Boston Women’s Journal - June/July 2008

Counting Sheep

We spend thousands of dollars on face creams, skin toners, and memberships at the gym to look and feel younger and be more vigorous. Often we ignore the most important element of our heath regimen which is free and available at all times. Sleep. Free and available, but not always so easy to come by.

I come from a family of insomniacs. My father used to stay up all night and then fall asleep driving home from work the next day. He would play the harmonica with the windows open to the cold air while driving in the car to keep himself awake. A family legend talks about my maternal grandfather yelling at a truck driver one late night on I-95 who thoughtful honked his horn when he began driving erratically “son of a gun you woke me up!” (actually the words were a bit stronger but I cleaned them up). I have on more occasions then I’d like to acknowledge gotten by on four or five hours of sleep and said, “Oh, I’m one of those people who don’t need much sleep”. That is not true for me or for anyone else, and surviving with little sleep is not the same as thriving with little sleep. At each stage of our life we need sleep to support both our minds and bodies.

We all know that babies are miserable (and make us) so if they can’t sleep. Their bodies need sleep every few hours to grow and develop neurologically and physically. Children deprived of sufficient sleep routinely test lower in school exams. Adolescents, who anecdotally seem to not sleep at all in fact need nine or ten hours of sleep for brain development and the last leg of their growth. As adults we feel we can burn the candle at both ends, but without a solid eight hours of sleep our reflexes, mood, and sanity certainly diminish. There are also long term health risks. Lack of sleep makes it harder to maintain a healthy body weight, is an additive factor in depression, and in extreme conditions can actually kill you. Do you know that after as little as one night without sleep you begin to hallucinate, your depth perception is off, and your judgment is impaired? Your body is crying for rejuvenation and rest to process and make sense of your day. Your body can survive weeks without food, days without water, but only five days without any sleep. And boy does it make us cranky!

Yes, there are individual differences, and I do get by with six hours when others need nine or ten. Sophia Loren, who looks better at her age then most of us will ever look, goes to bed at 8 p.m. I can honestly say for me it wouldn’t be worth it, but it sure is something to think about. She attributes a great deal of her continued beauty to her sleep regimen. Of course her genes probably have a bit to do with it as well.

Stress, the universal additive in all heath problems, has a big part to play in sleep. At a time when we really need to shut down the engines and let our body heal and our subconscious process our day through our dreams, we find ourselves pacing the floor and watching David Letterman. We just can’t always wind down.

One of the things I focus on in my work is figuring out what type of sleeper people are and how they can change their lives to get their individual sleep needs met. I feel that whatever work we do together to help them get well physically, emotionally, or even spiritually, sleep is a foundation element.

One of my most frightening experiences in my work was encountering an Emergency Room physician who informed me that she was on a rotating shift in her practice. As soon as she got used to a sleep cycle she rotated off it. She said she was exhausted all the time and her judgment was impaired. I asked her why her practice worked on rotating shifts, and she said she was the junior member of the practice and couldn’t rock the boat. I told her that volunteering for the late shift and staying on it all the time would be better than what she is doing. I also told her that she was much more likely to make critical errors at work on her current schedule, and she agreed that she had some close calls. In the culture of medicine it is macho not to need sleep, but last time I looked doctors were human too. This woman did some reading about sleep deprivation, took my recommendations and concerns to heart, and made some changes in her life. I am pleased to report that you are safe in her emergency room, but what about all the others?

If getting enough sleep is a problem for you, then get help. The drugs available are often dangerous and addictive. There are behavioral ways of effectively modifying sleep patterns. Work with someone who can help you figure out your optimal sleep needs, and establish a plan for meeting them. I may not be able to promise Sophia Loren looks and aging, but I can promise a better, healthier you - and no more counting sheep!