Sleep is very important and is, along with nutrition and exercise, a foundation of health and wellness.
Besides
allowing the body to rest and recharge, there are certain critical functions
that the brain conducts during sleep. Sleep gives the brain a chance to repair
itself and remove toxins that have accumulated during the day. It plays a
crucial role in consolidating memories by converting newly acquired information
into long-term memory. Adequate sleep also helps to regulate our emotions; a
lack of sleep can cause irritability, mood swings, and reacting emotionally. Less
than an optimal amount of sleep can also lead to decreased concentration,
lowered attention span, and cause problems with learning. It can lead to
decreased focus, depression, feeling tired, weight gain, and diminished
performance at work.
Regarding
the unexpected effect on weight, interestingly, research has shown that the
amount of sleep that we get at night affects the amount and types of food we
eat during the day. Lack of sleep is associated with an increased desire for
high calorie foods, and the more sleep deprived we are, the stronger the
craving. One study showed that, compared to people who slept nine hours, those
who only slept four hours consumed 300 extra calories the next day (Am J Clin
Nutr 2011; 94 (2):410-416).
Research
has also shown that people who are sleep deprived have a higher amount of
stress. This could be related to a lack of energy leading to a decreased desire
to exercise, and it is known that exercise relieves stress. Other possible
effects of insufficient sleep include high blood pressure, diabetes, stroke,
depression, and impairment of the immune system (J Immunology.214;(3)
3/2025.347-359).
* * *
The
National Sleep Foundation recommends that adults strive for seven to nine hours
of sleep nightly; teenagers should have eight to ten hours of nightly sleep.
Some people only require the minimum recommended time whereas others need to
sleep in the higher range.
The
body’s circadian cycle – its internal “clock” – governs sleep. When the sun
rises, the body produces cortisol, a hormone that makes us feel alert and
awake. As the amount of sunlight decreases, we produce melatonin, a hormone
that makes us feel sleepy. Electronic devices like smart phones and computers
give off short wavelength light, known as blue light. This decreases the amount
of melatonin produced, which decreases the amount of sleepiness that we feel.
In addition, it can lead to arousals that send the brain a wake-up signal
instead of winding down (https://pubmed.ncbi.nlm.nih.gov/26528465/). It is therefore
recommended that people avoid using computers or handheld electronic devices at
least one hour before bedtime and preferably two to three hours. If this is
difficult due to work responsibilities, you can purchase blue light filters.
Here
are several suggestions to optimize the chances of getting the ideal amount of
sleep. Firstly, the bedroom is for sleep and sleep only. Reading, eating, and working
on the computer should be done elsewhere. By restricting use of the bedroom
exclusively for sleep, we are training ourselves to associate the bedroom with
sleep. The bedroom should be cool, dark, and quiet. You should plan to go to
sleep and awaken at the same time every day, including weekends. If you do not
fall asleep within 30 minutes, you should leave the bedroom and do a relaxing
activity like listening to music or reading a book. When you feel tired, you
can return to bed. The optimum temperature for sleep is between 60 and 70
degrees but as close to 67 degrees as possible. You should not be exposed to
bright light in the evening. If needed, shades can be obtained to darken the
room, and earplugs can decrease noise.
You
should not eat or drink close to bedtime and avoid snacking after dinner. It is
prudent to avoid high sodium foods close to bedtime as well. Decrease alcohol
and caffeine consumption in general, and do not drink caffeine at night.
It
is wise to increase exposure to sunlight early in the day, move at least once every
waking hour of the day, and increase moderate exercise to 150 minutes weekly.
Hydration during the day is helpful, as is eating more whole food, plant-based
choices and increasing meditation.
Most
people have trouble sleeping on occasion. If it is a consistent issue, however,
you should consult with your medical provider to identify and treat underlying
causes. Another modality that has shown to be successful is cognitive
behavioral therapy for insomnia. In this way, we can optimize the amount and
quality of sleep that we need to be our most productive selves the next day.
Dr. Birnbaum practices Internal Medicine with
Lifestyle Medicine and sees patients at Johns Hopkins at Water’s Edge in
Belcamp, MD in Harford County. MD FACP, DipABLM
