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Sometimes we get so caught up in the little things that we miss the big important ones right in front of us. And this is especially true when it comes to health and wellness.

We can become so obsessed with the right post workout drink, perfecting that new plank variation, or reviewing workout data that we can forget one of the biggest tells of all: How are you actually feeling?

Trendy workouts and organic produce aside, perhaps the biggest element we all seem to neglect when it comes to how we perform and feel is sleep. Calm, beautiful, blissful sleep. We can get so caught up in all the dizzying array of things we’re supposed to do for our health, that we forget to stop and shut down in the name of health itself.

Sleeping Dog Tom Trevino

It’s pretty easy to see why this may be the case. It’s a seemingly passive element, and easily the first thing we sacrifice in the midst of a good time or a busy day. And since you’re just kind of laying there doing nothing, it’s a hard sell – and difficult to hype (though I think the dog picture above speaks volumes).

Nike hasn’t produced a slick ad with beautiful athletes adrift in slumber. Gatorade doesn’t have a beverage aggressively marketed toward counting sheep. And as much as social media has made us all braggarts, no one really wants to hear that you brushed your teeth and were in your pajamas by 8 p.m. (well, depending on the PJs, of course).

By not paying attention to our sleep, sleep patterns and not prioritizing it like we do other aspects of our well being, we’re missing out on a vital element of health. An element that not only has an impact on our general demeanor and focus, but also on things like body weight, diabetes risk, and even general mortality.

Probably not the best place to catch up on sleep. Photo(s) by Tom Trevino.
Probably not the best place to catch up on sleep. Photo(s) by Tom Trevino.

For more insight on the topic, I spoke with Dr. Michael S. Jaffee, a neurologist who has additional board certification in Sleep Medicine, and asked him ten big questions relating to sleep. Here’s what he had to say:

So, why do we need sleep?

Scientists don’t have a definitive answer to that question, but current theories include that sleep is involved in restoration of brain energy reserves that are depleted when we’re awake, and that sleep helps us consolidate new memories and learning.

What are some of the things that happen in the brain when we do sleep?

Sleep is actually a somewhat dynamic process in that our brain goes through several different cycles during the night. These cycles include different stages of Non-REM sleep and REM (rapid eye movement) sleep.  These stages activate different parts of the brain and different chemical messengers in the brain.

Is there an optimal amount we need to promote health and well being?

It appears to be individualized. Most sleep experts recommend 7 to 8 hours per night. The optimal amount for an individual is the amount they need to be fully functional the next day.

What happens when we don’t get enough?

Lots of things can happen; a decrease in pain tolerance, an increase in autonomic activity which relates to the flight or flight response and can be associated with an increased risk of heart disease, a potential decrease in insulin sensitivity and an increase in appetite and subsequent weight gain, suppressed immune function, and a decrease in cognitive function with regard to attention and memory. Recent data shows that it also puts people at greater risk of car accidents, and that sleep deprived medical professionals make more medical errors. Both of those observations have led to policy changes.

Can we get too much?

There is a difference between getting more sleep and getting too much sleep. There was a recent study involving college basketball players, and the athletes who performed best were those who slept more than their peers. There are some other studies that suggest an increased mortality rate for certain groups that get too much sleep on a chronic basis, but the mechanisms of that aren’t quite understood and haven’t been thoroughly investigated. This data does not apply to the individual who is getting recovery sleep following acute sleep deprivation. Certain individuals in the population have a need for more sleep than others, and we actually have a diagnostic name for them: long sleepers.

How important are sleep patterns (going to bed at the same time each night)?

A set pattern with a consistent sleep time and wake time is important in establishing a habit of getting a good night’s sleep. Once that’s established, it’s important tot try to stick to those habits as much as possible even on weekends or on vacation. Other factors that can help include: regular exercise, appropriate nutrition, avoiding caffeine or other stimulants in the afternoon and evening hours, and limiting or avoiding alcohol, which can help put you to sleep more quickly, but is known to lead to disruptive sleep throughout the night.

What happens if we stay up way too late?

Homeostatic mechanisms will be affected, and the chemical and neurotransmitter responses change. The one you’ve probably heard the most about is melatonin, which starts getting released late in the afternoon and builds up throughout the evening to help provide a chemical signal to help initiate sleep. The other big one is adenosine, which builds up during waking hours and correlates with feeling sleepy. What coffee and caffeine do is block the adenosine receptors, thereby creating a temporary chemical shift blocking this cue that tell us it’s time to sleep.

If we do turn in later than usual (or much, much later than usual), is it best to wake at our normal time, or try to get in the extra sleep we lost?

For people who have insomnia, experts recommend getting up at the regular time and avoiding naps, and use the homeostatic drive to get back to a normal pattern and increasing sleep efficiency. If staying up late is an unusual occurrence to your normal pattern, you can sleep in a bit to cover for it, but not too late as it may throw off your natural rhythm. It is important to distinguish insomnia from a disruption in our circadian rhythm. There are some people who cannot fall asleep until later in the evening. If allowed, they could sleep a full 7-8 hours. The challenge is that most people have jobs or school that requires awakening in the morning. The focus of these individuals with a delayed circadian phase is addressing the circadian issue to allow them to fall asleep earlier in the evening.

What are the most common causes of sleep disruption/deprivation (anxiety, alcohol, poor planning, kids, etc.)?

Lots of situational things here, which isn’t surprising considering that 30% to 50% of the population report having bouts of insomnia, with 10% to 30% in the chronic range.  It can be something external, like staying up late to watch a Spurs playoff game, or factors like changes in environment, schedule and stress. For some people going through those acute phases in life, it can be hard to get back on track even after the precipitating factor has resolved.

What one thing can we do tonight to get a better nights sleep?

A recent study picked up on a relatively new phenomenon: A significant percentage of people who reported sleep disruption, had an association with an electronic device. So, one tip would be to turn off or silence electronic devices. You can also try cutting off caffeine and stimulants after 4 p.m., and also be especially mindful of evening bright light and light sources (including personal electronic devices) which can repress melatonin from being released and affect the body’s natural chemical cue.

Tom Trevino is a writer, artist and wellness coach based out of San Antonio. His column, “The Feed,” addresses health and fitness issues and dispense practical advice for San Antonians attempting to wade through the often-confusing diet and fitness world. He holds a B.A. from the University of Texas, with training and certification from the Cooper Institute. He has a fondness for dogs, the New York Times, and anything on two wheels. When he’s not writing, training, or cooking, you can find him wandering the aisles of Central Market.

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