Dr. Day is a cardiologist/electrophysiologist at the Intermountain Medical Center Heart Institute in Salt Lake City, Utah. He graduated from Johns Hopkins Medical School and completed his residency and fellowships in cardiology and electrophysiology at Stanford University. He is the former president of the Heart Rhythm Society and currently serves as the president of the Utah chapter of the American College of Cardiology.
Did you know that losing even one hour of sleep can cause a heart attack? Did you know that occasionally taking a sleeping pill, something even as mild as an antihistamine, increases your risk of dying five-fold? Even more frightening is that both lack of sleep and taking sleeping pills increases your risk of dementia!
My Insomnia Struggles
I am a recovering insomniac. Since my college days I have struggled with falling asleep. It was especially bad before a major test.
I remember the night before I had to take the MCAT (Medical College Admission Test). My whole life I had wanted to become a doctor. I knew my chances all hung on getting a good MCAT score.
It was 2 am, I had been laying in my bed for four hours and still could not sleep. I gave in and took a Benadryl (antihistamine). An hour later I still was not asleep and took a second Benadryl. I finally feel asleep.
It seemed like just a split second and my alarm went off at 6 am. My head was in a fog. I thought I would have to look for a new career as there was no way I would ever do well on this test. Somehow, I did well enough on the MCAT to get into Johns Hopkins Medical School.
Medical school was no better. As a Chinese major coming out of college I was no match for all of my classmates in medical school with Ph.D’s in the sciences. I was a stress case and I could not sleep. I started taking an antihistamine every night to sleep.
Things got worse in my residency and fellowship training. Being paged all night long with erratic sleeping schedules never let me get into any kind of rhythm.
I was hooked. The Benadryl/antihistamine and melatonin habit would continue for the next 20 years.
To counter the effects of grogginess in the morning, I would start the day with a Diet Coke. Is it any wonder why I was tired all of the time? It never even occurred to me at the time that I could be causing my own lack of energy!
By my 40s I not only had trouble falling asleep but also struggled with staying asleep. It seemed that if I was not careful I had to get up in the middle of the night to pee. Once this happened I had no chance of going back to sleep.
At age 44 with my health in shambles, many chronic medical problems, and on 5 medications I decided it was time to turn my life around. I really thought I would never sleep again without medications.
How Critical is Missing Even 1 Hour of Sleep?
I recently was invited to speak at the Annual Scientific Sessions of the American College of Cardiology in Washington DC. While there, a study looking at the impact of even losing one hour of sleep from Daylight Savings Time caught my attention. In this study analyzing 42,000 recent heart attacks in Michigan they found two very interesting findings.
Your heart attack risk is increased 24% on the Monday following losing an hour of sleep due to Daylight Savings Time. In stark contrast, your heart attack risk is decreased 21% on the Monday after gaining an extra hour of sleep when we go off of Daylight Savings Time in the fall.
If just one hour can have such an impact, is it any wonder that jet lag and night shift workers have been shown to be at risk for many medical problems?
The Importance of Sleep
While we are sleeping our body is busy working to repair and prepare our bodies for the next day. In the brain, memories processed and new brain connections made. For the cardiovascular system it is when repairs need to be made to prevent heart attacks. Sleep also ensures that we have the proper balance of the hunger/full hormones so we don’t overeat the next day. Indeed, sleep deprivation can increase your risk of being overweight by 40%!
How much sleep do we need?
Adults need at least 7 hours of sleep for optimal health. Based on a study which averaged the results of 17 studies involving more than 1 million people, they found that short sleepers (less than 7 hours) are 38% more likely to die young Long sleepers are also at risk. From this same study, long sleepers (more than 9 hours) were 23% more likely to die too soon.
Is it OK to take sleeping pills to make sure I get enough sleep?
This is a dangerous trap to fall into which can lead to dependency and an early grave. For 20 years I had horrible insomnia. I became dependent, both mentally and physically, on 2 Benadryl tablets (50 mg) and a melatonin each night or I could not sleep.
Of course, there were many reasons why I had insomnia. My diet was awful, I was constantly awakened at night while being on call as a physician, my stress levels were sky high, and I was drinking Coke/Diet Coke through the day. Fortunately, I have been off any sleeping aids now for several years after completely changing my life.
Just how dangerous are sleeping pills?
In this study of over 10,000 people taking sleeping pills were 5 times more likely to die prematurely! Even taking a Benadryl or other antihistamine in this study less than 18 times a year tripled your risk of dying before your time.
In another study of approximately 34,000 people, taking a sleeping pill doubled your risk of dementia. Clearly, these are things that should best be avoided!
Is sleep apnea a problem?
For sleep to be effective it has to be rejuvenating. Too many people suffer from sleep apnea in this country. Sleep apnea is where people snore loudly at night and will stop breathing. This is primarily due to being overweight. People with sleep apnea might think they are sleeping at night but in reality they are not getting rest because they are subconsciously waking up all night long when they stop breathing.
Sleep apnea increases your risk of high blood pressure, heart failure, heart attacks, cardiac arrests, and dying too early.
How do I know if I have sleep apnea?
If you think you have sleep apnea, just ask your spouse as they can usually make the diagnosis. They will tell you that you snore way too loud and will stop breathing in the middle of the night. For the average person, if you are just 20 pounds overweight (BMI of 28) there is a 41% chance you have sleep apnea. If you have sleep apnea you need to get tested and treated until you can get the weight off. Fortunately, sleep apnea is something that is reversible. If you would like to be tested please speak with your doctor and they can order this test for you.
10 Ways to Cure Insomnia without Medications
Fortunately, things are much better now. Except for rare cases when traveling, I no longer need anything to help me sleep. I find that as long as I can follow my 10 rules below, my sleep is generally very good and I can get my recommended 7 hours of sleep.
1. Have a Strict Routine
Go to bed and get up at the same time every day. I realize this can be hard, especially when traveling, but this is probably the most important step. It can also be very hard if your spouse or sleeping partner have different sleeping schedules. For me, I try to go to bed at 10 pm and get up at 5 am. Start winding down about an hour before your bedtime. Dim the lights and stay away from TVs and electronic devices.
2. Avoid All Stimulants After 12 pm
It takes 4-6 hours for half of the caffeine to get out of your body. Thus, if you have caffeine at say 12 pm then at 10 pm there is still 25% of the caffeine that is still active and keeping you awake (2 half-lives). It is not just caffeine but any stimulant, including nicotine, after 12 pm could set you up for a sleepless night.
3. Don’t Eat or Drink 4 Hours Before Bed
If you go to bed with a full stomach then not only could you be kept awake from acid reflux or the grumblings of your digestive system but you will also pack on the weight. The only thing your body knows what to do with late night calories is to store them as fat. Also, if you drink before bed then odds are you will be up in the night having to use the bathroom.
4. Have a Cool, Dark, and Quiet Room
This seems intuitive but so often we neglect this one. We keep our cell phones by our beds. Flashing electronic lights will keep us up and interrupt our sleep. Trust me on this one. Keep it cool, eliminate all traces of light, and make it quiet and you will sleep much better.
5. Be Physically Active Outside During the Day
Physical activity allows us to work out our stress hormones so they don’t keep us up at night. Just be careful not to exercise right before bed as that could keep you up all night. By exposing your body to natural sunlight it helps it to regulate your sleep/wake hormones. If you work in an office, try to find as much natural light as possible. Our bodies were designed to work outside during the day and sleep at night. Don’t fight nature!
6. Be Smart With Naps
If you need a power nap during the afternoon that is fine. Just keep it short. Five to 20 minutes is enough. A long nap in the afternoon will keep you up at night.
7. Make the Bedroom Just for Sex and Sleep
Don’t bring your work into the bedroom. Also, don’t watch TV in your bedroom. Train yourself that the bedroom is only for the “S” activities. If you condition your mind it will make it so much easier for sleep.
8. Music and Meditation Techniques
For me, I can go to sleep so much faster with music. I set my iPhone to turn my music off in 25 minutes. I generally never even make it to the second song and I am out. Relaxation CDs/mp3s can also be helpful. For some people listening to the ocean puts them to sleep.
9. Manage Your Stress
Laying awake at night thinking about everything can keep you up. I find that writing down everything on my mind that I need to do helps to clear the stress. For others, deep breathing techniques may help to put them to sleep. Find what works for you and do it consistently.
10. Review Your Medications
It is possible that side effects from medications are keeping you up at night. Perhaps taking your medications in the morning or switching to a different medication may allow you to sleep better. If you think this could be a problem for you, please discuss this with your physician.
Do you suffer from insomnia? What has worked for you? Please share your tips to great sleep with me! You can leave a comment by clicking here.
Disclaimer Policy: This website is intended to give general information and does not provide medical advice. This website does not create a doctor-patient relationship between you and Dr. John Day. If you have a medical problem, immediately contact your healthcare provider. Information on this website is not intended to diagnose or treat any condition. Dr. John Day is not responsible for any losses, damages or claims that may result from your medical decisions.