We all know how amazing it feels to get a good night's sleep...waking up naturally, feeling rested and ready for the day? We tend to think of that as a luxury and it's often the first thing to be cut when life gets hectic. But is it really a luxury that people can do without? Science says no.
Virtually every aspect of health is hurt by inadequate sleep. Immune function is reduced, increasing your risk of catching that nasty cold that is going around. There is also evidence that disrupted sleep may increase your risk of developing cancer, as well as worsen your chances of recovery. Sleep deprivation also increases your risk for obesity and diabetes. Pay attention to your eating habits after an inadequate night's sleep. Normally, your body uses the hormones ghrelin and leptin to regulate energy balance, by stimulating or suppressing appetite. Sleep deprivation causes these hormones to become dysregulated. Abnormally high ghrelin triggers increases appetite, low leptin levels throw the system further out of balance, and hunger runs unchecked. Compounding this, inadequate sleep impairs your body's ability to use insulin by as much as 30%, a level typical for the most common form of diabetes. The relationship between sleep and mental health is complex, but no less dramatic. Difficulty falling or staying asleep can be a nonspecific symptom of virtually every mental illness, from ADHD to schizophrenia. It can also cause or trigger psychiatric symptoms, and people with ongoing sleep problems have poorer treatment responses.
I was assessing sleep habits as part of a recent initial psychiatric evaluation, when my new patient let out a frustrated sigh, and reminded me that he was there to talk about his concentration and possible ADHD. Why was I spending so much time talking about sleep? Sleep deprivation can cause cognitive symptoms that closely mimic true ADHD. After only 1-2 nights of 6 or less hours of sleep, cognitive impairment is already measurable. Mental fatigue impairs performance on monotonous tasks, as well as those that require quick reaction times. It also reduces working memory, making it more difficult to mentally manipulate complex information. When sleep deprived, people demonstrate reductions in the divergent thinking that is vital for creativity and problem solving. Imagine what it is like for someone who is sleep deprived and truly has ADHD! A stimulant may keep that person awake, but it will not treat the ADHD as effectively. It will not produce as much improvement in symptoms, and the limited benefit it does produce, will not last as many hour as in a well rested individual. And it will not prevent negative impact of inadequate sleep on your physical health!
Sleep is also critically important in bipolar (manic-depressive) disorder. It's fairly commonly known that bipolar disorder is associated with erratic sleep patterns. Sleep is a key component of how we define and diagnose the disorder. During a manic/hypomanic episode, the person experiences reduced need/ability to sleep, but without the expected degree of tiredness or fatigue. Keeping a regular sleep schedule is critically important for anyone who may have bipolar disorder. It, of course, makes it easier for us to monitor for signs of an oncoming mood shift, but sleep deprivation can actually cause a mood episode in people with bipolar disorder. A single night of inadequate sleep, is enough to impair the brain's ability to regulate mood state. This dysregulation can be severe enough trigger a manic episode and throw the person right back into the emotional roller coaster that they so desperately want to get off of! Sleep is so important in the management of bipolar disorder, that they developed a whole type of therapy around it! Interpersonal and Social Rhythm Therapy has been shown to help people get well more quickly, stay well longer, and function better in their lives.
By now, I'm sure it's clear that sleep is a big deal! So what can you do to improve your sleep? I'm including the basics here, but check out my twitter feed for more!
- Keep a regular schedule. Go to bed and wake up at about the same time every day!
- Reserve the bed for sleep and sex only! No TV, homework, paying bills, or anything else.
- Dim the lights and turn off electronics at least 1 hour before bedtime. Give your brain the message that it will soon be time to sleep.
- Avoid caffeine (8 hours), alcohol (2 hours) and nicotine (1 hour) before bed.
- Get exercise. Every day. If you find that doing strenuous exercise in the evening makes it harder to fall asleep, consider yoga or Tai Chi
- Limit use of over the counter sleep aids. Most contain antihistamines, which can have long term negative health effects.
If your sleep problems are severe, or don't improve with the above suggestions, make an appointment with your doctor, ARNP, or me!
Be well, and get some sleep!
Kit Ko, ARNP