it and temporarily move on. For me, mindfulness and meditation help more than a journal. After years of meditation, I’m able to say to my worries, “Hey, I see you, concern X. I’ll deal with you later, but for now I’m going to push you aside and ignore you. Sorry, but this is not the right time.” No problem gets solved at 2:00 in the morning.

Humans are the only species that WILLFULLY deprives itself of sleep. Sleep is critical to every human (and animal) on this planet. I love this part of the book, “Addressing the question of why we sleep from an evolutionary perspective only compounds the mystery. No matter what vantage point you take, sleep would appear to be the most foolish of biological phenomena. You cannot find a mate and reproduce. You cannot nurture or protect your offspring. Worse still, sleep leaves you vulnerable to predation. Sleep is surely one of the most puzzling of all human behaviors.” Every species sleeps. Giraffes sleep five hours, brown bats sleep 19 hours, opossums sleep 18 hours, elephants sleep four hours, and tigers sleep 15. Even scientists can’t put any rhyme or reason to it. Accounting for body size, or predator/prey status, metabolic function, diurnal/nocturnal nature, commonality with similar species… we don’t understand much of it. Even primitive worms, which predate all vertebrates on earth, sleep. So sleep, technically, has been around for longer than humans.

Less sleep = higher injuries and lower performance. Walker works with top athletes (LeBron James, Usain Bolt, Roger Federer, etc), and they all sleep for twelve hours (either consecutively, or ten hours with a two hour nap during the day). Athletes need this amount to repair and to reduce the inflammation caused by exercise. Interestingly, 35 minutes after waking up, Usain Bolt broke the world record for speed. How is this even possible; I can’t even make a cup of tea 35 minutes after waking up.

More sleep = better memory. During deep sleep, our short term memories are transferred into long term memories. People seem to equate advancing age with declining memory. However, Matthew insists that worse memory and worse sleep are interrelated, and the cognitive decline is often not caused by age but by the lack of sleep that often accompanies age. I dug deeper with other sleep specialists on this topic and interestingly, the ‘brain fog’ that menopausal and perimenopausal women experience may not be a result of hormonal swings as previously suspected, but may rather caused by the lack of sleep caused by night sweats/hot flashes and the vascular changes during perimenopause/menopause that impact our sleep quality.

Learning, memory, and logical decisions are impossible without adequate sleep, at any age. If you’ve had children, you’ll know the ‘baby brain’ mothers refer to. Broken sleep for months on end while you’re feeding and caring for a baby through the night do not make for a highly functional person the following day.

A single hour of missed sleep causes problems. Daylight savings causes health problems globally where people gain or lose an hour of sleep. There is a 24% increase in heart attacks in the population when just an hour of sleep is lost, and a 21% reduction in heart attacks when an hour of sleep is gained. I was too gobsmacked by this to write down the next statistic Matthew talked about, but apparently the number of car crashes, even in young people, following an hour of sleep lost is on a similar scale. Sleep loss is devastating to reaction time.

Lack of sleep demolishes your NK cells. The data point that spoke to me the most was on natural killer cells. They’re like the secret service agents of our immune system, killing rogue viruses and preventing tumour formation. Our bodies need quality sleep to produce them. One night of bad sleep causes a 70% drop in killer cells. One night! When I used to travel regularly for work, I was always sick. Not only was I being exposed to new germs and viruses in the course of travel, but crossing several time zones meant I wasn’t getting the sleep (and the killer cells) I needed to deal with them.

Sleep is our best approximation of immortality; it is truly non-negotiable for good health. This very simple fact has finally sunk in with me– there is no such thing as healthy and tired. I’m officially done with pretending my way through days of not enough sleep. Now, I just say No. No, I won’t stay out late at a party (very often). No I won’t watch a second episode of Killing Eve. No I won’t finish a blog post on the day I planned. No, I won’t finish an email before bedtime. No, I won’t stay up late having a long chat to houseguests. No I won’t keep scrolling through all the political outrage and funny comments on Twitter. My lights go out at 10:00 because my little boy wakes me at 6:00. I’m in charge of my health and my schedule… well, except for that 6:00 a.m. waking part 🙂  Except for my son, I no longer accommodate other people’s timetables at the expense of my own health.  So part of my new sleep routine involves me saying No a lot more, and not feeling remotely selfish about it.  I don’t have FOMO about anything except sleep!

There is so much information in the book that I want to tell you about, but I’m already well over 2000 words here. I’m making myself pull the hand break on spilling Matthew Walker’s facts and wisdom. It has been the most fascinating and life-changing book I’ve ever read. If you’re a terrible sleeper, I really hope it will help you as much as it has helped me.

I’m going to close with this cheerful paragraph from page 165 of the book: “As we approach midlife, and our body begins to deteriorate and health resilience starts its decline, the impact of insufficient sleep on the cardiovascular system escalates. Adults forty-five years or older who sleep fewer than six hours a night are 200 percent more likely to have a heart attack or stroke during their lifetime, as compared with those sleeping seven to eight hours a night. This finding impresses how important it is to prioritise sleep in midlife– which is unfortunately the time when family and professional circumstances encourage us to do the exact opposite.”

P.S. I still stand by every item I recommended in my previous sleep post, from the Calm App to Zirben oil. I’ve added one more thing to my bedtime ritual. (I love rituals as a means of separating my ‘normal’ life from my sleeping life… if you ask my husband, I’m pretty OCD about it). I was given a sample of Feather and Down pillow spray in a goody bag a few months ago, and I absolutely adore it. I’ve bought my own stash now and use the sample for travel. One deep inhale, and I’m instantly relaxed by the powdery/soapy/lavendery scent. The Zirben oil I keep in my room all the time, and the pillow spray I use on my linens just before I get into bed.

“Even a soul submerged in sleep
is hard at work and helps
make something of the world.”
― Heraclitus, Fragments

Picasso’s Asleep