Grace tried everything to help her sleep, melatonin, magnesium, valerian tea, nothing worked. So she did what most of us do when we can’t sleep, she went on Reddit.
She found solace on the Reddit insomnia board and she noticed that there was one doctor who was getting a lot of attention.
Dr. Charles Czeisler of Harvard Medical School has advised everyone from NASA astronauts to Fortune 500 executives to a few U.S. Presidents. They call him The Sleep Doctor.
He offered three simple strategies to help optimize your sleep and so Grace went for it. In just a few weeks Grace was logging eight restorative hours of sleep every single night.
Her husband and even her kids started practicing it. It got pretty competitive.
As time went on, Grace noticed something else, as her sleep improved, so did her mood. She had more energy and without even trying, she lost weight and her blood sugar levels improved so much that she was able to get off all of her meds.
From enhancing our mood, to helping us optimize our weight, to reducing our risk of chronic disease, sleep isn’t just a pillar of our health it may very well be the foundation.
Five years later, Grace is still a sleep jedi and today I get to share her strategy with you.
Welcome to the Better Medicine Podcast. I’m Dr. David Zodda and my job is to help you live a better life. I do this by digging into the most up to date research in health, fitness, and nutrition to uncover what actually works. I then share actionable insights and strategies so that you can get more of what works into your life.
What sets our platform apart from the others is that all of our content is referenced, evidence-based, and peer-reviewed by some of the most forward thinking leaders in medicine and nutrition.
In Act 1 of today's podcast, we’re going to explore why we sleep, what happens to our bodies and minds when we sleep, and what effects sleep has on our overall physical and mental health. We’re going to talk about the barriers that stand in the way of sleep efficiency and give you tools to better manage these challenges.
In Act 2, I share with you The Sleep Doctors’ blueprint for sleep optimization. We’ll discuss how sleep consistency may be more important than how many hours you sleep. We’ll explore the essentials of sleep hygiene, the role of exercise, and whether naps are good for us.
And if you fall asleep during this podcast, I won’t be offended. I’ll actually be pleased. My goal is to show you just how much agency you have when it comes to your health and ultimately get you feeling your very best.
The man or woman that has their health, have but a thousand dreams and the man or woman that does not, has but one. Welcome to Better Medicine.
Act 1: What Works
We spend a third of our lives asleep and yet until fairly recently doctors like myself could not give you a consistent answer as to why sleep is so important. However, scientific research over the last two decades has enhanced our understanding of sleep more than ever before.
From a purely evolutionary perspective, sleep doesn’t make a lot of sense. When you’re asleep you can’t eat, can’t drink, can’t check Reddit. On the surface, you’re in what appears to be in a pretty vulnerable state. So why for centuries have our bodies required sleep?
Fifty years ago, the research of Dr. Czeisler laid the foundation for what we now know as the two main factors that drive being awake and being asleep.1 The first factor is our body’s circadian rhythm. Think of it as our body’s natural internal clock.
When we wake up in the morning and open our eyes, a super small part of our brain, called the suprachiasmatic nucleus, detects the amount of light let in by our eyes. It then relays messages to specific parts of our brain and body to begin to wake.
Our brain releases hormones that increase our heart rate, our blood pressure, and turns on all of the necessary bodily functions needed to be awake. In the evening, as the sun sets, our brain’s natural rhythm reverses. Our body temperature begins to cool, our mind and muscles relax all in an effort to prepare us for sleep.
But our bodies are smart. You see, along with our circadian rhythm, there's another factor driving our sleep/wake cycle: it's called sleep pressure.
Dr. Czeisler’s work revealed that from the moment we wake up in the morning, a chemical called adenosine starts building up in our bodies. You can think of adenosine as our body’s natural sleeping pill. Adenosine gradually rises throughout the day landing on little sleep receptors in our brains.2
For most of us adenosine peaks 12-16 hours after being awake and creates so much sleep pressure that we can’t resist going to bed.
While we are sleeping, our brain rids itself of all of its accumulated adenosine and after 7-9 hours of sleep it's all gone. That’s why our body needs seven to nine hours of sleep to wake up feeling refreshed and restored.
Grace was getting nowhere near seven to nine hours of sleep. Her adenosine never fully washed out of the sleep centers in her brain and left her feeling drowsy every morning.
Like most of us, Grace would often reach for caffeine to help her feel more awake. The good news is that caffeine lands on the same receptors in our brain as adenosine and therefore reduces sleep pressure and makes us feel more wakeful.
The challenge with caffeine is that it works a little too well. You see the half life of caffeine is about six hours. That means that if you have a cup of coffee at noon, half of that caffeine is still in your body at six pm and a quarter of it remains at 9pm.
It’s therefore best to avoid caffeine after noon as it’s linked with lower sleep efficiency, more awake time during the night, and less total sleep time.3
But why do we even need to sleep at night?
Well, it turns out that some pretty miraculous stuff happens while we sleep.
Let’s take cancer for example. Right now while you are listening to this podcast, a few cells in your body are dividing at an abnormal rate. They are in the very early stages of becoming cancer cells.
The good news is that our body has an immune system and produces specialized cells called natural killer cells to knock out these cancer cells.
But if we don’t get enough sleep at night these cancer fighting cells can't work their magic. One study found that those with moderate sleep loss had a 70% reduction in their number of natural killer cells.4
This is why night shift workers, when compared to those that work regular 9-5 jobs, have higher rates of breast, prostate, and colon cancer.5
In fact the World Health Organization classifies night shift work as carcinogenic.6
Several women in Grace’s family had breast cancer. Simply by logging a solid eight hours of sleep every night, Grace helped reduce her odds of being next.
Beyond fighting cancer, sleep helps us in several other ways.
When we sleep, we cycle through several phases. There’s a phase of light sleep when your body relaxes, a phase of deep sleep when brain activity slows, and a phase of REM sleep, when we dream.
Deep Sleep and REM sleep is where the real magic happens. It’s when our body heals itself and consolidates memories. It’s also during these two phases where your brain flushes out amyloid proteins, the same proteins that are the hallmark of Alzheimer's disease.
Lower rates of REM sleep is a known predictor for dementia later in life.7 But here’s the catch, the majority of our REM sleep happens 5-7 hours after we fall asleep.
So let’s say that you typically sleep eight hours every night but one night you sleep six hours. You’ve lost 25% of your total sleep. But as your brain gets most of its REM sleep in the latter part of the night, you are likely losing 60-90% of your dementia preventing REM sleep.
Grace also noticed that as her sleep improved, she lost weight. That’s because our body produces digestive hormones while we sleep. These hormones help with making us feel full after meals. You can think of it as free ozempic. This free ozempic is elevated in those who get adequate sleep.
Grace saw her blood sugar levels improve as well. That’s because during deep sleep our body naturally lowers insulin resistance thus improving our body’s ability to regulate glucose.
The opposite happens when our deep sleep is reduced. Sleeping less than seven hours a night has been shown to lead to increased weight gain, higher rates of diabetes, cholesterol, and high blood pressure.8,9
Sleep also allows our bodies to heal. While we’re asleep, our body releases growth hormone into our bloodstream. As growth hormone travels the miles of our circulatory system it repairs tiny nicks and cuts to the walls of our blood vessels.
It’s like a little cleaning crew that comes in while we’re asleep, only this cleaning crew is cleaning the vessels that supply our vital organs like our brain and heart.
This is why we see lower rates of heart attack and stroke in individuals that get enough sleep.10 Quite literally the more you sleep the longer your life.
From fighting cancer, to helping us optimize our weight, to reducing our risk of chronic disease, sleep isn’t just a pillar of our health it may very well be the foundation.
Now look, on a personal note, I appreciate that bringing about meaningful change is hard. It brings about feelings of vulnerability and as someone who has struggled with my own sleep for years, there is no simple fix, it takes me constant work.
And when I accept that, when I move towards it and turn into it, it allows me to grow. It helps me embrace what works and let go of what doesn’t.
This is the type of change Grace was looking, maybe I’m looking for, maybe you're looking for as well. Coming up in Act 2 of today's episode we get into the Sleep Doctors blueprint for getting our sleep right.
But just before we go there, I just want to pause for a moment and say thank you for listening to the Better Medicine Podcast. Our goal here is simple. We research what works so that you can get more of what works into your life.
Please take a moment and go to our website BetterMedicine.com and subscribe to our monthly newsletter. It’s free and frankly, it’s the best way for us to stay in touch. At BetterMedicine.com you can find links to all of our podcasts, show notes, as well as discounts from our sponsors.
And if you’re interested in taking your health to the next level, you can sign up for personalized coaching sessions with me. As a professional health and wellness coach, I work one-on-one with you to help you explore and enhance your own personal nutrition and fitness goals to get you living and feeling your very best. Sign up today at BetterMedicine.com and thanks for listening.
Act II: How to get more of What Works into your life.
Strategy #1: Sleep Consistency.
A few years ago a group of researchers at MIT conducted an experiment. They wanted to see what was more important, sleep duration or sleep consistency.
Sleep duration is simply the number of hours you sleep each night. Sleep consistency is essentially going to bed and waking up at roughly the same time every day, including weekends.
They outfitted 100 MIT students with a fitbit tracker and asked them to wear it for an entire semester. Their main goal was to see how these sleep measures correlated with academic performance.
Their study found that those that got eight or hours of sleep every night scored higher on their exams when compared to those that got less. Not much of a surprise there, but they also found that those that maintained better sleep consistency, those that went to bed and woke up at the same time every day, scored even better.11
When your sleep and wake times are predictable, your circadian rhythm works more efficiently. Beyond the MIT lab, studies have shown that those with optimal sleep consistency display sharper thinking, better mood, and actually tend to live longer.12
When we go to bed at the same time and wake up at the same time every day, your ability to fall asleep faster improves and you obtain deeper, more restorative sleep.13
There’s no doubt that we need 7-9 hours of sleep every night and this is backed up by research from the American Academy of Sleep and the National Sleep Foundation.14
But this new data suggests that the timing of our sleep may be even more important than how long we sleep.
Dr. Czeisler also recommended a series of wind-down techniques for Grace to do each night.
Two hours before bedtime each night he recommended dimming all of the lights in the house, no screens, no eating, no alcohol, and finally a warm shower before bed.
The warm shower was key because while you think that it would warm you up it actually cools you down. When you step out of the warm shower, all of your body's blood vessels dilate to release heat and thus you cool down rapidly.
This cool down is where your body temperature wants to be just before sleep. This wind-down strategy combined with a set bedtime and wake time even on off days was step one of maximizing the Grace’s sleep efficiency.15
So how can we all get more sleep consistency in our lives?
Research shows that when individuals simply write down their planned sleep time goal they are three times more likely to achieve that goal than those that did not.16
Want to triple the likelihood of getting more sleep consistency this week?
Pause this podcast, open up your calendar, and schedule your goal sleep time for tonight and maybe even put in a comment: “Tonight from 8-10pm I’m going to dim the lights, ditch the screens, and about 30 minutes before bed, take a warm shower.”
Did you pause? Go ahead. I’ll wait.
Strategy #2: Sunlight
We mentioned the fact that we all have an inner clock, our circadian rhythm, that essentially wakes up our brain when we see sunlight. It turns out the best way to set this clock is to no surprise get some early morning sunlight.
Studies show that individuals that get just 30 minutes of sunlight exposure every morning achieve greater sleep quality when compared to those that do not get morning sunlight.17
When our bodies are exposed to direct sunlight it triggers this pathway between your brain and your adrenal glands which release cortisol. This hormone makes you feel more awake and alert.
Morning sunlight exposure increases serotonin production, a chemical in our bodies that helps to regulate our mood.18 Grace noted that not only did she feel more awake, she actually felt better!
Just 30 minutes of morning sunlight has been shown to elevate mental focus, alertness, and lower rates of anxiety and depression.19
The Sleep Doctor also recommended regular exercise to enhance sleep.
Exercise fine tunes our bodies natural circadian rhythm and it turns out that what time of day we exercise actually matters. Regular exercise particularly at 7a and between 1-4pm enhances melatonin production and therefore helps you get a better night's sleep.20
Exercising too late in the day has the opposite effect. Working out within four hours of bedtime has been shown to make it harder to fall asleep.21
Grace began waking up at the same time every day. She’d grab her coffee, stretch, and sit by a sunlit window. She started taking walks after lunch and while this helped there was still the occasional day where she still felt like she needed more sleep.
Strategy #3 Naps
Let’s face it, who doesn’t love a good nap. But there are mixed opinions on whether or not naps are in fact good for us.
As we mentioned, as soon as we wake up adenosine starts building up in our brain making us more sleepy as the day goes forward. If you take a nap particularly later in the day much of that adenosine gets washed out and this will lead to difficulty going to sleep at night.
But countless studies show that short, 20-30 minute naps taken early in the day can provide significant cognitive and emotional benefits, improving memory, focus, emotional regulation, and performance.22
Naps can be restorative. But there is a napping paradox that should be considered. It turns out that naps lasting longer than 30 minutes may lead to unwanted health consequences.
Napping for more than 30 minutes also can lead to increased sleep inertia which is that feeling of groginess that occurs after we wake up from a long nap. It also leads to poorer health outcomes.23
Grace loved a good nap and she wasn’t alone. Usain Bolt, the 100-meter sprinter, was famous for taking naps before breaking Olympic records. And it’s not just Bolt, da Vinci, Einstein, Churchill, Aristotle, JFK, and Eleanor Rosevelt all made napping a part of their daily routine.
To sum it all up, getting adequate sleep helps us fight cancer, improve our weight, fight chronic disease and all while elevating our mood and optimizing our performance.
And so I invite you to follow Grace’s lead. Start each day off with a healthy dose of sunshine. Level up your sleep consistency by creating a wind down routine that prioritizes going to bed and waking up at the same time every day. And when you need it, go ahead and take a nap. Your future self will thank you for it.
Thank you for listening to the Better Medicine Podcast where we research what works so that you can get more of what works into your life.
I’d like to thank Dr. Eric Sklar, board certified sleep medicine physician for peer-reviewing the content for today’s podcast.
I truly hope you enjoyed our conversation today. To learn more about today's show, including links, resources, coaching, and references to everything discussed go to BetterMedicine.com
I have one ask and that is that you take a few seconds now, go to BetterMedicine.com and subscribe to our newsletter. Once a month, you will receive a link to a podcast just like this one filled with actionable insights and strategies to help get you feeling your very best.
If you would like to support the podcast, the easiest and most impactful way to do so is to subscribe to the show on Apple podcasts and Spotify and feel free to leave a review.
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References
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