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People often ask me about tips to sleep better. And I go back to basics. It's kind of boring, but it's very necessary. The body likes routine. It likes to eat breakfast, lunch, and dinner. It likes to have adequate fluid. It likes its vitamins. It likes its exercise. It also really likes to sleep, but it wants to go to bed at the same time and wake up at the same time. It doesn't care about Saturday, Sundays, or Christmas or new years, the body doesn't know any better. It likes routine. So one of the things to do to train yourself to sleep better is to pick a wake time and pick a sleep time. What's easier to control is wake time because you know, when the alarm goes off at 6:00 AM, you'll wake up. You don't necessarily know when you'll go to bed or when you will fall asleep after you've gone to bed. So if you know that in general, you need eight hours of sleep and you have to get up at six because you need to get ready to go to work. You need to count backward from there. So eight hours, 6:00 AM. You need to go to bed at 10:00 PM.
People often ask me about tips to sleep better. And I go back to basics. It's kind of boring, but it's very necessary. The body likes routine. It likes to eat breakfast, lunch, and dinner. It likes to have adequate fluid. It likes its vitamins. It likes its exercise. It also really likes to sleep, but it wants to go to bed at the same time and wake up at the same time. It doesn't care about Saturday, Sundays, or Christmas or new years, the body doesn't know any better. It likes routine. So one of the things to do to train yourself to sleep better is to pick a wake time and pick a sleep time. What's easier to control is wake time because you know, when the alarm goes off at 6:00 AM, you'll wake up. You don't necessarily know when you'll go to bed or when you will fall asleep after you've gone to bed. So if you know that in general, you need eight hours of sleep and you have to get up at six because you need to get ready to go to work. You need to count backward from there. So eight hours, 6:00 AM. You need to go to bed at 10:00 PM.
So during our sleep, we have important functions and we're all biologically programmed to get, get it. It's not a voluntary activity. It's mandatory animals need their sleep. Even single cell organisms sleep. And of course, more complex organisms such as ourselves, elephants only need four hours of sleep. That's what their biological programming is, big cats in the wild, like lions and tigers, they need 16 to 20 hours of sleep. They have a different biology, but everybody needs sleep and it's got important functions and we can't live without it. Although we may try, when we've seen people be sleep deprived first, they act almost as if they're drunk, they may lose motor function. They may not balance well walk. Well, they may slur their speech and their cognitive functions are very much affected. So again, volunteers who participate in studies get sequentially, sleep deprived, and they're tested. We watch them do math and spelling and reading comprehension tasks, and their scores go down. The more awake they are. In fact, eventually they can hallucinate and even die. Sleep's mandatory. We've got to do it. It's a big problem today to not get enough sleep. And also there are many different sleep disorders which have finally become recognized and many treatments and evaluations, and even a specialty of medicine all about sleep because it's that important to good health.
In summary, I'd like you to have a cool, comfortable, calm bedroom environment. I want your bed to be comfortable. I want things to be uncluttered and I want your medications to be all supporting good sleep, avoiding exciting activities, such as TV and disturbing conversations. And don't be too full. Don't be too hungry and sleep well tonight.
"Sometimes people ask me about night owls and early birds. And in fact, this is a real biological phenomenon. 80% of us adults like to go to bed somewhere around 10 o'clock and wake up somewhere around 6:00 AM. That's 80% of adults. And in fact, that's kind of the way our society is structured, but there are 10% of the population who would like to go to bed early and wake up early. They've always been like this and it becomes more as they get older. On the other hand, there are night owls. People like to go to bed late and wake up late. Typically we make fun of early birds and we think of the early bird special at the restaurant. And in fact, there's something called advanced phase disorder. And for a certain percentage of older people, this is a change that occurs on the other hand, teenagers like to go to bed late and wake up late. But again, most of the time they outgrow that. By the time they had their adult sleep cycle in their early twenties, but some people are like this and it has an evolutionary reason. The reason may be that while the village was sleeping, there's a small group who needed to circle and survey the outside dangers. So those night owls took the first shift. And by the time they started getting sleepy, the early birds were waking up and they took the next shift. So most of the village could sleep. So there is actually a biology behind it. It's real. And while we might be able to shift our cycle a little bit an hour here, an hour there, who we are as an early bird or a night owl is biologically set. It does tend to run in families. And sometimes it's difficult to negotiate and romantic relationships work with regards to compatibility, but these things can be done and we can shift it a little bit, but it's real and it's not made up."
"Interestingly the most number of car accidents occur on Friday night, independent of alcohol. What this shows is that people who've been awake and more sleep deprived as the week goes on, are more likely of course, to get into car accidents, small details of attention, motor reaction time, all get affected, which can result in a car accident. Interestingly, which makes sense. The fewest amount of car accidents occur on Monday morning after people have had the whole weekend for some catch-up sleep. So we see the effects of sleep deprivation. So many different ways, certainly in the workforce, how well we think how we judge, how we make our critical thinking decisions, but also in our health and people who tend to be more sleep deprived are more likely to catch a cold. They don't have the immune proteins that are made as they should be during stage three sleep. They're more likely to get cancer for the same reason, because we need those immune proteins to fight the cancer cells that we're always making. We also are more likely to have hypertension, high blood pressure and other cardiovascular risk factors. Sleep deprivation definitely affects our mind, but I could take anybody off the street and poke them all night long for one week. And what would happen, what we'd expect. They'd be tired, they'd be cranky and irritable. Their thinking wouldn't be as good. Their blood pressure wouldn't be as low and their motor function. So whether their coordination is playing a sport or playing a video game, it would be affected."
"The average person needs five to 20 minutes to fall asleep. We call this sleep latency. So five to 20 minutes is normal. So some people come to me and they complain, ""oh gosh, it takes so long to fall asleep."" And I don't think they like to be alone in the dark with their own thoughts and feelings, but 20 minutes is totally appropriate. The flip side may come to my office and the patient says, Oh, I can fall asleep before my head hits the pillow. Well, if that's true, they're not necessarily a good sleeper. That person is too tired and should have gone to bed half an hour ago. So if you really needed to wake up at six and you know that your, your work time depends on that awakening go to bed at 9:30 or 9:45. So you have your five to 20 minutes to fall asleep, and then hopefully you'll get your eight hours. It will be absolutely continuous because it's absolutely normal in that sleep cycle to have some awakenings. So again, people come to my office and they complain. Dr. Sahni, I wake up four or five times during the night, and I say, so what that's perfectly normal. Waking up is not the problem, it's staying awake for too long. So I just want you to know wake is part of your night, not just sleep, it's not black and white, just like the daytime, even though the longer awake, the more tired we get, it's a linear relationship, that part's true. But superimposed upon that, there's a circadian rhythm, a 24 hour cycle. It's actually 24.2 hours and women are slightly longer. In men, a little bit less long, but on top of the average, no longer I'm awake, the more tired I get. There's certain times of the day that are more alert. And we all know this between nine and 11:00 AM. It's a pretty alert time of day. So if I slept really badly last night, I'm still pretty good at 10 o'clock in the morning. On the other hand, I might've slept really well last night, but now it's Saturday afternoon and I'm relaxed. I'm the only one home and I'm in my bedroom and the cat is on the bed asleep and it's two, three o'clock in the afternoon. I might want to lie down and join the cat. I might not be tired, but between two and 4:00 PM is a sleepy time of day, not the best time for me to give a lecture, but a very common time to take a snooze, whether you need it or not. So if you wait as long enough, you become more awake because again, the day changes. And so does our need for sleep and our sense of alertness."
The average adult human needs seven to nine hours of sleep each night. Cats need 16 hours, giraffes only need four, but we as humans need to spend one third of our lives sleeping, and we have to make that a priority. What we know is that just a generation and a half ago, our grandparents generation people slept about an hour longer than they do now. And no changes have happened in evolution, but now we have a 24-7 society. We're so busy and there's something to be done at all times. We need to get that seven to nine hours. The number one sleep disorder in America is literally called insufficient sleep syndrome. And it's making us sick.
"One of the things I do when I meet with people is I do a very exhaustive medication and drug review. And the reason I do this is that I know that medications that might be very well-intentioned, um, and prescribed by very good doctors may not always be good for sleep. Sometimes the side effect of drugs can be made to make you too sleepy or too stimulated. And sometimes it's just a matter of the time of day. So when I look at those medications, I look to see, does this affect sleep in a good way, in a bad way, and what time of day those pills are taken? So sometimes on the pill bottle, it simply says, take one today. And the patient decides, I think I'll take everything before bed because that's convenient. It's an on my bedside table, perfect logic. But if you're taking a medication, for example, like Wellbutrin, a common antidepressant, a good antidepressant, one of the side effects, however, is stimulation, which is why it's good for a sluggish depression, but it's not good before bed. The same may be true, even for over the counter medications, supplements B vitamins are good for your heart and lots of other things, and you need them. They tend to be stimulating. Well, that's a good thing. First thing in the morning to give yourself a boost of energy at breakfast time to let you go through the day, but definitely a bad idea. If you take your B supplement before bed coenzyme Q 10 can do that as well. Again, a good supplement, but not before bed. Certain medications should be taken before bed because they can cause sleepiness. So I may hear the opposite complaint. Oh, I'm tired all day long. And then I see the drug is kind of a sleepy drug and it shouldn't be taken first thing in the morning because it will affect us. So learning about the medications that you take, whether they are prescribed or sometimes over the counter supplements, even anti-histamines are common. We may have allergy season in the spring and fall and we think we're doing a good thing by taking a Benadryl or Claritin, perfectly good drugs, but they tend to have sedating effects. In fact, almost all the over-the-counter sleeping pills are just derivatives of Benadryl, Unisom and ZZQuil. And all those things are just Benadryl. So very, very sedating. So once we know what we're taking and what their side effects are, we can help control our energy during the day and also our sleep during the night."
A significant number of the American workforce are actually shift workers. They don't keep a conventional schedule of going to work at 9:00 AM and stopping at 5:00 PM. As our societies become more 24-7, we have more shift workers. So the swing shift or working just nights, certainly the medical profession, we've been doing this for a long time, but now it's in retail stores everywhere across America. There's always something awake and therefore somebody's gotta be manning their job. It's a problem for some people. Since 80% of us have a conventional schedule, it's hard to shift that the advantage of working nights is that the pay differential tends to be a lot better. And it tends to be that night owls are attracted to those shifts, but there's not enough of them to actually make that up. So what happens is that we're fighting our biology. It's normal to want to sleep for most of us in the dark and normal to be more alert during the day. So even if somebody has to work the night, they have a hard time falling asleep during the day. So typically they're very sleep deprived and some people really have a problem called shift work disorder. And what happens is that all the biological functions that are driven by the circadian rhythm, that 24 hour cycle, which affects our hormones, our immune system can get disrupted. So actually, especially in women, fertility and menstrual cycles are very obviously disturbed.
People often ask me, can they catch up on their sleep on the weekends? They may be working hard during the week and getting up early, going to bed late, taking care of all the responsibilities with finally Saturday and Sunday, they have time off and they want to use it resting. Can you make up all those hours of sleep on Saturday and Sunday? Well, the short answer is no, we can't, it's not quite the same. Might make up some of our sleep deficit, but we're never going to quite catch up as much as we need. It makes a lot more sense to try to go to bed earlier or wake up later and try to keep our weekends certainly for extra rest and recreation, but we can't make up all the sleep we lost.
If we don't get enough sleep we don't function very well. Some people are very lucky. They're called short sleepers and they buzz through state is wanting to sleep and just get the good stuff. And they may need only four hours of sleep and function perfectly. These are presidents and CEOs, and very busy and productive people. On the other end of the spectrum, we may have long sleepers people who literally need nine or 10 hours of sleep to function. Well, everybody's different. Probably we can get away with one hour or less than we need and still be okay. The next day, when people tell me that they can sleep an extra two or three hours on a Saturday morning, it would tell me that they're sleep deprived. And this is probably the biggest and most under-recognized sleep disorder in America. Sleep deprivation.
Sleep is a very active process, different than being awake, but it has four stages stages. One and two are light, and I can easily wake you up by calling your name. Stage three is deep. Restorative sleep is what we all want. It's where we make our growth hormone that keeps us young or testosterone that keeps us sexy. Our immune proteins that fight off infection and cancer in the world of neurology. Right now, stage three. Sleep is very exciting because it's where we clean up the proteins that are head. That can cause Alzheimer's disease. When we're old, then we have REM sleep, rapid eye movement, Sigmund Freud believed we did our emotional processing during our dreams, but we also know now that's where we'd make our memories. We consolidate memories. All four stages are important. And what should happen in the average adult sleep is cycles of these four stages. One, two, three REM brief awakening, one, two, three REM brief awakening, and each cycle tends to last about 90 minutes, maybe up to 120 minutes. We do this hopefully four or five, six times during the night with the brief awakenings in between sleep is active. It's busy and it's vital for good life.
Certified in Sleep Medicine by the American Board of Internal Medicine
Certified in Obesity Medicine by the American Board of Obesity Medicine
Certified in Sleep Medicine by the American Board of Internal Medicine
Certified in Obesity Medicine by the American Board of Obesity Medicine
Certified in Sleep Medicine by the American Board of Internal Medicine
Certified in Obesity Medicine by the American Board of Obesity Medicine
Certified in Sleep Medicine by the American Board of Internal Medicine
Certified in Obesity Medicine by the American Board of Obesity Medicine
Certified in Sleep Medicine by the American Board of Internal Medicine
Certified in Obesity Medicine by the American Board of Obesity Medicine
Certified in Sleep Medicine by the American Board of Internal Medicine
Certified in Obesity Medicine by the American Board of Obesity Medicine
Certified in Sleep Medicine by the American Board of Internal Medicine
Certified in Obesity Medicine by the American Board of Obesity Medicine
Certified in Sleep Medicine by the American Board of Internal Medicine
Certified in Obesity Medicine by the American Board of Obesity Medicine
Certified in Sleep Medicine by the American Board of Internal Medicine
Certified in Obesity Medicine by the American Board of Obesity Medicine
Certified in Sleep Medicine by the American Board of Internal Medicine
Certified in Obesity Medicine by the American Board of Obesity Medicine
Certified in Sleep Medicine by the American Board of Internal Medicine
Certified in Obesity Medicine by the American Board of Obesity Medicine
Certified in Sleep Medicine by the American Board of Internal Medicine
Certified in Obesity Medicine by the American Board of Obesity Medicine