For decades, medical science overlooked the considerable damage associated with smoking cigarettes, and it is hard to comprehend that physicians ever condoned smoking and overlooked its harm. Similarly, medical science is now rushing to highlight another long-overlooked risk factor – sleep deprivation. Poor sleep can worsen inflammation and increases the risk of high blood pressure, obesity, depression, and some cancers. In the short term, insufficient sleep can impair memory, attention, and executive function. There is even emerging evidence that poor sleep can even increase the long term risk for cognitive decline and Alzheimer’s disease (Weir, 2017). As Dr. Matt Walker put it, “No aspect of our biology is left unscathed by sleep deprivation. It sinks down into every possible nook and cranny” (Johnston, 2017).
Yet this advice flies in the face of our cultural tendencies to ‘always be on’ and ‘power through.’ It is not uncommon to hear Silicon Valley executives or politicians bragging about how little sleep they get. Here in Los Angeles, the film industry is a famous wrecker of sleep routines and normalcy. These days, one sometimes gets the impression that getting decent sleep is a sign of laziness.
On the other hand, Silicon Valley’s sleep deprived executives have been busy developing a host of sleep related devices in recent years. There are now sleep trackers that are worn on the wrist, several that sit on your nightstand and monitor you via remote sensors, smart pillows, and even smart mattresses. This new technology brings with it a host of health questions. Is it healthy to sleep with your body bathed in sonar all night? There are considerable privacy concerns. Do you really want your sleep and sexual habits to be archived in the cloud? Most importantly, do they even help? Unfortunately, there is very little in terms of unbiased, controlled research into the accuracy and utility of these devices.
Perhaps some of these will prove useful, but until then, we all have access to one incredibly sophisticated and highly refined mechanism for assessing your sleep quality – self-awareness!! Why not handle sleep the old fashioned way, with simple, effective, and proven techniques.
It helps to have a formal system of checking in with yourself, since research has demonstrated that people easily overlook the clear declines in cognitive functioning that are associated with sleep deprivation (Van Dongen et al, 2003). A great way to do this is with a sleep diary. There are countless examples available online, and all are intended to help you bring closer attention to your sleep patterns and their impact on energy, wakefulness, and mood.
Paying attention to sleep hygiene is absolutely crucial to good sleep. A few tweaks to sleep hygiene is enough to address many common problems and avoid medication or psychotherapy. Avoid screen time before bed to reduce exposure to the blue light of phones, tablets, and computers. If your device has a night mode, which makes the screen more yellow/orange in the evening, be sure to activate it. Caffeine and alcohol both interfere with sleep, so be wary of using them later in the day/evening.
Perhaps the most important component of sleep hygiene is establishing rhythms for when and how you go to bed. Try to establish a regular time for getting in bed as well as waking. While this may be harder to do on weekends, sticking to roughly similar times on Friday and Saturday will go a long way to making Sunday night’s sleep easier and more refreshing. In a sense, this is a way of privileging sleep, which for many is a necessary corrective in and of itself. Speaking of which, be sure to use your bed for only sleep and sexual activity. When we watch TV, do work, or eat in bed, we are training our mind to stay away in the bed, when we want the bed to only be associated with sleepiness. Finally, be very sure to have a half hour of time winding down before getting into bed. If you’ve just set down a work assignment or have been caught up in an intense TV show it can be difficult to settle down. Rather, simple routines like dressing, stretching, drinking tea, washing up, reading, journaling, or praying/meditating help our body prepare to turn off.
However, sleep hygiene is generally not sufficient to treat true insomnia. The good news is that the American College of Physicians now recommends that the first line treatment be psychotherapy for insomnia – specifically cognitive behavioral therapy for insomnia (CBT-I). Medications do not get to the underlying problems and can impact the normal patterns and quality of our sleep. For many there are also concerns about long term use and side effects. That is why it is welcome news to many that a handful of sessions of psychotherapy is more useful. CBT-I focuses on the choices, beliefs, attitudes that we have about sleep. In particular, it helps people to avoid getting stuck worrying about sleep, which can become an extremely vicious cycle. The best way to really mess up your sleep is to get all worked up about it and focus intently on falling asleep right now or else! Of course, changing this is easier said than done, which is why help from a trained psychotherapist is invaluable in tackling the thoughts and fears that fuel insomnia.
So, as with cutting out cigarettes, take a stand against sleep deprivation and enjoy the benefits of privileging quality sleep. It will help you to make the most of your day and might even assure you of more healthy days ahead.
Van Dongen, H., Maislin, G., Mullington, J., Dinges, D. (2003) The Cumulative Cost of Additional Wakefulness: Dose-Response Effects on Neurobehavioral Functions and Sleep Physiology From Chronic Sleep Restriction and Total Sleep Deprivation, Sleep, Volume 26, Issue 2, 1 Pages 117–126.