Friday, May 26, 2017
Memo To The Sleep Scolds: Not Everyone Needs Eight Hours Of Sleep A Night
"Oh my god, I'm gonna die if I don't get back to sleep! I need at least six hours!"
Let us agree at the outset that sleep is an absolute necessity and too many Americans are sleep-deprived, don't get enough. The question remains as to why this is so and what factors are responsible. Like the self-proclaimed "longevity scientists" who believe we will have people living to 150 very soon (no thought how they will support themselves) the "sleep scientists" are convinced that they know what is best for the rest of us. In this regard we are told over and over we ALL need at least seven to eight hours of sleep per night or we'll suffer the dire health consequences. No exceptions!
In the latest study emanating from the sleep scolds, we're informed all those who get less than six hours sleep a night and have metabolic syndrome have double the risk of dying "prematurely". They assure us, however, this conclusion is based on "associations" as opposed to actual cause and effect identifications. For those who need to know, "metabolic syndrome" is generally a precursor to diabetes and includes a set of conditions such as: oversized waistline, bad cholesterol (low HDL and high LDL, specifically), high blood pressure, high triglycerides, and high blood sugar (serum glucose levels, also a!c)
On yesterday's medical segment of CBS Early Show, Dr. Tara Narulla informed the hosts of this new study, even as Gail King proclaimed she had to be "dead woman walking" - getting barely 4 hours of sleep per night because of her morning gig. But then, King may or may not have metabolic syndrome - which was the central issue. Then there was Charlie Rose asking if naps counted - say in tabulating "total sleeping hours over a 24 hour period" - to which Narulla said absolutely not. (Since the study was based on night time sleep only). All of which again led the curious inquirer to ask: Exactly how much sleep is enough - irrespective of whether one has a deleterious health syndrome?
The fact is that getting eight, seven or even six hours of sleep at one go is a myth. Most of the modern sleep "specialists" - and I use that term loosely- appear to have missed the memo that the ancients never slept in eight hour "blocks" i.e. to get all their sleep one time. The actual, natural pattern of sleep for humans - for most of their history - at least up to the Industrial Age, was segmented, i.e. broken up into segments.
Enter historian Roger Ekirch of Virginia Tech who - in 2001- published a seminal paper, drawn from 16 years of research, revealing a wealth of historical evidence that humans used to sleep in two distinct chunks. His book: At Day's Close: Night in Times Past, published in 2005, unearths more than 500 references to a segmented sleeping pattern - in diaries, court records, medical books and literature, from Homer's Odyssey to an anthropological account of modern tribes in Nigeria. These references describe a first sleep which began about two hours after dusk, followed by waking period of one or two hours and then a second sleep. The segmented paradigm can also include naps (also called "siestas" in many countries), which Charlie Rose is fond of, as well as yours truly.
I don't think I've ever naturally slept a full eight hours unless I was ill, like with the flu (doped up on Nyquil), or had just completed a red eye flight someplace - and slept 8-9 hours straight at the destination hotel the next night. I simply am unable to sleep one single long stretch - at least without some kind of meds in the picture. (Which I prefer not to take just to sleep)
In his research into "segmented sleep" Ekirch found that references to the first and second sleep started to disappear during the late 17th Century. This started among the urban upper classes in northern Europe and over the course of the next 200 years filtered down to the rest of Western society. By the 1920s the idea of a first and second sleep had receded entirely from our social consciousness. While that may have happened, there has remained a core of us with "ancient" blood in our veins who are incapable of one continuous sleep at night. In my case it's usually 5 1/2 hours then a 1-2 hr. nap (generally after I take my BP med). Note that even when I don't nap, which admittedly is seldom, I seldom reach six hours of straight sleep. Even that is often broken up - maybe three hours or so first, then getting up to have some lemon and honey tea and reading the news on my laptop - then back to bed for the rest. Like Charlie Rose I don't fret because I can take a nap later.
Ekirch attributes the initial shift in sleep patterns to improvements in street lighting, domestic lighting and a surge in coffee houses - which were sometimes open all night. As the night became a place for legitimate activity and as that activity increased, the length of time people could dedicate to rest dwindled. According to Ekirch in a BBC interview:
"People were becoming increasingly time-conscious and sensitive to efficiency, certainly before the 19th Century. But the industrial revolution intensified that attitude by leaps and bounds."
Indeed it did. People were now bound to a regulated slot of work time - eight hours but originally more - and were also chained to an efficiency, factory model. (Thank the original "efficiency expert" - Frederick Winslow Taylor). Thus, there simply didn't exist the latitude for people- workers to break sleep into segments. If you had to be up and at 'em by 7 a.m. or so you'd best be in the sack sawing logs by 11 p.m. . Hence, the need to drive the biological sleep "clock" into getting eight hours at one stretch.
Strong evidence of this shifting attitude was contained in a medical journal from 1829 which urged parents to force their children out of a pattern of first and second sleep. It read in part:
"If no disease or accident there intervene, they will need no further repose than that obtained in their first sleep, which custom will have caused to terminate by itself just at the usual hour . And then, if they turn upon their ear to take a second nap, they will be taught to look upon it as an intemperance not at all redounding to their credit. "
Jeezus! An "intemperance"? What a damned scold!
Anyway, while most people seem to have adapted quite well to the new eight-hour sleep model , Ekirch believes many sleeping problems may have roots in the human body's natural preference for segmented sleep as well as the ubiquity of artificial light. Well, you can count me in that group. (Interestingly, my late father also had those problems - seldom able to sleep more than four hours at night, often awake by 3 a.m. - then napping in the afternoon.)
Ekirch and others conjecture this could be the root of a condition called sleep maintenance insomnia, where people wake during the night and have trouble getting back to sleep. Well, this is why I often just get up and make some beverage or other - usually after a trip to the bathroom and being unable to get back to zzzzzzzs.
Interestingly, the condition of sleep maintenance insomnia first appears in the literature at the end of the 19th Century, at the same time as accounts of segmented sleep disappear. Coincidence? Nope, I don't believe so. As the factory age demanded the eight hour sleep pattern to fit into the industrial efficiency mandate, many humans couldn't comply. Not because of not wanting to, but basic biology - they were unable to - and then were forced into taking sleep aids like Ambien.
According to sleep psychologist Gregg Jacobs, also interviewed by the BBC:
"For most of evolution we slept a certain way. Waking up during the night was part of normal human physiology. "
The idea that we must sleep in a consolidated block could be damaging, he added, if it makes people who wake up at night anxious, as this anxiety can itself prohibit sleep and is likely to seep into waking life too.
In a real sense, this is where I suspect the real risk of early death lies - from heart attack or stroke - because of anxiety in not being able to sleep, and driving up cortisol levels.
Russell Foster, a professor of circadian neuroscience at Oxford University, shares this point of view.
"Many people wake up at night and panic. I tell them that what they are experiencing is a throwback to the bi-modal sleep pattern."
But the majority of today's doctors (like Tara Narulla) still fail to acknowledge that a consolidated eight-hour sleep may be unnatural for some people. They prefer or insist there be a uniform, single sleep standard for all - like they insist everyone eat a uniform single type diet (low in proteins, high in plant based sources) , despite the fact most "natural" foods, veggies - fruits especially, lack the nutrients they had fifty years ago.
According to Foster:
"Over 30% of the medical problems that doctors are faced with stem directly or indirectly from sleep. But sleep has been ignored in medical training and there are very few centers where sleep is studied,"
Jacobs suggests that the waking period between sleeps, when people were forced into periods of rest and relaxation, could have played an important part in the human capacity to regulate stress naturally.
In many historic accounts, Ekirch found that people used the time to meditate on their dreams. Today, they more often than not latch onto their little electronic devices - about the worst thing they could do.
In Dr, Jacobs' words:
"Today we spend less time doing those things. It's not a coincidence that, in modern life, the number of people who report anxiety, stress, depression, alcoholism and drug abuse has gone up."
Maybe it's time to get back to a segmented sleep alternative - at least for those who need it! But at the same time, in the space between sleeps, let's not go grabbing for the smart phone and more stimulus we don't need.