On Sleep and Altered Brain States


This article was produced in collaboration with my good friend, Dr. Justin Trent, DPT. Enjoy!

“I’ll sleep when I’m dead.” “Sleep is for the weak.” “I can get by on six hours a night.” Do any of these phrases sound familiar? They are the cultural standards many of us live by. And they are a practice of our culture that is an underlying culprit of nearly every modern disease.

In our practice, we have seen nearly every musculoskeletal and neuromuscular condition under the sun, from post-surgical acute care to the treatment and management of patients with a 20 plus years’ history of chronic pain. In every first meeting with our patients, we ask some specific questions about their sleep habits:

– How long do you sleep every night?

– What position do you sleep in?

– Do you sleep in a pitch black room?

– Do you watch TV, use a computer, tablet, or smartphone within an hour of bedtime?

– Do you have a regular bedtime routine?

These are what we call the “sleep hygiene” questions. For anyone struggling to recover from a workout, heal an injury, lose weight, build muscle, deal with emotional/psychological problems, live or work in a high stress environment, lower blood sugar, decrease cholesterol levels, increase their sex drive, or even improve their concentration at work or school, quality sleep is absolutely essential.

Dr. Kirk Parsley, one of the foremost experts in sleep medicine, highlights several shocking facts about sleep:

  • After you’re awake for 18 consecutive hours, your reflexes and your ability to do math problems, make sound decisions, and drive safely are equivalent to performing at a blood alcohol level of 0.05%
  • After 24 hours of wake time (a common occurrence with shift workers, police, military and fire personnel), these performance markers are equivalent to a blood alcohol level of 0.08, the legal limit in the U.S.
  • If you “short sleep” yourself-meaning you get 2 hours less than the normal 8 you need every night-over the course of 11 consecutive nights, your performance is equal to how you’d perform after 24 consecutive hours of wake time. In other words, you’re performing like you’re legally drunk.
  • Stretch that short sleep out to 22 consecutive nights and you perform as if you’ve been up for 48 consecutive hours-and your day-to-day and physical performance really suffers.
  • A single night of poor sleep influences insulin and glucose regulation. Insulin drives the process of partitioning fuel (the food you eat) to certain areas in your body. When you short sleep, your insulin sensitivity drops, leading directly to more partitioning of fuel to body fat, an increase in your appetite for high glycemic (read: sugary) foods, and a measurable decrease in will power and impulse control.
  • Ambien, Lunesta, and the other “Z drugs” as Parsley refers to them, as well as common benzodiazepines (commonly prescribed as anti-anxiety and anti-depressant medications-think Xanax, Valium, Ativan) completely alter normal sleep architecture (the normal stages of sleep). These medications keep your brain in phase 2 of sleep, a transition phase of unconsciousness, preventing deeper stage 3 and 4 sleep where the normal process of repair and restoration take place. Being stuck in stage 2 means you’re just unconscious; you’re not actually sleeping.

So if we’re serious about optimizing our well-being, short term and long term, in any setting or situation, how do we get right on our sleep?

Here’s the skinny on application:

1) Aim for 7.5 hours a night, plus or minus 15 minutes. The research that supports this amount of sleep has existed for over 50 years, and there’s zero debate about it in serious science circles.

2) Pick a consistent bedtime every night, if possible. And set an alarm on your watch or phone to alert you when it’s time to start getting ready for bed.

3) Go “tech-free” an hour before bedtime. The blue light from those screens makes it next to impossible for your brain to get into bedtime-mode. If you have to be on your computer/laptop/phone,try the application f.lux. This app gradually blocks out blue light on your computer screen as afternoon turns to evening and the sun sets.

4) Black out your room. No TV, bright alarm clocks, night lights. The Blackout EZ Window Covers are some of our favorites and are  an affordable choice.

5) Sleep in a cold room. 67-68 degrees Fahrenheit is optimal.

6) Incorporate gentle stretching, journal, prayer, meditation, or 5 minutes of deep breathing into your bedtime routine. All of these activities have been shown to increase the activity of your Parasympathetic Nervous System, what we call the “Rest & Digest” system.

If after 30 nights you’re not looking, feeling, or performing better, you may need to seek out a consultation with a practitioner who can look for possible vitamin, mineral, and hormone deficiencies that could be making it hard for you to sleep well.

For further reading, visit www.docparsley.com or check out his Ted X Talk.

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