If ever there was an area of health in which “physician heal thyself” applied to me, it would be sleep.
Gluten-free, sugar-free, vegan diet? No problem. Extended fasts? I’ve done many. But getting to bed on time? I have to work at it every day.
On the one hand, I’m incredibly grateful for having found my way to optimal health which provides me with the kind of energy needed to support the passion I have for educating and empowering my clients and students to also live their best lives.
On the other hand, when you have the energy level I do and are as determined as I am to bring change so desperately needed to the conventional, disease-focused, broken healthcare system, sleep can sometimes feel like little more than a necessary inconvenience. But I know better.
There is a good reason that not just sleep, but “Restful Sleep” is one of my 7 Body Freedom Pillars upon which my programs for optimal health are built. Research links insufficient sleep to heart and kidney disease, high blood pressure, diabetes, stroke, obesity, depression, and anxiety. It’s also linked to a higher chance of injury in adults, teens, and children.
Lack of sleep is often referred to as a modern problem brought on by inventions that allowed activity to no longer be governed by the rise and fall of the sun, along with technology that enables a 24-hour work day. And the growing health problems brought on by sleep deprivation are often dismissed or believed to be remedied by the old adage that as long as a person gets their eight hours, it doesn’t matter when. This is no longer believed to be true.
Research now shows that shift workers are at a higher risk for all the illnesses associated with lack of sleep. In addition, they struggle with the dangers brought on by sleepiness, insomnia, or both as most people never completely adjust to late night and/or early morning schedules.
In addition, a 2021 Sleep in America Poll, conducted by the National Sleep Foundation, discovered a gap between people’s perception of sleep and the real-world impact it has on overall health and safety when clocks are adjusted just one hour for Daylight Saving Time.
How can this gap be closed? Empowerment and education!
The Rhythm of Sleep
Sleep is complicated. When working optimally it involves multiple organs that release a plethora of hormones in a tightly regulated pattern, on a schedule dictated by a person’s circadian rhythm (CR). The CR is, in turn, driven by the suprachiasmatic nucleus (SCN) located in the anterior part of the hypothalamus.
Science divides sleep into two phases and five stages: wake, N1, N2, N3, and REM (rapid eye movement). One phase is called non-rapid eye movement (NREM) and is made up of stages N1, N2, and N3, each stage a progressively deeper sleep. The second phase involves only the REM stage.
In a typical night, most people will go through 4 to 5 sleep cycles, each cycle occurring in the following order: N1, N2, N3, N2, REM. Each cycle takes approximately 90 to 110 minutes.
The first REM stage is short, but as the night progresses, each cycle involves longer periods of time spent in REM sleep and less time in deep sleep (NREM).
Each stage has the following characteristics:
- WAKE: During eye-open wakefulness, beta waves predominate. As individuals become drowsy and close their eyes, alpha waves become the predominant pattern.
- N1 (Stage 1) – Light Sleep (1- 5 minutes, 5% of total sleep time.)
EEG recording: theta waves – low voltage
This is the lightest stage of sleep and begins when more than 50% of the alpha waves are replaced with low-amplitude mixed-frequency (LAMF) activity. There is still a tone to skeletal muscles and breathing tends to be regular.
- N2 (Stage 2) – Deeper Sleep (25 minutes in first cycle, progressively lengthening with each successive sleep cycle, eventually 45% of total sleep time.)
EEG recording: sleep spindles and K complexes
In this stage heart rate and body temperature drop and is characterized by the presence of sleep spindles, K-complexes, or both. Sleep spindles are brief, powerful bursts of high frequency brain activity. This is believed to be integral to synaptic plasticity which impacts learning and memory. Numerous studies suggest that sleep spindles play an important role in memory consolidation.
K-complexes are long delta waves that last for approximately one second and are known to be the longest and most distinct of all brain waves. They have been shown to function in maintaining sleep and memory consolidation. This stage of sleep is when teeth grinding occurs.
- N3 (Stage 3) – Deepest Non-REM Sleep (25% of total sleep time.)
EEG recording: delta waves – lowest frequency, highest amplitude
N3 is also known as slow-wave sleep (SWS). This is considered the deepest stage of sleep and is characterized by signals with much lower frequencies and higher amplitudes, known as delta waves.
This stage is the most difficult to awaken from. As people age, they tend to spend less time in slow delta wave sleep and more time in stage N2 sleep. Although it has the greatest arousal threshold, if someone is awoken during this stage, they will have momentary mental fogginess, known as sleep inertia, and moderately impaired mental performance for 30 minutes to an hour. During this stage the body repairs and regrows tissues, builds bone and muscle, and strengthens the immune system. This is also when sleepwalking, night terrors, and bedwetting occurs.
- REM – (10 minutes in first cycle, progressively lengthening to as much as an hour by last. Approx. 25% of total sleep time.)
EEG recording: beta waves – similar to brain waves during wakefulness.
REM is associated with dreaming and is not considered a restful sleep stage. Brain metabolism can increase by up to 20%. While the EEG is similar to an awake individual, the skeletal muscles are limp and without movement, except for the eyes and diaphragmatic breathing muscles. Breathing becomes more erratic and irregular. This stage typically starts 90 minutes after you fall asleep. REM is also when dreaming, nightmares, and penile/clitoral tumescence occur.
Briefly waking up one or two times during the night is normal. But if you wake up four or more times during the night, for an extended period of time, you could be heading for trouble – if you haven’t already found it.
When sleep cycles are repeatedly interrupted, your body basically has to reboot and start the progression of stages all over again. This not only prevents deep, restorative sleep, but it disrupts a countless number of processes, science is only beginning to understand, vital to proper body function and disease prevention.
What is known is that in addition to the chronic disease I mentioned earlier, sleep deprivation can cause tremors, memory loss, decreased creativity, inflammation and an impaired immune system.
And despite modern technology that allows activity to continue 24/7, the body still prefers the clock it has used for thousands of years; the sun. The suprachiasmatic nuclei (SNC) still sets the body’s circadian rhythm primarily through the natural light taken in through the retina.
Artificial light may allow nighttime activity, but it doesn’t stop the body’s desire to continue a diurnal sleep/wake cycle dictated by the 24-hour solar day. If the untimely light does have an effect, it is often negative, serving to confuse the SNC which can lead to sleep disorders, mental health issues, and illness.
The Importance of Overcoming Sleep Deprivation
One of the first things I review with clients in my Empowered Self-Care Lab is sleep hygiene. They are always surprised when they come to me for issues such as weight gain, high blood sugar, or hormone imbalance and the first thing I ask about is their quality and quantity of sleep. What many don’t realize is poor sleep can be the root cause of these problems.
It is also the reason I stress the importance of sleep education with students in my Nutritional Endocrinology Practitioner Training (NEPT) program. You will never see me supporting the outrageously harmful schedules most interns in conventional medicine are expected to keep. It poses a risk for everyone involved.
It’s vital clients and students alike learn the importance of putting their own health first, and at the foundation of their health is restorative sleep. I learned it the hard way. Others don’t have to.
In my blog, “Can’t Sleep? What’s Your Problem? I review primary reasons for sleep disorders and the progressive ways in which functional healthcare is providing solutions. Join me there and discover ways that can help resolve the modern issue of sleep deprivation.
Extent and Health Consequences of Chronic Sleep Loss and Sleep Disorders – Sleep Disorders and Sleep Deprivation – NCBI Bookshelf
Physiology, Sleep Stages – StatPearls – NCBI Bookshelf
Sleep Spindles in Humans: Insights from Intracranial EEG and Unit Recordings – PMC
Effects of light on human circadian rhythms, sleep and mood – PMC
National Sleep Foundation