Good quality sleep, 6-8 hours per night but not more, is statistically associated with longevity. \u00a0Is there a causal connection? \u00a0Experiments with rats and data from people doing shift work suggests that yes, there is. But how to get good sleep, and even what good sleep means varies widely from one person to the next. \u00a0Different people need more or less sleep, and different sleep schedules can work with different job schedules and life styles. \u00a0Regularity is important, and changing sleep patterns from day to day is not good for you. \u00a0Melatonin supplements can be an aid to regular sleep, and melatonin is itself a longevity hormone. \u00a0If you are one of those people who wakes after a few hours in bed, you need not fight with your body to sleep through the night. \u00a0A scheduled period of waking in the middle of the night can be part of a regular daily cycle, and you may find the midnight time is especially good for inspirational or creative activities.<\/i><\/p>\n
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George was my partner in piano duets and also my buddy in all things concerning health and longevity. \u00a0We did yoga and meditation, jogged and cycled and gently competed, never for speed. \u00a0We discovered caloric restriction and got skinny together in the mid-1990s. \u00a0George worked nights as engineer at a TV station, and didn\u2019t like to sleep during the day. \u00a0Some evenings he caught a couple of hours of sleep before reporting for work, some evenings he would just catch a few winks duing his midnight \u201clunch\u201d break. \u00a0A few weeks past his 60th birthday, George fell asleep in front of his TV and never woke up.<\/p>\n
I\u2019ve learned to take sleep seriously as a longevity factor. \u00a0Just what to do about it isn\u2019t so clear. \u00a0(And yes, TV viewing is a mortality risk<\/a> independent of lack of exercise.)<\/p>\n Sleeping more than 8 hours per night adds 20% to mortality risk, and sleeping less than 6 hours adds 10% [ref<\/a>]. \u00a0The added mortality is not associated with any particular disease.<\/p>\n \u201cShift work [ref<\/a>] and chronic jet-lag [ref<\/a>] reduce mental acuity and increase the risk of a number of medical problems including cancer, digestive diseases including peptic ulcers, and sleep disorders.\u201d [ref<\/a>]<\/p>\n For some people, sleeping in total darkness helps to maintain continuous sleep. \u00a0Light is a strong trigger for depressing melatonin, and some researchers say that even the light that gets through the eyelids reduces melatonin in the blood. \u00a0Sunlight or bright blue light<\/a> can help with morning wakefulness, again in some people more than others.<\/p>\n Melatonin is a natural hormone, available inexpensively without prescription, and used by many people to regulate sleep. \u00a0In our natural circadian rhythm, melatonin in the blood peaks at bedtime, and makes us feel sleepy. \u00a0Conversely, disappearance of melatonin from the blood precedes waking in the mornoing. \u00a0You can try melatonin at bedtime to help get to sleep, or if you\u2019re one of those people who wakes after a few hours in bed, you can try melatonin in the middle of the night. \u00a0Mice that are given daily melatonin live longer [ref<\/a>, ref<\/a>]. \u00a0Experiment with the dosage. \u00a0\u00bd mg or 1 mg is plenty for most people, and some people find that too large a dose makes them groggy the next day. \u00a0Caution: Melatonin can exacerbate sleep apnea in some people.<\/p>\n From WebMD<\/a>:<\/p>\n “Magnesium<\/b> apparently plays a key role with sleep. Research has shown that even a marginal lack of it can prevent the brain from settling down at night. You can get magnesium from food. Good sources include green leafy vegetables, wheat germ, pumpkin seeds, and almonds. Check with your doctor before taking magnesium supplements. \u00a0Magnesium can interact with many different medications, and too much of it can cause serious health issues.”<\/p>\n Narcotics and alcohol can help you fall asleep, but I think they\u2019re a bad idea, likely to make you sleepy during the day, and need more sleep in the long run. \u00a0Not recommended. \u00a0I advise avoiding even the new generation of sleep medications (Ambien, Rozerem, etc).<\/p>\n Caffeine can interfere with sleep if taken late in the day, and even if you take it early in the day it might it might not help your energy level in the long run. \u00a0Coffee consumption is not associated with increased mortality risk, and may even have a modest longevity benefit [ref<\/a>]. \u00a0But habitual consumption of caffeine causes the body to reset to a lower<\/i> energy level (classic addiction response). \u00a0So I use caffeine sparingly, when I\u2019m speaking or writing and I want to assure an enhanced level of alterness and verbal fluency, and I remain sensitive and responsive to very small hits of caffeine.<\/p>\n Finish eating about 3 hours before bedtime, so digestion doesn\u2019t interfere with sleep. \u00a0A longer period of fasting before bedtime may be fine, if you are not kept awake by hunger.<\/p>\n \u00a0<\/strong><\/strong><\/p>\n Apnea<\/b><\/p>\n Fifteen years ago, I had no idea that I was stopping breathing frequently during the night until my wife noticed and alerted me. \u00a0Sleep apnea is the most common sleep disorder in the world, and increases in prevalence with age. \u00a0Statistics are soft because there are more cases unrecognized than on record.<\/p>\n I went in to a clinic, and spent a night there, wired up to a machine that monitored my breathing and heart rate. \u00a0I was incredulous when the doctor told me that through the parts of the night when I was asleep, I was in a 3-minute cycle, holding my breath until the CO2 buildup woke me up, gasping as I awoke, gradually calming my breathing, falling back asleep, and beginning the cycle all over. \u00a0I didn\u2019t remember any of this, and demanded to see the recording, before I was convinced.<\/p>\n Much later, with focused attention as I was napping during the day, I could observe myself falling into a pattern of holding the breath until I awoke in a panic. \u00a0Apnea left me tired sometimes during the day, with occasional bouts of narcolepsy.<\/p>\n Long term risks of apnea include heart disease, stroke and loss of brain cells. \u00a0It\u2019s not the oxygen deprivation that is the problem, but the re-oxygenation afterward that causes the damage.<\/p>\n Apnea is a mortality risk<\/a>, apparently independent of obesity<\/a>, with which it is strongly associated. \u00a0Fat in the neck can cause constriction of the air passage, making it more likely to collapse. \u00a0This is \u201cobstructive sleep apnea\u201d. \u00a0There is another flavor, \u201ccentral sleep apnea\u201d, which is unrelated to obesity or the size of the air passage, but comes instead from a failure of the autonomic nervous system.<\/p>\n The standard treatment for apnea, a cash cow for thousands of sleep clinics, is the CPAP machine (continuous positive air pressure), a face mask and pump that pushes air into the lungs. \u00a0Many people are helped by CPAP and find it worth the inconvenience and discomfort. \u00a0Many more can\u2019t tolerate the CPAP. \u00a0(For me, the CPAP made my apnea worse, since I was failing to exhale, rather than to inhale which is more common. \u00a0Negative pressure \u201cCNAP\u201d or \u201cINAP\u201d (intermittent negative air pressure) machines do not exist\u2014the acronyms are my own invention.<\/p>\n There are straps that hold the mouth closed and mouthguards that pull the lower teeth out in front of the top teeth. \u00a0There are suction devices that pull the tongue out of the mouth (while holding the mouth open enough so you can\u2019t bite your tongue). \u00a0There is a surgically-implanted electrical device<\/a> that stimulates the tongue to push forward at the appropriate point in the breathing cycle. \u00a0All of these work for some people.<\/p>\n Further out therapies for apnea include Buteyko breathing<\/a>, orofacial myofunctional therapy<\/a>, and singing melismas<\/a> The latter even has some data behind it<\/a>.<\/p>\n I’ve kept my apnea under control by re-training myself not to sleep on my back. \u00a0It helps, but is not a complete solution.<\/p>\n Tension and anxiety<\/b><\/p>\n Some sleep problems are extensions of day problems\u2014anxiety, depression, ennui, overstimulation, work pressures. \u00a0These are often better addressed by life changes than by therapies. \u00a0But relaxation practices can help: yoga asanas and breathing, meditation, biofeedback, heart rhythm coherence, Alexander technique, martial arts. \u00a0Vigorous exercise and time outdoors helps with every aspect of health, longevity, mood, relationships, productivity, creativity…and sleep, too.<\/p>\n Learning to relax has benefits that go well beyond improved sleep. \u00a0Many people find that through self-hypnosis or mental relaxation, yoga or meditation techniques, they can relax at night and feel fully rested even on nights when sleep may be elusive. \u00a0These same techniques are good for the \u201cpower nap\u201d, when a brief submersion of 10-30 minutes can precipitate a boost in alertness, productivity and good humor.<\/p>\n \u00a0<\/strong><\/strong><\/p>\n Two-phase Sleep<\/b><\/p>\n In 1979, I was fortunate to be acquainted with Bryn Beorse<\/a>, then in the last year of his life, but productive, healthy and quietly charismatic at age 84. \u00a0I knew him as a UC Berkeley engineering prof and lifelong advocate of renewable energy from the ocean. \u00a0But he was also an unlikely guru, with a small but loving following of meditators and Sufi practitioners. \u00a0Bryn told me that his habit and practice was to awake about 1AM and do an hour or two of Sufi exercises and meditations before returning to sleep out the night. \u00a0This and other things he said made a lasting impression on me.<\/p>\n Much more recently, I have learned how common it is for people to sleep in 3-4 hour cycles rather than 6-8 hours. \u00a0Some say that before the Industrial Revolution, bi-phasic sleep<\/a> was part of the culture. \u00a0A period of wakefulness in the middle of the night is part of the body\u2019s natural rythm for many of us, and if it is so for you, I suggest you might adapt to it rather than fight it. \u00a0Use the waking period for something nourishing, sustaining and relaxing. \u00a0Yoga or meditation are ideal. \u00a0You can read something inspirational, practice singing or playing music, listen to music that contributes to your wellbeing. \u00a0For some, it can be a creative time, writing or painting or composing, but I don\u2019t recommend using the time to extend your work day or answer emails. \u00a0Creative play is an alternative, but video games less than optimal. \u00a0When you feel the first wave of sleepiness return, don\u2019t hesitate to go back to bed.<\/p>\n It\u2019s not so common in America, but through much of Asia and South Europe, mid-day siesta is part of the culture. \u00a0People sleep less at night, and nap after lunch. \u00a0The right to a two-hour lunch break is written into the Chinese constitution.<\/p>\n Some studies show that sleeping twice a day is more efficient than sleeping once, but the decision will be based on your metabolism and your daily schedule.<\/p>\n