By Dr. John G. Alevizos
The subject of sleep has always fascinated me as I have a difficult time falling asleep and staying asleep. My wife, on the other hand, can be sitting in the car and fall asleep mid-sentence. Statistically, about 40% of Americans experience intermittent insomnia, and approximately 15% suffer from severe or chronic insomnia. It is also well-known in the anti-aging community that premature aging, in large part, is a result of sleep deprivation.
Unfortunately, as we get older, our sleeping problems get worse. We experience a decrease in REM (rapid eye movement) sleep and an increase in the number of disturbances that awaken us throughout the night and interfere with deep sleep. Many of us think the answer to this problem is daytime napping. However, if one wants to rest optimally at night, daytime napping should be discouraged (at least this is what the sleep specialists say).
Some sleeplessness is because of medical conditions. The pain of severe arthritis and/or a musculo-skeletal sprain/strain may awaken people every time they turn in bed. People with Alzheimer’s disease and other brain disorders often have difficulty sleeping. Women who go through menopause do not have progesterone, the calming hormone, and therefore, their bodies do not optimally produce melatonin, the sleep hormone. Also, women with PMS can have sleep disruption. People with various psychological disorders (too many to list here) also have sleep issues.
However, the most serious sleep problem is sleep apnea, which is usually found in people with obesity and men whose necks measure more than 18 inches. The treatment for this is to sleep attached to a machine, which is attached to a mask that blows pressure to forcefully open the airway to force oxygen into the lungs. What are the various stages of sleep? Stage 1 is falling asleep. Our bodies start to relax and our eyes may still be moving, even though our eyes are closed. In Stage 2 sleep, the eye movements slow down to a stop and brain waves start to slow. In Stage 3 sleep, we get the emergence of delta waves. Delta waves are associated with the deepest stages of sleep, also known as slow-wave sleep. In Stage 3 sleep, less than 50% of the waves are delta waves.
For some unknown reason, females have been shown to have more delta wave activity across most animal species. This discrepancy starts becoming apparent in humans in their 30s and 40s, and men show greater age-related reduction in delta wave activity than female counterparts. Stage 4 sleep is comprised mostly of delta wave activity and this is when we are in very deep, unresponsive sleep. It should be noted that there is no eye movement in Stage 4 sleep and our muscles are completely relaxed. In Stage 5 sleep, we see REM sleep, rapid breathing, eye movement and dreaming.
In order to have healthy, optimal and restful sleep, it is vital to pass through all of the five stages in natural order. However, every prescription-strength sleeping medication that we take will affect one or more of these stages, which is not to say that people should never use prescription-strength sleep medications. Later, I will give you some “natural alternatives.” Among my patients, however, I find that a lot of sleep deprivation is self-induced. For example, people who ingest caffeine and energy drinks, people who don’t follow a regular bedtime schedule, people who have an uncomfortable bed, people who try to sleep in a room that is not dark, people who try to sleep in a temperature that is not optimal, etc., can all suffer from sleep deprivation.
Sleep experts say that the bed should only be used for two things—sleep and sex—so that subconsciously, once our head hits the pillow, we are not primed to be stimulated by a TV program or surfing the internet, or eating, drinking or talking. How long does caffeine remain in our systems? I have read papers that say six hours, and I have read other papers that say three days, but I believe it varies significantly according to the individual, and all of us are different.
I have read that shift workers (people who work at night) tend to have a lifespan that is–believe it or not—10 years shorter than those of us who work during the day. The reason for this is that our bodies make human growth hormone, testosterone and various other hormones when we are in deep sleep. As a matter of fact, I have heard one world-renowned expert say that human growth hormone is released only from 10:00 p.m. until 2:00 a.m.
Because of sleep deprivation, our hormone supplies are reduced and we get various amounts of fatigue, poor concentration, anxiety, depression and stress. Many accidents occur because of sleep deprivation, which can easily be as dangerous as driving drunk or distracted. Personally, several times in my life, while riding my bagger with the music playing and sinking comfortably into its soft seat, I have found myself starting to doze off! However, I have managed to very quickly awaken as I realized the gravity of this situation. This has not happened on my sportbike, as my body is in a more uncomfortable position.
As I mentioned previously, all the prescription sleep medications interact with various stages of sleep. But what about over-the-counter sleep medications? Although these are also labeled as sleeping medications, their main ingredient is diphenhydramine and various other antihistamines. The problem with antihistamines is that they have been associated with bladder problems, cardiovascular arrhythmias, nocturnal falls, confusion and even delusion in the elderly.
What do we need to do to have restful sleep? Regular bedtime routines; a comfortable, quiet, dark environment; comfortable pillows and mattresses; and less caffeine and stimulants (depending upon how your own body handles stimulants) will all help in achieving optimal sleep.
The herbs that in the anti-aging world that are backed by scientific evidence to be calming agents include valerian, chamomile, ashwagandha, passion flower and catnip. Valerian has been used as a sedative for more than 1000 years and is generally regarded as being safe. It is known to relax muscles and does not cause a hangover. Some advocate amino acids; however, they have to be taken in such a large amount that I believe they cause an imbalance with our central amino acids. Melatonin is an effective option (see my article regarding melatonin in the May, 2012, MCN). The correct amount is as little as needed, and you can begin with a single .5mg tablet taken before bedtime and use as much as 10mg/day if needed. Also, as noted in my article about exercises, people who exercise, especially at the right time of the day (not too late in the evening) tend to have better quality sleep, as a lot of their stress response is burned off during exercise rather than stimulating the brain while trying to sleep.
As stated above, a good night’s sleep will increase longevity and decrease the symptoms of stress and various other medical disorders.
To schedule an appointment with Dr. John G. Alevizos, D.O., please call 949-916-3600.