Editor's note: This is part two of our four-part "Be Well and Vital" Series.
"Sleep knits up the raveled sleeve of care," Shakespeare tells us, and Micah Howard, MD agrees. "Sleep is not a luxury, it's a necessity," he tells his patients, and a growing body of research bears out the advice.
But modern life may be depriving us of the sleep we need for our health and wellness. "Our society is really missing the boat on that," Howard says. "The quality of your sleep equals the quality of your life, energy, mood stabilization, all of those things.
"When somebody says they're sleeping for six hours a night, I ask them if they have ever been on vacation and slept eight or nine hours. How did they feel the next day? Their energy level was probably much higher."
Before the invention of the electric light, Howard says the average person slept about 10 hours. Today's averages range closer to six or seven. One major culprit is television which interferes with our normal circadian rhythms. "The average person watches TV a couple of hours a night, and TV is the equivalent of sleep Kryptonite," Howard says. "It's bright enough to fill a room. And when light strikes the eye, our body thinks it's daytime so it revs up all the systems that get our body ready for the day."
Just one example of sleep's crucial role in our bodies' processes is research that shows a person who goes for 36 to 48 hours without sleep can demonstrate insulin resistance equal to Type 2 diabetes. "This reverses back to normal with sleep," Howard says. "But it's interesting to see how quickly that can happen."
Research from the University of Colorado shows that 98 percent of our genes are tied to our circadian rhythm. "Your genes, and the proteins they make, are influenced by the sun coming up and the sun going down," Howard says. "For example, it only takes one second of looking at a 100-watt light bulb to turn off our melatonin production, which is amazing."
Another modern invention that interferes with sleep is the smart phone. "The last thing many people do before they go to bed is to check their phone, a light equivalent of standing on a street corner in Las Vegas," Howard says. "These phones, screens and tablets emit blue light at a concentration that didn't even exist until 2007 when the smart phone was invented, so we've never had that kind of light shining in our eyes until now."
When we eat and drink also plays a role, Howard says. "I see a line of people at Starbucks at 5:00 p.m., getting their caffeine and sugar. There was a great study recently about how caffeine works in the brain. They found out that coffee doesn't really give you energy, it works on a chemical pathway that disguises fatigue.
"And even though alcohol gets a reputation as a sleep aid, that's not the case. That's because its half-life is short. It may make you want to lie down, but it causes nighttime awakening so it's a poor way to get to sleep. Any alcohol should be stopped at least three hours before your head hits the pillow. And ideally, dinner should also be at least three hours before going to bed. The same goes for exercise, which is best when done in the morning.
He says that one way to increase the length and quality of sleep without medication is to establish a "digital sunset" in your nighttime routine, without television or smart phone, as your body winds down toward time for sleep. In the newest iPhone OS, a bedtime alarm feature can prompt you for the tasks that prepare your body for restful sleep.
"With common insomnia issues, the words that come up the most are 'stress' and 'anxiety.' Meditation is one way to help ramp our bodies down at night. Another factor involved in sleep is room temperature. Ideally it should be a few degrees cooler than normal, say 68 or 69. Our bodies are geared to sleep longer in wintertime," Howard says.
Howard's basic sleep questions for patients are "'How much are you sleeping? Can you add one more hour of sleep?' Change some things, and it can improve your health and add to the quality of your life."