Let's talk about sleep
and why you likely need more of it
First, my apologies to those of you who are expecting a nutrition post today - I’ve been procrastinating. Truth is, I have so much to say and I’m not quite sure where to start. If only I could download all of the random information in my brain for all of you to see. Or maybe that wouldn’t be a good thing….anyway, be on the lookout for a nutrition-related series in the near future.
Today, since I am well rested (shhhhh, don’t want to jinx it), let’s explore sleep’s role in all things health & wellness.
The adage, “I’ll sleep when I’m dead,” is rarely questioned in our uber-productive, fast-paced world. As Dr. Matt Walker states, the idea of sleep “appears to be the most foolish of biological phenomena,” for it is an extended period of time when our safety and survival are most vulnerable. Yet he/we are learning that evolution didn’t get it wrong - the benefits of sleep outweigh the risks. By not taking sleep seriously, we are, ironically, increasing our risk of harm.
Chronic sleep deprivation affects all areas of health in the Insight into Health framework - physical, functional, cognitive, and emotional. Chronically poor sleep (which includes quantity as well as quality) increases the risk of most major causes of death, shortens lifespan and quality of life, and is a risk factor for depression & anxiety.
On that last point, look no further than my household - things start to fall apart when one of us doesn’t get enough sleep. And if more than one of us is in a deficit, forget about it. Stay away. No fun zone.
So why has "sleep neglect” become an epidemic? It comes down to a misalignment between the competing clocks in your life: circadian clock, responsibility clock, and social clock:
Circadian clock - a genetically-driven 24-hour-ish cycle that determines alertness & sleepiness, appetite & metabolism, body temperature, hormones, bowel habits, and so much more. You likely know1 if you are a so-called “early bird” or “night owl” or fit somewhere in between. These differing daily rhythms where some stay up late and others wake up early likey developed as a way to keep groups of people safe by limiting the sleep vulnerability window.
Responsibility clock - relying on an alarm to ensure you wake to meet the demands of work, school, or any other of a long list suggests that the resonsibilities of your life may not be aligned with your circadian clock. (The true test of how much sleep you need is how long you naturally sleep for a period of at least 7 days when you go to bed about the same time and wake up without an alarm, pets, partner, children, devices etc.)
Social clock - calling myself out here. I love my bed and I love to get in it as early as possible. Not only am an early bird through and through (circadean clock), but I’ve also passed on this rhythm to my young daughter (responsibility clock), which unfortunately isn’t all that condusive to being a ton of fun as social clocks are ticking into the wee hours. And while I still get teased about it in my 40’s (yes, TJ Carter, I need a nap before making it to an evening gig), you can only imagine the fun I was in college, tucking myself in at the late hour of 9pm….
The idea of “sleep hygiene” has become trendy, with social media awash with advice about blue-light blocking glasses, weighted blankets, and (as my teenager just informed me) the Sleepy Girl Mocktail.
And while some of these tips do have some merit, they all fall into the what to do category of health advice. My goal is to help you understand why something may, or may not, help and how to decide if it is right for you.
First up - melatonin, the main driver of sleepiness:
Melatonin production is directed by sunlight. When exposed to sunlight your natural melatonin production is turned down, helping you feel awake and alert.
The less sunlight you get, the more melatonin is produced, and the more tired you feel. Thus, my feelings of sleepiness with the setting sun are a textbook example of the interaction of sunlight, melatonin, and energy levels.
Difficulty falling asleep can often be tied to the light-dependent melatonin cycle because of:
Inadequate sun exposure as people spend less time outside, melatonin production isn’t turned off all the way, affecting alertness.
Exposure to artificial light continues far past sunset and often through the night, not fully turning “on” melatonin production needed to get to sleep.
Expectation that sleep should occur instantly after getting into bed (despite having just finished watching the news, responding to work emails, or being caught in the scrolling trap). Remember, your body needs some time to dial up melatonin production, it doesn’t happen at the flick of a switch.
While melatonin tops the list of most-used supplements, the benefits are often a drop in the bucket compared to supporting your natural internal melatonin production:
Geting at least 20 minutes of sun exposure early-ish in the day
Decreasing sunlight and artificial light exposure 2-3 hours before you want to be asleep
Limiting sources of light in your sleep environment (or consider a sleep mask)
A lesser-known player in sleep, adenosine, slowly builds up in your brain while awake.
As adenosine levels rise throughout the day, fatigue starts to set in
Adenosine is cleared during sleep
Inadequate sleep results in inadequate adenosine clearance and that“fuzzy” feeling after a poor night sleep
Caffeine blocks the brain’s ability to notice the buildup of adenosine, tricking you into feeling less tired. Yet, as caffeine is cleared from your system, adenosine-fueled fatigue hits you like a ton of bricks. This, along with building tolerance to the effects of caffeine, results in caffeine’s addictive potential and miserable caffeine withdrawal headaches.
While this may sound like an anti-caffeine campaign, it is not. There are several compelling benefits of regular caffeine consumption that I’ll go into some other time. Instead, I hope that understanding how caffeine works can prevent it from working against you, especially when consumed later in the day or to force alertness during periods of chronic sleep deprivation.
I’m debating how much more to share about sleep. For those of you who know me well, you know I could go on and on, waving my hands around and getting louder as I get more excited.
I want you to know why a warm bath before bed helps you feel drowsy (it mimics how your body temperature natually decreases as you ease into sleep) and why blue light has become the latest sleep villian (it’s probably less about the blue light and more about what is emitting the light - bad news, scary movies, anxiety-provoking scrolling). Oh, and why keeping a consistent bedtime and waketime, even on the weekends, is key (the body thrives on predictability and needs time to adapt to changes - thus changing sleep timing of more than an hour night-to-night isn’t going to support a good night sleep).
I’ll resist anymore and call it here for today. Check out more sleep hygiene tips and Dr. Peter Attia’s deep dive into the subject, including a podcast all about insomnia that I started last night (lol).
~Allison
There are many lifestyle factors that affect sleep, but also many medical causes so please work with your healthcare provider to rule out any medical concerns. This information is for educational purposes only. Please consult with your medical provider to individualize based on your unique and changing needs.
Yes -underated sleep, off to bed for me, trying no phone in room, turning WiFi off. Haven't seen that diagram, thank you!