Your Sleep Regimen — Part 2
When we can’t sleep well we’re not our best — in any area of life. And our lives are demanding! We have obligations, responsibilities, AND we want to enjoy the time we have with family and friends. With that said, we need to be able to serve the Lord well. Therefore, sleeping well is of primary importance.
God gives His beloved sleep (see Psalm 127:2). Sleep is a wonderful gift that is talked about often in the Bible. It’s also used to describe the ultimate rest we enter into upon passing away. For those who belong to Christ, we never actually die. Rather, it says we “go to sleep” or “enter into rest.” Sleep is divine, and it’s absolutely vital to living a quality life.
If you’re not sleeping well, there is a reason. Finding out what that reason is can be difficult. This post can help you begin that search.
We kicked off April with Your Sleep Regimen: Part 1, discussing keys to establishing a healthy sleep regimen. We are kicking off the month of May by continuing that conversation with respect to understanding the sleep cycles and how to avoid and treat insomnia. In this post we’re going to cover the following points:
1.) The way God created sleep to function and its miraculous restorative properties
2.) What hinders sleep and creates insomnia, and how to avoid or treat it
3.) The physiologic sleep cycles and circadian rhythms
Understanding How God Created Sleep
What most people don’t realize is how sleep works, and why it’s so vitally important. God created sleep as a unique but powerful restorative process, which begins at the cellular level.
When we sleep, we both grow and restore, which is why sleep requirements change so drastically throughout the life span. Newborns sleep upward of 16 to 18 hours per day due to the enormous growth demands. Toddlers and school age children still require 12 to 16 hours. Teenagers, despite their active lifestyles, require 9 to 12 hours of sleep per day to function optimally, as their brains are still developing (specifically the frontal lobe which is responsible for judgement and decision-making). They often sleep late and require naps. The frontal lobe is not complete until age 25-28 for males; age 22-25 for females, meaning college students are often sleep-deprived. Only a mature full-grown adult (25-40 years) requires a minimum of 6 to 8 hours, and naps are still welcomed or desired by many. Middle aged adults (40-65) will often require a minimum of 8 to 10 hours to function optimally. A geriatric individual (65-80) does not require as much sleep, as growth cycles are completed and restorative processes are slowing. They may sleep 6 to 8 hours, or less, depending on their demands. Those entering the acute dying process begin to sleep frequently, and for long periods of time. This is where the scales tip. In fact, long and frequent sleep patterns are one of the first signs of the dying process in an aged adult. This is a completely natural and expected pattern.
Sleep is often mistaken as merely being an opportunity to rest, which is untrue. When you sleep you’re body begins a deep and complex restorative process which is activated by key hormones and healing chemical agents which are produced exclusively while you sleep. Your body cannot and does not produce these at any other time.
These complex healing agents and their processes protect you from cancer, restore damaged cells, regulate hormones, and defend against disease. When we sleep our body aligns internally — physically and mentally. When we lack sleep our cells and tissues are denied that deep restorative process, which leaves us vulnerable. As a result, we become acidic through an overproduction of lactic acid, creating sore muscles and stiff joints, which our bodies work hard to correct in an effort to preserve vital organ function — essentially robbing Peter to pay Paul. That compensatory process is a delicate one, which can be very expensive for the body.¹ There are limitations. That compensation can’t be repeated often without consequences. It simply can’t be afforded. An acidic environment is one within which cancer cells thrive, and when the body can’t correct this readily, disease is inevitable. The body responds to sleep deprivation in precisely the same way it responds to disease and invaders — immunity is compromised, the inflammatory response is engaged, and white blood cell production increases.² This is why sleep-deprived individuals often complain of varying aches and pains that often go unrelieved. In short, they are at risk. The body’s restorative abilities are limited, and when left uncorrected, compensatory mechanisms can near depletion, setting the stage for damage and disease.
Restorative sleep is very healing — in fact it’s one of the key healing processes that your body engages in naturally. Biologically, it’s absolutely vital. We cannot live without sleep. When you sleep, your body goes to work in a different way, restoring itself from deep within. It’s a truly miraculous process, and one that is very complex. When it’s halted or hindered — you suffer the ill effects of exhaustion, cellular damage and death, and the subsequent loss of cellular regeneration, which equates to poor function and low energy levels, leaving you vulnerable to disease. The body works hard to compensate for these deprivations when they occur, and can do so in limited amounts if we’re otherwise healthy. We can push through and the body will actually provide us a “second wind”. But to prolong sleep deprivation is very, very dangerous. In addition to the physical side effects, individuals who are sleep deprived for frequent or extended periods will also suffer ill psychological effects such as emotional outbursts, anger, irritability, poor judgment and memory, and in severe cases even hallucinations and other dangerous mind-altering symptoms. Mood swings and personality changes that are otherwise out of character can be common for a sleep deprived individual. Once sleep is restored, these symptoms often resolve with time.
However, sleep we lose is never sleep we can regain. Once lost, that particular restorative process at that juncture in life is permanently gone, which is why sleep deprivation can actually shave years off an individual’s life span when it’s prolonged or frequently repeated.
Today, a prime example would be the Karōshi phenomenon in Japan. Many articles have been written about the severe sleep deprivation in the Japanese population driven by their hardcore work ethic. I can personally vouch for this because one of my very best friends is Japanese. I’ve known her for more than 20 years. She has spoken with me about this on various occasions. Most Japanese work seven days a week, pulling 10-12 hour days (sometimes longer) with no break or time off. Unfortunately, she is one of them. As a result, sleep deprivation is an epidemic — and the outcome is that people are very literally dropping dead. Sudden heart attacks, strokes, and otherwise unexplained sudden deaths are seen in young individuals who should be considered vibrant and healthy. The Japanese call this phenomenon Karōshi. It’s real — it’s happening — and it’s directly connected to severe sleep deprivation and its subsequent effects of extraordinary stress upon the body.
Sleep deprivation has cumulative effects. It creates a complex web of actions and reactions within the body at the cellular level which are driven by blood pH levels, hormones, and other chemical agents. These have a detrimental cascade effect. Let it be known that these symptoms are essentially due to cellular breakdown, cellular death, and the body’s inability to compensate effectively, wherein the ability to restore or rejuvenate is severely hindered or ultimately lost.
Avoiding and Treating Insomnia
It is vain for you to rise up early, to sit up late, to eat the bread of sorrows: for so he giveth his beloved sleep,” (Psalm 127:2, KJV).
Although we touched on insomnia in Part 1 with some basic information regarding sleep aids and adjuvants, we are going to dive a bit deeper here.
Insomnia is something with which many people struggle, and for varying reasons, which can be difficult to pinpoint. Insomnia is not always rooted in a physiological problem. Sometimes it can stem from a psychological one, meaning the state of our internal soul can have a direct effect on our sleep and the duration of our sleep cycles.
Insomnia is characterized by any of the following:
1.) The inability to fall asleep
2.) Shallow or fitful sleep
3.) Interrupted sleep (frequent wakening)
4.) Incomplete sleep (shortened or incomplete sleep cycles)
If you have done your due diligence to prepare a sound sleep regimen, and afforded yourself a bed and bedroom that is conducive to sound sleep — yet you are still struggling, it’s time to investigate contributing intrinsic factors, which can sometimes be enough to keep the internal lights on at night when we are done and ready to sleep.
Truly, there are a plethora of physiologic and psychological reasons why people may struggle sleeping, which require careful evaluation by a sleep specialist (physician). This is where sleep studies come into play. Your bed or bedroom may not be the issue. And if you’ve afforded yourself the awesome bed and bedroom, and you have implemented a healthy sleep regimen, chances are that you have already eliminated most extrinsic factors that could contribute to any insomnia.
Two common reasons insomnia occurs are:
1.) Your ability to produce melatonin may be hindered.
2.) Your ability to process melatonin may be hindered. Meaning, you may be producing melatonin well enough, but your melatonin uptake is poor in that your neuro-receptors cannot receive and process it effectively.
The inability to produce or process melatonin requires diagnostic testing, which only a licensed physician can perform. When all else fails you may need to seek a Sleep Specialist. Through a careful assessment of lifestyle, medications, medical history, lab work, and diagnostic sleep studies they can help identify the root cause. Insomnia can be caused by conflicting medications, stress hormones, natural biologic and hormonal changes, and other physiological, psychological, or relational issues. All of these factors must be evaluated carefully, as they meld together. One affects the other very readily. So, if you are able, it will be beneficial for you to begin assessing other intrinsic factors that may appear to be entirely unrelated. Chances are — they are creating the perfect storm. If you can do some homework prior to seeing your physician, offering him or her an outline of these areas, this will be to your advantage. Come prepared with some hard information with which they can work and begin to piece together. Do as much as you can to help them help you on the front end.
Here are some suggestions for information you need to be ready to present to your physician in documented form:
1.) Sleep habits and regimen: Disclose your sleep regimen in full. See Part 1 for a list.
2.) Eating and drinking habits / patterns: What you eat, when, how much, and how frequently needs to be discussed. Diets and eating patterns are important. Especially with foods and beverages that can affect sleep such as caffeine and alcohol. Foods that are high in sugar, salt, and fat can affect sleep as well.
3.) A full list of medications, including dosage and frequency — both prescribed and over the counter, including any vitamins, herbal remedies, or homeopathics. Oral, topical, injected, inhaled, and inserted medications must all be included. If you’re taking hormonal creams or breathing treatments at home, these need to be listed specifically. Also discuss whether or not you are consistent in your dosing, and whether or not you are taking your medications as prescribed. If you are doubling doses on medications, or taking them more frequently than directed, these can create problems. More is not always better. More can mean toxic — and have detrimental side effects.
4.) Life Events & Stressors: We usually think of life stressors as being negative events. Although that is commonly true, some of the most stressful life situations can be good ones. Those ranked highest are moving; marriage; a new job, transfer or layoff; new baby; divorce; and death of a loved one. Sometimes these all go together! You get married, move, have a baby, and start a new job within a relatively short period of time. These huge life events can stack, as they are often interrelated. But other life stressors need to be discussed as well such as any stressful relationships, abuse, financial disruptions, and other issues. Be ready to disclose them to your physician.
5.) Biologic & Hormonal Changes: An endocrine evaluation can be important for your physician to consider, especially when other contributing factors have been eliminated. In fact, endocrine issues are often the problem, so don’t be surprised if they jump on this first in an effort to rule it out as a probable cause. Some simple serum blood tests are where those evaluations begin. Biologic and hormonal changes are especially common in postpartum mothers and menopausal women. If you are taking birth control pills, estrogen or progesterone creams, or taking fertility medications, you can request your hormone levels be checked via a serum blood test. Thyroid issues are also high on the list. If your thyroid is high (or low), you will more than likely have other hallmark symptoms alongside your insomnia which your physician will readily recognize and investigate, such as anxiety, energy patterns, and weight changes.
6.) Relational & Social Assessments: Relationships are huge, and the health of our closest relationships can affect our physical health. Especially when they are ones we cannot escape or change readily. They may involve our spouse, children, or aging parents. It may be a best friend, or even our boss. Is there a particular relationship that is causing your stress or heartache? If so, delineate that carefully to your physician. If there are other social issues affecting your life, note those as well.
7.) Work Patterns: Many jobs and even professions require a night shift. I’m an RN who worked more than five years as a night shift nurse. I know what it’s like to come home during the day and struggle to sleep through lawn-mowers, dogs, and kids playing — among many other daytime disturbances such as UPS ringing my doorbell, garbage trucks, and construction work. It’s extraordinarily difficult creating a haven for sweet sleep when so many factors are outside our control. If this is you, I suggest you discuss options with your physician. When your biological clock is running backward — it affects everything. Your body works hard to compensate in ways you may not realize. If worst comes to worst, and this is your primary factor, you may want to consider a career change. I did, and it was one of the best things I’ve ever done for myself. You can only sacrifice so much.
8.) Elimination Patterns: This is where it gets personal, but nevertheless — it’s necessary. Obviously, if you have bowel or bladder issues that keep you up at night — you’re not going to sleep well. They need to be discussed with your physician.
Treating insomnia is one thing. But avoiding it is the real key. As much as there are things outside our control, there are some very practical things we can do that help us avoid insomnia. An ounce of prevention is worth a pound of cure. To take a look at some ideas, please see Part 1.
Understanding Circadian Rhythms & the Sleep Cycles
This is where sleep becomes more complex. The sleep cycle is a fascinating and wondrous thing, which is regulated by our Circadian Rhythms, which are physical, mental, and behavioral changes which fluctuate throughout a 24-hour period. Humans, animals and plants all have circadian rhythms which are driven primarily by light and dark. That is not surprising, given this is the first thing God created. Light turns on and off the genes which control our Circadian rhythms, which are in turn responsible for (primarily) sleep-wake cycles, appetite and eating patterns, body temperature, hormone levels, and energy levels which fluctuate throughout the day.
We’ve all heard of the “biological clock”. It’s true that we all have one. That clock is based upon a cyclic 24-hour pattern regulated within the hypothalamus, which is part of the SCN (Suprachiasmatic Nucleus). This clock controls our circadian rhythms. Every living thing has a circadian rhythm, including the fungi and microscopic life forms. The sleep cycle is merely one of many circadian rhythms controlled by “the master clock” within our SCN.³
The Stages of Human Sleep
Given the complexity of the individual sleep stages, the following is taken directly from the National Sleep Foundation (please visit the link for a full list of their annotations):4
Following the discovery of rapid eye movement (REM) sleep in 1953, researchers learned that there are three basic states of consciousness: wakefulness, REM sleep, and non-rapid eye movement (NREM) sleep.16
REM sleep is “an active period of sleep marked by intense brain activity. Brain waves are fast and desynchronized, similar to those in the waking state. Breathing becomes more rapid, irregular, and shallow; eyes move rapidly in various directions and limb muscles become temporarily paralyzed. Heart rate increases and blood pressure rises. This also is the sleep stage in which most dreams occur.”17
REM sleep is thought to play a role in memory consolidation, the synthesis and organization of cognition, and mood regulation.18 Depriving someone ofjust REM sleep (by waking the subject upon when he or she enters into REM, but allowing NREM to occur) results both in the person making increasingly frequent attempts to enter REM sleep and spending increased time in REM sleep.
NREM sleep is characterized by a reduction in physiological activity. As sleep deepens, a person’s brain waves slow down and gain amplitude, both breathing and the heart rate slow down, and the individual’s blood pressure drops.
NREM sleep consists of three stages:19
• N1 (formerly “stage 1”) is a time of drowsiness or transition from being awake to falling asleep. Brain waves and muscle activity begin slowing down in this stage. People in N1 sleep may experience sudden muscle jerks, preceded by a falling sensation.
• N2 (formerly “stage 2”) is a period of light sleep during which eye movements stop. Brain waves become slower, with occasional bursts of rapid waves (called sleep spindles) and spontaneous periods of muscle tone mixed with periods of muscle relaxation. The heart rate slows and body temperature decreases.
• N3 (formerly “stages 3 and 4”) is called “slow wave sleep” (SWS) and is characterized by the presence of slow brain waves called “delta waves” interspersed with smaller, faster waves. Blood pressure falls, breathing slows, and temperatures drops even lower, with the body becoming immobile. Sleep is deeper, with no eye movement and decreased muscle activity, although muscles retain their ability to function. It is most difficult to be awakened during SWS, and people may feel groggy or disoriented for several minutes after they wake up from this stage. During SWS, some children experience bedwetting, night terrors, or sleepwalking. SWS seems to be associated with bodily recovery, certain types of learning,20 and central nervous system changes.21 The amount of SWS a person gets is directly related to accumulated sleep need — the longer a person has been awake, the more SWS he or she gets when sleep occurs.
Although the role each of these states plays in overall health is uncertain, having the right balance between them is believed to be important for obtaining restful, restorative sleep and for promoting processes such as learning, memory, mood, and ability to concentrate.22 No one sleep state is more important than the other, just as no one organ in your body is more important than the other. Each is necessary for life, as deprivation of any one of those stages has been shown to reduce health and longevity in laboratory animals.
Sleep is vital to living a healthy productive life, and is worthy of our full investment. It is just as important as food, water, or air. I pray this post has helped you and given you the information you need to pursue a healthy sleep regimen and begin sleeping well.
Cheers & Shalom,
¹ Biology of Sleep Substances by Shojiro Inoue, CRC Press, March 31, 1989, pg. 6-8.
² Mercola: Take Control of Your Health
³ National Institute of General Medical Sciences:
4 National Sleep Foundation: