Everything You Need to Know About Sleep: Part 1

Everything You Need to Know About Sleep: Part 1

Our goal here at Nightlight Chiropractic is to give you information that’s going to help you with your health now and in the future. Recently we’ve been hearing a lot from our patients on the topic of sleep. People are asking: “Why can’t I sleep like I used to?”

Sleep is not part of our curriculum during undergrad or during chiropractic school. It’s not something that a doctor is going to know much about unless you go out and study on your own or get some post-doctoral training. Because so many people came to me with questions about sleep, I decided to dig in. I really like this book called ‘Why We Sleep’ by Mr. Matthew Walker, Ph.D., a professor of neuroscience at UC Berkeley. It’s a fantastic book with lots of stories mixed into it, but it’s also incredibly didactic. You’re going to learn so much about a topic that you honestly should know a lot about. I’ll also weave in information from the National Institutes of Health and some other sources.

What do you think that you already know about sleep?

Do you know why you sleep? Have you ever thought about why we sleep? Is sleep this passive thing that you just kind of fall into and your brain shuts off and there’s nothing else that happens.? Absolutely not. Nothing of the sort. The less you sleep, the shorter your life. That’s crazy, right? I mean, think about that for just a second. If you don’t sleep enough, your life is going to be shortened by something called all-cause mortality. The risk of you dying from all causes across the board goes up the less you sleep.
It’s a huge thing. So keep that in the back of your mind, as we’re talking about this. The less you sleep, the shorter your life is going to be. So why do we sleep? Sleep is linked to memory, both short-term and long-term memory. It’s linked to physical performance, and not just endurance training, but also muscle strength and recovery. It’s linked to creativity: the less you sleep, the less creative you are. Sleep is also linked to your emotional state and mental illness.

Why do you get sleepy?

Did you ever wonder what determines when we’re awake, when we’re tired and when we’re actually asleep? What happens? You’re awake. And then suddenly you’re tired and then suddenly you’re asleep. How does that exactly, exactly happen? There are two different ideas at play, which determine when you’re awake, when you’re tired and when you’re asleep. One of those things is your circadian rhythm. Light plays a big role, but the other thing that goes into it is adenosine. Adenosine is a chemical in your body that builds up the longer you’re awake. So if you’re awake long enough, this adenosine builds up until it forces your body to sleep.

So adenosine creates that feeling of tiredness that then sets off your melatonin. Melatonin is released in your brain and it’s like the starting pistol for you to go to sleep. When it gets dark, your circadian rhythms tell you, hey, we should get tired and go to sleep. It starts that process of shutting some things down and getting our body temperature cooled down a little bit. Adenosine also eventually will just force you to go to sleep, once it builds up enough.

The stages of sleep

The act of sleep is put together in three different stages. You have light REM sleep and you have deeper REM sleep and those two play different roles. When you’re in REM sleep, your brain processes the information that went in throughout the day. It’s taking it from shorter-term memory, pushing it into longer-term memory, and making connections with that information to help it make sense. Dreaming is helping you repackage some of that information. And then REM sleep is the creative side of sleep, where you’re taking some of that new information, and then you’re putting it together with older information and creating all new ideas.

REM sleep is also when your body shuts down your muscles. So your muscles are not responsive to you during that cycle. The reason for that is that your brain is putting together these new fairytales and these new ideas, so usually your muscles would try to start acting out. If you’re dreaming that you’re running, your body would try and make your legs start working to run. And clearly, we don’t want to do that while we’re sleeping. If you miss a night of sleep, let’s say you pulled an all-nighter, it’s going to take you three days to catch up on that one night of sleep. It takes three nights of good sleep until everything is fully recuperated and ready to go.

Are naps good or bad?

In most industrial countries, we sleep in a monophasic pattern, where we are awake in the daytime and we go to sleep at night. In fact, naps, here in the U.S., are sometimes looked at as a sign of laziness. “Oh, you’re napping because you’re lazy because you have nothing to do.” In other countries, naps are looked at much less harshly, and they are used to a biphasic pattern of sleep. If you look at hunter-gatherer tribes in less industrialized areas, they still do most of their sleep at night, but then they take a nap in the middle of the day. Spain, Italy, and Greece, for example, still celebrate the siesta where they will take naps in the middle of the day. Research shows that better sleep makes you live longer. In some of the countries where naps are the norm, people are living into their nineties and hundreds more often than we are here in the United States. So maybe we can take something from that. I do think that naps should not be quite as harshly looked at as they used to be. If you’re practicing the monophasic sleep cycle, sleeping just at night, there’s nothing wrong with doing that, but you’re going to need more sleep during that monophasic period.

How much sleep do you need?

I get this question all the time. Everyone’s like, “Well, there are 24 hours in a day. I need more than 16 to get all my stuff done. Sleep’s got to give. How much sleep can I skip so I can get all my stuff done?” And the answer is not much. Sleep is so important that I would argue that anything else that you have to do should take second place. Seven hours is the absolute bare-bones minimum. Based on the research, after 10 days of sleeping less than seven hours, your brain is functioning equal to missing an entire night of sleep. That’s bad for you driving. That’s bad for you concentrating. That’s bad for you physically. It’s bad across the board. This is not going to work out for you. You need at least seven hours of sleep. You should shoot for eight or maybe even nine, depending on what stage of life you’re in.

If you’re wondering if you’re getting restful sleep, try a sleep tracker. Fitbits and Apple watches can tell you what restful sleep you get. You can see what time you fell asleep, what time you woke up, how much restful sleep you got, what your heart rate was doing. You’ll see when the train went by. You’ll see when your dog barked because it all shows up on those sleep trackers. If you’re against all that technology, think about this: if you didn’t have an alarm clock, would you wake up? If your alarm didn’t go off, are you going to pop awake at 7:00 AM and jump out of bed, or are you going to totally miss that and keep sleeping? If your natural wake-up time is very different from when you actually wake up, it’s likely that you’re not getting enough sleep and that it’s going to affect you negatively in the future.

Why can’t I sleep like I used to?

Patients are always telling me, “When I was younger, when I was in my teens and I was in my twenties, I could sleep just fine. And now that I’m in my forties and fifties and sixties, my sleep is just terrible.” Here are some things that may be messing up your sleep. Alcohol just devastates your sleep. It’s terrible for your sleep. Any alcohol before bedtime is going to mess up all of your sleep cycles. You’re either not going to get enough in REM or REM sleep, and you’re not going to get a restful night’s sleep. If you’re drinking alcohol around bedtime, stop doing it because it messes up your sleep. And it’s going to take you days to catch up on that sleep.

The second thing is fragmentation. As we get older, we wake up more to use the restroom, and sometimes we’re awakened by children in the household. So, we get this fragmented sleep that doesn’t allow us to sleep through the night. And therefore it’s not as restful as when we were younger. There’s also a lower quality of sleep. As we age, the chemical activity in our brains isn’t working like it used to, so it takes a little bit more sleep to get the same restful sleep.

The last thing is the regression of sleep. As you get older, you want to go to bed earlier. If you’re not getting to sleep when your brain is telling you to go to sleep, you might be missing that window where the melatonin is telling your brain that it’s sleep time. If you miss that window, it’s harder to get to the starting line, right? So you want to hit that window where your melatonin is ramping up to put you to sleep. If you’re missing that window because it’s too late, nothing good happens. It’s harder to get to sleep. In Part Two of our blog, we’ll address how you can get better sleep, so please stay tuned!


About Dr. Merrill

headshot of Dr merrill
Dr. Andrew Merrill is a passionate active clinician and owner of Nightlight Chiropractic Orlando where him and his team treat hundreds of patients each month. With a strong background in exercise science from Stetson University, clinical skills from Palmer College of Chiropractic, and continued postdoctoral training in spinal disc injuries and clinical nutrition, Dr. Merrill is very well versed in the healthcare landscape. With topics ranging from "what to do for common ailments" to "why the medical system is failing you" Dr. Merrill and this blog in particular aim to keep readers up to date on what the research shows and how you can put it into practice NOW to keep yourself healthy for a lifetime.