Winnipeg Free Press - PRINT EDITION

Shorting yourself on shut-eye bad for health, potentially deadly, founder of clinic warns

To sleep, perchance... to live

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Every morning you're startled by your alarm clock, only to hit the snooze button a few times before you reluctantly drag yourself out of bed.

Yesterday morning was a bit different.

Thanks to the end of daylight saving time (we turned the clocks back in the middle of the night) you could savour an extra hour of sleep.

Even though the time change may not seem like a big enough deal to make a huge dent in your sleep debt, every bit of quality sleep matters, says Dr. Meir Kryger, a Yale University professor of medicine and sleep specialist who founded Winnipeg's cutting-edge St. Boniface General Hospital Sleep Disorders Clinic in the early 1990s.

"So if you sleep, let's say, a half an hour less than you should for four or five days in a row, you become intensely sleepy to the point where it feels as though you haven't slept at all," says Kryger. "In other words, it sort of adds up. People need to understand that the sleep debt kind of accumulates so the function gets worse and worse."

It turns out that 10 to 15 per cent of adults have chronic insomnia, according to the National Center on Sleep Disorders Research at the National Institutes of Health.

Another root of sleep deprivation: People simply don't make sleep a priority, says Kryger who, during his three decades in Winnipeg, treated 15,000 Manitobans with sleep disorders, many of them life-threatening.

In the midst of Hurricane Sandy, Kryger -- who left Winnipeg in 2006 and now lives in Connecticut -- took time to answer some questions about sleep. Here's what the physician -- who wrote the hefty textbook used by all sleep doctors in the world -- had to say about his favourite subject:

What's the best advice you can give people about their sleep habits?

The most important tip is to make sleep a priority. A lot of people figure sleep is a waste of time and they don't give it a high priority in their life. People need to change their thinking about that. It has to have the same kind of priority as eating and exercising and drinking water.

What sorts of effects can a lack of sleep have on the body?

Your brain doesn't function so hot. Making decisions is difficult. Even driving a car can be difficult. Doing work might be difficult. Concentrating would be tough. Your immune system doesn't work well. Your hormonal system changes. You're more prone to develop things like obesity and (type 2) diabetes if you don't sleep enough. It's not just the brain not working well. It's the rest of the body might not work well, either.

So it's true that people who don't sleep well gain weight more easily?

Yes. There are two important hormones affected by sleep deprivation. One is ghrelin. It's produced in the intestinal tract and it makes you hungry. The other is leptin, a hormone that is produced by fat cells that normally make you stop eating when you've had enough. When you get sleep-deprived, ghrelin goes up and leptin drops. So you eat more and have less of a switch to tell you to stop eating.

Do you have patients whose sleep deprivation has ruined their lives?

Oh yeah. Once you get in a terrible accident and someone is killed, that's as bad as it can get. People need to realize that when they don't sleep well, when they go out on the road when they are tired, they can kill someone, they can kill themselves.

Being severely sleep deprived is no different than being drunk in a lot of ways. People should not even think about driving when they are impaired. If you've slept three or four hours in a given night, there's a very high likelihood you're going to be impaired.

Have any of your patients died as a result of their sleep deprivation?

I've had lots of patients in accidents who have killed other people. Accidents are very, very common in people who have sleep disorders. Truck drivers, in particular, can be a real menace if they're sleepy because they are driving something that weighs tons and tons.

You once talked about a study in which the tails of sleep-deprived animals fell off. Can you explain?

There was a brilliant set of experiments done about 15 years ago. Animals were sleep-deprived continuously, and one of the lessons from that experiment is that sleep is necessary, because all the animals ultimately died; they died sort of a strange death. They started to lose a lot of weight in spite of eating, their fur fell out and they seemed to have immune problems. Those kinds of experiments tell us sleep is important and necessary in order to be healthy. It's hard to do these kinds of studies on people. But in people who are sleep-deprived and you measure the functions of their immune system -- for example, the ability to be vaccinated for influenza -- it turns out the vaccination is not as robust as it is if they'd had a normal night of sleep.

How much sleep to do we need?

Between seven and nine hours. People need to know how to match their needs There are some people who want to sleep; their brains tell them to sleep later. If you're the kind of person whose brain is telling you to go to sleep at two in the morning, don't even think about becoming a surgeon or an anesthesiologist.

Can coffee disrupt sleep?

Yes. People need to not take a huge amount of stimulant stuff. A lot of people are taking energy drinks, which in some cases contain huge amounts of caffeine. You get stuck in a vicious circle.

Are naps a good idea?

Napping can be wonderful and it can be lifesaving. Most naps should not be longer than 20 to 40 minutes. If the naps are too long, the person can become groggy when they wake up.

Can people get into a deep sleep in 20 minutes?

You don't necessarily want to go into a deep sleep when you nap. That's what makes you groggy.

What if your spouse likes to watch television in the bedroom at night, but you want to sleep. How can that relationship work?

A TV does not belong in a bedroom. A computer does not belong in a bedroom. A smartphone does not belong in a bed. This is something people need to recognize.

Some people, they will watch TV and the TV is on all night and every once in a while a commercial comes on and it kind of wakes them up and they sort of nod off to sleep again. Their sleep is not all that restful. Your sleeping environment should be optimized. Get rid of all of the stuff that wakes you up at night.

Questions and answers have been condensed and edited for clarity and space constraints.

 

 

Have an interesting story idea you'd like Shamona to write about? Contact her at shamona.harnett@freepress.mb.ca

Republished from the Winnipeg Free Press print edition November 5, 2012 D1

History

Updated on Monday, November 5, 2012 at 12:57 PM CST: Updates link.

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