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Ahh, good sleep! How to get more

By on March 23, 2020 in Columnist with 1 Comment
Jim Brown

By Jim Brown, M.D.

As I said in last month’s article, getting adequate sleep of seven to eight hours a night is vital to our health, longevity, regulating our appetite and helping to control our body weight. 

The latter is of vital importance considering we are a nation of obesity where 34 percent of adults and 20 percent of our children are considered obese.

We humans are not the only ones who need adequate sleep. Every living species sleeps, including insects like flies, ants, bees, as well as fish and even worms sleeps. 

When I have watched and marveled at the whales in the Sea of Cortez and Bandera Bay in Mexico, I wondered how they coped since they need air now and then. What I didn’t know is that whales do sleep but when they do, only one half of their brain sleeps at a time, amazingly allowing them to live and feed around the clock.

Most people have heard of REM sleep (rapid eye movement) in which we dream and replace our memories. REM sleep in a sense has a healing quality for our worries and anxieties. REM sleep actually starts in the uterus in the third trimester for babies before they are born.

NREM or non-REM sleep starts when we first fall asleep and cycles with REM sleep every 90 minutes while we sleep. NREM sleep is responsible for making fact-based memories permanent. Sleep improves our ability to learn, memorize and make logical decisions and choices.

I know a teacher in our valley who teaches an “intervention” class of ninth graders. Most of these students have been sent to her class by other teachers because of behavioral, motivation, learning issues and disruptive behavior and teachers couldn’t deal with them in their own classrooms. 

At times, she has shared with me the problems she has to deal with her students. At first I thought this must be a result of their home environment or lack of parental involvement, supervision or caring. 

I now suspect that a major contributor to their problems is lack of adequate sleep. Many of these kids are up late at night, even as late 4 a.m., playing video games, on Xbox or on their phones. They often come to school and fall asleep. It is nearly impossible to teach or learn in situations like that.

Without adequate sleep, it is hard to retain information. Even college students who cram the night before a test or “pull an all-niter” the night before are doing exactly the opposite of what would bring them the best test results. 

When I was in pre-med and later in medical school, I didn’t know anything about the role of sleep in learning. I tried to study as much as possible in the afternoon and early evening in the school library. By about 9 at night I just told myself “I am tired and I just can’t pack anything else into my brain” and went to bed. 

I see now in retrospect I was lucky as this is probably the main reason I got though the eight years of college and med school.

Two readers of my last article about sleep asked me the question, “How do we get this adequate sleep that you are telling us we need?”

First of all, we need to have a sleep schedule of going to bed and waking up at the same time each day. For me that is about 9:30 at night and awakening about 6:30 a.m. It is hard to adjust to frequent changes in sleep times. Stick to a regular schedule as best as you can. 

It is important to have your bedroom cool and as dark as possible. I wear a soft, comfortable sleep mask to insure absolute darkness. 

Don’t keep your computers or iPads in your bedroom. If feasible, get a comfortable mattress and pillows.

I love exercise in all forms and know how good it is for my body. It is important to avoid exercise two to three hours before bedtime. 

Another issue is the use of caffeine, alcohol and nicotine before bedtime. This includes coffee, colas, black tea and chocolates, all of which contain caffeine. 

It takes up to eight hours to metabolize caffeine from our body. This is particularly true as we age because with age it takes more time to metabolize caffeine. 

I love my morning coffee but I rarely drink coffee after noontime. 

It is important to avoid alcohol near bedtime. It might relax or sedate you, but it does not produce natural sleep and reduces valuable REM sleep.

We also should avoid eating a large meal and drinking excessive beverages of any kind especially late in the evening. 

Avoid sleeping pills! Studies of over 10,000 participants in one and another of 20,000 participants taking sleeping pills regularly over a two-and-a-half year period showed that those taking sleeping pills regularly were 4.6 times more likely to die over this short time period than those not using sleeping pills. 

Another study comparing heavy users of sleeping pills, taking more than 132 pills per year, were 5.3 times more likely to die compared to a control group not taking sleeping pills.

Naps are OK in the afternoon but should be avoided after 3 p.m. since they make it harder to sleep later. 

Try to relax before bedtime by reading a book or magazine, but not on a device that will interfere with your natural melatonin production. 

It is good to take a hot bath or shower before bedtime. Afterwards, as your body cools down, it is easier to fall asleep. 

Don’t lie in bed awake. After 20 minutes if still awake and anxious, get up and do a relaxing activity. The anxiety of not falling asleep might keep you awake. 

There are numerous over-the-counter sleep aids on the market, most of which contain the antihistamine diphendramine including Benadryl. They may be OK for occasional use, but if used regularly they don’t produce good deep sleep and tolerance to them can develop.

Sleep is one of the most important things we can do to have better health and a longer life expectancy.

Sleep well. Pleasant dreams.

Jim Brown, M.D., is a retired gastroenterologist who has practiced for 38 years in the Wenatchee area. He is a former CEO of the Wenatchee Valley Medical Center.

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  1. James S. Russell says:

    I enjoyed this follow-up because it gave a list of behaviors to prepare me to get a good sleep. I like the list because it complements other recommendations I’ve read but he nicely consolidated them. He also added scientific studies about medications that were compelling, probably because they matched my biases. 🙂 Keep up the good work.

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