Sleep On It

I love listening to podcasts, and one of the best new ones is Chasing Life, by Sanjay Gupta MD. Dr. Gupta is the chief medical correspondent for CNN, and he did a year long podcast before this one that gave us daily updates on the coronavirus situation as it unfolded. He is smart, well educated, insightful, and interviewed many different kinds of people who offered insights into the pandemic and our responses to it.

Chasing Life is the logical continuation of his first offering, looking at how we are trying to get back to our lives as the coronavirus pandemic winds down slowly. In the Tuesday, June 22nd edition of this podcast, he looked at sleep and how it has been affected by COVID-19 and related problems. He began this podcast by talking about Cliff Luther, a man who functioned quite well on no more than four hours of sleep routinely, and who had also managed to get three graduate degrees, start work on a doctorate, and coparent his children all at the same time. It was a mixed bag to Mr. Luther to be able to function well on so little sleep, knowing that it might be affecting his brain adversely in some way. It turns out that he did indeed have a rare condition that lead to his needing so little sleep compared to the rest of us.

In 2016, the CDC had found that more than one third of Americans got less than seven hours of sleep per night. As the coronavirus pandemic unfolded, it was noted that people on average were sleeping 14-20 minutes more per night in March and April of 2020, compared to the same period the year before. The pandemic seemed to throw sleep patterns off for many of us. Some people were sleeping more, some less, some got up earlier and some went to bed later. Someone during that period coined the term “coronasomnia” to describe these changes in normal sleep patterns. Some people who had COVID-19 infections have noted ongoing problems with sleep that have lasted varying amounts of time.

Rebecca Robbins, who is a sleep researcher at Brigham and Womens Hospital and has an affiliation with Harvard Medical School, told Dr. Gupta that sleeping less than six hours per night can cause a decrease in mood, increased irritability, brain fog, and decreased ability to focus. It might even cause us to make unethical or foolish decisions, or take risks that we might not otherwise take. One study in February 2021 hinted at a possible increased risk of Alzheimer’s Disease and dementia bought on in part by insufficient sleep.

If you trained in medicine like Dr. Gupta and I did, you remember being told something like “you can sleep when you’re dead”, meaning that you needed to be awake, active and doing something productive almost every minute of your day. But are there reasons that we should be sleeping, and sleeping the seven to nine hours that we hear is the prescribed amount for most of us? According to Rebecca Robbins, when we sleep our glial cells expand, allowing an increased flow of neurotoxins to flow out and away from our brains. Satiety hormones like leptin work the way they should, signaling when we are full and keeping us from overeating. One study found that when people slept less than five hours, the effect on the functioning of this satiety hormone caused them to eat two hundred more calories that they normally would have.

Who is at risk for poor sleep? Older adults, in that our best sleep habits and functioning occur in our thirties to forties and change for the worse after that. Women tend to have sleep issues more than men across the board according to Robbins. There may even be some economic correlation to quality of sleep, in that those who are in poorer socioeconomic groups might live in areas where unbroken sleep might be an impossibility.

What helps us to get better sleep or learn better sleep habits? According to Robbins, cognitive behavioral therapy for insomnia can be very helpful. Relaxation training can be beneficial. She also spoke of the necessity of stimulus control. This includes using the bedroom only for sleep (or sex), only sleeping in the bed (not on the sofa or in the recliner), decreasing the temperature of the bedroom toward seventy degrees, and making sure that you are sleeping on a good quality mattress. Despite the holy grail of trying to get the most beneficial effects out of the least amount of slumber, conventional wisdom still tells us that most people do best if they get from seven to nine hours of sleep per night.

I would encourage you to check out this podcast, Chasing Life with Sanjay Gupta MD, for more interesting insights into the pandemic, our responses to it, and how we are entering the post pandemic phase and are beginning to figure out what is means to live normal lives again.

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