Sunday, March 25, 2018

Sleep and Denial

At my wife's urging, I just read Why We Sleep, by Matthew Walker. It has already convinced me to change my habits.  The short version is that we have all long known that inadequate sleep is bad for our health, makes us worse drivers and students, and that the ubiquity of electrical illumination may not be an unmixed blessing. The reality is worse. Those things are true, and more dramatically than we like to think; secondly, there are other things like higher blood pressure, lower testosterone and sperm count, worse glucose processing, worse memory, increased depression, mania, and anxiety, irritability, bad judgement and loss of temper; thirdly, many of the benefits of sleep occur in hours 6-8 and have to be set up by the previous 6 hours; fourthly, you can't recover much of what you lost from a bad night's sleep by getting more the next night or even over the next week.  Each bit of damage is real, however slight, and unrecoverable.

So get eight hours every night. Getting used to being one of those awake-achievers who gets by on 5-6 a night (which you brag about), is a set-up for Alzheimer's.

Some background on how bad my own decisions have been, which is why I may seem harsh now:  I have had a sleep movement disorder, twitching and even kicking, for decades.  This makes the deepest sleep more elusive. I avoided a sleep specialist referral for years even though my snoring is horrendous, because I have hypopnea, not apnea.  That is, my night breathing was poor, but never stopped in those non-breathing intervals that send spouses into panic. So I figured No Biggie. Though I knew I was by nature a night owl with a later clock, I kept jobs which required early arrivals. I even worked the graveyard shift for four years, because my wife and I were determined to reduce the number of hours our children spent in (gasp) day care overrode other considerations. Now that I think how one's children turn out is much, much more genetic than environmental, this looks like an amazingly bad choice.  22hrs/week versus 16 hrs/week in day care?  That's a big deal?

My first sign of aging - okay, I started balding at 20, so my second sign of aging - was bags under my eyes. By longstanding folk wisdom, we get bags under our eyes because of lack of sleep, but I laughed that off as accidental. Well no, it actually is a sign of inadequate sleep, and it shows up as early as childhood. I attributed my inability to drop off to sleep at a decent hour (the few times I tried), always lying abed 60-90 minutes, as anxiety. That goes back as far as high school, and has to do with night owl/morning lark differences. Whenever I had days off with no morning obligations I would sleep 11 hours, days running, my body trying to catch up.

I did catch a 45 minute nap at lunch on work days because I was so impossibly sleepy, and as we are designed for biphasic sleep and should have kept that siesta pattern, I did stumble on one healthy thing. Here's the thing: I was not one of those awakeness-warriors determined to press on, I get 6.5-7.5 hours per 24 (including the nap). It's just that it wasn't very good sleep until about 10 years ago, and that's still not enough. I am a night owl with a half-hour commute for 8am. It just doesn't work. I ignored this, thinking it was bad, but not very bad.

The one that shook me awake, so to speak, was the glucose processing. 50% worse the next day on six hours sleep versus 8.  I have greatly reduced my starches (sweets were never a thing) over the last 6-7 years, and have fair but not terrible eating habits, but did not start losing weight until my semi-retirement 15 months ago, at which point I started sleeping more. So I'm gonna ride that sleep solution hard and get even more sleep.  It's those last 90 minutes that lay down the glucose and blood-pressure healing mechanisms (medical details in the book).

Sleep cures nothing but treats everything, it seems.

Discussion: Teenagers move into the night-owl category, then drift back as adults into the 40% morning lark, 30% night owl, 30% midrange continuum. A century ago high school started at 9am. We moved to earlier starts in the 20's and 30's, and it's not good. Some districts are developing options for later starts.  The 20% of kids who remain early risers dominate at school, but the 80% get cheated. It's not laziness or lack of discipline (necessarily). Their bodies won't fall asleep earlier, and the "getting wiser as you get older" is more biology than decision.

There are a few employment categories which are worst about sleep, but medicine and the military are the worst.  I get the reasoning.  They are trying to raise the floor, of making adequate decisions automatic even under the worst of conditions, because sometimes the conditions are terrible. With the military, the camaraderie of working through hardship is also important. Yet this is in contrast to, say, athletes, who strive to find the ceiling, the best conjunction of diet, sleep, and training for optimal performance.  That might be more important information in today's warfare and medical care.

Plus, why would want your army, or your basketball team, to have less testosterone?


Christopher B said...

My own experience is that the weight loss factor builds on itself. I snored awfully and slept poorly (I know in hindsight) when I was heavier. Lost weight and started sleeping better. I also see how poor sleep drives my eating, as I snack more when I'm not sleeping enough or well enough.

Does he say anything about sleeping arrangements? It sounds like the book might make a case for sepersep beds.

Christopher B said...

should be seperate beds.

GraniteDad said...

Send the book over to me, we want to read it.

Assistant Village Idiot said...

We have had separate beds for years. When necessity requires us to sleep in the same bed, I am outside the bottom two layers of covers. Sometimes she can still feel the twitches, though.

james said...

The noise a CPAP makes isn't quite as soothing as tropical rain on a tin roof--whether it is on your face or on someone else's. I gave up on mine; she benefits from hers. But if I wake up for any reason, I tend to stay awake.

RichardJohnson said...

I worked nights for 8 months as an aide in a psych hospital, including 12 summer weeks of taking classes in the morning. I found out that was a schedule beyond my capabilities, so that was the last time I tried it.

In the oil field I worked a lot of nights. I found out that 4 a.m. was the hardest time. Get past 4 a.m. and you can keep awake until noon. Before working nights in the oil field, the only time I drank coffee was as a safe water source in Latin America.

Fortunately, most of the time I wasn't on 24 hour call, so I had 12 hours to sleep. One time when I was on 24 hour call, I got 8 hours of sleep in 5 days. The well was close to blowing, which gives rather strong motivation for overcoming sleep deprivation. I called the office for some relief, and for my final two days I had a trainee to spell me. (Several weeks after I left, the well blew, I was told.)

One time on a rig in Guatemala, instead of a 12 hour shift, my coworker and I tried 8 hour shifts. I found an 8 hour shift easier to deal with. Which surprised me.

As a teenager, I wasn't a night owl. One night I stayed up late to finish a term paper. I was miserable that afternoon at track practice.

Donna B. said...

I "should" be going to bed now, but... I've always been a night owl and after several years of working graveyard in my younger years, it's hard for me to fall asleep this early. I'm fond of 8 hours sleep, but I'd prefer to get them from 4am to noon.

I'm keeping my daughter's dog while they're on vacation and since I'm still up, he is too. He's rather obviously irritated with me.

Deevs said...

I used to have quite a bit of trouble getting to sleep. I'd lie in bed for at least an hour before nodding off. I chalk it up to the self-perpetuating cycle of worrying about not getting enough sleep. Anxiety as you mention, though it was anxiety I'd be rested enough to perform the tasks ahead of me, rather than the specific tasks themselves. Grad school wasn't much help, at least initially.

I was often up late working on homework or research and would not have enough time to get even 5 hours of sleep. I'd then proceed to lie in bed for another hour worrying about getting to sleep. A year or two ago, I simply accepted I would be tired the next day, and I started falling asleep much quicker. It appeared I solved my falling asleep problem just by accepting it. It could just be an age thing (though I was only 32 at the time), but I'm still leaning towards the change in attitude as the cause.

I've also found that I can rarely sleep past 9:00 AM despite what time I go to sleep. This post is a good reminder that I need to go to bed earlier. Technology is the obvious hurdle to that.

Oh, and I also began loosing my hair at an early age (20-21). I unfortunately let it affect my self-esteem more than it warranted. Turns out that's another problem I was able to solve just by accepting it.