Sleep and Wellness: Quality of Life

Sleep is needed for humans to exist. All organisms from the fruit fly to the zebrafish to human beings sleep. It is an essential part of life similar to food, water and air. Sleep occupies up to 20 to 40% of our day.

Insufficient Sleep is a public health epidemic. Despite being considered as one of the three pillars of health (in addition to wellness and physical activity), it has not been prioritized. A third of US adults admit that they get less than the recommended number of sleep hours despite admitting that it contributes to next day effectiveness. Based on the Sleep in America poll, 10 percent pick sleep as a prioritized personal activity, compared with 35 percent for physical fitness and nutrition, 27 percent who select their work and 17 percent who cite hobbies and personal interests. Nine percent pick their social life (Sleep & Effectiveness are Linked, but Few Plan Their Sleep). Not getting enough sleep is linked to several chronic diseases like type 2 diabetes, heart disease, obesity and depression which threatens our nation’s health. 

 Functions of Sleep:

1. Rest: This is the most common function of sleep that we know  
2. Restoration and the ability of the body to rid itself of toxins.
3. Healing and repair.
4. Cognitive benefits including 
5. Memory consolidation
6. Attention and creativity 
7. Concentration and decision making
8.  Sleep is important for hormonal balances regulating weight. When a person is sleeping, leptin, a satiety hormone, rises, while ghrelin, a hunger hormone decreases. This combination helps curb appetite.

Lack of Sleep May Cause:

1. Worse cardiovascular outcomes
2. Risk of chronic diseases: such as type 1 diabetes. Sleep duration and quality are predictors of hemoglobin A1c, an indicator of glucose control with high levels seen in people with Type 2 diabetes.
3. Abnormalities of the immune system 
4. Worse pain tolerance
5. Higher mortality rates
6. Productivity losses at work 

The societal impact on sleep is great. Firstly, work is the strongest determinant of how much sleep we get as adults. With longer and longer work hours, the emergence of the 24/7 society and globalization, sufficient sleep is becoming a rarer commodity. As with adults, children are also not  getting the recommended hours of sleep due to various reasons. Electronics have become standard features in the bedroom. In a national US survey, up to 90% of Americans use electronics within one hour of bedtime. These devices can be disruptive to the quality and duration of sleep. Adolescents in high school experience challenges with adequate sleep. Teenagers already experience a shift in their circadian rhythm such that they prefer a later bedtime and a later wake time. With the early school start time model that prevails in many public school districts, research has shown these children have difficulties with learning, mood and performance. There is also a higher risk of drowsy driving and increased car crashes. 

Several health organizations including the American Academy of Sleep Medicine (AASM) released a position statement supporting a change in school start times  for middle and high school which better fits their physiologic  needs  Some of these changes have been implemented in certain school districts with reported improvement in duration of night time sleep,  excessive daytime sleepiness, school performance and improved quality of life.

How do we prioritize sleep in a productivity consumed society? 

1. Have a bedtime routine: Be consistent with this as much as possible. A family bed time routine with kids is easier to stick to. This can include 2 to 3 calming activities such as a bath and reading a book. It is best to stick to this as much as possible, even on the weekends. 
2. Use the bed for sleep: Ensure the bed is used for sleep only. Avoid taking your work to bed with you. Limit screens in the bedroom. This helps your mind shift from “work mode” to sleep mode. 
3. Have a set work start time and end time: limit work related activities at least two hours before bed time. Learn to create boundaries in order to make time for other aspects of life. Set a time limit for when you stop responding or sending emails. As a leader this is a good example to set. 
4. Take notes: After a busy day at work, you may notice your mind racing as you review the days activities and mentally plan for the next day. If ideas or actions steps come into your mind, write them down. Once you are tempted to keep thinking of these items, speak to yourself something like “today’s work is done, tomorrow is another day to pick up from where I stopped”. 
5. Meditation and mindfulness: This is very helpful if you work in a stressful industry or have a big task ahead. It helps to make mindfulness a daily habit. Practice this for about 5 to 10 minutes before bedtime. There are now several apps available that include guided meditation. It is amazing how this can help you wind down. 

When you feel so busy that you don’t seem to have enough time to sleep suggests that you DO need to sleep. Prioritize sleep consistently to help improve your effectiveness and productivity at work and build better relationships with your friends, family and coworkers.