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Sleeping

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By Leah S. Dunaief

Leah Dunaief

There are people who think sleeping is a waste of time. These people go to sleep each night with great reluctance and insist they only need three or four hours of sleep to function well. Maybe they do. There are
others who walk around chronically sleep deprived, nodding off immediately when the house lights dim at a lecture or performance, because in spite of their best intentions, they just don’t get enough sleep. 

I’m here to declare that sleeping is one of the more creative pursuits, that in addition it is enjoyable, and that the end result the next day is to enable one to leap tall buildings at a single bound.

I enjoy sleeping.

Now presumably everyone knows what sleep is. But studies have shown that sleeping is a different experience from one mortal to the next. For example, I readily acknowledge that I am one of the lucky ones (good genes) who lie down in bed and almost immediately drift off to sleep. Indeed, I run out of gas and have to go to sleep, like a child, willingly or not. I understand that some people have a terrible time falling asleep. My husband was one of these. Watching me sleep, he surely had acute sleep envy.

How does that happen? I can tell you how it is for me — a statistical sample of one. As soon as I lie back and close my eyes, something akin to a story or even a movie begins in my head and leads me into sleep. If I am interrupted before I fall entirely asleep, a different story starts up when I go back to bed, even if it’s just a couple of minutes later, and I’m off. 

I have read all sorts of suggestions for people who struggle to fall asleep, hoping to help my husband. Maybe what I’ve learned can be of help to you if that is also your problem.

I do not have distractions in my bedroom. It’s rather sparsely furnished, mostly with pictures of my family and some knickknacks I have carried home from my wanderings. It is one of the best-ventilated rooms in the house, and I like it quite cool and quiet when I sleep. I have an outrageously comfortable mattress that is turned every three months. I also enjoy colorful sheets and a comforter rather than a blanket. My pillows are neither very fluffy nor flat, and they are down-filled.  

I almost never read in bed, nor watch television. I don’t have a desk there, with lots of correspondence to answer, nor a computer. Sometimes I take a bath before bedtime, sometimes a shower, sometimes neither, and I never drink hot milk. In fact, if I have alcohol, I may fall asleep even more quickly, but I am surely going to wake up around 3 a.m., when the effect has worn off. Best of all, I find, is to drink nothing after dinner so one’s bladder is skinny.

I also sleep pretty soundly, getting up sometimes once in the night. I find it tempting, after I return to bed, to pick up a book or newspaper to see what’s happening in the world — I am a news junkie — but I resist that urge and as a result usually fall back to sleep. If I don’t, I urge myself to get up and wash the kitchen floor, and that will generally do it.

There are, of course, different internal clocks for different people. Some are perfectly happy going to bed at 11 p.m. and waking up at 7 a.m. in time to get ready for work or school. Others start whipping around at 11 p.m. and are most productive when the rest of the world quiets down. My mother and father were badly mismatched in that way. My dad was used to living on a farm, where he went to bed at 8:30 p.m. and got up in time for the 4:30 a.m. milking. My mother did her work between midnight and 4 a.m. Somehow they did get together, but it wasn’t easy.

My advice: Find a job that fits your biological clock and you’ll be a happy person.

You might wonder that I find sleep creative. If I have a problem, whether mathematical or any other kind, I will often go to sleep at night with it on my mind and wake up with the solution at hand. Sleep is such a mysterious process. The brain works during sleep, and the body feels so much the better for the respite in the morning. 

Rerun for emphasis from Oct. 19, 2006.

Left, Lauren Hale; above, teenagers need 8 to 10 hours of sleep every night.

By Daniel Dunaief

Around this time of year, people shop for gifts for others, decorate for the holidays, and generally raise their stress level as they search for the perfect holiday plan. Somewhere in between the to-do lists and the to-buy lists, some ambitious holiday revelers also consider making a for-me list, or the equivalent of a collection of pre-New Year’s resolutions.

Often appearing in that collection is a desire to live better, to stick to a diet, to embark on a healthy lifestyle and to enjoy the moments, big and small, on the horizon in 2019.

Often overlooked in the end-of-the-year cycle is if people hope for the chance to get more sleep. That, however, may make many of those other goals — weight loss, better work performance or a calm reaction to events — more manageable.

Times Beacon Record News Media recently spoke with Stony Brook University sleep expert Lauren Hale, who is a professor of family, population and preventive medicine and teaches in the Program in Public Health at Stony Brook. Hale is also the editor-in-chief of Sleep Health.

TBR: You recently published a journal article in Sleep Health in which you linked late night social media use by National Basketball Association players with their performance. Can you talk about that?

LH: This is a coarse estimate at showing that being up late is associated with worse outcomes. It’s not necessarily saying it’s only because they’re staying up late.

TBR: How much data did you examine?

LH: We looked at seven seasons of data. We were interested in how players did on games following late night tweets compared to games following no tweeting activity. … If your shooting percentage drops by 1.7 percentage points, that could be the difference between a win and a loss.

TBR: Have you extended this work to any teams?

LH: I’m talking with the Stony Brook Athletics Department to incorporate sleep hygiene into the players’ routines. We’re hoping to start with men’s basketball in the spring of 2019.

TBR: What are some sleep strategies?

LH: There is a list of sleep hygiene strategies. Many will seem like common sense. They include having a regular bedtime, which you calculate based on when you need to wake up and how many hours of sleep you need to get, limiting caffeine, tobacco and alcohol… [They also include] not eating too many heavy foods right before bed, exercising, preferably earlier in the day and reducing screen time at night.

TBR: Does the optimum number of hours of sleep change with age?

LH: Yes. Little kids sleep a lot and need a nap. As they get older, they lose the nap, but still need to sleep 9 to 11 hours. Teenagers need 8 to 10. Adults typically need 7 to 9 hours.

TBR: How do you manage sleep in your house?

LH: We have young children, so we know how challenging it can be. The younger one goes to day care and naps two hours. It’s hard to get him to go to sleep. I’m not good about putting my phone down in the hour before bed. We do have a charging location downstairs in our house, so the devices are limited in the bedroom. The children don’t watch screens in the half hour or hour before bed.

TBR: What’s the link between sleep and weight loss?

LH: Sleep duration is inversely associated with weight gain. Individuals not getting enough sleep are more likely to gain weight. The choices of food you make when you’re sleep deprived are worse. Your hormones make you hungrier and less full. The choices you make also show less self-discipline. When you’re sleep deprived, you’re unlikely to make yourself a salad.

TBR: Did you see the recent study that links sleep and anger?

LH: It is consistent with some work I’m doing on teenagers. We know sleep is important for emotional regulation. I’m not surprised that it’s linked.

TBR: Should people who want to lose weight focus on sleep?

LH: There are obesity experts who have taken on sleep as one of the three pillars of optimal health: sleep, exercise and diet. Among those three, sleep is usually the one that’s the most overlooked.

TBR: How else does sleeping affect weight?

LH: If you want to stick to your diet, stay on a regular sleep schedule that’s going to give you the sleep you need. Eating during normal activity phases — daytime for humans — prevents obesity. 

TBR: Is there evidence that too much sleep can be bad for health as well?

LH: There’s not good evidence of a casual link between long sleep and poor health. There is strong evidence that there’s an association, due to reverse causality, that shows that sicker people need more sleep. If you’re sleeping more than 11 hours, that might be a sign that you have an underlying condition that is contributing to you needing 11 hours.

TBR: What is your next sleep-related study?

LH: My primary current research is about studying teenagers and the causes and consequences of their insufficient sleep. Some of the factors that affect adolescent sleep are screen-based media use and early school start times.

TBR: Could sleep patterns be an important indicator of health?

LH: We would love to see sleep treated as a vital sign, in which every patient gets asked. It’s not asked about and it’s not, in and of itself, sufficient [for a specific diagnosis]. It’s a good marker of well-being.

TBR: Did people believe a certain amount of sleep was optimal 50 years ago and has that number risen or fallen since then?

LH: The number of recommended hours has been relatively consistent over time. There’s just more science to support the recommendations now.

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Professor Helen Benveniste. File photo from SBU

Sleeping doesn’t just provide a break from the daily grind, prevent you from chowing down on more Oreo cookies, or keep you out of trouble when it gets dark. It may also serve an important brain-cleaning function, getting rid of tau and beta amyloid proteins.

Merely shutting your eyes and letting the sandman sprinkle dust on your forehead may not be enough. You might actually help your brain, over the long term, with the way you sleep.

Helene Benveniste, a professor of anesthesiology and radiology and vice chair for research in the Department of Anesthesiology at Stony Brook University, recently conducted research on anesthetized rodents, tracking how the glymphatic system worked in various sleep positions. The animals were better at flushing tau and beta amyloid proteins from their brains when they slept laterally, or on their sides, than when they slept on their stomachs. Resting on their backs wasn’t as efficient as sleeping on their sides, although it was better than face down.

These proteins aren’t just a part of everyday maintenance. They likely play a role in the onset of Alzheimer’s disease and other age-related neurological problems, Benveniste said.

Since Benveniste published her study in the Journal of Neuroscience in early August, she has received a flood of emails from around the world, including from Brazil, France and Colombia, with people asking about various sleep positions and neurological disorders.

The Stony Brook professor said it is too soon after this study to come to any conclusions about sleep or preventing cognitive disorders. For starters, she and a research team that included scientists at the University of Rochester, NYU Langone Medical Center and Stony Brook conducted the studies on animal models, rather than on humans.

“In general, the rodent is a pretty good model for core aspects of human brain function,” said Dennis Choi, the chairman of the Neurology Department at Stony Brook. The specifics, however, can differ from one species to another. As a result, Benveniste said, “I don’t think anybody should panic” about the way he or she sleeps.

Scientists know that in the glymphatic pathway, cerebrospinal fluid moves through the brain and exchanges with interstitial fluid to get rid of waste. In the studies with rodents, the face down position seemed to divert the cerebrospinal fluid away from the brain, Benveniste said.

The research could be another step toward understanding how sleep might help with the human glymphatic system.

An anesthesiologist who does clinical work one day a week, Benveniste said she started thinking about conducting this kind of study a few years ago. Benveniste is a “good example of a physician/scientist,” Choi said.

Two years ago, a study by a co-author on the paper, Maiken Nedergaard from the University of Rochester, showed that sleep or general anesthesia enhances the clearance of waste from the brain of rodents.

“Since I am an anesthesiologist, I immediately thought about how body/head positions during anesthesia might affect clearance,” Benveniste said. The data took over a year and a half to collect and analyze.

“The quantitative aspect of this system should not be overlooked. To find out how these [proteins] are moving through the brain is a huge issue,” she said. The collaboration with Jean Logan, senior research scientist in the Department of Radiology at NYU “enabled us to move forward.”

Benveniste used a dynamic contrast MRI method to calculate the exchange rates between the cerebrospinal fluid and the interstitial fluid. The next step in these studies is to move toward the human brain. Benveniste said she is working with colleagues at the National Institutes of Health.

Just from observing wildlife outside the lab, Benveniste said many animals tend to sleep in what she and her team found was the optimum position for clearing waste in rodents: on their sides. “Even elephants lie down in recumbent, lateral positions,” she added.

As for Benveniste, she said she naturally sleeps on her right side. She said she’s well aware of how well she slept during the night. If she wakes up after getting enough rest, she said she thinks, “this was a good night’s sleep. This was good for my brain.”

Benveniste, who lives in Northport with her husband, Peter Huttemeier, is also an advocate of exercise for brain health, although she doesn’t suggest marathon running. “I do think this may be affecting the cerebrospinal fluid flow dynamics,” she said, adding that she wants to take up yoga.

Benveniste is eager to continue to build on this sleep study. “The workings of this system so far has been an amazing exploratory adventure,” she said.