What You’re Missing Most
How sleep impacts our health
As I work with patients and conduct health and wellness seminars, people often ask, “Of all the health strategies we’ve been discussing and learning about, which is the most important?”
I usually smile and answer, “The most important health strategy for you is the one you’re not following!”
If you’re neglecting or overlooking a particular strategy for optimizing your health, you’re not only depriving yourself of the benefits of that particular strategy, but you’re also not taking advantage of the synergy that comes from the interaction between all the components of a comprehensive wellness program. Every time you add one more effective approach to the list of wellness strategies you’re implementing, you get an exponential increase in healing potential because of the synergy effect.
Is There One Key Health Strategy?
But setting all that aside for a moment, is there a single health strategy that is more important than any other, and if so, what would it be?
Would it be good nutrition? Nutrition is clearly a powerful influence on the body.
What about regular exercise? Exercise is so critical and makes such a tremendous impact on health.
Hydration? How long can a person survive without water? Not long. It may be possible, in certain environments and circumstances, to survive up to two weeks without water. But even a day without water significantly compromises our health. Proper hydration is essential to our physical existence and well-being.
How about the lack of sunlight or vitamin D? These dramatically increase our risk for disease.
Perhaps the most important wellness strategy is avoiding such things as smoking or alcohol or other substances that create stress and a toxic condition in the body.
Finally, what about daily exposure to fresh air, proper rest and sleep, or forgiveness and trust?
Is there a single health strategy that is key to making all the others successful?
Adequate Sleep Is Key
When I was a freshman in high school, I really cared about my health. I thought a lot about it and about how I could be as healthy as possible. I had read in Ellen White’s classic, The Ministry of Healing,1 about eight laws of health—good nutrition, regular exercise, keeping hydrated, sunlight and vitamin D, avoiding things such as tobacco and alcohol, fresh air, proper rest and sleep, and an attitude of forgiveness and trust. And I wondered if there was one that I needed to focus on most.
I had early-morning classes, and I was working after school, so my life was pretty full. I noticed that when I went to bed late, the next day never went quite as well as it could have. Instead of getting up early and jogging for a mile, I would be tired and hit the snooze button several times. Instead of enjoying a healthful breakfast, I found myself looking for something a little sweeter, a little more processed—something to satisfy my feeling of “dis-ease.” I just didn’t feel as good as I did when I had gotten a good night’s sleep the night before.
Have you experienced that? Do you make a habit of eating or drinking something first thing in the morning simply because you need it to “medicate” or improve the way you feel? I believe that millions of individuals in this world wake up in the morning with a sense of “dis-ease”—a sense that they just don’t feel quite right. So they are looking for shortcuts to restore that feeling of wholeness, that feeling of wellness. Too often those shortcuts are causing them to burn the candle at both ends, leading to adrenal fatigue and countless other physical and emotional problems.
I truly believe that sleep and proper rest is the most important key to regulating all the other health strategies, because if you are not waking up refreshed and restored, your body is not rejuvenating and healing itself during those hours of sleep as it is supposed to do.
In today’s fast-paced world many of us feel we don’t have time to get as much sleep as we need or would like. We are trying to fit everything in, and it just won’t fit! So the hours for sleep are where we often make sacrifices. That thinking has destroyed generation after generation of people’s health. Kids today are staying up until 1:00 and 2:00 in the morning, studying for exams or finishing school papers. They are destroying their health for the sake of a grade.
I would much rather my children get no A’s at all in school and get a good night’s sleep every night than for them to have a 4.0 GPA at the expense of their future health. Not getting enough sleep is setting up our children for all the chronic diseases that we are trying to prevent or reverse in adults. Sleep deprivation sets us up for obesity, 2 heart disease,3 diabetes,4 and Alzheimer’s.5
Loss of sleep is bad for physical, intellectual, emotional, and spiritual health. It is especially bad for the brain.
The Negative Effects of Inadequate Sleep
One of my favorite stories when I was growing up was the story of Charles A. Lindbergh, a dashing young pilot in the days when flying was in its infancy. 6 In 1919 a New York City hotel owner offered a $25,000 prize to the first aviator to fly nonstop across the Atlantic Ocean from New York City to Paris. Lindbergh determined to be that aviator. He obtained financial backing and built a custom airplane, the Spirit of St. Louis. Although it was not a requirement for winning the prize, he decided to fly solo. This meant he would have to be at the controls for at least 22 hours. It actually turned out to be 33 hours.
On May 20, 1927, Lindbergh took off from Roosevelt Field on Long Island. He was so excited that he didn’t sleep at all the night before the flight. In fact, by the time he lifted off the ground, he had been without sleep for 22 hours. Lindbergh became the first pilot to fly nonstop across the Atlantic, but how he wished many times during that 33-hour flight to Paris that he had slept the night before!
He was fortunate to make it to Paris alive, very fortunate—and not just because of the limited aviation technology of that time. Fifty-five hours without sleep, even to accomplish such an amazing feat, exacts a tremendous toll on health and well-being.
Have you ever fallen asleep with your cellphone in your hand?
From April 2015 study by Braun Research and Bank of America
What does such sleep deprivation do to our genes? The Allen Institute for Brain Science reported that in studies on mice, some 224 genes showed a negatively changed genetic expression because of sleep deprivation and that thousands of genes appeared to be regulated by the 24-hour circadian rhythm. 7
You might be thinking, That’s interesting. But that study involved mice, not human beings. However, since that study, some great research in this area has been done on humans. One study, conducted by the University of Surrey in the United Kingdom and published in the Proceedings of the National Academy of Sciences, found that just one week of getting less than six hours of sleep each night significantly altered 711 genes, dramatically increasing inflammation.8 One of the things that drives the body into an inflammatory state is inadequate sleep.
Another study of young adults who went to bed at 3:00 in the morning, instead of at their usual bedtime, showed that the function of their immune system was depressed 50 percent. 9 The only variable in the study was the fact that they went to bed quite late. This means that the immune cells weren’t doing their job destroying viruses and bacteria and other threats to their health. And all this is the result of only one night of poor sleep!
The study went on to show that after just one week of getting less than six hours of sleep a night, the cognitive thinking process was dramatically impaired.
Disrupting the Cirdadian Rhythm
Lest you think that it’s only a matter of how much sleep one gets and that the timing isn’t important, consider the results of another study conducted at the University of Surrey and published in 2014 in the Proceedings of the National Academy of Science.10 In this study, researchers changed people’s rhythm of sleep by moving sleep time from nighttime to the afternoon. Subjects in the study slept for six and a half hours—from 12:00 noon until 6:30 p.m. What was the result?
Just three days of a disrupted sleep cycle significantly altered the expression of 1,172 of the 1,400 genes normally tied to the body’s circadian rhythm. Researchers went on to suggest that sleep disruption ultimately affects about one third of the entire human genome. That means that some 7,000 of the 20,000 genes in our body become dysfunctional simply because we are not sleeping according to the rhythm of nature.
Getting proper rest and enough sleep have critically important benefits for the body and for our health. We know, for example, that sleep helps neural functioning. We know this intuitively. We know that when we get a good night’s sleep and awake rested and refreshed, we have a different outlook on life than when we are not getting enough sleep. We can remember things better; our minds are clearer. We don’t have that foggy, fuzzy feeling in our brain that I hear about so often from patients. Sleep gives our neurons a chance to recuperate.
Children and Adequate Sleep
A study done by Eve Van Cauter 11 states that children under the age 10 need about 10 hours of sleep a day. This is an area in which society is really missing an opportunity to dramatically affect children’s health in a positive way. Those between 12 and 21 years of age require about nine hours of sleep. Yet how many children and teenagers are getting adequate sleep? In this age group sufficient sleep is important for brain development. It strengthens the immune system and contributes to good social behavior. British psychologist Tanya Byron has said that parents are ruining their children’s lives by failing to teach them to sleep.12
The International Journal of Obesity published a study in October 2010 showing that obesity rates increased for young children who had less than seven or eight hours of sleep a night. For boys 4 to 8 years old, there was a 300 percent increase. For girls 9 to 13 years old, the increase in obesity rates was 500 percent.13
How could just this one factor—inadequate sleep—have such a huge impact on obesity in children? We usually think of obesity as a problem caused by overeating or lack of exercise. And of course those things are certainly part of the problem. But we have to look at the bigger picture and ask, “What are the factors that cause a person to choose to eat a cookie or a bag of chips instead of a piece of fruit?”
Burning the Midnight Oil
If you were in the military, you probably heard one of your superior officers warn you as you were being released for weekend leave, “Nothing good happens after midnight. Be in bed before midnight.” If you played college athletics of any kind, your coach probably told you the same thing. “Be in bed before midnight; nothing good happens after that.” But the value of that advice goes far beyond just the notion of avoiding bad situations that are likely to get you into trouble. This is also good advice for health and for other aspects of life.
When it comes to academic performance, for example, if you choose to burn the midnight oil in order to gain more knowledge, or do well on a test, or finish an assignment, you are going against what science is telling us about rest, brain activity, and mental efficiency.
I’ve watched individuals who were facing hard classes or important exams, and I’ve noticed something interesting. The night before a test, for example, some would go to bed at 9:00 p.m. and sleep until 3:00 a.m., at which time they would wake up and begin studying. Others would study until midnight and sleep until 6:00 a.m. Both were getting the same amount of sleep—six hours. But those who went to sleep early before getting up to study did better. Even though they were getting only six hours of sleep, going to bed at 9:00 p.m. greatly enhanced the quality of that sleep and increased its potential to restore the brain and body. Studies have shown that getting to bed at a reasonable hour is a strong predictor of GPA in college. 14
In 2014 Roxanne Prichard and Monica Hartmann, both professors at University of St. Thomas, analyzed data from 43,000 college students across the United States and discovered that sleep timing and sleep-related problems were far more related to poor academic performance than were binge drinking, marijuana use, and even illicit drug use! 15
Of course, consistently going to sleep at least one or two hours before midnight would likely make it a lot easier to avoid alcohol and drugs. Good sleep habits make us feel much better and make us less likely to start looking for unhealthy shortcuts that temporarily boost or calm our mood.
Staying True to Your Biological Clock
If you aren’t consistently getting a good night’s sleep, a new study suggests you could be reducing your ability to lower oxidative stress. 16 Uncontrolled oxidation is one of the primary toxins that leads to heart disease, promotes cancer, and causes strokes, autoimmune problems, and inflammation. It accelerates aging and increases motor and neurological deterioration.
While discussing his 2010 study published in the journal Aging, Natraj Krishnan, a professor at Oregon State University, stated that young people “may be able to handle certain stresses, but the same . . . [stresses] at an older age cause genetic damage and appear to lead to health problems and earlier death. And it’s linked to biological clocks.”17 These studies demonstrate that inadequate sleep, or simply going to bed late, will disrupt the way our circadian clock genes function. If the circadian clock gene is expressed in unhealthy ways and damaged, it will greatly reduce our ability to handle the toxic effects of oxidative stress on our health.
Our bodies are very resilient and appear to handle significant abuse when we are young. But these unhealthy behaviors in our teens and early 20s alter the function of our genes, leading to premature aging and dysfunction. A study of 70,000 women conducted by Harvard University found that those who slept five hours a night had a 40 percent higher rate of heart attacks than did those who slept eight hours. 18 We need to be true to our biological clocks.
When the International Agency for Research on Cancer ranked various causes of cancer in 2009, it placed working the night shift just below exposure to known carcinogens, such as asbestos, as a cause of cancer. 19 Our biological clocks play a much greater role in our health than we realize. The human body seems designed to be active during daylight hours and to use the hours of darkness for rest and rejuvenation. When we disrupt that cycle for any reason, we disrupt the body’s ability to optimize health. We put a great deal of emphasis on toxins from our environment, as we should. But it is also critically important to understand that appropriate sleep is one of the most important strategies for removing toxins from the brain.
Sleep and Insulin Resistance
Not getting enough sleep leads to hepatic and peripheral insulin resistance. In nonmedical jargon, that means that when you don’t sleep well or you don’t sleep enough, your liver becomes resistant to insulin. 20 As a result, it starts dumping sugar into the bloodstream. This is one reason so many people with prediabetes or diabetes have high blood sugars first thing in the morning—often much higher than they do after they eat. When the liver becomes resistant to insulin, the pancreas compensates by producing a tremendous amount of insulin. It is trying to force the liver to reabsorb some of that sugar. But the liver isn’t the only place insulin resistance can develop; it also happens in the muscles.
Think of all the different hormones in your body as participants in a symphony. For this symphony to make beautiful music, each hormone must play its part and be in sync with the others. What would happen in an orchestra if the violins or the horns just started going their own way with no regard for the other instruments? It would ruin the experience of the symphony. That is something like what happens when insulin levels become erratic. Insulin is one of the most dominant hormones in the body. When insulin levels become excessive and dysfunctional, they negatively influence cortisol balance. Fluctuation of the stress hormone cortisol will lead to many undesirable health effects and symptoms, including fluctuation of many other hormones. This can lead to a roller-coaster effect on our levels of energy, our mood, and our ability to concentrate, and can greatly influence our ability to make good decisions. There are long-term effects as well. Insulin resistance, with its resulting excess insulin production, is the primary factor promoting cardiovascular disease. 21 And it is a major factor in such common cancers as breast,22 prostate,23 and colon24 cancers25.
Inadequate Sleep and Obesity
A study published in the Journal of Clinical Endocrinology and Metabolism in 2010 showed that people who were getting only five to six hours of sleep a night had a 69 percent greater risk for obesity, compared to those getting seven to eight hours. The effect of inadequate sleep is also determined by how long we persist in poor sleep habits. A study done in Spain showed that lack of sleep strongly promoted weight gain over time.
Compared to women who slept seven hours each night, women getting less than five hours of sleep were more than three times as likely to gain 12 pounds during the next two years. 26 That’s six extra pounds per year of poor sleep habits.
It’s important that we allow the biological clock in our brain to cleanse itself and reset itself every night.
Some people don’t become too concerned about increased risk factors for various diseases, but they are concerned about their appearance. Of course, obesity affects both our health and our appearance. We should be very much involved in our health and do everything we can to be as healthy as possible. But I also understand the importance of appearance.
There is little doubt that poor sleep habits negatively affect our appearance. The only proof we need is to stay up late and then look in the mirror the next morning.
Sleep Deprivation and Motor Skills
Several studies have shown that sleep deprivation can impair your judgment and motor skills even more than alcohol intoxication does. 27 One such study involved young mothers with small children. These young women were not getting enough sleep because of having to care for infants, and the quality of the sleep they did get was poor. When these sleep-deprived moms were placed in auto driving simulators and asked to negotiate various traffic routes, they made 30 percent more driving mistakes and misjudgments than did a control group of young mothers who were intoxicated from drinking alcohol!28
The Biological Clock in Your Brain
Human beings have an internal biological clock that is synchronized with the cycle of light and dark, day and night, in the physical world. Have you ever seen someone who is really burned out, who just can’t handle life as they used to be able to? New studies show that burnout is directly related to the ability of sleep to rejuvenate and restore the brain to optimal function.
In October 2013 Dr. Maiken Nedergaard, at the University of Rochester, published a study in the Journal of Science that caught my attention. In it he states that the by-products of daytime brain function must be detoxified at night. This is accomplished by the glymphatic system pumping cerebral spinal fluid through the brain at night, flushing toxins into the circulation and to the liver.29
This is a new concept. The by-products of daytime brain function must be detoxified at night. Did you ever think that your brain is actually generating toxins all day long as a by-product of what it is doing? We have to deal with those toxins somehow; they cannot stay in the brain, or it will become neurotoxic.
“Seventy-five percent of the energy derived and stored by the body from carbohydrates is ultimately used by the body to sustain brain function.” 30 We have a hard time visualizing that, because we think of the brain as just sitting there, not doing any physical work. Actually, it is working tremendously hard, and that means it is naturally producing toxins that will need to be flushed out of the system.
The brain has its own detoxifying system that washes and flushes itself out every night. It’s something like washing out a paintbrush after use, so that it will be ready to be used the next day. The brain does the same thing at night. But why does the glymphatic brain detoxification system work mainly at night?
Some have compared this nightly cleansing of the brain to having a party at your house. While the party is going on and there are people everywhere enjoying a good meal and social activity—that is not the time to clean the house. You clean after the party is over and everyone has gone home. Your brain can’t function and clean itself up at the same time. Detoxifying the brain is such an important task that it takes place at night while we’re fast asleep. That’s when the glymphatic system cleans toxins from the brain.
Isn’t that amazing? Our bodies and our brains are fearfully and wonderfully made. But we have to give them time to heal every night. And if we don’t give them proper rest, we’re extending the amount of time our brains are exposed to toxins.
There is speculation by some scientists that one reason Alzheimer’s is increasing exponentially in our society is because we’re not giving the brain adequate time to detoxify at night. It’s important that we allow the biological clock in our brain to cleanse itself and reset itself every night. That is yet another reason a good night’s sleep is so vitally important.
Optimizing Sleep for Maximum Well-being
God designed us for joy and health. But we’re not going to experience that unless we take advantage of restorative sleep. Nothing tends to promote health of body and spirit more than an attitude of praise and gratitude. But we’re not going to be able to have that kind of attitude unless we clear our brains of toxins each night through restorative sleep. We can enjoy each day in a way that gives us even more joy tomorrow, but only if we optimize the benefits of a good night’s sleep.
- Ellen G. White, The Ministry of Healing (Mountain View, Calif.: Pacific Press Pub. Assn., 1905).
- E. de Jong et al., “Association Between Sleep Duration and Overweight: The Importance of Parenting,” International Journal of Obesity 36 (2012): 1278-1284, doi: 10.1038/ijo.2012.119 (published online July 24, 2012).
- Sanjay Patel, David P. White, Daniel J. Buysse, Allen Blaivas, “Sleep and Heart Disease: What’s the Link?” video transcript, http://sciencedaily.healthology.com/sleep-disorders/sleep-disorders-information/video2940.htm.
- E. Donga et al., “A Single Night of Partial Sleep Deprivation Induces Insulin Resistance in Multiple Metabolic Pathways in Healthy Subjects,” Journal of Clinical Endocrinology and Metabolism 95, no. 6 (2010): 2963-2968, doi: 10.1210/jc.2009-2430.
- Adam P. Spira et al., “Self-reported Sleep and ß-Amyloid Deposition in Community-dwelling Older Adults,” Journal of the American Medical Association Neurology 70, no. 12 (2013): 1537-1543, doi: 10.1001/jamaneurol.2013.4258.
- Charles A. Lindbergh, The Spirit of St. Louis (New York: Avon, 1953).
- llen Institute for Brain Science and SRI International, November 2007, http://help.brain-map.org/display/mousebrain/Documentation.
- Carla S. Möller-Levet et al., “Effects of Insufficient Sleep on Circadian Rhythmicity and Expression Amplitude of the Human Blood Transcriptome,” Proceedings of the National Academy of Sciences of the United States of America 110, no. 12 (2013): E1132-E1141 (published ahead of print Feb. 25, 2013), doi: 10.1073/pnas.1217154110.
- Irwin Michael et al., “Partial Night Sleep Deprivation Reduces Natural Killer and Cellular Immune Responses in Humans,” Journal of the Federation of American Societies for Experimental Biology 10 (1996): 643-653.
- Simon N. Archer et al., “Mistimed Sleep Disrupts Circadian Regulation of the Human Transcriptome,” Proceedings of the National Academy of Sciences of the United States of America 111, no. 6 (2014): E682-E691 (published ahead of print Jan. 21, 2014), doi: 10.1073/pnas.1316335111.
- Van Cauter’s works include K. Spiegel, R. Leproult, E. Van Cauter, “Impact of a Sleep Debt on Metabolic and Endocrine Function,” The Lancet 354 (1999): 1435-1439; K. Spiegel, R. Leproult, R. L’Hermite-Balériaux, G. Copinschi, P. Penev, E. Van Cauter, “Impact of Sleep Duration on the 24-Hour Leptin Profile: Relationships With Sympatho-Vagal Balance, Cortisol, and TSH,” Journal of Clinical Endocrinology and Metabolism 89, no. 11 (November 2004): 5762-5771.
- De Jong et al.
- M. Lowry et al., “The Link Between Sleep Quantity and Academic Performance for the College Student,” Sentience: The University of Minnesota Undergraduate Journal of Psychology 3 (Spring 2010).
- J. R. Prichard and M. Hartmann, “What Is the Cost of Poor Sleep for College Students Calculating the Contribution of Academic Sleep Failures Using a Large National Sample,” 28th Annual Meeting of the Associated Professional Sleep Societies, Journal of Sleep and Sleep Disorders Research 37 (2012): Abstract Supplement 1068.
- N. Krishnan, D. Kretzschmar, K. Rakshit, E. Chow, J. Giebultowicz, “The Circadian Clock Gene Period Extends Healthspan in Aging Drosophila Melanogaster,” Aging 1 (2009): 937-948.
- Patel, White, Buysse, and Blaivas.
- Kenneth MacDonald, “Night Shifts Spark Cancer Payout,” BBC News online, Mar. 15, 2009, http://news.bbc.co.uk/2/hi/uk_news/scotland/7945145.stm.
- Donga et al.
- D. Eddy, “Relationship of Insulin Resistance and Related Metabolic Variables to Coronary Artery Disease: A Mathematical Analysis,” Diabetes Care 32 (2009): 361-366.
- Ruslan Novosyadly and Derek LeRoith, “Hyperinsulinemia and Type 2 Diabetes,” Cell Cycle 9, no. 8 (2010): 1449, 1450.
- R. James Barnard, “Prostate Cancer Prevention by Nutritional Means to Alleviate Metabolic Syndrome,” American Journal of Clinical Nutrition 86, no. 3 (2007): 8895-8935.
- Edward Giovannucci, “Insulin and Colon Cancer,” Cancer Causes and Control 6, no. 2 (1995): 164-179.
- American Association for Cancer Research (AACR), “Melatonin May Lower Prostate Cancer Risk,” Science Daily, Jan. 20, 2014 (retrieved Apr. 10, 2015, from www.sciencedaily.com/releases/2014/01/140120085058.htm).
- E. López-García et al., “Sleep Duration, General and Abdominal Obesity and Weight Change Among the Older Adult Population of Spain,” American Journal of Clinical Nutrition 87, no. 2 (February 2008): 310-316.
- P. Haraldsson et al., “Drowsiness—Greater Traffic Hazard Than Alcohol. Causes, Risks, and Treatment,” Lakartidningen 98, no. 25 (June 20, 2001): 3018-3023.
- J. T. Arnedt et al., “How Do Prolonged Wakefulness and Alcohol Compare in the Decrements They Produce on a Simulated Driving Task?” Accident Analysis and Prevention 33 (2001): 337-344.
- L. Xie, M. Nedergaard, et al., “Sleep Drives Metabolite Clearance From the Adult Brain,” Science 342, no. 6156 (Oct. 18, 2013): 373-377, doi: 10.1126/science.1241224.
Wes Youngberg, Dr.P.H., and fellow of the American College of Lifestyle Medicine (FACLM) is a lifestyle medicine specialist. He practices in Temecula, California.
This article is abridged from a chapter, ”Rest is Best,” appearing in Dr. Youngberg’s new book, Hello Healthy. The 2015 publication is available from the Youngberg Clinic at http://dryoungberg.com/hello-healthy, and at www.adventistbookcenter.com/hello-healthy.html. A previous volume by Dr. Youngberg, Goodbye Diabetes, was the subject of a 2013 interview published in the Adventist Review: http://archives.adventistreview.org/article/6180/archives/issue-2013-1509/goodbye-diabetes