Sleep is your superpower!, 1119 SCBJ, SC Lawyer, November 2019, #34

• Author: By Lucinda D. Gardner
• Position: Vol. 31 Issue 3 Pg. 34

Sleep is your superpower!

Vol. 31 Issue 3 Pg. 34

South Carolina BAR Journal

November, 2019

By Lucinda D. Gardner

deprivation is not good for us and not good for society. “Every component of wellness, and countless seams of societal fabric, are being eroded by our costly state of sleep neglect: human and financial alike. So much so that the World Health Organization (WHO) has now declared a sleep loss epidemic throughout industrialized nations.”¹ It’s time for lawyers to celebrate the superpower of sleep and boast about getting eight hours of sleep.

Sleep is a powerful health reservoir that is essential to cognitive, emotional, and physical well-being. If you regularly sleep less than six hours, pull all-nighters, or feel perpetually exhausted, it’s time to upgrade your sleep habits. Poor sleep habits make you more vulnerable to cancer, dementia, depression, anxiety, obesity, stroke, chronic pain, diabetes, loneliness, heart attacks, and other health issues.² Healthy sleep is critical for memory consolidation, immune system function, and endocrine and thermal regulation.³ Before Thomas Edison changed history with the electric light, adults averaged nine hours of sleep each night.⁴ In 2019, adults average only 6.2 hours of sleep. In the 140 years since Edison fled his patent for the light bulb, our sleep patterns have strayed from their compelling evolutionary roots.

Circadian rhythms and social jet lag

What is a normal sleep cycle for our brains and bodies? Our sleep and wake cycles are tied to circadian rhythms-the mental, physical, and behavior changes we undergo in a 24 hour period which are also affected by daylight and darkness.⁵ In fact, each of us has individual “clock genes,” and a small part in the brain’s midline called the suprachiasmatic nucleus or SCN serves as a master clock for all mammals.^[6] According to chronobiologist Till Roenneberg, each of us has a chronotype, an internal timing type defined by our midpoint of sleep which guides our sleep cycles.⁷ Laptops, 24 hour news cycles, cellphones, and endless connectivity leave little room for circadian rhythms. “The disconnect between our internal, biological time and social time - defined by our work schedules and social engagements - leads to what Roenneberg calls social jet lag, a kind of chronic exhaustion resembling the symptoms of jet lag and comparable to having to work for a company a few time zones to the east of your home.”⁸

Neuroscientist Russell Foster believes we are being “supremely arrogant” by ignoring the importance of sleep.⁹ “We feel we can abandon four billion years of evolution and ignore the fact that we have evolved under a light-dark cycle. What we do as a species, perhaps uniquely, is override the clock. And long-term acting against the clock can lead to serious health problems.”¹⁰

Brain waves

How does your brain regulate your sleep cycle? Deep in the reptilian part of our brain are the key players in the elaborate regulation of our sleep.¹¹ Sleep researchers measure electrical brain waves during sleep by electroencephalograms or EEGs. By using EEGs to monitor the sleeping brain’s electrical activity, researchers established that the average adult sleep cycle lasts about 90 minutes and contains five defined phases: Phase 1 Sleep – Alpha waves occur with the mind at rest, eyes closed and breathing slowed; Phase 2 Sleep – Theta waves or light sleep; Phase 3 Sleep – Delta waves or deep sleep (also known as non-REM sleep); Phase 4 Sleep – Rapid Eye Movement or REM sleep or dreaming; and Phase 5 Sleep – Theta waves or light sleep.¹² In between cycles, we are not asleep but in a twilight zone.¹³ REM sleep, which occurs during the later hours of sleep, is crucial to learning and memory.¹⁴ According to Matthew Walker, Ph.D., professor of neuroscience and psychology and director of the Center for Human Sleep Science at UC Berkeley, and author of Why We Sleep: Unlocking the Power of Sleep and Dreams (2017), “[t]here does not seem to be one major organ within the body, or process within the brain, that isn’t optimally enhanced by sleep (and detrimentally impaired when we don’t get enough). That we receive such a bounty of health benefits each night should not be surprising.”¹⁵

Learning and sleep make a dream team

Sleep is a proven memory aid before and after learning. All stages of sleep - light non-REM sleep, deep non-REM sleep, and REM sleep - benefit learning. How does the process work? Sleep the night before learning rejuvenates the brain’s ability to create new memories. The hippocampus, a long, fingershaped structure deep in the brain, is a vital hub for memory and learning. It serves as temporary information storage for accumulating new memories but has limited storage capacity. The bursts of electrical activity (or sleep spindles) in the brain during light Stage 2 sleep transfer the information from the hippocampus to the cortex of the brain, the large memory hard drive. After this transfer, the hippocampus has fresh space for the new facts and experience. What happens during sleep after learning? Deep non-REM sleep transports memory packets to long term storage or consolidates memories into permanent storage in the cortex. Sleep is also crucial for motor skill memory. Research finds that overnight motor-skill enhancement, including increases in speed and accuracy, takes place during the last two hours of non-REM sleep during an eight-hour night of sleep.¹⁶

High performance athletes and coaches appreciate sleep’s potential as an athletic performance enhancer.^[17] The Chicago Bulls, Minnesota Timberwolves, Portland Trailblazers, Milwaukee Brewers, New England Patriots, as well as other professional sports teams and college sports teams, are hiring sleep coaches to educate and guide players to optimize sleep during grueling travel seasons.¹⁸ Gold medalist sprinter Usain Bolt has taken naps in the hours before shattering world records and winning gold medals.¹⁹ Elite athletes who get less than six hours of sleep decrease their aerobic output, decrease time to physical exhaustion by 10-30%, reduce their vertical jump height, and decrease their peak and sustained muscle strength, in addition to a variety of other impairments such as lactic acid build-up, reduction in blood oxygen saturation, and ability to cool off through sweating. ²⁰ Chronic lack of sleep dramatically increases the risk of injury.²¹ An athlete, professional or otherwise, needs sleep for optimal performance.

Find your sleep number

The shorter your sleep, the shorter your life. Along with learning and memory, sleep likewise restores our physical health. Numerous studies have examined sleep’s impact on our cardiovascular health, obesity, our immune system, reproductive health, athletic performance, dementia, and quality of life.²² In a 14-year Japanese study of 4,000 males, those who slept six hours or less were 400 to 500 percent more likely to suffer cardiac arrest than the men who slept more than six hours.²³ Short sleep results in an imbalance of appetite-controlling hormones leptin and ghrelin, which leads us to consume more calories in the form of sugar and carbohydrates.²⁴ The less you sleep, the more you eat. Research suggests a causal link between poor sleep and toxic buildup of beta-amyloid protein in the brain, which has been linked to the pathology of Alzheimer’s disease.²⁵ A lack of sleep increases stress hormones such as cortisol, which increases fat storage. Sleep deprivation also takes a toll on reproductive health. For women, being sleep-deprived decreases follicular-releasing hormone necessary for ovulation and conception. For men, a study of mid-20’s healthy males who were sleep-deprived for only one week resulted in a marked drop in testosterone levels. “The size of the hormonal blunting effect is so large that it effectively ‘ages’ a man by ten to fifteen years in terms of testosterone virility…. [M]en who report sleeping too little-or having poor-quality sleep- have a 29 percent lower sperm count than those obtaining a full and restful night of sleep, and the sperm have more deformities….[U]nder-slept men also have significantly smaller testicles than their well-rested counterparts.”²⁶

Studies have also investigated chronic anxiety and the neural link between non-REM sleep and its role in calming the overactive brain.²⁷ The preliminary findings showed the more time spent in deep non-REM sleep, the less anxiety you experience in the morning.²⁸ Poor sleep can also trigger feelings of loneliness and social rejection. “The less sleep you get, the less you want to socially interact. In turn, other people perceive you as more socially repulsive, further increasing the grave social-isolation impact of sleep loss….That vicious cycle may be a significant contributing factor to the public health crisis that is loneliness.”²⁹ Sleep-deprived brains have heightened activity in the neural circuit that perceives potential threats. “There’s no biological or social safety net for sleep deprivation as there is for, say, starvation. That’s why our physical and mental health implodes so quickly even after the loss of just one or two hours of sleep.”³⁰ Just one night of good or bad sleep can influence a person’s sense of loneliness the next day.

Our immune system and sleep are intimately connected. Sleep allows the immune system to protect the body. Studies involving people exposed to a common cold virus showed a clear, linear relationship between the amount of sleep they had the week before exposure and infection rate.³¹ The less a person slept the week before exposure to the virus, the more likely that they would be infected and catch a cold. Indeed, our DNA appears to be altered by chronic sleep loss. When we are chronically sleep deprived, research indicates that DNA segments or gene stability is affected. Wobbly genes can’t effectively communicate their instructional code to direct biologic functions within cells. Not getting proper sleep is like performing a genetic engineering experiment!

How do lawyers sleep?

Deadlines, high caseloads, toiling toward partnership, and concerns about clients can create high levels of anxiety and sleepless nights. According to a 2015 Chicago Tribune article entitled, “Why lawyers are miserable,” data suggest that working long hours damages our health, our productivity, and our families. Lawyers are the second most sleep-deprived profession ahead of police officers, doctors and paramedics, economists (puzzling!), and social workers.^[32] When a lawyer is sleep deprived, her ability to perform cognitive tasks and comply with professional responsibility requirements for competence decreases dramatically. Research shows that after 17-19 hours of wakefulness, human performance on cognitive and physical tasks is equivalent to someone with a blood alcohol concentration (BAC) level of 0.05 percent. With longer sleep deprivation, the level of performance drops to the equivalent to a BAC of 0.1 percent. An alcohol level of 0.08 percent is the DUI threshold in most states. No lawyer wants to practice under the influence! Sleep deprivation dramatically upsets our body and brain chemistry.

Serious medical conditions can also cause sleep deprivation and include sleep disorders such as obstructive sleep apnea, narcolepsy, and restless leg syndrome. These sleep disorders should be evaluated by a physician.

In order to manage stress, maintain well-being, and be an effective and healthy lawyer, it is essential to use your superpower – sleep! There is good news. You can wriggle into the superhero suit and find your superpower.

How do we improve our sleep? Establish your good sleep habits:

1. Avoid stimulants – regulate caffeine intake (no Red Bull!) such as coffee, tea, chocolate for four to six hours before bedtime. Nicotine is a stimulant too.

2. Avoid alcohol and marijuana – while alcohol is a nervous system depressant that may help people fall asleep, it also produces withdrawal symptoms that may cause lighter sleep and arousals. Alcohol also blocks REM sleep which is a crucial part of the sleep cycle. Marijuana appears to mimic the same effects.

3. Create an appealing sleep environment-your bedroom should be quiet, dark, 65 degrees (the optimal sleep temperature), with a comfortable mattress and pillows. No computers, TVs, smart phones, iPads or pets that wake you up. Get black out curtains and an eye mask, and if your feet get cold, wear socks.

4. Go to bed and wake up at the same time every day, even after a bad night of sleep or on weekends.

5. Establish a wind down routine. An hour before bed, start relaxing – stretch, do some mindful meditation, do some light reading, turn the lights down, listen to calming music, prepare a “To Do” list for the next day to avoid thinking about those things as you get in bed.

6. If possible, avoid medicines that disrupt your sleep. Common medications used to treat high blood pressure, heart issues, asthma, coughs, colds, and allergies (prescription and over the counter) can interfere with sleep. If you’re having sleep trouble, talk to your doctor or pharmacist about whether these medications might be contributing.

7. Sleeping aids. Sleep medications (prescription and over the counter) do not induce natural sleep. Older sleep medications such as diazepam were sedative hypnotics that sedated you rather than helped you sleep. Newer medications such as Ambien (zolpidem) or Lunesta (eszopiclone) are similar but less sedating. They do not generate sleep that produces the deepest brainwaves of natural sleep. Sleep aids can also create rebound insomnia when you stop using them. Rebound insomnia is a type of dependency which alters the brain’s chemistry so that when the drug is stopped, there is a spike in severity of insomnia. Melatonin is a circulating messenger hormone that helps regulate timing of sleep by signaling darkness. It does little to generate sleep but may have a significant sleep placebo effect. Melatonin is not regulated by the FDA and concentrations in any over the counter pills may vary.

8. Don’t watch the clock. Set your clock (not your smart phone!) facing away from you. Looking at the clock can exacerbate anxiety and make it harder to fall asleep.

9. Avoid naps or nap early. If naps are needed, take a short 20-minute nap before 3 p.m. Late afternoon naps can make it more difficult to fall asleep at night.

10. Take a hot bath before bed. The relaxation from the bath and drop in body temperature when you get out of the bath may make you feel sleepy.

11. Have the proper amount of sunlight exposure. Daylight is key to regulating sleep patterns. Try to get outside in natural sunlight for at least 30 minutes a day. If you can, wake up with the sun or use bright lights in the morning. If you have trouble falling asleep, you should get an hour of exposure to morning sunlight and turn down the lights before bedtime.

12. Appropriate diet, hydration, and exercise are paramount. There is a significant trend toward increasingly better sleep with increasing levels of physical activity. Try not to exercise at least three hours before bedtime.

13. Don’t lie in bed awake. If you’re awake for more than 20 minutes, get up and do a relaxing activity until you feel sleepy. If you want to mindfully meditate to fall back to sleep, you can stay in bed longer.

14. Check out apps such as Insight Timer, Calm, Awoken, Relax Melodies, CBT-i Coach or SHUT-i. Many are free and offer guided sleep meditation, sleep stories, and sleep music. The last two apps are based on Cognitive Behavioral Therapy research which offers evidence based, highly effective solutions to insomnia.

15. Foods that help you sleep include sweet potatoes, almonds, bananas, turkey, fatty fish, cherries, kiwi, honey, oatmeal, passionfower tea, chamomile tea, and walnuts.

16. Everyone responds to supplements in different ways. Some of the top supplements to consider are magnesium, CBD, melatonin, valerian, GABA, 5-HTP, and L-theanine.

Resources

The Owner’s Manual for The Brain, Everyday Applications from Mind-Brain Research, Pierce J. Howard, Ph.D., 3rd Edition, 2006.

Why We Sleep, Unlocking the Power of Sleep and Dreams, Matthew Walker, Ph.D., 2017.

The Sleep Revolution, Transforming Your Life One Night at a Time, Arianna Huffngton, 2016.

http://ariannahuffngton.com/ wp-content/uploads/2016/04/ Sleep-Revolution-Sleep-Quality-Questionnaire.pdf https://www.sleepfoundation.org

https://startsleeping.org/sleep-re-sources https://medical.mit.edu/communi-ty/sleep/resources

https://www.hopkinsmedicine.org/ health/wellness-and-prevention/ sleep

https://www.ted.com/talks/matt_ walker_sleep_is_your_superpow-er?language=en https://vcresearch.berkeley. edu/research-unit/center-hu-man-sleep-science

Lucinda D. Gardner, J.D., M.A. is Assistant Director of Student Affairs at American University Washington College of Law in Washington, D.C. She is a member of the SC Bar Wellness and Diversity committees.

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Notes:

[1] Matthew Walker, Ph.D, Why

We Sleep: Unlocking the Power of Sleep and Dreams 4 (2018).

[2] Id.

[3] Id.

[4] Id.

[5] Rosenburg, Internal

Time: Chronotypes, Social Jet Lag, and Why You’re so Tired (2017); Marc Wittmann et al., Social Jetlag: Misalignment of Biological and Social Time (2006).

[6] Id.

[7] Id.

[8] Maria Popova, Brain Pickings, The Science of Internal Time, Social Jet Lag, and Why You’re So Tired (May 11, 2012) available at https://www.brainpickings.org/2012/05/11/ internal-time-till-roenneber/.

[9] Russell Foster, Why Do

We Sleep? (Sept. 22, 2015) availible at https://www.brainfacts.org/

thinking-sensing-and-behaving/sleep/2015/ russell-foster-why-do-we-sleep

[10] Id.

[11] Pierce J. Howard, Ph.D., The

Owners Manual for The Brain, Everyday Applications from Mind-Brain Research, 189-220 (1994).

[12] Id.

[13] Id.

[14] Id.

[15] Walker, supra note 1 at 3-12.

[16] Id. at 127.

[17] Araceli Gomez-Aldana, Athletes

Get a New Type Type of Coach, For Better Sleep, NPR (February 8, 2019, 5:12 AM), available at https://www.npr. org/2019/02/08/692614236/athletes-get-a-new-type-of-coach-for-better-sleep.

[18] Keenan Mayo, The Sleep Doctors to Elite Athletes, CEOs - Even Rock Stars (2019), available at https://www.mensjournal.com/

sports/sleep-doctor-elite-athletes-ceos-even-rock-stars/

[19] Walker, supra note 1 at 128.

[20] Id. at 129.

[21] Id.

[22] Id. at 165.

[23] Id.

[24] Id. at 171-172. (Leptin signals satiety and ghrelin signals hunger).

[25] Yasmin Anwar, Poor Sleep Linked to Toxis Buildup of Alzheimer’s Protien, Memory Loss, Berkeley News (June 1, 2015) available at https://news.berkeley.edu/2015/06/01/alzhei-mers-protein-memory-loss/.

[26] Walker, supra note 1 at 178-180.

[27] Yasmin Anwar, Chronically Anxious? Deep Sleep May Take the Edge Off, Berkeley News (November, 6, 2018) available at https://

news.berkeley.edu/2018/11/06/chronically-anxious/.

[28] Id.

[29] Yasmin Anwar, Poor Sleep Triggers Viral Loneliness and Social Rejection, Berkeley News (August 14, 2018) available at https://news. berkeley.edu/2018/08/14/sleep-viral-loneli-ness/

[30] Id.

[31] Walker, supra note 1 at 182.

[32] Catherine Rampell, America’s 10 Most Sleep-Deprived Jobs, New York Times (February 22, 2012,4:41 PM) available at https://

economix.blogs.nytimes.com/2012/02/22/

americas-10-most-sleep-deprived-jobs/

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