The A to ZZZZ on Sleep

There’s a lot of information, apps, home remedies, and anecdotal evidence surrounding sleep. We all do it every night, with varying degrees of success, so we have a backlog of personal experience (and probably bad habits) as well.

Setting the Record Straight

Similar to eating, sleeping is fraught with conflicting emotions and confounding data. To separate fact from fiction, I had coffee (decaf) with Dr. Sarah Zallek, MD, from the Illinois Neurological Institute at OSF HealthCare. She is board certified in Sleep Medicine and Neurology and has a keen understanding of the workings of the human brain and why it’s sometimes difficult to turn the darn thing off for 8 hours a night!

“It’s a misnomer to say ‘turn off’,” Dr. Zallek says. “Sleep is an active process involving your brain as well as other critical systems in your body.”

The scientific community has not proven why we sleep, but they can certainly agree on the negative effects of not getting enough quality sleep. Most of Dr. Zallek’s patients come in the door sleepily complaining of one of three things: they are too sleepy; they can’t sleep; or, they do something funny in their sleep like walking, talking, or snoring.

Most sleep issues can be attributed to imbalances in four main areas: quantity, quality, internal drive, or timing, Dr. Zallek explains.

Every person is different, so she listens to each patient’s story and tries to solve the puzzle. “A good doctor is really a sleuth who is fitting the pieces together; it’s exactly why I love medicine,” she says. Under normal circumstances, our bodies get sleepy because our internal clock (circadian rhythm) is telling us it’s time to sleep or we haven’t slept in a while, and our body needs to rest. Although external forces like tax codes and Aunt Ethel’s explanation of diseases threatening her African violets may seem to make you sleepy too, it’s usually an effect of an underlying sleep issue, not a cause.

I’m Cycling as Fast as I Can

We cycle through four stages of sleep throughout the night while completing 4-6 cycles. As we start to fall asleep, we go into NREM, which is composed of N1, N2, and N3 stages and then progress into the REM (rapid eye movement) stage where dreaming occurs. We cycle into a REM stage every 90 minutes. Deeper sleep tends to occur in the earlier parts of the night. REM sleep gets longer and more abundant toward the end of the night.

“Even though you may not remember your dreams or feel like you don’t dream at all, you may simply be waking after completing REM sleep,” Dr. Zallek explains.
If you aren’t getting enough REM sleep, you may not be sleepy during the day, but you may not be as sharp. REM sleep recharges those parts of the brain responsible for learning and memory. Whether you are dreaming or not, continuous sleep is what refreshes your body.

Most adult humans need 7-8 hours of sleep a night (even those folks who brag they don’t need that much).

“Anything less than 6 hours a night, for several nights in a row, will impair everyone’s motor and cognitive performance, which means accounting errors, flight judgement errors, or pitching errors,” confirms Dr. Zallek. We live in a highly plugged-in, 24/7 world where caffeine flows freely and is marketed as a solution to poor sleeping habits. “There are so many more activities to engage in from gaming to internet shopping and binge-watching that it’s difficult to remain firm on our bedtimes,” she says. We all tend to believe we can get by with less and are inclined to discredit the ill effects. Sleep deprivation can lead to weight gain, depression, high blood pressure, heart disease, and stroke.

There are even recent findings linking sleep deprivation to the presence of markers for Alzheimer’s disease, Dr. Zallek says.

Sleep is not something to brush under the bed. When we sleep, our brain waves may slow down, but our immune system is busy cleaning and repairing things like the lining of blood vessels, so you do “feel better in the morning,” and your body is able to control critical functions like your blood pressure. In addition, certain hormones are released during sleep that trigger growth and development. Overall, the brain and body are restored and re-energized during critical sleep hours.

I Get it, But I Can’t Get to Sleep!

Dr. Zallek says it can take 10-30 minutes to fall asleep. One of the most common complaints she hears from patients is the inability to turn off their mind. Good sleep stems from a well-trained brain. In other words, your brain needs to understand that the bed is for sleeping. Dr. Zallek explains it like this:

Your mind is like a parking lot with all your myriad thoughts looking for parking. There’s one, prime VIP space closest to the store where all your thoughts want to crowd when you’re trying to get to sleep. You need to reserve that space for one thought: a single, fabulous experience in your life that makes you feel great. Focus your mind on that experience. If other thoughts start to push into your VIP space, actively replace with your “great” experience. As you focus on that single thought, your brain relaxes and you fall asleep.

It’s important to use the same experience every night because you are training your mind to relax and sleep. Everyone is different, so there is no magic timeframe for this to take effect. It depends on your level of discipline and how quickly you start to apply the brain train. “If you’re lying in bed and still not asleep after 30 minutes, get up, go to another room, read a little or do a puzzle, and try again when you feel tired,” she says. A regular sleep routine will also reinforce the message that “it’s time to sleep.”

Better Sleep in Three Steps

According to Dr. Zallek, the three most important rules that will give the biggest return on better sleep are:

  1. Setting regular wake and sleep times (you can flex 30 minutes on the sleep time, but not on the wake time)
  2. Reserving your bed for sleeping or intimacy only
  3. Covering or turning your alarm clock around; no checking until it wakes you up the next morning

Even following all the rules, everyone experiences a slump in energy around 2pm every day, but don’t resort to caffeine to pick yourself back up. Moving or engaging in conversation are easy ways to re-energize to get you through the rest of your day without compromising your sleep. And, the “Monday morning blahs” is actually a thing.

“It’s called social jet lag,” says Dr. Zallek. We all go out over the weekend, stay up late, sleep in, and it’s like flying to California for two days. Our routine and our internal clock are out of sync.

Certain foods, herbal supplements, or specific exercises may claim to enhance sleep, but none have been scientifically proven to work. Exercise will help deepen your sleep, provided it’s not done too close to bedtime. Even popular melatonin supplements are not going to help if you have a quantity, quality, or internal drive issue.

Personally speaking, the simple act of turning my clock around at night and sticking to a reasonable bedtime has helped me in just a few short days. We can all be good sleepers if we put our minds to it!

Dr. Zallek recommends that if you have good sleep habits and are still experiencing sleep issues, it might be time to see your doctor for a closer look. Download a complete list of healthy sleep hygiene from the Illinois Neurological Institute.

Post your sleep questions in the comments below and we’ll get answers from Dr. Zallek to a random selection.

This article is for informational purposes only.

CITATIONS

Begley, Sarah. “How to Get Better Sleep: The 9 New Sleep Rules.” Time.com, Time Inc., 30 April 2017. Accessed 25 September 2017.

“What Happens When You Sleep?” Sleepfoundation.org, National Sleep Foundation. Accessed 25 September 2017.

Blahd, William. “Insomnia: Sleep Tips Slideshow.” WebMD.com, WebMD, LLC, 6 October 2016. Accessed 25 September 2017.

7 comments on “The A to ZZZZ on Sleep

  • I am constantly struggling with the balance between getting enough sleep and keeping my internal clock in sync. So I have 2 closely related questions regarding this struggle:

    1. On weekends when I don’t have anything going on, I let myself wake up naturally. But sometimes I can sleep for 10-12 consecutive hours. Is my body telling me I need this extra sleep and should I listen? Or is it best to set an alarm so I don’t mess up my internal clock?

    2. Often, I’m unable to get the sleep I need during the week due to work and social engagements. Is it possible to “catch up” on the sleep I lost during the week on the weekends?

    Reply
    • Lisa McSherry says:

      Jill,

      If you are sleeping much later on the weekends you’re probably not getting quite enough sleep on the weeknights. It’s best to aim for about the same amount of sleep on weeknights and weekends, which for most people is 7-8 hours a night. Setting an alarm for the morning to keep your wake time about the same each day is a good idea, and then follow your sleepiness in the evening to set your bed time in order to get enough sleep.

      You can try to catch up on weekends if you really can’t get enough sleep on weeknights, but you might never get the same total amount of sleep as you would if you kept a more regular sleep schedule.

      -Dr. Zallek

      Reply
  • Can dreams teach us anything about ourselves and our sleep habits, or are they just the random firings of a recharging brain?

    Reply
    • Lisa McSherry says:

      Nick,
      Dreams are not random firings but probably allow us to process some things we learn in wakefulness. There are a lot of theories on dream content, and a psychologist or psychiatrist would have more expertise than a sleep neurologist.
      -Dr. Zallek

      Reply
  • I have struggled with insomnia for many years, are there any behavior modifications you would recommend that help to ease this without the use of medication?

    Reply
    • Lisa McSherry says:

      Louise,
      If you follow the suggestions in the blog post all together like a recipe (not just trying one thing at a time and deciding whether it works and trying the next thing) and they don’t work, it’s probably time to see a sleep physician for a consultation. Some of the important points include: keeping a regular bedtime and wake time, using your bed only for sleep and intimacy, not sleeping anywhere but your bed, tapering completely off of caffeine, and never ever looking at the clock between bedtime and when your wake up alarm goes off.
      – Dr. Zallek

      Reply

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