Sleep On This…

You’ve probably heard that poor sleep hygiene is associated with a whole host of diseases. Well, it’s true. I’d be an embarrassment to the neurosurgical community if I didn’t inform you of the well-documented association between lack of sleep and Alzheimer’s disease. It’s very real and thought to be specifically REM sleep deprivation (during which toxins are normally washed free from the brain through channels aptly known as “glymphatics,” a concatenation of the words of “glia” and “lymphatics”) that predisposes us to neurodegenerative disease. Sleep also lowers cortisol levels, and you know what chronically elevated cortisol does to the body, right? Your immune system falters (that means you get sick more often), you get fat, feel lousy (fatigued) and the next thing you know, and you’re in the ER with crushing chest pain. Conjure up images of the late newscaster Tim Russert. Enough said.

So how do you improve your sleep?

How do you better this restorative physiologic process, the workings of which are wired into nearly every species, all the while remaining so mysterious? It’s true. We know very little about sleep, relatively speaking. What we do know, however, is that sleep is critical to our health and well-being. To the same extent that its mechanisms prove elusive so does a sound night’s sleep for many of us. But there’s hope! If anyone were a poster child for poor sleep hygiene, it’d be a neurosurgeon whose practice is exclusively limited to trauma. Disrupted sleep is a habit to me, yet I manage to log ample REM time nightly, and into the fray, I go the following day.  [That rhyme was unintentional.] Here are some cool tricks (the product of much trial and error – and sleepless nights) that may be of benefit to you, should your profile picture also grace the pages of Webster’s Dictionary under the “Sleep-challenged:”

  • Exercise regularly: This will lower stress levels (and therefore cortisol, a sleep disrupter). Exercise will also prompt the body to sleep in order to recover from your training session earlier in the day. Do not exercise with 2-3 hours of bedtime, however (given the release of excitatory neurotransmitters such as epinephrine).
  • Stop eating at 7 PM nightly: For a variety of reasons, eating late is detrimental to your health. Carbohydrates, in particular, interfere with sleep induction. If you must eat after 7 PM, choose a handful of raw almonds. It’s optimal, however, to stop eating 11-12 hours before your wake time.
  • Make sleep a habit: Head to bed at a similar time each night. This will reinforce and pattern your sleep-wake cycle, a critical rhythm in the body. Supplemental melatonin (the sleep hormone) will “encourage” your body to sleep on schedule. Starting dosage: 1 mg before bedtime on an empty stomach.
  • Ditch the cell phone. Learn something instead: I know, you may go through an alcohol-like withdrawal without your cell phone two hours before bed. Bottom line? The blue light from cell phones, tablets and laptops decimate the production of melatonin. So instead of Candy Crush, dim the room lights a bit, and read a book. Your brain will thank you for it.
  • Sleep in a cool environment: 65-70 degrees Fahrenheit! That’s right. We sleep optimally when cold. Also, cooling the body increases the production of brown fat that has a thermogenic effect (and helps you stave off diseases such as type II diabetes). I use a water-cooled pad (with a pump system) underneath my mattress to lower my core body temperature.  
  • Catch up on weekends: This one is critical. Sleep deficit is cumulative. Any neurosurgeon will tell you this. What did we do on our weekends off during residency? Slept, of course, in an attempt to rectify the sleep deficit accrued during the 120-hour workweeks – It’s now illegal to enslave residents for more than eighty hours per week. And for a good reason. Error rates are higher in the sleep-deprived. Your brain simply doesn’t function optimally without a periodic reboot, not unlike a computer. So treat it as one. After all, that amorphous mass between your ears is the most complex computer in the universe.

Shut it down…