Sleep Part II - Sleep Science - It's not So Simple

Mar 9, 2020

By Barret Procyshyn, Family Pharmacist at Dauphin Clinic Pharmacy

Last week the focus was on how to handle time change time change a little better this year and covered some general sleep tips. If you missed it, you should read it on our website at www.dcp.ca. If you are still feeling a little tired from spring forward in time, perhaps you are like the 1 in 3 adults who simply don't get enough sleep. Maybe you are getting enough sleep, but it's not quality sleep.

The effects of poor sleep are devastating. Various studies looking at people who are jet lagged, have scheduled shift work (police officers, doctors, nurses) and those who do not sleep enough, have shown not getting proper quality sleep produces a mass of health concerns. Some include metabolic issues, insulin insensitivity, weight gain, inability to lose weight, digestive issues, potential increase risk of cancer and even shorter lifespan. One night of missed sleep puts an otherwise healthy person into a prediabetic state. Sleep issues are likely more serious than you thought, aside from causing everyday issues like decreased productivity, inability to concentrate.

Feeling under the weather or foggy after a poor night's sleep is because of the effect on brain function. Sleep is vital for allowing the brain to adapt to various stimulus during the day. No rest makes us unable to process what we learn during the day and decreases the ability to remember it in the future. Sleep also allows the removal of waste products from brain cells at a much higher rate then when we are awake.

We like to laugh off sleep, not take it seriously and show it little respect. I was one of those people who thought and said, "sleep when you die". However, sleep is what recharges your batteries and is quite a complex process. Once asleep, the brain will cycle repeatedly through two different types of sleep: non- REM (rapid eye movement) sleep and REM sleep. Non-REM sleep is composed of four stages. Stage 1 is being awake and then falling asleep. The second is light sleep, when heart rate and breathing regulate and body temperature drops. The third and fourth stages are deep sleep. We are now beginning to learn the non-REM stages are more important than REM stages for learning and memory, as well as being the more restful and restorative phase of sleep. As you enter REM sleep, the eyes move rapidly behind closed eye lids, and brain waves surge. Breathing also increases and we dream as the body becomes temporarily paralyzed as we dream. The cycle then repeats itself, about 4 to 6 times if you are sleeping properly, each cycle lasting about 90 minutes. This is why many sleep experts suggest planning your sleep at 90-minute intervals. If you want to feel the most awake when your alarm rings, either set it for 7.5 hours or 9 hours of sleep.

Our sleep cycle or circadian rhythm is dependent on light we expose ourselves to, and chemicals that respond and react to this light. One of the most important hormones involved in sleep is melatonin, which makes us feel drowsy and tells us to sleep. Melatonin increases in our bodies in the evening and peaks in the middle of the night. It then decreases in the morning allowing us to wake up.

When the eye is exposed to light a signal goes directly to the brain regions which control hormones and body temperature. Signals also get to the pineal gland where melatonin is produced. During the day signals hold melatonin at bay, while toward the evening it's production is allowed. Adenosine also has a role in sleep by slowing down the activity of neurons. Gradually building up through the day, it makes us feel sleepy by the end of the day. During sleep it breaks down so the cycle can repeat.

From the sleep science it is easy to see that good sleep starts when your alarm goes off in the morning. We need to expose ourselves to light, preferably natural light when we wake up or as soon as possible during the day. Because it is completely dark until 7:30am in March, you may want to purchase a light "wake-up" alarm or light therapy system to help with getting you feeling energized for the day. In the evening it becomes crucial to limit the amount of light you are being exposed to and sleep in complete darkness (or as close as you can get). Limiting blue light exposure from electronic screens is extremely important, although it's a problem many of us struggle with. Most sleep experts will plead for you to turn off your screens at least an hour before bed and turn on the flue light filter if you need to use a screen later in the evening.

Based on the importance of melatonin, it's not surprising may people use it as a sleep aid. It is considered safe and is readily available in any pharmacy, including Dauphin Clinic Pharmacy, in a wide variety of formulations. However, you do have to be cautious with its use and it has its limitations. Remember Melatonin will only help you regulate your sleep, it will not initiate sleep. It also does not contribute to the creation of a healthy sleep environment. We do not yet fully understand the effects of long-term use of melatonin, although more evidence is showing that if you supplement with it on a regular basis, it may decrease your body's ability to naturally produce the hormone. Just like all prescription sleeping pills, less is better.

Watch for next week's feature as we will keep the focus on sleep and talk about caffeine, diet and more information to help you improve the quality of sleep you are getting. Because March is Pharmacists Awareness Month, remember to #rethinkpharmacists and talk to us about how to sleep better.

 


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