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Tuesday, October 21st 2008

9:19 PM

10 Reasons Not to Skimp on Sleep

You may literally have to add it to your to-do list, but scheduling a good night's sleep could be one of the smartest health priorities you set. It's not just daytime drowsiness you risk when shortchanging yourself on your seven to eight hours. Possible health consequences of getting too little or poor sleep can involve the cardiovascular, endocrine, immune, and nervous systems. In addition to letting life get in the way of good sleep, between 50 and 70 million Americans suffer from a chronic sleep disorder--insomnia or sleep apnea, say--that affects daily functioning and impinges on health. Consider the research:

1) Less may mean more. For people who sleep under seven hours a night, the fewer zzzz's they get, the more obese they tend to be, according to a 2006 Institute of Medicine report. This may relate to the discovery that insufficient sleep appears to tip hunger hormones out of whack. Leptin, which suppresses appetite, is lowered; ghrelin, which stimulates appetite, gets a boost.

2) You're more apt to make bad food choices. A study published this week in the Journal of Clinical Sleep Medicine found that people with obstructive sleep apnea or other severely disordered breathing while asleep ate a diet higher in cholesterol, protein, total fat, and total saturated fat. Women were especially affected.

3) Diabetes and impaired glucose tolerance, its precursor, may become more likely. A 2005 study published in the Archives of Internal Medicine found that people getting five or fewer hours of sleep each night were 2.5 times more likely to be diabetic, while those with six hours or fewer were 1.7 times more likely.

4) The ticker is put at risk. A 2003 study found that heart attacks were 45 percent more likely in women who slept for five or fewer hours per night than in those who got more.

5) Blood pressure may increase. Obstructive sleep apnea, for example, has been associated with chronically elevated daytime blood pressure, and the more severe the disorder, the more significant the hypertension, suggests the 2006 IOM report. Obesity plays a role in both disorders, so losing weight can ease associated health risks.

6) Auto accidents rise. As stated in a 2007 report in the New England Journal of Medicine, nearly 20 percent of serious car crash injuries involve a sleepy driver--and that's independent of alcohol use.

7) Balance is off. Older folks who have trouble getting to sleep, who wake up at night, or are drowsy during the day could be 2 to 4.5 times more likely to sustain a fall, found a 2007 study in the Journal of Gerontology.

You may be more prone to depression. Adults who chronically operate on fumes report more mental distress, depression, and alcohol use. Adolescents suffer, too: One survey of high school students found similarly high rates of these issues. Middle schoolers, too, report more symptoms of depression and lower self-esteem.

9) Kids may suffer more behavior problems. Research from an April issue of the Archives of Pediatric and Adolescent Medicine found that children who are plagued by insomnia, short duration of sleeping, or disordered breathing with obesity, for example, are more likely to have behavioral issues like attention deficit hyperactivity disorder.

10) Death's doorstep may be nearer. Those who get five hours or less per night have approximately 15 percent greater risk of dying--regardless of the cause--according to three large population-based studies published in the journals Sleep and the Archives of General Psychiatry.

Sarah Baldauf

Three Ways to Get Better Sleep and Improve Your Health

When it comes to keeping good health habits, many of us make a concerted effort to eat salads and whole grain cereal, go on power walks with friends, maybe even try a yoga class. But how many of us make sleep a top health priority?

My friends—mostly working moms like myself—complain about how little sleep they get, almost turning it into a competition. There's the teacher who's answering E-mails from parents at 1 a.m., and the lawyer who cooks five-course meals for company into the wee hours on Thursday nights. And, yes, last night I can brag that I was up until midnight addressing invitations to my son's birthday party.

I wonder, though, if women would so easily shirk off sleep if we considered how important it is for our health. A new Duke University study underscores the health consequences of poor sleep habits, noting that women suffer far more than men. For example, sleeping fitfully was associated with greater body weight in women but not in men. And if it takes a woman longer than 30 minutes to fall asleep at night, she's at particular risk. "We found these women had a worse cardiovascular and metabolic risk profile, meaning they had risks for heart disease and type 2 diabetes that were pretty significant," study leader Edward Suarez tells me. For example, about 35 percent of them had high levels of an inflammation marker in their blood that's linked to both heart disease and diabetes, compared with 21 percent of the men who had similar trouble falling asleep. Other studies suggest that high testosterone levels are common in men who are poor sleepers, and Suarez says this could protect them against abdominal fat and inflammation, thus helping to explain the gender difference.

If I've persuaded you to put sleep at the top of your to-do list, here are three steps to getting better rest:

1. Run like a German train. Put yourself on a regular schedule, going to bed and getting up at the same time each day. This will cause your body to release melatonin (the hormone that makes you sleepy) at a consistent time every night—helping you fall asleep more easily. As melatonin researcher Mark Rea told me when I recently interviewed him about the health effects of light at night, "a healthy life is a boring life." OK, so maybe allow yourself one late night a week to get things done or take in a midnight movie but no more than that.

2. Cut back on sleep killers, like the Diet Coke, Starbucks, Red Bull, or other caffeine pick-me-ups that you think you need because you're feeling exhausted. You'll be even more tired at first, but the deeper sleep you get will pay you back in full. You can still have that morning coffee, but go cold turkey after 2 p.m. Also avoid alcohol and heavy meals right before bed. They might make you drowsy but may cause you to sleep fitfully rather than more deeply and restfully.

3. Create a pre-sleep ritual. Ideally, nights should be as relaxing as possible, but try telling this to a working mom who needs to get a million things done. If your mind is sometimes still racing once you get into bed, you might want to set aside a few minutes to wind down. Before turning out the lights, read a few pages of a book, listen to some music, or just focus on your breathing. If you still find yourself wide awake in the dark, try setting aside a 15-minute "worry time" while commuting to work or after dinner. And if that doesn't work, remind yourself that you've entered the sleep zone; it's much like the treadmill in terms of the health benefits you'll reap, except far more enjoyable.

Deborah Kotz